Periodic Reporting for period 2 - METABODY (METABODY: Body Metacognition, Mentalization and Metamorphosis) Reporting period: 2021-03-01 to 2022-08-31 Summary of the context and overall objectives of the project No other period in history has seen such cultural and technological dedication to the manipulation and modification of the physical body, and particularly its appearance, as a way to experience and socially ‘share’ the self. The psychological motivations and consequences of these body modification practices have not been addressed.These practices and technologies of body modification include modifying the body itself (rather than its image), with millions of individuals electively undergoing invasive procedures for aesthetic, or ‘preference’ reasons. Eating Control and Disorders. There is also increased management of eating habits as a way to achieve an ‘ideal’ body rather than a healthy body. Up to 40% of the general population in the US and Australia report regular unhealthy weight control practices, while clinical eating disorders such as Anorexia Nervosa (AN) are much rarer but have severe health consequences, with AN being associated with severe morbidity and the highest mortality rate among all mental health disorders (Arcelus et al., 2011).In three work-packages (WPs), METABODY aims to study body image ‘awareness’ and modification phenomena from the interdisciplinary vantage points of:(1) Metacognition. WP1 will address why certain individuals form aberrant beliefs about their body and also have poor insight into these beliefs and related emotions about their body appearance. (2) Social Cognition. WP2 will explain why certain individuals are more susceptible than others to external influences about the body. (3) Decision Making. WP3 will address why and how people decide to modify their body appearance digitally or in ‘the flesh’, despite the risks and costs of such decisions. Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far METABODY has a stratified methodology. In Phase A (first two years), body-specific psychophysical paradigms have been designed and in some cases (prior to Covid19) tested in healthy university-aged populations. We have successfully gain ethical approval for conducting the studies of Phase A at UCL, hired the relevant staff, as well as established a number of collaborations with clinical teams. Unfortunately, in the second year of this phase all our testing was discontinued as follows and we had to postpone or substitute some of our studies, so an extension will most likely be needed. Specifically:WP1: Body Metacognition: Balancing the Imagined and the Sensory. In the first year of the project, as planned, we have piloted several versions of the planned body-image specific, and interoception tasks (we had to stop the development of a multisensory metacognition task, have collaborated with colleagues in York and Spain to try to build some insights in the meanwhile), and concluded in a number of optimised designs looking at prospective rather than retrospective metacognition. For the latter, in our future clinical studies we will use existing and widely used paradigms, e.g. Palmer et al., 2014; Rouault et a., 2018; Allen et al., 2021. We have also explored some of this paradigms in collaborations with clinicians in Italy and planned a study visit for our PhD student in Edinburgh, in order to gain further insight into relevant parameters for our future clinical studies. We are currently preparing the first manuscript for pre-printing of our pilot studies and preregistration of the next follow-up study, to be conducted in collaboration with colleagues in Greece, Spain and in Italy to facilitate with Covid19 related challenges in the future. Sadly, testing has been interrupted in the past year due to Covid19. To make up some of the lost time, we have relied on a large set of available data from an online survey on touch (the largest in the UK, runn with BBC/Wellcome Trust), to examine the relation between subclinical body image concerns, interoception and touch. We have preregistered these studies and are currently analysing the data. WP2. Body Mentalizing: Balancing the Self and the Social Body In the first year of the project, we have designed and extensively piloted a novel Embodied Mentalizing Tasks for Body Image Research and we have also started to develop a body rejection task, that had to be discontinued and then converted into an online task (ongoing). Moreover, in collaboration with colleagues in London but also in Belgium and in Italy we have applied some of these paradigms to relevant clinical populations revealing disturbances in the self-other distinction and greater altercentricity biases. Sadly, testing has been interrupted in the past year due to Covid19. To make up some of the lost time, we have relied on a large set of available data from an online survey on touch, to examine the relation between subclinical body image concerns, social attachment style and touch. We have preregistered these studies and are currently analysing the data. WP3. ‘Body Image Making’: Balancing the Current and the Ideal (Future) Value of the Body. In the first year of the grant we developed and tested, in collaboration with colleagues in Italy) the Body Risk Task, in combination with the standard Balloon Analogue Risk Task (BART; Lejuez et al., 2002), we have modelled the data and offered an original transdiagnostic approach (Jenkinson et al., 2020). In the second year of the project, we fully designed and prepared also effort discounting paradigms with healthy individuals showing subclinical disordered eating and separately a history of cosmetic surgery, or unhealthy male body modification practices. Unfortunately, these studies were discontinued by Covi19. Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far) Assuming we will be allowed to test in person again, we anticipate all the discontinued studies to restart, conclude and inform future clinical and neuroimaging studies. In the interim we have published the following studies . 20211. Jenkinson, P., Koukoutsakis, A., Panagiotopoulou, E., Vagnoni, E., Demartini, B., Nisticò, V., Fotopoulou, A. (2020). Body appearance values modulate risk aversion in eating restriction. 10.31234/osf.io/rnzgs and in revision .2. Kirsch, L. P., Mathys, C., Papadaki, C., Talelli, P., Friston, K., Moro, V., & Fotopoulou, A. (2020, December 4). Updating beliefs beyond the here-and-now: the counter-factual self in anosognosia for hemiplegia, 10.31234/osf.io/5c4u9 and accepted, Brain Communications. In press 6. Neustadter, E. S., Fotopoulou, A., Steinfeld, M., & Fineberg, S. (2021). Mentalization and embodied selfhood in borderline personality disorder. PsyArXiv and Journal of Consciousness Studies, in press .Invited Lectures and Keynotes Given :2020 Invited Keynote: Bi-annual Eating Disorders International Conference, Beat UK (online)2020 Invited Keynote; Social Bridges: International Conference on Social Cognitive Neuroscience2019 Invited Keynote: Interdisciplinary Meeting on Interoception, University of Milan, Italy2019 Invited Lecture: Aarhus Interaction Centre International Meeting, University of Aarhus, Denmark 2019 Invited Keynote: Royal College of Psychiatrists Annual Meeting, University of Oxford, UK 2019 Invited Keynote: International Meeting on Mentalisation, University of Athens, Greece Metabody project
