The scientists report: "The psychoticism value was only slightly increased, the score in Beck´s Depression Inventory was low, and only somatic reactions in emotional situations were clearly increased. Only one patient had a noticeable depression score and showed aberrances in other tests.
One explanation for BIID is a neurological brain defect, e.g. a developmental defect in the fetal status with the result of a reduced representation of the concerned limb in the CNS. But in our studies we found BIID-sufferers with a change of the wish for amputation, e.g. from the left to the right side. This finding is not in accordance with the brain-dysfunction theory.
Instead, these people have an ideal of a perfect body minus one arm or leg. Most admire the beauty of a stump. Many of them see one-legged or one-armed persons as ´heroes´, who still survive in a difficult world due to personal strength and in spite of their handicap.
BIID is not a homogenous disturbance, but rather a disorder consisting of three main components:
1. a slight neurological disorder of the body representation system
2. a hardly noticeable mental disorder which leads to this strange wish to be handicapped
3. an erotic component"
Kastner and 34 other experts contributed to the interdisciplinary reader "Body Integrity Identity Disorder: Psychological, Ethical and Legal Aspects" (edited by A. Stirn, A. Thiel, S. Oddo)