Bigorexia Bodybuilding And Muscle Dysmorphia Pdf
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- Table of Contents
- Recognition and treatment of muscle dysmorphia and related body image disorders.
- Appendix A: Checklist for assessing the methodological quality of the studies
Table of Contents
Int J Psychol Psychoanal Even though muscle dysmorphia MD is classified as a body dysmorphic disorder, it shares similarities with eating disorders ED. The aim of the present study was to explore similarities between men with MD, women with ED, and a control group of men with body related preoccupations, regarding self-esteem, body esteem, and personality traits.
Analyses revealed that clinical groups reported lower body esteem, more perfectionism and narcissism than the control group; only the ED group showed a significantly lower self-esteem than the control group. Also, men with MD showed higher self-esteem and body-esteem, as well as a higher level of narcissistic grandiosity than women with ED.
Even though, we cannot exclude that gender differences could partly explain these findings, the present results suggested that a preserved self-esteem and a heightened narcissistic grandiosity tend to characterize MD. Muscle dysmorphia, Eating disorders, Self-esteem, Personality, Narcissism. In today's society, men are facing important social pressures to reach a muscular and lean body [ 1 - 3 ].
They are increasingly exposed to an ideal body more unveiled and muscular than before through several media [ 4 - 6 ]. According to a meta-analysis, the male body ideal conveyed by various media magazines, advertising, toys has a significant negative impact on males' body satisfaction, self-esteem, and is associated with specific behaviors, such as dieting and excessive exercising [ 7 ].
Men present more muscularity-oriented thoughts and behaviors than women due to stereotypical traditional perceptions of what it means to be a man [ 8 - 10 ]. Men tend to be more often dissatisfied with their body than they used to [ 11 , 12 ].
More precisely, men's preoccupations focus mainly on developing a more muscular body shape, as well as a physical strength. Muscle Dysmorphia MD has been introduced to conceptualize an excessive concern about one's own muscularity. It is mainly characterized by an intense drive for muscularity while maintaining a low body fat percentage [ 11 ]. MD has been included in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders [ 14 ] as a body dysmorphic disorder specification, which his classified as an obsessive-compulsive disorder.
However, this field of study has emerged way before that. Indeed, Pope, et al. These criteria were developed from studies about MD, case examples and clinical features Appendix 1. The principal criterion is a preoccupation with the idea that one's body is not sufficiently lean and muscular. Based on these criteria, Olivardia and colleagues [ 16 ] compared a group of 24 men with MD to a control group of 30 men who regularly train in a gym but did not report any MD symptoms.
Despite MD's belonging to the obsessive-compulsive disorders spectrum, similarities with feeding and eating disorders' ED's contribute to the debate pertaining its classification [ 17 - 23 ]. Accordingly, Murray, et al. Furthermore, few authors have drawn parallels between MD and ED clinical features. Foremost, they are all characterized by high levels of body dissatisfaction and cognitive distortions about body shape; for MD, one's body is never muscular or lean enough, and never skinny enough for ED [ 16 , 17 , 24 , 25 ].
Furthermore, dieting and excessive exercising are central features for all these conditions [ 19 , 21 ]. A study comparing 24 men with anorexia nervosa AN , as diagnose with the DSM-5 criteria, to 21 men suffering of MD as diagnosed with Pope's criteria, and 15 men gym-using controls showed that men with MD and AN reported clinical similarities regarding disturbed body image, disordered eating, as well as excessive exercising [ 22 ].
MD and ED also share underlying psychological features. A study from Davis, Karvinen and McCreary [ 26 ] showed that neuroticism and perfectionism are significant predictors of both drive for thinness among women and drive for muscularity among men.
More recently, Murray and colleagues [ 23 ] showed, with a student sample, that components of a transdiagnostic model of ED mood intolerance, low self-esteem, self-oriented and socially prescribed perfectionism also predicted MD symptoms. Finally, Davis and Scott-Robertson [ 28 ] compared a group of 22 bodybuilders with a group of 46 women with anorexia, on self-esteem and personality.
Results showed no significant differences between groups on all variables except for self-esteem and body self-esteem, which were higher for the bodybuilders' group. Moreover, when compared to normed data, their results showed that both groups were more obsessional, perfectionistic, narcissistic, and reported more physical anhedonia than the general population.
Although these results suggest that MD symptoms are associated with determinants that are traditionally linked to ED, very few clinical studies have empirically demonstrated it. To date, MD symptoms have mainly been assessed with self-reported questionnaires. The present study goes a step further by ensuring that the MD group met the diagnosis criteria proposed by Pope before comparing it to an ED group.
Consequently, the aim of the present study was to identify a group of men with MD using a semi-structured interview based on Pope's criteria [ 15 ], and to compare them with a group of women with ED, and with a control group regarding self-esteem self-esteem, body self-esteem and personality traits perfectionism, obsessive-compulsive personality traits, pathological narcissism.
According to this objective, it is expected that both clinical groups would display similar levels of self-esteem and body esteem.
They are also expected to display similar levels of perfectionism, obsessive-compulsive traits and narcissism. Participants were 63 men and 28 women from 18 to years-old. An experienced psychiatrist diagnosed women from this group, based on DSM-5 criteria for anorexia and bulimia nervosa. General sociodemographic information about age, gender, family situation, citizenship, education and salary were collected through a homemade questionnaire.
Other information regarding weight maximum, minimum and current weight, height, presence of body image concerns and onset of these body image concerns was also collected with this questionnaire.
MD was evaluated with a semi-structured interview elaborated by our research team, based on the diagnostic criteria proposed by Pope and colleagues [ 15 ] as well as by Leone and colleagues [ 29 ]. The DIMD represents a more complete diagnostic tool than the actual self-reported questionnaires, allowing to clarify questions and to ask sub-questions if needed Appendix 2. The interview contains 13 questions, divided in three distinct categories: exercising, dietary habits, and the social impact of exercising and dietary habits.
It has been built to make sure that all the criteria were concisely covered. Moreover, the coding process consists of asking questions to the participant until the experimenters can take a clinical decision on each criterion does the participant meet the criterion? As for the evaluation of all mental disorder according to DSM 5, the clinician must be able to document with examples whether the person met the diagnosis criterion.
The final decision is bipolar, it means that the experimenter must conclude to a diagnostic of MD MD group or not. For the present study, the experimenter completed the rating scale for every male participant to maintain a standardized procedure. A good knowledge about diagnostic features of MD is needed to conduct the interview adequately.
In order to ensure that the interview distinguished the two group of male MD and control group , a Chi-square was conducted on all criteria. It has been designed by Rosenberg [ 30 ] to assess positive and negative attitudes towards the self. It is a item questionnaire, answered on a four-point Likert-type scale from strongly agree to strongly disagree. A higher score indicates a higher level of self-esteem. This questionnaire has shown a very satisfying internal consistency alphas from 0.
In the present study, the RSES's internal consistency was excellent, reaching 0. The Body-Esteem Scale [ 32 ], a item questionnaire used to assess body satisfaction, is divided in three subscales: Appearance, Weight, and Attribution. Items are answered on a five-point Likert-type scale ranging from never 0 to always 4. A higher score on each subscale indicated higher body self-esteem and a positive appearance evaluation [ 33 ].
The Multidimensional Perfectionism Scale was used to assess perfectionism [ 36 ]. Each participant answers the 35 items on 5-point likert scale ranging from strongly disagree 1 to strongly agree 5. Psychometric properties were evaluated in four studies; internal consistency analysis of all subscales showed that MPS has an acceptable to excellent internal reliability, with Chronbach's alphas ranging from 0.
Obsessive-compulsive personality was evaluated with the Obsessive-Compulsive Personality Scale [ 37 , 38 ], a item, true-false self-reported questionnaire, composed of six subscales Emotional Constriction, Organization, Parsimony, Perseverance, Inflexibility and High Superego.
A higher total score on this questionnaire indicates stronger obsessive-compulsive personality traits. The Pathological Narcissism Inventory [ 40 ], a item self-report questionnaire, was used to assess multidimensional pathological narcissism.
The questions are answered on a 6-point Likert-type scale ranging from 1 not at all like me to 6 very much like me. Men were recruited through advertisements in 28 gyms in the Quebec Metropolitan area.
The same ad was sent by email to the whole community of Laval University students and employees. To take part of the study, men must be preoccupied by their muscularity. Participants were invited to come to the teaching clinic of the School of Psychology at Laval University.
After explaining the study, participants red and signed the consent form, approved by the Laval University's Ethics Research Committee. Afterwards, male participants completed the diagnosis interview to assess MD. To standardize the interviews, two doctoral students in clinical psychology received an appropriate training by a psychologist specialized in psychopathology. Following the interview, participants were left alone to compute the computerized survey. Groups were formed using Pope's diagnosis criteria [ 15 ]: Individuals who met the significant number of criteria were assigned to the clinical group MD condition and individuals concerned about their muscularity Criterion A but who did not meet other MD's criteria were assigned to the control group control condition.
To validate the coding process, a psychologist specialized in psychopathology offered consultation periods to clarify some difficult aspects of the coding process ex: Identification of distinctive aspects of men's distress, participants with unclear diagnosis, etc. Then, both interviewers reviewed each interview to ensure similar diagnostic norms.
Furthermore, to establish inter-rater reliability, a doctoral student in clinical psychology has been recruited to act as a blind coder. Before the coding process, he received the appropriate training to code the interviews, and during it, he received the same consultation opportunities than the initial coders. The inter-rater agreement according to the final decision pertaining to the clinical group or control group was calculated with SPSS They had to meet the diagnostic criteria for ED as described in the DSM-5, to be eligible for the study.
A psychiatrist conducted a semi-structured interview based on DSM-5 to confirm the diagnostic. Afterwards, if women agreed to participate to the study, they signed an informed consent form and completed the questionnaires.
Data were analyzed using SPSS Participants of the three groups MD, control group and ED were compared on all studied variables self-esteem, body self-esteem, perfectionism, obsessive-compulsive personality traits and narcissism , using ANOVAS, to see if significant differences exist among them. Fisher's LSD tests were used to identify the potential differences between groups. All variables were examined for normality and the presence of outliers. ANOVA's assumptions of homoscedasticity, normality of the dependent variable, and independence of observations were all met.
No outliers were identified for the present variables. Results of these analyses are presented in the Table 1. More specifically, only women of the ED group reported a lower self-esteem compared to the control group p 0. Also, MD group had significantly higher self-esteem's scores, and body self-esteem's scores related to appearance, weight, and attributions, than the ED group p Table 1: Differences between groups on self-esteem and personality measures.
View Table 1. Significant differences between groups were also observed in relation with personality traits perfectionism, obsessive traits, and narcissism. A similar pattern was observed for the narcissistic vulnerability, on which both clinical groups reported higher levels compared to the control group p The main objective of this study was to enhance our knowledge on MD by comparing a group of men with MD based on a diagnostic interview, to a group of women with an eating disorder ED , and a control group of men concerned with their muscularity, regarding self-esteem and personality traits.
Comparisons between groups ED, MD and control revealed some interesting findings. Similarly, to David and Scott-Robertson [ 28 ], the present results suggested that participants with MD as well as those with ED reported similar levels of perfectionism and narcissism and that both groups were more perfectionist and narcissistic narcissistic vulnerability than men from the control group.
Recognition and treatment of muscle dysmorphia and related body image disorders.
DOI : Background: Although bigorexia symptoms are rapidly increasing, it is mostly an underrecognized condition in Turkish male bodybuilders. There are no validated screening tools to identify the symptoms. Objective: The purpose of this study is to evaluate the validity of the Turkish version of the MDDI and the BIG towards the diagnosis of bigorexia and to provide health care professionals with early screening tools. Methods: One hundred twenty male bodybuilders, fifty-eight professional bodybuilders and sixtytwo recreational bodybuilders, all of whom matched the research criteria, were included in this study.
Int J Psychol Psychoanal Even though muscle dysmorphia MD is classified as a body dysmorphic disorder, it shares similarities with eating disorders ED. The aim of the present study was to explore similarities between men with MD, women with ED, and a control group of men with body related preoccupations, regarding self-esteem, body esteem, and personality traits. Analyses revealed that clinical groups reported lower body esteem, more perfectionism and narcissism than the control group; only the ED group showed a significantly lower self-esteem than the control group. Also, men with MD showed higher self-esteem and body-esteem, as well as a higher level of narcissistic grandiosity than women with ED. Even though, we cannot exclude that gender differences could partly explain these findings, the present results suggested that a preserved self-esteem and a heightened narcissistic grandiosity tend to characterize MD. Muscle dysmorphia, Eating disorders, Self-esteem, Personality, Narcissism.
Appendix A: Checklist for assessing the methodological quality of the studies
Muscle dysmorphia MD is associated with a self-perceived lack of size and muscularity, and is characterized by a preoccupation with and pursuit of a hyper-mesomorphic body. Included studies needed to assess MD using a psychometrically validated assessment tool. Study quality was evaluated using an adapted version of the validated Downs and Black tool. We also extracted data describing psychological or other characteristics associated with MD.
Individuals with MD have a preoccupation with not being sufficiently lean and muscular. According to the DSM-5, individuals with MD are preoccupied with the idea that their body build is too small or insufficiently lean or muscular, even though they have a normal-looking body or are quite muscular. Consequently, they perform repetitive behaviors e. Other DSM-5 diagnostic criteria specify the following necessary traits of the disorder: a appearance preoccupation should cause clinically significant distress or impairment in social, occupational, or other important areas of functioning; and b it should not be better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder. Nevertheless, other studies have failed to find an association between MD and ED symptomatology e.
Metrics details. The drive for muscularity behaviors are very common in male athletes, especially in male bodybuilders. Studies have related drive for muscularity behaviors to body dissatisfaction, eating disorders and muscle dysmorphia. This study applied the trans-contextual model of motivation to the drive for muscularity behaviors of male bodybuilders at risk of developing muscle dysmorphia.
Paterson: , pp Muscle dysmorphia is deemed to be a sub-type of body dysmorphic disorder. It is seen primarily in men who usually perceive themselves as puny, or not muscular enough. In Paterson , muscle dysmorphia is defined as a syndrome seen in both men and boys who feel dissatisfied with their bodies; not believing they are muscular enough. Body dysmorphia occurs almost exclusively in males and is a condition that consists of believing that one cannot be big enough Andersen et al:
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Muscle dysmorphia is an emerging condition that primarily affects male bodybuilders. Such individuals obsess about being inadequately muscular.
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