Muscularity concerns among men: development of attitudinal and perceptual measures

The current study reports the development and psychometrics of a figure rating scale with leanness and muscularity dimensions and a 13-item questionnaire assessing symptoms associated with muscle dysmorphia (MD). Three separate samples of men and women completed the muscle dysmorphic disorder inventory (MDDI), the bodybuilder image grid (BIG) or both to measure 1-week test–retest reliability, internal consistency, convergent and divergent validity and valid placement of BIG figures along interval scales of body fat and lean muscle mass. The MDDI and MDDI subscales (drive for size, appearance intolerance, and functional impairment) had good reliability, internal consistency, convergent and divergent validity. The BIG had good to excellent test–retest reliability, good convergent and divergent validity and validity as an interval scale. Implications for characterizing body image disturbance in men and benefits and limitations of the measures are discussed.     

The interference effect of men's handling of muscular action figures on a lexical decision task

It has been shown in previous work [Action figures and men. Sex Roles 53, 877–885] that male participants who handled extremely muscular action figures had lower body esteem than those who did not handle action figures or a Ken doll. However, the internal mechanisms that dictated this effect are unclear. Therefore, the current study extended this previous work by having male participants handle action figures of varying muscularity and completing a lexical decision task with target words that consisted of both positive and negative body words and feeling words in order to determine if males would be primed to think negatively about their bodies and self or if positive thoughts about their bodies and self would be interfered with. The results show that those participants who handled the extremely muscular action figures responded significantly more slowly to feeling positive words (e.g., content, confident) and marginally more slowly to body positive words (e.g., muscle, bicep) than those who did not handle any action figures. Overall, this suggests that the interference of positive words, not the priming of negative words, is the internal mechanism that produces the decreased body image satisfaction after exposure to muscular stimuli. Implications and future research are discussed.     

The relationship between the drive for muscularity and anthropometric measures of muscularity and adiposity

Researchers have found consistently positive associations between women's body dissatisfaction and the desire to be thin and anthropometric indices of the amount of body fat they care on their frame. However, with the increasing emphasis being given to men's body image concerns, such as the drive for muscularity, it is important to study the relationship between men's desire to become more muscular and the actual amount of muscle they carry on their frames. That is, because men who want to become muscular can achieve that through strength training, do those with a high drive for muscularity have a high level of muscle mass? We explored this issue in a sample of 100 college-aged men and found that only one of four anthropometric measure of muscularity (flexed bicep circumference) was predictive of engaging in muscularity-oriented behaviors, while none predicted attitudes about becoming more muscular. These findings suggest either that men's drive for muscularity is unrelated to their actual level of muscularity or that current anthropometric indices are not accurate enough for a significant relationship to emerge. Suggestions for future research and study limitations were discussed.     

The dark side of bodybuilding: the role of bodybuilding activities in compensation of frustrated basic psychological needs

The main purpose of the current study was to investigate the explanatory mechanism of the drive for muscularity on the relations between frustrated basic needs and diverse indicators of muscle dysmorphia. To achieve this purpose, in the first place, as a pilot study needed to pursue the hypotheses of the main study, Basic Psychological Needs Satisfaction and Frustration Scale was adapted to Turkish and its psychometric properties were examined. In the main study, data were collected from 245 men with a mean age of 22.73 (SD = 3.86), who were engaged in regular bodybuilding activities. After the adaptation of Muscle Appearance Satisfaction Scale, the indirect predictive effects of frustrated basic needs on muscle dysmorphia symptoms through the drive for muscularity were examined via two structural equation models. Also, the moderating role of the drive for muscularity in the associations between each of the frustrated needs and muscle dysmorphia symptoms was tested via another structural equation model. Results revealed that (1) both the composite score of frustrated basic needs and frustrated relatedness are indirect predictors of all muscle dysmorphia symptoms through drive for muscularity and (2) drive for muscularity has a moderating role only in the relation between frustrated relatedness and muscle dissatisfaction (i.e., an indicator of muscle dysmorphia). These findings did not only support the assumptions of Self Determination Theory (SDT) indicating the link between frustrated needs and ill-being situations but also provided preliminary evidence for a new direction of SDT studies.

     

Body dysmorphic disorder and appearance enhancing medical treatments

This article reviews the literature on body dysmorphic disorder (BDD) in persons who seek appearance enhancing medical treatments such as cosmetic surgery and dermatological treatment. We begin with a discussion of the growing popularity of cosmetic surgical and minimally invasive treatments. The literature investigating the psychological characteristics is briefly highlighted. Studies investigating the rate of BDD among persons who seek appearance enhancing treatments are detailed and, collectively, suggest that approximately 5–15% of individuals who seek these treatments suffer from BDD. Retrospective reports suggest that persons with BDD rarely experience improvement in their symptoms following these treatments, leading some to suggest that BDD is a contraindication to cosmetic surgery and other treatments. The clinical management of patients with BDD who present for these treatments is briefly described and directions for future research are provided.     

Muscle Dysmorphia Research Neglects DSM-5 Diagnostic Criteria

This systematic review aimed to collect, evaluate, and synthesize the research on muscle dysmorphia (MD) post official recognition as a specifier for body dysmorphic disorder (BDD) in the DSM-5, and provide recommendations for future research. Literature searches were conducted in four databases to see if inclusion criteria were met. Results revealed 33 studies meeting inclusion criteria, none of which utilized DSM-5 criteria for MD or acknowledged the criterion in their research. Few studies acknowledged the association between MD and BDD, and the methodological quality of recent MD research was considered low due to a lack of clinical samples, measurements not using validated cutoff scores, and the research designs. In conclusion, future MD research is encouraged to utilize DSM-5 diagnostic criteria to better inform clinical practice and significantly improve the methodological quality. As such, more effective treatment options may be developed, reducing the risk of health-harming consequences in these individuals.     

Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder

Patients with Body Dysmorphic Disorder (BDD) may spend many hours in front of a mirror but little is known about the psychopathology or the factors that maintain the behaviour. A self-report mirror gazing questionnaire was used to elicit beliefs and behaviours in front of a mirror. Two groups were compared, which consisted of 55 controls and 52 BDD patients. Results: Prior to gazing, BDD patients are driven by the hope that they will look different; the desire to know exactly how they look; a belief that they will feel worse if they resist gazing and the desire to camouflage themselves. They were more likely to focus their attention on an internal impression or feeling (rather than their external reflection in the mirror) and on specific parts of their appearance. They were also more likely to practise showing the best face to pull in public or to use “mental cosmetic surgery” to change their body image than controls. BDD patients invariably felt worse after mirror gazing and were more likely to use ambiguous surfaces such as the backs of CDs or cutlery for a reflection. Conclusion: Mirror gazing in BDD consists of a series of complex safety behaviours. It does not follow a simple model of anxiety reduction that occurs in the compulsive checking of obsessive–compulsive disorder. The implications for treatment are discussed.     

Muscularity rationality: An examination of the use of Rational Emotive Behaviour Therapy (REBT) upon exercisers at risk of muscle dysmorphia

Research in the area of body image suggests that muscularity dissatisfaction is a prominent concern among men and women. At its apex, this concern manifests into a convoluted and debilitating body image disorder termed muscle dysmorphia (MD), characterised by a marked preoccupation with ones (subjective) muscularity and leanness inadequacy. Prevention of MD is critical, however, empirical evidence informing intervention protocols are profoundly scarce. The principal aim of this study was to examine the effectiveness of a one-to-one Rational Emotive Behaviour Therapy (REBT) intervention, comprising five, 60-min one-to-one sessions, in decreasing MD symptomatology, irrational beliefs and increasing unconditional self-acceptance in a mixed-sex cohort of four exercisers at-risk of MD. A single-case, staggered multiple-baseline across participant A-B design was adopted to examine the effects of REBT. Visual and statistical analyses, and social validation data, indicated reductions in MD, irrational beliefs, and increases in unconditional self-acceptance across all participants from pre-post intervention phases, with reductions upheld at a 6-month follow-up. This study highlights the potential role of rational and irrational beliefs in the onset and maintenance of MD. This study is the first to report the application of a CBT approach to MD symptomology, and has demonstrated the use of REBT as a potential preventative approach for individuals at risk of MD. Practitioners working with individuals at risk of MD should take a benefit-focussed approach to support individuals in developing unconditional self-acceptance beliefs, as well as a problem-focussed approach to support individuals in reducing irrational beliefs.     

Perceived teasing experiences in body dysmorphic disorder

Individuals with body dysmorphic disorder (BDD) are excessively concerned about imagined or slight defects in their appearance (e.g., asymmetrical facial features). Cognitive-behavioral models of BDD propose that several factors, including dysfunctional appearance-related beliefs and life experiences, such as teasing, contribute to the avoidance behaviors or rituals (e.g., mirror checking, grooming) characteristic of BDD. Previous research has demonstrated an association between perceived teasing and body dissatisfaction. In the current study, we examined whether individuals with BDD (n = 16) report to have been teased more often than do mentally healthy controls (n = 17). The group comprising individuals with BDD reported more appearance- and competency-related teasing than did control participants. This study provides preliminary evidence for the association between perceived teasing and BDD.     

Facial asymmetry detection in patients with body dysmorphic disorder

Cognitive-behavioral models of body dysmorphic disorder (BDD) propose that individuals with BDD may possess a better or more developed sense of aestheticality than do individuals without BDD. Evidence for this proposition, however, is limited. One perceptual process that could contribute to heightened aestheticality is the ability to detect differences in symmetry. In this experiment we tested whether individuals with BDD (n = 20), relative to individuals with obsessive compulsive disorder (OCD; n = 20) and healthy controls (n = 20), show an enhanced ability to detect differences in the symmetry of others’ faces, symmetry of dot arrays, and/or show a greater preference for symmetrical faces. Individuals with BDD were not significantly more accurate in detecting differences in facial symmetry or dot arrays relative to individuals with OCD and healthy controls. Individuals with OCD took longer to make facial symmetry judgments than did individuals in the other two groups. All participants, regardless of diagnostic group, preferred more symmetrical faces than nonsymmetrical ones. Taken together, our results do not support a heightened perceptual ability or evaluative preference for symmetry among individuals with BDD.     

Effects of exposure to muscular and hypermuscular media images on young men's muscularity dissatisfaction and body dissatisfaction

This study examined the effects of exposure to muscular and hypermuscular media images on young men's body images, and the moderating roles of baseline body dissatisfaction (BD) and muscularity dissatisfaction (MD). Men (M age = 21.9, SD = 2.8) were exposed to pictures of muscular (n = 34) or hypermuscular (n = 29) male physiques throughout a 30-min health seminar. In support of the study hypotheses, higher levels of baseline BD and MD were associated with greater post-seminar BD and MD. In addition, MD moderated the effects of the exposure conditions on BD; greater baseline MD was associated with greater post-seminar BD, but only among men who viewed the muscular images. These results speak to the importance of pre-existing muscularity concerns in determining men's reactions to muscular physique images, and suggest that exposure to the media ideal of muscularity, and not muscularity per se, elicits body dissatisfaction in men with pre-existing muscularity concerns.     

Victimization,social anxiety,and body dysmorphic concerns: Appearance-based rejection sensitivity as a mediator

Body dysmorphic disorder (BDD) is characterized by extreme preoccupation with perceived deficits in physical appearance, and sufferers experience severe impairment in functioning. Previous research has indicated that individuals with BDD are high in social anxiety, and often report being the victims of appearance-based teasing. However, there is little research into the possible mechanisms that might explain these relationships. The current study examined appearance-based rejection sensitivity as a mediator between perceived appearance-based victimization, social anxiety, and body dysmorphic symptoms in a sample of 237 Australian undergraduate psychology students. Appearance-based rejection sensitivity fully mediated the relationship between appearance-based victimization and body dysmorphic symptoms, and partially mediated the relationship between social anxiety and body dysmorphic symptoms. Findings suggest that individuals high in social anxiety or those who have a history of more appearance-based victimization may have a bias towards interpreting further appearance-based rejection, which may contribute to extreme appearance concerns such as BDD.     

The relationship of hypercompetitiveness and gender roles with body dysmorphic disorder symptoms in a nonclinical sample

This study examined whether hypercompetitiveness was a moderator between body dysmorphic disorder (BDD) symptoms and gender roles in 345 college students. To test this, the Body Dysmorphic Disorder Examination-Self Report (BDDE-SR), the Hypercompetitive Attitude Scale, and the Personal Attributes Questionnaire (PAQ) were used. Significant positive correlations were found between BDD symptoms and hypercompetitiveness in men and women. For men and women, no significant correlation was found between female-valued items on the PAQ and the BDDE-SR. A statistically significant negative correlation was found between male-valued items on the PAQ and the BDDE-SR for both genders. Hypercompetitiveness, however, was found not to be a moderator between BDD symptoms and gender roles.     

Body checking behaviors in men

Males have been facing increasing pressure from the media to attain a lean, muscular physique, and are at risk for body dissatisfaction, disturbed eating and exercise behaviors, and abuse of appearance- and performance-enhancing drugs (APEDs). The aim of the current study was to examine the relationship between body checking and mood, symptoms of muscle dysmorphia, importance of shape and weight, and APED use in undergraduate males. Body checking in males was correlated with weight and shape concern, symptoms of muscle dysmorphia, depression, negative affect, and APED use. Body checking predicted APED use and uniquely accounted for the largest amount of variance in Muscle Dysmorphic Disorder Inventory (MDDI) scores (16%). Findings support the view that body checking is an important construct in male body image, muscle dysmorphia, and body change strategies and suggest a need for further research.     

Empirically Defining Treatment Response and Remission in Body Dysmorphic Disorder Using a Short Self-Report Instrument

Determining response or remission status in body dysmorphic disorder (BDD) usually requires a lengthy interview with a trained clinician. This study sought to establish empirically derived cutoffs to define treatment response and remission in BDD using a brief self-report instrument, the Appearance Anxiety Inventory (AAI). Results from three clinical trials of BDD were pooled to create a sample of 123 individuals who had received cognitive-behavioral therapy for BDD, delivered via the Internet. The AAI was compared to gold-standard criteria for response and remission in BDD, based on the clinician-administered Yale–Brown Obsessive Compulsive Scale, modified for BDD (BDD-YBOCS), and evaluated using signal detection analysis. The results showed that a ≥ 40% reduction on the AAI best corresponded to treatment response, with a sensitivity of 0.71 and a specificity of 0.84. A score ≤ 13 at posttreatment was the optimal cutoff in determining full or partial remission from BDD, with a sensitivity of 0.75 and a specificity of 0.88. These findings provide benchmarks for using the AAI in BDD treatment evaluation when resource-intensive measures administered by clinicians are not feasible.     

A Preliminary Investigation of Body Dissatisfaction and Eating Disorder Symptomatology with Bisexual Individuals

Body dissatisfaction and eating disorder symptomatology were examined in bisexual individuals (n?=?139 women, n?=?37 men) and compared to lesbian/gay (n?=?51 women, n?=?96 men) and heterosexual individuals (n?=?82 women, n?=?34 men) in a U.S. online sample. Age, body mass index (BMI), income, and exercise frequency served as covariates. MANCOVA results showed a significant gender by sexual orientation interaction and significant main effects of gender and sexuality. Univariate tests were used to explore multivariate results. ANCOVA results for body dissatisfaction showed a significant gender by sexual orientation interaction. Post-hoc comparisons revealed higher levels of body dissatisfaction among all groups compared to heterosexual men. ANCOVA results for eating disorder symptomatology showed a significant main effect of sexual orientation. Post-hoc comparisons revealed higher levels of eating disorder symptoms among bisexual compared to heterosexual individuals. For bisexual men, gay community involvement, maladaptive social comparison, drive for muscularity, self-esteem, gender role orientation, and body dissatisfaction were explored as predictors of eating disorder symptomatology while controlling for age, BMI, exercise frequency, and income in a hierarchical regression analysis. The same factors, minus body dissatisfaction, were explored as predictors of body dissatisfaction in bisexual men. For bisexual women, similar factors, with the exception of drive for muscularity, were explored. Drive for muscularity predicted body dissatisfaction and exercise frequency predicted eating disorder symptomatology in bisexual men. BMI and self-esteem predicted body dissatisfaction in bisexual women; gay community involvement and body dissatisfaction predicted eating disorder symptomatology.     

A qualitative study of body image and appearance among men of Chinese ancestry in Australia

Little is known about the body image of non-White men living in Western countries, even though it has been suggested that they may be more at risk of body image concerns, especially if they internalize Western ideals. This study focused on identifying the main body image and appearance themes among 15 men of Chinese ancestry in Australia using semi-structured interviews and grounded theory. Moderate muscularity was the preferred ideal and height dissatisfaction was shown to be the primary concern. The majority was not invested in achieving muscularity and had a “holistic” approach to their body image that included concerns about hairstyling and clothing. In addition, the men were influenced by both Asian and Western ideals, and this included comparison targets with both Asian and Western men. Further studies are needed to assess the extent of men's body image and appearance concerns, and the role played by Asian and Western influences.     

Mind over muscle? Sex differences in the relationship between body image change and subjective and objective physical changes following a 12-week strength-training program

This study examined sex differences in body image change and its correlates over the course of a 12-week strength-training program. Participants were 28 men and 16 women (M age = 21.6, SD = 2.4) who completed pre- and post-intervention measures of body image (Body Areas Satisfaction Scale, Social Physique Anxiety Scale, and Drive for Muscularity Scale) and subjective and objective assessments of body fat, muscularity, and strength. They participated in a 12-week, 5-day/week full-body progressive resistance training program. Significant body image improvements were found for both sexes (p < .05). Correlates of body image change varied somewhat between the sexes. For men, body image improvements were correlated only with subjective physical changes. For women, body image improvements were correlated with subjective physical changes as well as objective increases in strength. These results suggest that although men and women derive body image improvements from strength training, they may benefit for different reasons.     

Pinning down the problems and influences: Disordered eating and body satisfaction in male wrestlers

ObjectivesDisordered eating and body dissatisfaction are common concerns among athletes. However, these variables have been minimally explored in male wrestlers. Sociocultural influences can impact drive for muscularity, body satisfaction, and disordered eating, but it is unclear which influences are most prominent in this population. The present study had two aims: 1) examine the nature of drive for muscularity, body satisfaction, and disordered eating in collegiate wrestlers, and 2) investigate which sociocultural influence (general, coach/teammate, sport appearance pressures) most strongly predicts drive for muscularity, body satisfaction, and disordered eating.Methods and designThis study was cross-sectional. Participants included 103 National Collegiate Athletic Association Division I male collegiate wrestlers in the U.S. who completed surveys in season on sociocultural influences, drive for muscularity, body satisfaction, and disordered eating.ResultsWrestlers had a high drive for muscularity and engaged in many unhealthy behaviors to lose weight; however, they had relatively high body satisfaction. Relative weight analyses showed that sport appearance pressures were the strongest predictor of drive for muscularity while general pressures were the strongest predictor of body satisfaction and restricting eating behaviors.ConclusionsFindings suggests that disordered eating needs to be addressed among wrestlers and potential influences to target.