title: Paralyzed by desire:  a new type of body integrity identity disorder.
abstract: BACKGROUND
  Body incongruity in body integrity identity disorder (BIID) manifests in the desire to have a healthy limb amputated. We describe a variant of the disorder: the desire to become paralyzed (paralysis-BIID).
  
  
  METHODS
  Sixteen otherwise healthy participants, recruited through Internet-based forums, websites, or word of mouth, completed questionnaires about details of their desire and accompanying symptoms.
  
  
  RESULTS
  Onset of the desire for paralysis typically preceded puberty. All participants indicated a specific level for desired spinal cord injury. All participants simulated paralysis through mental imagery or physical pretending, and 9 (56%) reported erotic interest in paraplegia and/or disability. Our key new finding was that 37.5% of paralysis-BIID participants were women, compared with 4.4% women in a sample of 68 individuals with amputation-BIID.
  
  
  CONCLUSIONS
  BIID reflects a disunity between self and body, usually with a prominent sexual component. Sex-related differences are emerging: unlike men, a higher proportion of women desire paralysis than desire amputation, and, while men typically seek unilateral amputation, women typically seek bilateral amputation. We propose that these sex-related differences in BIID manifestation may relate to sex differences in cerebral lateralization, or to disruption of representation and/or processing of body-related information in right-hemisphere frontoparietal networks.
authors.affiliation: Experimental Neuropsychology Research Unit, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, South Australia, Australia.
authors.forename: Melita J
authors.initials: MJ
authors.lastname: Giummarra
authors.forename: John L
authors.initials: JL
authors.lastname: Bradshaw
authors.forename: Leonie M
authors.initials: LM
authors.lastname: Hilti
authors.forename: Michael E R
authors.initials: ME
authors.lastname: Nicholls
authors.forename: Peter
authors.initials: P
authors.lastname: Brugger
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology; D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000523:psychology*; D010262:Paraphilic Disorders / Q000523:psychology; D012727:Sex Characteristics