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Sizing it up: A Systematic Review of the Nosology of Muscle Dysmorphia
... Chacune des études comprenait un questionnaire sociodémographique et le Muscle Dysmorphic Disorder Inventory -Franç ais (MDDI-Fr). La première étude comportait 342 étudiants à l'université (Mage = 20,9 ; SDage = 2,9), tandis que la seconde étude impliquait 1822 pratiquants en musculation (Mage = 23,9 ; SDage = 5,9). La validation a été réalisée à l'aide des mesures de la cohérence interne et des analyses factorielles. ...
... Chacune des études comprenait un questionnaire sociodémographique et le Muscle Dysmorphic Disorder Inventory -Franç ais (MDDI-Fr). La première étude comportait 342 étudiants à l'université (Mage = 20,9 ; SDage = 2,9), tandis que la seconde étude impliquait 1822 pratiquants en musculation (Mage = 23,9 ; SDage = 5,9). La validation a été réalisée à l'aide des mesures de la cohérence interne et des analyses factorielles. ...
... Chacune des études comprenait un questionnaire sociodémographique et le Muscle Dysmorphic Disorder Inventory -Franç ais (MDDI-Fr). La première étude comportait 342 étudiants à l'université (Mage = 20,9 ; SDage = 2,9), tandis que la seconde étude impliquait 1822 pratiquants en musculation (Mage = 23,9 ; SDage = 5,9). La validation a été réalisée à l'aide des mesures de la cohérence interne et des analyses factorielles. ...
Introduction: Muscle dysmorphia, a theme mainly investigated by Anglo-Saxon research, is a specific body dysmorphic disorder that characterizes individuals who think they are insufficiently muscular and lean. Understudied in francophone countries, tools translated and validated in French to measure the symptomatology of muscle dysmorphia remain rare.
Objectives: The aim of this study was the translation into French and the psychometric validation of a tool evaluating muscle dysmorphia, the Muscle Dysmorphic Disorder Inventory (MDDI-Fr), through 13 items divided into three dimensions: the “Drive For Size” (DFS), the “Appearance Intolerance” (AI) and the “Functional Impairment” (FI).
Methodology: A first translation step was conducted, followed by two cross-sectional studies conducted in France. In both of the latter studies, a sociodemographic questionnaire and the Muscle Dysmorphic Disorder Inventory – French version (MDDI-Fr) were administered. The first study included 342 university students (Mage = 20.9; SDage = 2.9), and 1822 athletes for the second study (Mage = 23.9; SDage = 5.9). Validation was performed using internal consistency measures and confirmatory factor analysis.
Results: The correlation matrices showed good significant results between items and dimensions. The three dimensions appeared distinct from each other with significant intra-dimension correlations. The internal consistency of the tool and its three dimensions show valid Cronbach's alphas (study 1: DFS = 0.79, AI = 0.74, FI = 0.75, MDDI = 0.74; study 2: DFS = 0.72, AI = 0.75, FI = 0.83, MDDI = 0.75). In addition, the trifactor analysis shows significant and promising scores for the tool in three dimensions and 13 items for study 1 (χ2/df = 4.67, CFI = 0.85, TLI = 0.83, RMSEA = 0.10, SRMR = 0.00), as for study 2 (χ2/df = 16.08, CFI = 0.87, TLI = 0.84, RMSEA = 0.09, SRMR = .06). Gender analyses were conducted on study 2, which
showed that the DFS subscale (items 1, 4, 5) and the AI subscale (items 6 and 9) presented the greatest differences in factor loadings between genders.
Conclusion: The translation, as well as the validation of the MDDI-Fr structured with13 items and three dimensions, showed significantly satisfying results for its adaptation in French in a population of French men and women practicing weight training. However, the “Appearance Intolerance” dimension shows moderate links
with the global tool, which should be investigated in future studies. Although the psychometric properties of the MDDI-Fr are promising, additional research is needed to gain a better understanding of gender differences in the results, especially for the DFS dimension.
... Et, d'autre part, de respecter un consensus international devant s'imposer face à la richesse des informations associé es à la dysmorphie musculaire, notamment sur la question tant discuté e de son identité nosographique. La ré ponse à la question de dé part, à savoir « qu'est-ce que la dysmorphie musculaire, et comment l'e´valuer », se dé veloppera donc à travers la ré fé rence nosographique du DSM-5 1 , classant la dysmorphie musculaire en tant que peur d'une dysmorphie corporelle, tout en ne perdant pas de vue l'actuelle question soulevé e par la conceptualisation d'une caté gorie de « Body Image Disorders » à laquelle elle pourrait appartenir [1,7]. ...
... Litté ralement traduit comme « inventaire du trouble de dysmorphie musculaire », ce test fut dé veloppé par Hildebrandt 7 Drive for : « Course à ». 8 Drive for size : Course à la taille. 9 Drive for muscularity : Course à la muscularite´. ...
... Tantô t les é tudes ont pu questionner la probabilité de la voir comme un trouble des conduites alimentaires non spé cifique « reverse anorexia », tantôt comme une nouvelle forme de trouble de l'image du corps (Body Image Disorders), tantôt comme une entité nosographique à part entiè re, ou encore comme une dysmorphophobie corporelle spé cifique. D'autres é tudes se sont même opposé es à sa rentré e officielle dans le DSM-5 de par les biais mé thodologiques inhé rents à ces controverses et le manque d'harmonisation des é tudes [4,7,48,50,61]. Ainsi, la pertinence d'une é niè me mé ta-analyse sur la classification de la dysmorphie musculaire est à questionner. D'autant plus que les manques se situent au sein des conflits actuels entre sa dé finition diffé rente en recherche et dans le DSM-5, mais aussi de par les manques considé rables d'é tudes cliniques sur sa description, sa prise en charge et ses protocoles de soins ainsi que l'absence totale d'é tudes longitudinales. ...
Résumé
Au cœur de la controverse, la dysmorphie musculaire subit encore de nombreux questionnements quant à son appartenance nosographique. La légitimité de son entrée dans le DSM-5, en 2013, en tant que dysmorphophobie corporelle spécifique, fut rapidement associée à un manque de rigueur méthodologique face au non-respect des guidelines nécessaires à l’inscription de toute maladie mentale au sein de cette classification. Ainsi, un réel travail de zététique se justifie pour cadrer la définition de la dysmorphie musculaire et de ses moyens d’évaluation. Ce qui constituera un préambule à tout travail réflexif qui aidera à éclaircir la place adéquate de la dysmorphie musculaire dans les classifications des maladies mentales. Notre travail de revue de la littérature s’est intéressé aux publications entre 1997 et 2019 sur le développement d’outils évaluant la dysmorphie musculaire. Ce qui a abouti à : i) un listing exhaustif des outils hétérogènes utilisés ; ii) à la mise en exergue du décalage entre les critères d’évaluation de la dysmorphie musculaire et sa définition nosographique ; ainsi que de iii) la formulation de guidelines quant à son dépistage. De futurs travaux sur l’identité de la dysmorphie musculaire en clinique devront servir à enrichir les connaissances actuelles recueillies à partir des cohortes de recherches ces vingt dernières années et, in fine, à repenser notre façon d’évaluer la dysmorphie musculaire.
... It is sometimes studied as an eating disorder, referred to as "reverse anorexia" (Pope et al., 1993), and sometimes as a body dysmorphic disorder, such as its current classification in the DSM-V as "specific body dysmorphic disorder" (2013). Some authors have suggested that muscle dysmorphia could be a body image addiction Griffiths et al., 2015), or a new emerging category of "body image disorders" (Blomeley et al., 2018) and finlly an obsessivecompulsive disorder (Chung., 2001). MD is questioned in the same way as bigorexia (Véléa., 2002) or orthorexia (Chapy., 2020), i.e. in terms of the normal or pathological character of the behaviors implemented. ...
Over the past three decades, the development of knowledge about muscle dysmorphia has enabled the scientific community to gain a better understanding of its etiopathogenesis and mechanism. However, few cases have been described, due to the absence of screening protocols and treatment guidelines. The aim of the current study was to evaluate muscle dysmorphia symptomatology, through an integrative psychological assessment, in two young female bodybuilders. In the first case study, we will focus on Mrs. I., who practices recreational bodybuilding, suffers from muscle dysmorphia with a form of eating disorder, and uses illegal APEDs. For the second case study, we will focus on Mrs L., who suffers from muscle dysmorphia, but with a predominant form of body dysmorphic disorder. The two case studies provided nuance of muscle dysmorphia symptomatology, leading a better understanding with its comorbidities, particularly in relation to eating disorders, body dysmorphic disorders and pathological exercise. Our study highlights the importance of an integrative psychological assessment in muscle dysmorphia and shows the interest of using pluri-modal approach in its diagnostic, whether for the field of psychopathology or sports psychology.
... La poursuite de cet idéal corporel, appelé « Drive for Muscularity », amène les individus souffrant de dysmorphie musculaire à présenter une détresse clinique significative liée à l'altération de leur fonctionnement au quotidien (compulsions à s'entraîner, limitations des activités sociales et récréatives, entraînement malgré une santé dégradée, usage de produits améliorant l'apparence et la performance). Bien que des controverses subsistent quant à sa classification nosographique (Blashfield et al., 1990 ;Nieuwoudt et al., 2012 ;Foster et al., 2015 ;Nieuwoudt, 2015 ;Blomeley et al., 2018 ;Cooper et al., 2020), il apparaît essentiel de considérer ses liens étroits avec les troubles des conduites alimentaires, les troubles obsessionnels compulsifs, les troubles dysmorphophobiques ainsi que les pratiques problématiques de l'activité physique (Cuadrado et al., 2022). ...
L’objectif de cette présente étude était d’examiner si des facteurs tels que l’alexithymie, le sentiment d’auto-efficacité concernant la régulation de l’alimentation et l’acceptation de son image corporelle, la consultation de contenus fitspiration ainsi que des comportements de pratique problématique de l’activité physique pourraient constituer des prédicteurs significatifs de la dysmorphie musculaire, et de pouvoir identifier un profil de sportifs à risque de cette pathologie. Ainsi, 342 étudiants pratiquant la musculation à l’université (Mage = 20,9 ans, ET = 2,9) ont été recrutés pour répondre à un questionnaire sociodémographique (âge, sexe, façon de pratiquer la musculation, consultation réseaux sociaux, consommation de produits améliorant l’apparence et la performance (APEDs) puis à des auto-questionnaires visant à évaluer la symptomatologie de la dysmorphie musculaire (MDDI), le sentiment d’auto-efficacité concernant la régulation de l’alimentation et l’acceptation de son image corporelle (EDRSQ), ainsi que l’alexithymie (TAS-20). Dans la population investiguée, les résultats montrent une prévalence de 18,7 % ( n = 64) pour la dysmorphie musculaire. L’identification des émotions, le sentiment d’acceptation de son image corporelle, la pratique des activités physiques avec la recherche d’une sensation de douleur et de congestion, la consommation de substances améliorant l’apparence et la performance (APEDs), l’objectif de recherche de construction musculaire et de maintien de sa forme, la comparaison aux modèles fitness et les comportements de vérification dans le miroir à la salle (gym-mirror checking) se sont montrés prédicteur pour la dysmorphie musculaire (R2 = 0,379, pour le modèle multivarié final). Cette étude met en évidence le réseau complexe de déterminants de la dysmorphie musculaire et les comportements de pratique des activités physiques qui peuvent se montrer à risque de cette pathologie, facilement repérables pour les professionnels concernés.
... Since 2015, MD has been classified as a specification of BDD within the obsessivecompulsive disorders (OCD) category in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [13], but debate over MD classification is still relevant [14][15]. In fact, a recent review demonstrated that 26% of articles considered MD as a subtype of BDD, 24% as an ED, 9% as part of the broad spectrum of OCD and 41% considered that there is not enough evidence to include MD in any of the existing nosological categories [2]. ...
Objectives:
Muscle dysmorphia (MD) is a disorder affecting mainly men and is characterized by significant dissatisfaction with muscles. The idea that MD could represent an addiction has been theoretically discussed, but no empirical data are available. Based on Foster et al. (2015) framework, the Addiction to Body Image Inventory (ABII) was developed. This study aims to validate the ABII and to evaluate its capacity to capture MD severity.
Methods:
A first community sample of 466 participants was recruited and completed the ABII and questionnaires on MD and body esteem. A second sample of 47 men at risk of MD was recruited mostly in gyms and completed the ABII and questionnaires on MD, eating and psychological symptoms.
Results:
With the community sample, the results showed that the ABII had a valid factorial structure, good internal consistency, and good convergent validity. With the sample of men at risk of MD, the results showed that the ABII had good convergent validity with MD and eating symptoms but not with psychological symptoms. The results of a regression model showed that the ABII explained 12% of the MD variance.
Conclusions:
This study brings the first measure of addiction to body image and suggests that MD must be understood as a complex phenomenon including eating symptoms and addictive tendencies.
... Esta patología cada vez ha tenido más reconocimiento y ha sido más investigada los últimos años (Blomeley et al., 2018). Las diversas investigaciones analizan los síntomas de la dismorfia muscular y su relación con algunas variables psicológicas. ...
La dismorfia muscular es la preocupación patológica por no estar suficientemente musculados, la cual produce gran malestar. Se ha relacionado con otras patologías como los trastornos de depresión y ansiedad o baja autoestima. Se estima que su prevalencia es mayor entre los hombres y los que se dedican a realizar ejercicios de desarrollo de masa muscular. El objetivo es analizar la relación de la dismorfia muscular con los trastornos de ansiedad, depresión y autoestima, en culturistas y otros atletas de mayor riesgo. Se ha realizado una revisión sistemática siguiendo las directrices PRISMA durante el proceso, incluyendo 16 investigaciones encontradas en diferentes bases de datos (ProQuest y Scopus principalmente). Los resultados parecen confirmar una relación significativa entre la presencia de dismorfia muscular y las poblaciones dedicadas al ejercicio físico relacionado con el desarrollo de masa muscular. También parece plausible la relación entre este trastorno y los síntomas de depresión y ansiedad, así como baja autoestima. Por tanto, la presencia de estos síntomas podrían ser factores de riesgo de la dismorfia muscular, a pesar de que serían necesarios estudios de causalidad para poder concluir, con mayor seguridad, la verdadera relación entre estas variables.
... Called "reverse anorexia" after Pope et al. studied a sample of bodybuilders suffering from eating disorders and taking AAS 1 [1], it was renamed "muscle dysmorphia" [2]. Asked several times as linked to eating disorders [3], body image disorders [4] or addiction to body image [5], muscle dysmorphia was classified in the DSM-V as "Obsessive-Compulsive and Related Disorders" as Body Dysmorphic Disorder [6], although this formalization is questioned [7,8]. ...
Background and aims
The internalization of ideal hypermuscular body and pro-muscularity media's influence have shown their importance in muscle dysmorphia development. The aim of the current study is to have a better understanding of links between specific body checking behaviors and muscle dysmorphia in social network context.
Methods
In total, 342 students practicing weightlifting at the university gym in Bordeaux answered to a survey with sociodemographic information and body checking symptoms including taking specific selfies of muscles and muscularity “Muscle Pics” and the MDDI (Muscle Dysmorphic Disorder Inventory).
Results
Muscle dysmorphia was prevalent in 18.7% of our population (64 students). We observed that muscle dysmorphia was correlated to “Muscle Pics”, “Follow-up”, “Message”, “Selfie”, and gym mirror checking with significant results (P < 0.01). Also, « Muscle Pics » were linked to APEDs use, pro-muscularity websites, fitness model comparison and gym mirror checking (P < 0.01). For muscle dysmorphia, “Muscle Pics” have strong predictive results (OR = 5.10, P = 0.000) and (OR = 4.08, P = 0.000) for adjusted. “Follow up” (OR = 4.76, P = 0.000) and (OR = 3.83, P = 0.000) for adjusted, “Muscle Pics Selfie” (OR = 11.20, P = 0.000) and (OR = 11.55, P = 0.000) for adjusted, “Muscle Pics Message” (OR = 4.49, P = 0.001) and (OR = 5.78, P = 0.001) for adjusted.
Conclusion
“Muscle Pics” showed several links with muscle dysmorphia for global score “drive for size”, “functional impairment” but not for “appearance intolerance” dimension. Pro-muscularity websites, fitness model comparisons and gym mirror checking are linked to muscle dysmorphia and “Muscle Pics”. Future research on “Muscle Pics” will help to provide a better understanding of muscle dysmorphia and its link with pro-muscularity influence websites.
... Les é tiopathogé nies de ces troubles partagent des dé terminants communs, mais se distinguent en entité s psychopathologiques dé limité es par leur expression singuliè re. Derniè rement, l'é tude de Blomeley et al. (2016) [6] a mis en lumiè re le fait que la dysmorphie musculaire serait principalement é tudié e comme un trouble spé cifique de l'image du corps lié aux troubles des comportements alimentaires et des dysmorphophobies corporelles. Cette information relance la né cessaire question taxonomique de la dysmorphie musculaire -oscillant entre les troubles des comportements alimentaires et les dysmorphophobies corporelles -mais aussi son besoin actuel d'une place à part entiè re dans la classification des maladies mentales, abandonnant la vision ré ductrice d'une dysmorphophobie corporelle spé cifique. ...
Introduction. – Ces dernières décennies, les points de vue divergents dans le domaine de la recherche sur la dysmorphie musculaire ont permis de penser cette pathologie et ses déterminants avec plusieurs approches nosographiques. Malgré sa classification dans le DSM-V au sein des dysmorphophobies corporelles spécifiques, un déterminant transnosographique aux troubles du comportement alimentaire et de l’image du corps est utilisé tantôt comme critère diagnostique, déterminant ou encore comorbidité. Il s’agit des « Drive For » littéralement traduit comme « course à » pour exprimer les motivations intrinsèques de l’individu sur sa recherche de normes « esthético-corporelle ».
Méthodologie. – A l’aide de la méthodologie Prisma et des mots-clés : « muscle dysmorphia », « Drive for », « Drive for Muscularity », « Drive for Thinness », « Drive for Leanness », « Drive for Size », « Dive for Power », « Drive for Tone », « Drive for Bulk ». Nous avons étudié les bases de données bibliographique Cochrane, Ebsco, PsycInfo, Pubmed, Science Direct, Web of science entre 1993 et 2018.
Résultats. – Il a été retenu 58 articles traitant de ces sujets. L’analyse de ces études nous a permis d’observer le maillage de relations entre la dysmorphie musculaire et les « Drive For », mais aussi entre ces derniers. Il est apparu que les « Drive For » constituent les piliers sur lesquels reposent le développement de la dysmorphie musculaire, et autour desquels s’articulent un ensemble de facteurs qui donneront un visage singulier à l’expression symptomatologique de la dysmorphie musculaire. Cependant, la mise en avant de certains « Drive For » au détriment d’autres, ont contribué à limiter la possibilité de voir la dysmorphie musculaire comme une entité nosographique à part entière dans laquelle co-existerait des formes spécifiques grandement façonnées par l’influence majoritaire de « Drive For » spécifiques.
Discussion. – Plusieurs questions ont été soulevées suite à notre travail, trouvant une place légitime dans le tableau actuel des recherches sur la dysmorphie musculaire et de son appartenance nosographique. Il apparait saillant de repenser l’influence des « Drive For » dans l’expression symptomatologique des différentes formes de dysmorphie musculaire, afin d’optimiser les repérages des signes précoces d’apparition de ce trouble mais aussi afin d’amorcer le développement de stratégies de soins adaptées à chaque forme rencontrée en clinique.
... A third issue is that BDD has a particular variant, where the focus of concern is body habitus, the individual 'seeing' their body composition as puny or slight, when it is actually normal or even very muscular, and seeking to achieve a muscular ideal (American Psychiatric Association, 2013). This form of BDD (muscle dysmorphia) largely occurs in males and encompasses a number of behaviours not usually evident in people with BDD, notably excessive muscle-enhancing exercises; specific low-fat, high protein diets; and the use of supplements and potentially dangerous anabolic steroids, testosterone, and medications such as thyroid hormone, insulin, and estrogen modulators (which may be illicitly obtained) (Tod et al., 2016;Blomeley et al., 2018). These issues add a further layer of complexity to BDD management and require attention to the habitual exercise and dietary regimens as well as advice about and treatment for abuse of muscle-enhancing agents and other substances if abused. ...
Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived appearance flaw or flaws that are not observable to others. BDD is associated with distress and impairment of functioning. Psychiatric comorbidities, including depression, social anxiety, and obsessive-compulsive disorder are common and impact treatment. Treatment should encompass psychoeducation, particularly addressing the dangers associated with cosmetic procedures, and may require high doses of selective serotonin reuptake inhibitors* (SSRI*) and protracted periods to establish full benefit. If there is an inadequate response to SSRIs, various adjunctive medications can be employed including atypical antipsychotics*, anxiolytics*, and the anticonvulsant levetiracetam*. However, large-scale randomized controlled trials are lacking and BDD is not an approved indication for these medications. Oxytocin* may have a potential role in treating BDD, but this requires further exploration. Cognitive-behavioural therapy has good evidence for efficacy for BDD, and on-line and telephone-assisted forms of therapy are showing promise. CBT for BDD should be customized to address such issues as mirror use, perturbations of gaze, and misinterpretation of others' emotions, as well as overvalued ideas about how others view the individual.
... However, at least some of the hypothesized dysfunctions of AN are thought to be in common with BN and, more importantly, to some mental disorders other than EDs. For instance, the body-image dysfunction seems also to underlie muscle dysmorphia (MD), which in DSM-5 is listed as a subtype of body dysphoric disorder and is regarded as a condition in which the principal symptom is a marked preoccupation with one's body being insufficiently muscular-despite often being of above-average muscularity and lean body mass (Blomeley et al. 2018). This means that the underlying dysfunction plays only partially an epistemic or individuating role in identifying and demarcating AN from other mental disorders. ...
This paper aims at considering the conceptual status of feeding and eating disorders (FEDs). Now that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has changed the classification and some relevant criteria of FEDs, it is particularly relevant to evaluate their psychiatric framework and their status as mental disorders. I focus my efforts on addressing only one specific question: Do FEDs fit the DSM-5 general definition of mental disorder? In DSM-5 a mental disorder is defined as a syndrome that reflects a dysfunction and is usually associated with significant distress or disability. More importantly, there is an explicit statement saying that all mental disorders listed in the manual must meet the requirements highlighted by the general definition. Thus, I evaluate whether or not FEDs are really meant to reflect a dysfunction and are usually associated with significant distress or disability.
... The popularity of bodybuilding has been increasing with the desire to have a lean and muscular body. Paralleling these developments, muscle dysmorphia (bigorexia), which is a body dysmorphic disorder, has begun to be observed especially among young adult males 6 and bodybuilders. 1,7,8 It has been reported that males have gravitated towards gaining more weight and becoming muscular. ...
Purpose
This study aims to determine the prevalence of muscular dysmorphic disorder (bigorexia) and orthorexia nervosa in male students and to evaluate the relationship between these conditions and self‐esteem.
Design and methods
This cross‐sectional study included 430 male students.
Findings
While the tendency of orthorexia among faculty of sports sciences (FSSs)' students was 28.8%, this rate was 16.3% for nursing department (ND); for tendency to bigorexia, it was found to be 16.3% in FSS students and 6% in ND. There was a negative correlation between the ortorexia scale and self‐confidence scales. And, there was a week negative correlation between the bigorexia Inventory and the self‐confidence scale.
Practice implications
This study is thought to help understand the factors affecting body image perception and to identify risky situations especially in young university students. It is thought that health professionals will guide the planning of initiatives that will help individuals gain healthy lifestyle behaviors.
Physical appearance is an important aspect of daily life. Social psychological research has repeatedly demonstrated that more attractive individuals are judged more favorably by others. Also, they receive preferential treatment across a range of interpersonal situations. These observations also likely explain, in part, why tens of millions of people worldwide undergo aesthetic procedures each year. A new large body of research has investigated the psychological aspects of aesthetic surgical and nonsurgical treatments. Much of this work has studied women, representing approximately 90% of individuals who undergo these procedures. While relatively few studies of the most traditional procedures have focused on men, many of the psychological characteristics of prospective patients and the psychological changes that occur following treatment are likely more similar than different for men and women. This literature will be reviewed. Studies of male patients are highlighted. While most patients are believed to be appropriate for treatment from a psychological perspective, some have serious mental health issues, such as body dysmorphic disorder, which warrants attention from the physician provider. The growing number of individuals interested in genital procedures (either for cosmetic purposes or as part of gender-affirming care) warrants specific attention from clinical teams as well.
Bu araştırma vücut geliştirme sporcularının bigoreksiya ile özgüven düzeylerini tespit etmek ve birbiri ile olan ilişkisini incelemek amacıyla gerçekleştirilmiştir. Sporcuların bigoreksiya ile özgüven düzeylerini incelemek amacıyla tarama modelinde tasarlanmış bir araştırmadır. Araştırma grubu Aksaray ilinde bulunan ve düzenli olarak vücut geliştirme sporu ile ilgilenen 145 erkek sporcudan oluşmaktadır. Verilerin sağlanmasında “Kas Dismorfik Bozukluğu (Bigoreksiya) Envanteri” ve “Sportif Sürekli Kendine Güven Ölçeği” kullanılmıştır. Katılımcıların bigoreksiya ve özgüven düzeylerini tespit etmek amacıyla “tanımlayıcı istatistiklerden aritmetik ortalama ve standart sapma” tekniklerinden yararlanılmıştır. Sporcuların bigoreksiya ve özgüven düzeylerini antrenman süresine göre karşılaştırmak için tek yönlü varyans analizi (Anova) kullanılmıştır. Farkın kaynağına ulaşabilmek amacıyla post-hoc (Tukey) testine başvurulmuştur. Sporcuların bigoreksiya ile özgüven düzeyleri arasındaki ilişkinin incelenebilmesi için pearson korelasyon analizi gerçekleştirilmiştir. Bigoreksiyanın özgüven üzerindeki yordayıcılığı ise basit doğrusal regresyon analizi kullanılarak test edilmiştir. Sonuç olarak sporcuların bigoreksiya düzeylerinin yüksek, özgüven düzeylerinin ise düşük olduğu sonucuna varılmıştır. Antrenman süresi bakımından sporcuların bigoreksiya düzeylerinde anlamlı bir farklılığa rastlanırken (p0.05). Ayrıca bigoreksiya ile özgüven arasında negatif yönlü anlamlı bir ilişkinin olduğu görülmüş, bigoreksiyanın özgüven üzerinde güçlü bir yordayıcı olduğu sonucuna varılmıştır.
Purpose of Review: There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males.
Recent Findings: Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature.
Summary: Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations.
Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of
muscularity-oriented disordered eating in males.
Despite the pervasive social endorsement of " cheat meals " within pro-muscularity online communities , there is an absence of empirical work examining this dietary phenomenon. The present study aimed to characterize cheat meals, and explore the meaning ascribed to engagement in this practice. Thematic content analysis was employed to code the photographic and textual elements of a sample (n = 600) that was extracted from over 1.6 million images marked with the #cheatmeal tag on the social networking site, Instagram. Analysis of the volume and type of food revealed the presence of very large quantities (54.5%) of calorie-dense foods (71.3%) that was rated to qualify as an objective binge episode. Photographic content of people commonly portrayed highly-muscular bodies (60.7%) in the act of intentional body exposure (40.0%). Meanwhile, textual content exemplified the idealization of overconsumption, a strict commitment to fitness, and a reward-based framework around diet and fitness. Collectively, these findings position cheat meals as goal-oriented dietary practices in the pursuit of physique-ideals, thus underscoring the potential clinical repercussions of this socially-endorsed dietary phenomenon.
Past research has revealed a relationship of perfectionism with dysmorphic appearance concern (DAC). Little research, however, has examined moderators of this relationship, including among men, whose appearance concerns are underresearched compared with women. Emotion regulation is one potential moderator that may be particularly compromised among men. Thus, the aim of the present study was to examine the role of emotion dysregulation in the relationship of perfectionism with DAC among men. Participants were 106 undergraduate men who completed an online survey that included questions about DAC, difficulties in emotion regulation, perfectionism, and depressive symptoms. Results showed that increased emotional awareness and low impulse control were associated with DAC. Moreover, difficulties in emotion regulation moderated the relationship between perfectionism and DAC. Implications of the present findings are discussed.
Studies using traditional screening instruments tend to report a lower prevalence of eating disorders (EDs) in men than is observed in women. It is therefore unclear whether such instruments are valid for the assessment of ED in males. Lack of a formal diagnostic definition of muscle dysmorphia syndrome (MD) makes it difficult to identify men at risk. The study aimed to assess the prevalence of ED and MD in male university students of Buenos Aires.
A cross-sectional, two-stage, representative survey was of 472 male students from six different schools in Buenos Aires, mostly aged between 18 and 28 years. The first stage involved administration of self-report questionnaires (Eating Attitude Test-26; scores ≥15 indicate "at risk" status). In Stage 2 students at risk of developing EDs were evaluated with a clinical interview, the Eating Disorder Examination (EDE; 12th edition). Two control students were interviewed for every at risk student.
The prevalence of EDs among university male students was 1.9% (n = 9). All participants with an ED presented with illness classified as eating disorder not otherwise specified (EDNOS). Using the Drive for Muscularity Scale (DMS) with a 52-point threshold we identified possible MD in 6.99% (n = 33) of the sample.
The prevalence of ED detected in this study is comparable with previous findings in male populations, and below that observed in female populations. However, the prevalence of possible cases of MD resembles the total rate of EDs in women. Characteristics associated with EDs and MD in men are also discussed. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015).
© 2015 Wiley Periodicals, Inc.
This cross-cultural study examined the nature and correlates of muscle dysmorphia (MD) in Mexicans who lift weights, compared symptomatology in Mexicans to that in Americans, and investigated the roles of bodybuilding and acculturation in the presentation of MD symptoms. The sample consisted of 46 Mexicans and 67 Americans who lift weights (N = 113). Participants completed measures regarding symptoms of MD, engagement in bodybuilding, acculturation, exercise dependency, eating pathology, and steroid use. Contrary to predictions, results indicated similar occurrences of MD symptoms in both samples. MD symptoms were correlated with bodybuilding, exercise dependence and eating pathology in both Mexican and American men, as well as American women. Engagement in bodybuilding in men was similar in both samples; however, in the American sample, bodybuilding behaviors were more related to MD. Acculturation to American culture was not related to symptoms of MD. Steroid use was greater in both samples than in previous studies. Findings are discussed in terms of cross-cultural and clinical implications.
The perception that eating disorders occur predominantly in young white upper-class women has been challenged. This study examined temporal differences to the demographic correlates of eating disorder behaviors over a 10-year period.
Data from cross-sectional general population surveys in 1998 (n = 3010) and 2008 (n = 3034) were collected on demographics (sex, age, income, residency), current eating disorder behaviors (binge eating, extreme dieting, purging), and health-related quality of life (SF-36).
Below-median annual household income was associated with increased prevalence rates from 1998 to 2008 in binge eating, extreme dieting, and purging. Male sex was associated with increased prevalence rates in extreme dieting and purging. Age over 45 years was associated with increased prevalence rates in purging. In 2008 versus 1998, binge eating was associated with greater mental health-related quality of life impairment in males but not females; and greater physical health-related quality of life impairment in regional but not metropolitan areas. Extreme dieting was also associated with greater physical health-related quality of life impairment in 2008 versus 1998 in the lower but not the higher socioeconomic sector.
Findings suggest the ‘democratization’ of disordered eating, with greatest levels of associated impairment being within marginalized demographic sectors. Implications include the need for broader intervention programs and recruitment of demographically representative samples in eating disorder research.
Background
Orthorexia and muscle dysmorphia are disorders affecting above all young adults whose prevalence and social impact are still unclear. We aimed to evaluate the prevalence of the traits of orthorexia and muscle dysmorphia among freshmen attending university courses focused on nutrition (Dietetics) and body care (Exercise and Sport Sciences). Students of Biology were considered as a control group. The prevalence of eating disorder (ED) traits were also evaluated.Methods
All participants (n =¿440; n =¿53 Dietetics school, n =¿200 Exercise and Sport Sciences school, n =¿187 the Biology school) completed the following questionnaires: ORTO-15, Muscle-Dysmorphic-Disorder-Inventory, and Eating Attitudes Test-26.ResultsThe prevalence of the traits of EDs, orthorexia, and muscle dysmorphia was 9.1%, 25.9%, and 5.9%, respectively. When compared to other students, those attending the Dietetics school showed a 2-fold higher risk of EDs and those from the Exercise and Sport Sciences school a 10-fold higher risk of muscle dysmorphia. The prevalence of orthorexia traits was high in all schools (35.9%, 22.5%, 26.5% in Dietetics, Biology, and Exercise and Sport Sciences schools, respectively). Overall, individuals with traits of any of these disorders were more frequently on diet or on supplement use. In a logistic regression model, attending the Dietetics school (OR =¿2.71; 95%CI 1.14-6.48) was significantly associated with the ED traits, but not with the orthorexia traits (OR =¿1.75; 95%CI 0.93-3.29), while attending the Exercise and Sport Sciences school was significantly associated with the muscle dysmorphia traits (OR =¿5.15; 95%CI 1.44-18.4). Finally, when evaluating the relationships among the types of study programs as dependent variables and traits of these disturbances, the associations between the traits of ED (OR =¿3.35; 95%CI 1.38-8.13) and matriculation at the school of Dietetics, and between the traits of muscle dysmorphia (OR =¿4.32; 95%CI 1.16-16.1) and the choice of the Exercise and Sport Sciences school were confirmed.Conclusions
The choice of the university courses might be influenced by pre-existing disorders in eating behaviors, which were relatively frequent in the considered sample.
Gender role norms may play a crucial role in the male experience of eating disorders. The masculinity hypothesis proposes that conformity to masculine gender roles including dominance, confidence, sexual success, and physical and emotional self-control places men at risk for muscularity-oriented body dissatisfaction and disordered eating. However, despite some empirical support for this hypothesis, several gaps in the literature remain. The present study was the first to use multidimensional instruments of gender role conformity to investigate whether masculinity and femininity are associated with male body dissatisfaction and disordered eating. Participants were 246 young heterosexual men who com- pleted an online survey that asked questions about muscle dissatisfaction, body fat dissatisfaction, thinness- and muscularity-oriented disordered eating. Results from 4 simultaneous multiple regressions showed that increased conformity to masculine norms predicted greater muscle dissatisfaction and muscularity-oriented disordered eating, but not body fat dissatisfaction or thinness-oriented disor- dered eating. Conformity to feminine norms predicted greater muscle dissatisfaction, thinness- and muscularity-oriented disordered eating. The results provide support for the masculinity hypothesis and extend it to include muscularity-oriented disordered eating. Furthermore, the results suggest that the femininity hypothesis, which proposes that feminine norm endorsement is a risk factor for body dissatisfaction and disordered eating in women, may also generalize to men. Clinicians should consider integrating gendered perspectives into treatments for men with eating disorders. Future research into the mechanisms through which gender role conformity influences body image and eating outcomes in males is necessary.
Muscle dysmorphia (MD) is a psychiatric condition characterised by the extreme pursuit of muscularity and simultaneous reduction in body fat. Although current diagnostic criteria effectively illustrate the behaviours involved in the pursuit of greater lean muscularity, clinical utility is limited by the lack of a clear delineation concerning the degree to which these characteristics are present in pathological presentations. This allows for considerable variation in the potential scope of those diagnosed with MD, and the possible inclusion of non-pathological muscle-building endeavours. The purpose of this article is to review the efficacy of distinguishing between pathological and non-pathological muscle enhancing endeavours.
Background
Given recent assertions suggesting that gender role endorsement may be relevant in the divergence of male body image concerns, this study examined the self-reported gender role endorsement in opposing dimensional extremes of male body image disorders, namely, muscle dysmorphia and anorexia nervosa. This study further examined the relationship between gender role endorsement and eating disordered and muscle dysmorphia disorder pathology.
Methodology
Participants were 21 male muscle dysmorphia patients, 24 male anorexia nervosa patients, and 30 male gym-using controls from Australia, the United Kingdom, and the United States. All participants completed multidimensional measures of masculinity and femininity, and measures of eating disorder and muscle dysmorphia symptomatology.
Results
Patients with muscle dysmorphia reported significantly elevated adherence to masculine (but not feminine) norms relative to control gym-using men and men with anorexia nervosa, whereas patients with anorexia nervosa exhibited elevated feminine (but not masculine) gender role endorsement relative to control gym-using men and men with muscle dysmorphia.
Conclusions
Masculine and feminine gender role endorsement appear to be associated with the divergence of body image concerns towards muscularity and thinness-oriented ideals respectively.
The present study examines how muscle dysmorphia (MD), a clinically significant preoccupation that one's body is inadequately muscular, relates to trait anxiety and obsessive-compulsive symptoms. 97 college-age men completed the MD Inventory, the Drive for Muscularity Scale, the Male Body Attitudes Scale, the Social Physique Anxiety Scale, the trait scale of the Speilberger State-Trait Anxiety Inventory , and an abbreviated version of the Yale Brown Obsessive-Compulsive Scale. Bivariate correlation analyses revealed that trait anxiety and obsessivecompulsive symptoms demonstrated strong relationships with both social physique anxiety and overall MD symptomology. Path analysis indicated that anxiety-related variables accounted for 77 percent of the variance in MD symptoms. The findings lend support to the assertion that MD should be placed within the obsessive-compulsive spectrum of disorders.
The DSM-IV classification of body dysmorphic disorder (BDD) refers to an individual's preoccu- pation with an 'imagined' defect in his or her appearance or markedly excessive concern with a slight physical anomaly (American Psychiatric Association, 1994). An Italian psychiatrist, Morselli, first used the term 'dysmorphophobia' in 1886, although it is now falling into disuse, probably because ICD-10 (World Health Organization, 1992) has discarded it, subsuming the condition under hypochondriacal disorder. The most common preoccupations are with the nose, skin, hair, eyes, eyelids, mouth, lips, jaw and chin. However, any part of the body may be involved and the preoccupation is frequently focused on several body parts. Complaints typically involve perceived or slight flaws on the face, the size of body features (too small or too big), hair thinning, acne, wrinkles, scars, vascular markings, paleness or redness of the complexion, asymmetry or lack of proportion. Sometimes the complaint is extremely vague; it may amount to no more than the patient feeling generally ugly.
Background
The aim of this study was to identify dietary strategies for physically active individuals with muscle dysmorphia based on a systematic literature review.
Method
References were included if the study population consisted of adults over 18 years old who were physically active in fitness centers. We identified reports through an electronic search ofScielo, Lilacs and Medline using the following keywords: muscle dysmorphia, vigorexia, distorted body image, and exercise. We found eight articles in Scielo, 17 in Medline and 12 in Lilacs. Among the total number of 37 articles, only 17 were eligible for inclusion in this review.
Results
The results indicated that the feeding strategies used by physically active individuals with muscle dysmorphia did not include planning or the supervision of a nutritionist. Diet included high protein and low fat foods and the ingestion of dietary and ergogenic supplements to reduce weight.
Conclusion
Physically active subjects with muscle dysmorphia could benefit from the help of nutritional professionals to evaluate energy estimation, guide the diet and its distribution in macronutrient and consider the principle of nutrition to functional recovery of the digestive process, promote liver detoxification, balance and guide to organic adequate intake of supplemental nutrients and other substances.
For some time, society’s emphasis on appearance has negatively affected women. Now we’re finding increasing numbers of men who are also overly dissatisfied with their bodies. This trend has led to a new disorder, muscle dysmorphia (MD), which is charac- terized by a preoccupation with muscularity accompanied by per- ceptual, affective, and behavioral components that interfere with daily activities. Currently, MD is not included in the DSM-IV, although it is purported to be a kind of body dysmorphic disorder (BDD), which in turn is a somatoform disorder. This study investi- gated relationships among symptoms of MD and variables most relevant to a DSM classification of men who lift weights regularly. No relationship was found between MD and a measure of somato- form disorder. Instead, BDD, OCD (obsessive-compulsive disor- der), body dissatisfaction, and hostility are the main predictors of MD. This suggests that MD is an OCD spectrum disorder, rather than a somatoform disorder.
FREE author eprint: http://www.tandfonline.com/eprint/P4FuHBJEKUtJWHvUcfSy/full
The current study sought to explore sex differences in the presentation of probable fullsyndrome
and subthreshold body dysmorphic disorder (BDD) in adolescents from an
Australian community sample. Specifically, it examined sex differences in the types of BDD
symptoms endorsed, body areas of concern, and the association with elevated symptoms of
comorbid disorders. In male participants, it also compared the presenting features of those with
and without muscle dysmorphia. Of 3,149 adolescents assessed using self-report questionnaires,
162 (5.1%) reported probable BDD (57.4% male,Mage = 14.89 years, SD = 1.33, primarily from
Oceanian or European cultural backgrounds). All participants completed measures of BDD
symptoms; past mental health service use; and symptoms of anxiety, depression, obsessivecompulsive
disorder, and eating disorders. Male participants completed additional measures of
quality of life, drive for muscularity, hyperactivity, conduct disorder, peer problems, and
emotional symptoms. Controlling for demographic variables that varied by sex, male and
female participants reported similar BDD symptom severity, rates of most elevated comorbid
symptoms, and mental health service use. Concerns regarding muscularity, breasts/nipples, and
thighs differed by sex. Female participants were more likely than male participants to report
elevated generalized anxiety symptoms. In male participants, muscle dysmorphia was not
associated with greater severity across most measures. The presenting features of BDD were
broadly similar in male and female participants, and in male participants with and without
muscle dysmorphia. Future research should seek to increase mental health service use in
adolescents with BDD and to improve rates of disorder detection in clinical settings.
Objective:
This randomized control trial is an evaluation of the effectiveness of enhanced cognitive behavioral treatment (CBT-E) for eating disorders adapted for a group setting. The study aimed to examine the effects of group CBT-E on eating disorder psychopathology and additional maintaining pathology.
Method:
A transdiagnostic sample of individuals with eating disorders with a BMI ≥ 18 kg/m(2) (N = 40) were randomized to an immediate-start or delayed-start condition so as to compare therapeutic effects of group CBT-E with a waitlist control. Global Eating Disorder Examination Questionnaire (EDE-Q) scores, BMI, and measures of Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were measured across the 8-week control period, throughout the group treatment and at 3-months post-treatment.
Results:
Over 70% of those who entered the trial completed treatment. The first eight weeks of group CBT-E were more effective at reducing Global EDE-Q scores than no treatment (waitlist control). By post-treatment, good outcome (a Global EDE-Q within 1 SD of Australian community norms plus BMI ≥ 18.5) was achieved by 67.9% of treatment completers and 66.7% of the total sample. Symptom abstinence within the previous month was reported by 14.3% of treatment completers and 10.3% of the total sample. Significant reductions in Clinical Perfectionism, Self-Esteem, Interpersonal Difficulties, and Mood Intolerance were also observed.
Discussion:
This study demonstrated that a group version of CBT-E can be effective at reducing eating disorder psychopathology in a transdiagnostic sample of individuals with eating disorders. Group CBT-E could provide a means of increasing availability of evidence-based treatment for eating disorders.
Purpose: Robust empirical evidence has illustrated a rising prevalence of body dissatisfaction and disordered eating among males, noting that both may be oriented more toward muscularitydas opposed to thinness-oriented concerns. While an elevated prevalence of premorbid anorexia nervosa (AN) has been noted among those with muscle dysmorphia, little evidence has examined the process of this transition from thinness-oriented to muscularity-oriented disordered eating.
Methods: This clinical observation presents a case of AN in an adolescent male, whose symptom presentation transitioned during the course of treatment for AN, into more muscularity-oriented disordered eating.
Results: Despite the core body image disturbance and disordered eating behaviors being retained, the behavioral expression of muscularity-oriented disordered eating was difficult to detect during treatment for AN, and he was discharged from treatment as his muscularity-oriented disordered eating escalated.
Conclusions: Transdiagnostic crossover between thinness-oriented and muscularity-oriented disordered eating represents an important clinical concern, which may be challenging to measure and assess. Implications for treatment are discussed, and the early detection of muscularity-oriented disordered eating.
Anabolic-androgenic steroids (AAS) are synthetic forms of the hormone testosterone and their non-medical use is related to increased muscle size, muscle mass, and strength. A primary concern regarding exogenous AAS use is its potential to suppress endogenous (natural) testosterone production. In response, some users seek out substances to use post-cycle to mitigate problems associated with the resumption of endogenous testosterone production. This study sought to understand issues related to post-cycle therapy (PCT) among a sample of performance and image enhancing drugs (PIED) users in Australia. Semi-structured interviews were conducted with 26 participants (n = 24 male) who reported the use of a range of performance and image enhancing drugs (PIEDs), including AAS, human chorionic gonadotropin, growth hormone, clenbuterol, tamoxifen, insulin, and peptides. Interviews were conducted in person or by telephone, recorded, and transcribed. Data were analysed following a process of thematic analysis. Three themes emerged: (1) access to PCT; (2) maintenance of gains, maintenance of health; and (3) PCT and links to mental health. Steroids were seen as easier to access than PCT; as such, participants tended to continue to use steroids rather than taper down their use, leading to health concerns. Participants wanted access to PCT for several reasons, including minimising any loss of muscle or strength gained through their PIED cycle; because they were concerned that they were no longer naturally producing hormones; or because they were concerned about their mental health, particularly when coming 'off cycle', and the need for PCT to help adjust. This study contributes to the existing literature suggesting that PCT may act as a harm reduction measure, allowing PIED users to safely reduce or cease steroid use or to address any negative effects from use, particularly those related to mental health.
Treatment for body dysmorphic disorder (BDD) often involves a combination of psychological and pharmacological interventions. However, only a small number of randomised controlled trials (RCTs) have been undertaken examining the efficacy of different therapeutic interventions. The aim of this study was to systematically review the RCTs involving psychological and pharmacological interventions for the treatment of BDD. The literature was searched to June 2015, and studies were included if they were written in English, empirical research papers published in peer-review journals, specifically assessed BDD patients, and involved a RCT assessing BDD symptoms pre- and post-intervention. Nine studies were identified: six involving psychological and three involving pharmacological interventions. Cognitive behaviour therapy, metacognitive therapy and selective serotonin reuptake inhibitors were identified as treatments with potential benefit. The small number of RCTs and the heterogeneity of findings emphasises the need for more high quality RCTs assessing both psychological and pharmacological interventions for BDD.
Background:
Body dissatisfaction is associated with impairment in women's quality of life (QoL). To date, research has not examined the relationship between body dissatisfaction and men's QoL, or sex differences in this relationship.
Methods:
A community sample of 966 males and 1,031 females living in Australia provided information about their body dissatisfaction, mental health and physical health-related QoL, and eating disorder symptoms. Data were analysed using three hierarchical multiple regressions and interactions between body dissatisfaction and sex were examined.
Results:
For both sexes, increasing levels of body dissatisfaction were associated with poorer mental and physical health-related QoL and greater psychological distress. The adverse associations between body dissatisfaction and mental health-related QoL, and between body dissatisfaction and psychological distress, were more pronounced for males.
Conclusion:
High levels of body dissatisfaction may threaten the psychological and physical wellbeing of both men and women. Body dissatisfaction appears to be a public health problem, distinct from the eating disorders and other adverse psychological phenomena for which body dissatisfaction is commonly discussed as a risk factor. Males, historically understudied and underrepresented in body image research, warrant increased empirical attention.
Review of the LiteratureFamily-Based Treatment for Adolescents with Anorexia NervosaPutting Together a Treatment TeamSetting Up TreatmentConclusions
The purpose of this study was to determine if associated characteristics of muscle dysmorphia (MD) were different between elite-level competitive bodybuilders and power lifters. Elite-level competitive bodybuilders (n = 100) and power lifters (n = 68) completed the muscle dysmorphia inventory (MDI) at the time of or immediately before competition. A 2 X 6 (group X MDI subscales) multivariate analysis of variance indicated that bodybuilders were significantly more likely to report body size-symmetry concerns (F(1, 167) = 10.31, P < 0.001), physique protection (F(1, 167) = 10.27, p < 0.001), dietary behavior (F(1, 167) = 28.38, p < 0.001), and pharmacological use (F(1, 167) = 19.64, p < 0.001) than were power lifters. These results suggest that elite-level body builders are significantly more likely to engage in characteristics associated with MID than are elite-level power lifters.
Increasingly boys and men are suffering with eating disorders and related body image problems. Some have full-blown conditions such as anorexia nervosa, bulimia, binge eating, compulsive exercising or bigorexia. Others are distressed by slightly lesser degrees of disordered eating or over-exercise and seek ways of overcoming their problems. The Invisible Man applies the latest research to produce a practical, problem-focused self-help manual for men with eating disorders and body image problems. Divided into four sections, this evidence-based survival kit covers: the wider cultural context of male body image problems features unique to men science fact and science fiction a 7 stage approach to treatment. By combining the science of cognitive behaviour therapy with motivational enhancement and problem-solving therapies, The Invisible Man provides help to all men with body image disorders, as well as families and professionals involved in their care.
In his etiological model, Grieve (2007) postulated that negative mood states contribute to the development of muscle dysmorphia. It was expected that there would be a positive correlation between muscle dysmorphia symptoms (as measured by the Muscle Dysmorphia Questionnaire) and depressive symptoms (as measured by the Center for Epidemiologic Studies-Depression Scale). Participants for this study were 100 college-aged males recruited through the university study board. As predicted, a significant correlation was discovered between muscle dysmorphia and depressive symptoms. Also, data regression demonstrated that depression symptoms significantly predicted muscle dysmorphia symptoms.
Introduction and aim:
To understand health service access and needs of people who use performance and image enhancing drugs (PIED) in regional Queensland.
Design and methods:
Semi-structured interviews were conducted with 21 people (n = 19 men) who reported the use of a range of PIEDs, including anabolic-androgenic steroids, human chorionic gonadotropin, growth hormone, clenbuterol, tamoxifen, insulin and peptides.
Results:
Participants reported accessing a range of services, including needle and syringe programs and pharmacies, for sterile injecting equipment. While PIEDs users attributed some stigma to needle and syringe programs, they were seen as an important service for injecting equipment. Participants reported receiving either positive care from health-care providers, such as general practitioners (GP), or having negative experiences due to the stigma attached with PIED use. Few participants reported disclosing their PIED use to their GP not only because of the concerns that their GP would no longer see them but also because they felt their GP was not knowledgeable about these substances.
Discussion and conclusion:
Participants in the study reported no difficulty in accessing health services based on living in a regional area, with their concern focused more upon how they were viewed and treated by service staff. [Dunn M, Henshaw R, Mckay F. H. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services? Drug Alcohol Rev 2015;00:000-000].
Existing content analyses of pro-eating disorder web content have focused on thinness-oriented eating disorder pathology. With the increasing prevalence of muscularity-oriented body image concerns, we conducted a systematic content analysis of 421 active pro-muscularity websites including static content websites, blogs, and online forums. Emergent coding methods were utilized (Cohen's kappa range=.78-.88), and eight distinct thematic categories were identified: rigid dietary practices (26.2%), rigid exercise rules (18.4%), the broader benefits of muscularity (16.1%), the encouragement of the drive for size (15.9%), the labeling of non-ideal body (11.4%), marginalizing other areas of life (6.1%), muscle enhancing substances (3.3%), and minimizing medical risk (2.6%). Pro-muscularity websites provide explicit material surrounding potentially non-healthful muscularity-oriented eating and exercise practices. Clinician awareness of the potentially non-healthful behaviors involved in the pursuit of muscularity may enhance the detection and treatment of male eating disorders, in particular.
Previous research has indicated that exposure to pro-eating disorder websites might increase eating pathology; however, the magnitude of this effect is unknown. This study aimed to conduct a systematic review and meta-analysis to examine the effect of exposure to pro-eating disorder websites on body image and eating pathology. Studies examining the relationship between exposure to pro-eating disorder websites and eating pathology-related outcomes were included. The systematic review identified nine studies. Findings revealed significant effect sizes of exposure to pro-eating disorder websites on body image dissatisfaction (five studies), d = .41, p = .003; dieting (six studies), d = .68, p < .001, and negative affect (three studies), d = 1.00, p < .001. No effect emerged for bulimic symptoms (four studies), d = .22, p = .73. Findings confirmed the effect of pro-eating disorder websites on body image and eating pathology, highlighting the need for enforceable regulation of these websites. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
Male body dissatisfaction is now approaching parity with female body dissatisfaction, and generally manifests as either a drive for enhanced thinness, as in anorexia nervosa, or more commonly as a drive for enhanced muscularity, as in muscle dysmorphia. However, little research has been undertaken to explicate the factors implicated in the divergence of male body image disorders amongst body dissatisfied males towards either thinness or muscularity oriented body image concerns. We aim to review several constructs which have been explored in attempting to better understand the causal pathway into this divergence, including sexuality and gender role identification. Gender role orientation may be particularly relevant in underpinning this divergence, in that masculinity is likely implicated in the drive for muscularity, whereas femininity is implicated in the drive for thinness amongst body dissatisfied males. Suggestions and implications for future research in further explicating the role of gender role orientation in the divergence of male body image psychopathology are discussed.
In this paper, we investigated the relationship between traditional masculine ideology, body image discrepancy, self-esteem, and the pursuit of muscularity in a sample of school going boys. Constructs were measured using the Traditional Masculine Ideology Scale, Lynch and Zellner's Body Figure Drawings (1999), Rosenberg's Self-Esteem Inventory, and the Drive for Muscularity Scale. Questionnaires were administered to 508 boys, from Grades 10, 11, and 12, at a public single-sex high school in KwaZulu-Natal, South Africa. Analysis revealed significant positive correlations between traditional masculine ideology, the pursuit for muscularity, and body image discrepancy. Indian school boys experienced body image discrepancy more severely than their Black and White counterparts in the sample. Further, there was a significant use of muscle supplements and steroids by school going boys.
Men with muscle dysmorphia (MD) are preoccupied with the idea that their bodies are insufficiently lean or muscular. This study used multidimensional scaling analysis to explore distortions in male body perception associated with MD. Men aged 18-46 were grouped into 41 low- and 16 high-MD samples using the Muscle Dysmorphia Inventory (Rhea, Lantz, & Cornelius, 2004). Participants judged similarities among photos of 27 male bodies (including icons representing Actual and Ideal Selves) and rated the bodies on nine attribute dimensions. MDS analysis found that both low- and high-MD men used the same dimensions in organizing their perceptions of male bodies, but high-MD men displayed significantly greater distance between Actual and Ideal Selves than did low-MD men on several dimensions. MDS is described as a useful tool for understanding the perceptual and cognitive distortions of MD that may have value in diagnosing MD, initiating therapeutic discussions, and evaluating outcomes.
The ego-syntonic nature of anorexia nervosa means that sufferers often deny their symptoms or experience them as positive or comforting. Positive beliefs about eating disorder symptoms may contribute to the development and/or maintenance of eating-disordered behaviour. To date, however, research in this field has been confined to women and anorexia nervosa. Given increasing scientific interest in muscle dysmorphia, a potential eating disorder with ego-syntonic qualities, there is a need to extend current research to include men and muscle dysmorphia. The present study examined whether positive beliefs about anorexia nervosa and muscle dysmorphia were associated with more marked eating disorder symptoms and explored sex differences in these associations.
Male and female university students (n = 492) read descriptions of a male or female character with clinically significant symptoms of anorexia nervosa or muscle dysmorphia. Participants subsequently answered questions about the characters and completed a measure of disordered eating. Knowledge, personal history and interpersonal familiarity with the conditions were assessed.
Results from two simultaneous multiple regressions showed that more positive beliefs about anorexia nervosa and muscle dysmorphia were uniquely associated with more eating disorder symptoms for both male and female participants. Effect sizes for these relationships were medium to large (partial eta-squared = 0.09-0.10). The relationships were not moderated by the sex of the participant, nor the sex of the character.
Although preliminary, these findings suggest that, among young men and women, positive beliefs about anorexia nervosa and muscle dysmorphia may contribute to the development and maintenance of these conditions. Some symptoms of muscle dysmorphia may be perceived as ego-syntonic, providing another parallel with anorexia nervosa.
© The Royal Australian and New Zealand College of Psychiatrists 2015.
An ACT Approach Chapter 1. What is Acceptance and Commitment Therapy? Steven C. Hayes, Kirk D. Strosahl, Kara Bunting, Michael Twohig, and Kelly G. Wilson Chapter 2. An ACT Primer: Core Therapy Processes, Intervention Strategies, and Therapist Competencies. Kirk D. Strosahl, Steven C. Hayes, Kelly G. Wilson and Elizabeth V. Gifford Chapter 3. ACT Case Formulation. Steven C. Hayes, Kirk D. Strosahl, Jayson Luoma, Alethea A. Smith, and Kelly G. Wilson ACT with Behavior Problems Chapter 4. ACT with Affective Disorders. Robert D. Zettle Chapter 5. ACT with Anxiety Disorders. Susan M. Orsillo, Lizabeth Roemer, Jennifer Block-Lerner, Chad LeJeune, and James D. Herbert Chapter 6. ACT with Posttraumatic Stress Disorder. Alethea A. Smith and Victoria M. Follette Chapter 7. ACT for Substance Abuse and Dependence. Kelly G. Wilson and Michelle R. Byrd Chapter 8. ACT with the Seriously Mentally Ill. Patricia Bach Chapter 9. ACT with the Multi-Problem Patient. Kirk D. Strosahl ACT with Special Populations, Settings, and Methods Chapter 10. ACT with Children, Adolescents, and their Parents. Amy R. Murrell, Lisa W. Coyne, & Kelly G. Wilson Chapter 11. ACT for Stress. Frank Bond. Chapter 12. ACT in Medical Settings. Patricia Robinson, Jennifer Gregg, JoAnne Dahl, & Tobias Lundgren Chapter 13. ACT with Chronic Pain Patients. Patricia Robinson, Rikard K. Wicksell, Gunnar L. Olsson Chapter 14. ACT in Group Format. Robyn D. Walser and Jacqueline Pistorello
The goal of the current study was to examine the relationship between critical comments that men recall others making about their bodies and their current level of muscle dysmorphia (MD) symptoms. It was expected that higher levels of MD symptoms would be associated with remembering comments, severity of the comment, and negative emotions associated with the comment. Participants were 118 college men. Results indicated that no significant differences were found on MD symptoms between participants who recalled comments about their bodies and those who did not recall such comments. However, analyses revealed significant relationships between severity level of the comment and MD symptoms. Also, more negative reactions to the critical comment were associated with higher levels of MD symptoms.
A growing body of evidence suggests that the prevalence of male body dissatisfaction and muscle dysmorphia is rising. To date, however, there is no published evidence on the efficacy of treatments for muscle dysmorphia. We present the case of a 15-year-old boy who met full diagnostic criteria for muscle dysmorphia, whose symptoms were treated into remission with eating disorder-focused, family-based treatment. The age of this patient fell within the time period in which symptoms of muscle dysmorphia are most likely to develop and this case represents the first published case report of family-based treatment for muscle dysmorphia in this age group. Thus, this case report has important implications for clinicians considering treatment options for presentations of muscle dysmorphia when first presenting in adolescence. Implications for the development of treatment guidelines for muscle dysmorphia and for the diagnostic debate surrounding muscle dysmorphia are also discussed.
The nature and extent of stigma toward individuals with anorexia nervosa and muscle dysmorphia remains underexplored. This study investigated attitudes and beliefs likely to be conducive to stigmatization of individuals with these conditions.
Male and female undergraduate students (n = 361) read one of four vignettes describing a fictional male or female character with anorexia nervosa or muscle dysmorphia, after which they responded to a series of questions addressing potentially stigmatizing attitudes and beliefs toward each character.
Characters with anorexia nervosa were more stigmatized than characters with muscle dysmorphia, female characters were more stigmatized than male characters, and male participants were more stigmatizing than female participants. A large effect of character diagnosis on masculinity was observed, such that characters with anorexia nervosa were perceived as less masculine than characters with muscle dysmorphia, and this effect was more pronounced among male participants. However, no significant corresponding effects were observed for femininity.
Females with anorexia nervosa may be particularly susceptible to stigmatization, especially by males. Anorexia nervosa and muscle dysmorphia are perceived as "female" and "male" disorders respectively, in line with societal gender role expectations, and this stigmatization is tied more strongly to perceptions of sufferers' masculinity than femininity. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013).
Objective:
Recent advances in neuroimaging techniques have enabled a better understanding of the neurobiological underpinnings of anorexia nervosa (AN). The aim of this paper was to summarise our current understanding of the neurobiology of AN.
Methods:
The literature was searched using the electronic databases PubMed and Google Scholar, and by additional hand searches through reference lists and specialist eating disorders journals. Relevant studies were included if they were written in English, only used human participants, had a specific AN group, used clinical populations of AN, group comparisons were reported for AN compared to healthy controls and not merely AN compared to other eating disorders or other psychiatric groups, and were not case studies.
Results:
The systematic review summarises a number of structural and functional brain differences which are reported in individuals with AN, including differences in neurotransmitter function, regional cerebral blood flow, glucose metabolism, volumetrics and the blood oxygen level dependent response.
Conclusion:
Several structural and functional differences have been reported in AN, some of which reverse and others which persist following weight restoration. These findings have important implications for our understanding of the neurobiological underpinnings of AN, and further research in this field may provide new direction for the development of more effective treatments.
The two body image disorders anorexia nervosa (AN) and body dysmorphic disorder (BDD) share many similarities. Delusionality in BDD has recently gained increased attention, as the new DSM-5 criteria for BDD include an insight specifier. However, delusionalilty in AN has rarely been examined. We evaluated the delusionality of appearance-related beliefs in AN (n=19) vs. BDD (n=22) via structured interview. Participants also completed measures of disorder-specific psychopathology and body image. Compared to those with AN, individuals with BDD exhibited significantly greater delusionality on a dimensional scale (p=0.0014, d=1.07), and were more likely to meet dichotomous criteria for delusional beliefs (p=0.021, V=0.36). In AN, delusionality was associated specifically with shape concerns and drive for thinness; in BDD, delusionality was related to the severity of BDD symptoms (all p<0.05). Delusionality of appearance beliefs is present in individuals with AN, but is less pronounced than in BDD. Nevertheless, as high delusionality might predict poor treatment outcome in AN, treatment strategies that were originally developed to address delusionality in BDD might be modified for AN.
"Threatened masculinity" theory proposes that males have experienced an increased drive for muscularity in recent times as a result of females' expanded accomplishments among traditionally male dominated domains. We tested this hypothesis experimentally by examining the effects of competitive performance feedback against either a male or female opponent on male's state self-esteem, body image, and confidence in physical performance. Sixty-six male undergraduate students were given false performance feedback on a competitive task in a 2 (failure versus success feedback) × 2 (male versus female opponent) factorial design. Men felt worse about their appearance and less confident in their physical ability following failure In general. They felt less muscular after failing to a female. These results lend some support to the threatened masculinity hypothesis and demonstrate that failure to a woman, even on a nonphysical task, may elicit compensatory drive for muscularity among men.
The current study examines the influence of self-objectification on men's drive for muscularity, body satisfaction and self-esteem, and symptoms of muscle dysmorphia. Participants were 74 men recruited to complete an on-line self-report questionnaire to measure these experiences. The results indicate that men who scored high on measures of self-objectification also indicated a greater drive for muscularity and more symptoms of muscle dysmorphia compared to men who scored low on measures of self-objectification. No differences were found between the two groups on measures body satisfaction and self-esteem. These findings suggest that self-objectification increases men's risk for experiencing symptoms of muscle dysmorphia. The results of the study support Grieve's (2007) etiological model for muscle dysmorphia.