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Xu Y, Song J, Ren Y, Barnhart WR, Dixit U, Ji F, Chen C, He J. Negative emotional eating patterns in general Chinese adults: A replication and expansion study examining group differences in eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties. Eat Behav 2024; 54:101899. [PMID: 38936286 DOI: 10.1016/j.eatbeh.2024.101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
Previous research identified four patterns of negative emotional eating in American and Chinese university students and proposed future directions (e.g., exploring potential differences in emotion regulation across patterns and replicating the patterns in a general, non-student population). Furthermore, prior research has not explored group differences in muscularity-oriented eating disorder symptomatology or psychosocial impairment. Therefore, the present study addressed these gaps in a sample of general Chinese adults, further testing group differences in typical and muscularity-oriented eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties across patterns of negative emotional eating. A total of 600 Chinese adults were recruited. Latent class analysis (LCA) was used. Results replicated the four patterns of negative emotional eating in previous research, including non-emotional eating (non-EE), emotional over- and under-eating (EOE-EUE), emotional over-eating (EOE), and emotional under-eating (EUE). Significant class differences were identified in eating disorder symptomatology, psychosocial impairment, and emotion regulation difficulties. Specifically, individuals with EOE and EOE-EUE patterns exhibited higher eating disorder symptomatology, higher psychosocial impairment, and more emotion regulation difficulties than those with non-EE and EUE patterns. Therefore, these two classes (i.e., EOE and EOE-EUE), especially the poorly researched EOE-EUE group, should be further examined to elucidate research and clinical applications. Furthermore, findings underscore the role of emotion regulation difficulties in further describing the differences across these negative emotional eating patterns, which can be considered in future interventions for reducing negative emotional eating.
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Affiliation(s)
- Yinuo Xu
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong 518172, PR China.
| | - Jianwen Song
- Department of Education Psychology, Baylor University, Waco, TX, USA.
| | - Yaoxiang Ren
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong 518172, PR China.
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA.
| | - Urvashi Dixit
- Department of Psychology, University of South Alabama, Mobile, AL, USA.
| | - Feng Ji
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada.
| | - Chun Chen
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong 518172, PR China.
| | - Jinbo He
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong 518172, PR China.
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González-Alvarado Y, de Jesús Saucedo-Molina T, Unikel-Santoncini C. Risk of eating disorders in Mexican university students. Acta Psychol (Amst) 2024; 246:104281. [PMID: 38636403 DOI: 10.1016/j.actpsy.2024.104281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVE To determine the distribution of the risk of developing an eating disorder, other psychological variables, body mass index (BMI) and physical activity in Mexican university students. The second aim was to determine the association between the risk of developing an eating disorder and all variables by sex. DESIGN A cross-sectional study was carried out. SETTING The Health Sciences Institute and the Agricultural Sciences Institute within the Autonomous University of Hidalgo State, Mexico. PARTICIPANTS 395 university students (65 % women) aged 18 to 29. ANALYSIS Descriptive, correlational and binary regression model. RESULTS The risk of developing an eating disorder (moderate and high) was 37.3 % for women and 32.6 % for men. A logistic regression analysis of women showed that thin-ideal internalization (12.9 times), BMI (3.5 times) and inactivity (2.6 times) increased the risk of developing an eating disorder. In men, the drive for muscularity (7.5 times) and BMI (2.3 times) increased the risk. CONCLUSION AND IMPLICATIONS The variables associated with the risk of developing an eating disorder differed by sex, except for BMI, which increased the risk in both sexes. Findings should be considered in the design of future interventions to prevent the risk of eating disorders and associated factors.
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Affiliation(s)
- Yazmín González-Alvarado
- Área Académica de Nutrición, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, México.
| | | | - Claudia Unikel-Santoncini
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México.
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Zhang J, Cui S, Xu Y, Cui T, Barnhart WR, Ji F, Nagata JM, He J. Introducing Diagnostic Classification Modeling as an Unsupervised Method for Screening Probable Eating Disorders. Assessment 2024:10731911241247483. [PMID: 38676565 DOI: 10.1177/10731911241247483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Screening for eating disorders (EDs) is an essential part of the prevention and intervention of EDs. Traditional screening methods mostly rely on predefined cutoff scores which have limitations of generalizability and may produce biased results when the cutoff scores are used in populations where the instruments or cutoff scores have not been validated. Compared to the traditional cutoff score approach, the diagnostic classification modeling (DCM) approach can provide psychometric and classification information simultaneously and has been used for diagnosing mental disorders. In the present study, we introduce DCM as an innovative and alternative approach to screening individuals at risk of EDs. To illustrate the practical utility of DCM, we provide two examples: one involving the application of DCM to examine probable ED status from the 12-item Short form of the Eating Disorder Examination-Questionnaire (EDE-QS) to screen probable thinness-oriented EDs and the Muscularity-Oriented Eating Test (MOET) to screen probable muscularity-oriented EDs.
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Affiliation(s)
| | - Shuqi Cui
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yinuo Xu
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | | | | | - Feng Ji
- University of Toronto, Ontario, Canada
| | - Jason M Nagata
- University of California, San Francisco, California, USA
| | - Jinbo He
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
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Rica R, Sepúlveda AR. Going deeper into eating and body image pathology in males: Prevalence of muscle dysmorphia and eating disorders in a university representative sample. EUROPEAN EATING DISORDERS REVIEW 2024; 32:363-377. [PMID: 37966996 DOI: 10.1002/erv.3048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023]
Abstract
Disorders associated with body dissatisfaction such eating disorders (ED) and muscle dysmorphia (MD) in males are understudied and surrounded by controversy regarding their nosological aspects. The current study examined the prevalence rates of clinical cases of ED and MD through a two-phase study with gold standard clinical interview in a representative sample of 850 Spanish undergraduate men, of whom 141 were interviewed. Levels of body dissatisfaction, compulsive exercise, anxious-depressive symptoms and the amount of physical activity were also explored. A prevalence rate for ED of 1.4% and 1.3% for MD was found. No differences were observed between the clinical groups on scales related to body image, supporting the current perspective that MD as well as ED and Body Dysmorphic Disorder could be clustered in a new spectrum of body image disorders, where the behaviours performed to achieve body change could range from restriction or muscularity-oriented eating alterations to pathological exercise or cosmetic surgery. The usefulness of the cut-off points of the screening questionnaires in MD and ED in males are discussed.
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Affiliation(s)
- R Rica
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - A R Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
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Prevention and early intervention in eating disorders: findings from a rapid review. J Eat Disord 2023; 11:38. [PMID: 36899428 PMCID: PMC9999654 DOI: 10.1186/s40337-023-00758-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are complex psychological disorders, with low rates of detection and early intervention. They can lead to significant mental and physical health complications, especially if intervention is delayed. Given high rates of morbidity and mortality, low treatment uptake, and significant rates of relapse, it is important to examine prevention, early intervention, and early recognition initiatives. The aim of this review is to identify and evaluate literature on preventative and early intervention programs in EDs. METHODS This paper is one of a series of Rapid Reviews, designed to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded, and released by the Australian Government. To provide a current and rigorous review, peer-reviewed articles between 2009 and 2021 published in English were searched across three databases: ScienceDirect, PubMed and Ovid/Medline. Priority was given to high-level evidence including meta-analyses, systematic reviews, Randomised Control Trials, and large population studies. Findings from selected studies pertaining to prevention and early intervention in EDs were evaluated and are presented in this review. RESULTS In total, 130 studies were identified in the current review, 72% relating to prevention and 28% to early intervention. Most programs were theory-driven and targeted one or more ED risk factors such as thin-ideal internalisation and/or body dissatisfaction. There is reasonable evidence to support prevention programs reducing risk factors, particularly as part of school or university-based programs, with established feasibility and relatively high acceptance among students. There is increasing evidence around the use of technology (to increase dissemination potential) and for use of mindfulness approaches (targeting emotional resilience). Few longitudinal studies assessing incident cases following participation in a prevention program exist. CONCLUSIONS Although several prevention and early intervention programs have been shown to significantly reduce risk factors, promote symptom recognition, and encourage help-seeking behaviour, most of these studies have been conducted in older adolescent and university aged students, past the age of peak ED onset. One of the most targeted risk factors, body dissatisfaction, is found in girls as young as 6 years old, indicating a need for further research implementing prevention initiatives at younger ages. Follow-up research is limited; thus, the long-term efficacy and effectiveness of studied programs is unknown. Greater attention should be paid to the implementation of prevention and early intervention programs in identified high-risk cohorts or diverse groups, where a more targeted approach may be necessary.
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Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia-a rapid review. J Eat Disord 2023; 11:23. [PMID: 36793104 PMCID: PMC9933292 DOI: 10.1186/s40337-023-00738-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Understanding of the epidemiology and health burden of eating disorders has progressed significantly in the last 2 decades. It was considered one of seven key areas to inform the Australian Government commissioned National Eating Disorder Research and Translation Strategy 2021-2031, as emerging research had highlighted a rise in eating disorder prevalence and worsening burden-of-illness. The aim of this review was to better understand the global epidemiology and impact of eating disorders to inform policy decision-making. METHODS Using a systematic Rapid Review methodology, ScienceDirect, PubMed and Medline (Ovid) were searched for peer-reviewed studies published between 2009 and 2021. Clear inclusion criteria were developed in consultation with experts in the field. Purposive sampling of literature was conducted, which predominately focused on higher-level evidence (meta-analyses, systematic reviews, and large epidemiological studies), synthesised, and narratively analysed. RESULTS 135 studies were deemed eligible for inclusion in this review (N = 1324). Prevalence estimates varied. Global Lifetime prevalence of any eating disorder ranged from 0.74 to 2.2% in males, and 2.58-8.4% in females. Australian 3-month point-prevalence of broadly defined disorders was around 16% in females. Eating disorders appeared more prevalent in young people and adolescents, particularly females (in Australia: eating disorders ~ 22.2%; disordered eating ~ 25.7%). Limited evidence was found on sex, sexuality and gender diverse (LGBTQI +) individuals, particularly males, who had a six-fold increase in prevalence compared to the general male population, with increased illness impact. Similarly, limited evidence on First Australian's (Aboriginal and Torres Strait Islander) suggests prevalence rates similar to non-Indigenous Australians. No prevalence studies were identified specifically assessing culturally and linguistically diverse populations. Global disease burden of any eating disorder was 43.4 age-standardised disability-adjusted-life-years per 100,000; increasing by 9.4% between 2007 and 2017. Australian's total economic cost was estimated at $84 billion from years-of-life lost due to disability and death, and annual lost earnings ~ $1.646 billion." CONCLUSIONS There is no doubt that eating disorder prevalence and impact are on the rise, particularly in at-risk and understudied populations. Much of the evidence came from female-only samples, and Western, high-income countries which more readily have access to specialised services. Future research should examine more representative samples. There is an urgent need for more refined epidemiological methods to better understand these complex illnesses over time, to guide health policy and development-of-care.
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Body image as a global mental health concern. Glob Ment Health (Camb) 2023; 10:e9. [PMID: 36861019 PMCID: PMC9970735 DOI: 10.1017/gmh.2023.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/16/2022] [Accepted: 01/24/2023] [Indexed: 03/03/2023] Open
Abstract
Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data. Given the harmful consequences of body image concerns in terms of mental and physical health, their global burden is high. Interventions to mitigate these concerns at the individual and systemic level are warranted.
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Alhaj OA, Fekih-Romdhane F, Sweidan DH, Saif Z, Khudhair MF, Ghazzawi H, Nadar MS, Alhajeri SS, Levine MP, Jahrami H. The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression. Eat Weight Disord 2022; 27:3215-3243. [PMID: 35925546 PMCID: PMC9362208 DOI: 10.1007/s40519-022-01452-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world. METHODS An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex. RESULTS Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p value = 0.001. Bayesian meta-analysis produced an estimate of 0.24, 95% credible intervals [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased. CONCLUSIONS These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment. LEVEL OF EVIDENCE I, systematic review and meta-analysis.
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Affiliation(s)
- Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- The Tunisian Center of Early Intervention Is Psychiatry, Department of Psychiatry “Ibn Omrane”, Razi Hospital, rue des orangers, Manouba, Tunisia
| | - Dima H. Sweidan
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | | | - Mina F. Khudhair
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Hadeel Ghazzawi
- Nutrition and Food Science Department, Agriculture School, The University of Jordan, P.O.Box 11942, Amman, Jordan
| | - Mohammed Sh. Nadar
- Occasional Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | | | - Michael P. Levine
- Emeritus Professor, Department of Psychology, Kenyon College, Gambier, OH 43022 USA
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Barnhart WR, Cui T, Cui S, Han X, Lu C, He J. Examining appearance pressures, thinness and muscularity internalizations, and social comparisons as correlates of drive for muscularity and thinness-oriented disordered eating in Chinese heterosexual men and women: Testing an integrated model. Body Image 2022; 43:429-439. [PMID: 36345081 DOI: 10.1016/j.bodyim.2022.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Given existing empirical support for the tripartite influence and social comparison models to explain variance in body dissatisfaction and disordered eating across diverse populations in the Western context, research is needed to describe these models in non-Western populations. The present study tested an integrated model inclusive of appearance pressures, thinness and muscularity internalizations, and social comparisons in relation to drive for muscularity and thinness-oriented disordered eating in heterosexual Chinese adult men (n = 510) and women (n = 473). Separated by gender, two integrated models had good fit statistics per structural equation modeling. In men and women, higher appearance pressures were uniquely related to higher drive for muscularity and thinness-oriented disordered eating. In men and women, higher thinness and muscularity internalizations were uniquely related to higher thinness-oriented disordered eating and drive for muscularity, respectively. In men and women, higher upward body image comparisons were uniquely related to higher drive for muscularity, and in men only, higher downward body image comparisons were uniquely related to higher thinness-oriented disordered eating. The present findings, which extend theories of eating pathology, may aid in improving treatment efforts for body dissatisfaction and disordered eating in heterosexual Chinese adult men and women.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Tianxiang Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China; Department of Psychology, University of Macau, Taipa, Macau, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Xinni Han
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Chen Lu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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Jabali O, Saeedi M, Rabayaa M, Othman N. Zoom dysmorphia in e-teaching: shifting the value from attributes to appearance. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 28:6781-6799. [PMID: 36465426 PMCID: PMC9684764 DOI: 10.1007/s10639-022-11470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 05/25/2023]
Abstract
The current study is motivated by Tory Higgins's self-discrepancy theory and the objectification theory. It aimed to investigate university staff members' perspectives towards zoom dysmorphia while involved in e-teaching during the Covid-19 Pandemic in terms of its popularity, causes, and instructors' experiences with the healing or eliminating mechanisms. Put simply, the researchers meant to identify the impact of the pandemic on body image and the long-term repercussions of e-teaching on instructors' quality. A descriptive online questionnaire was compiled to explore the way (630) university staff members having academic and academic/administrative positions evaluate, perceive, and handle zoom dysmorphia while teaching online. The study results showed several associations between the variables studied. Gender was significant because females proved to have more features of dysmorphia; faculty members who serve in scientific faculties also proved to expect more features of dysmorphia as they tended not to turn on their cameras. The study results also showed that sufferers of zoom dysmorphia warranted that their appearances occasionally made them feel insecure and occupationally unstable. Therefore, they tried different healing mechanisms to eliminate or, at least, reduce its traits. The study concluded that the prevalence of zoom dysmorphia may result in shifting the value from good, effective attributes (e.g., professionalism, adaptability, collaboration, empathy, and patience) of instructors to merely outside physical appearances. The researchers recommend that educators should elicit the presence of zoom dysmorphia at an early stage. They should prepare courses to improve instructors' self-confidence, and provide them with proper technical experience.
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Affiliation(s)
- Oqab Jabali
- Language Center, Faculty of Humanities, An-Najah National University, Nablus, Palestine
| | - Munther Saeedi
- Language Center, Faculty of Humanities, An-Najah National University, Nablus, Palestine
| | - Maha Rabayaa
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Nihad Othman
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Use of online and paper-and-pencil questionnaires to assess the distribution of orthorexia nervosa, muscle dysmorphia and eating disorders among university students: can different approaches lead to different results? Eat Weight Disord 2022; 27:989-999. [PMID: 34110598 PMCID: PMC8190766 DOI: 10.1007/s40519-021-01231-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/28/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Administration of questionnaires to assess the diffusion of disordered eating behaviours via the web is becoming common today. The aim of this study is to assess whether two different approaches of administering a test to assess traits of eating disorders (EDs), orthorexia nervosa (ON) and muscle dysmorphia (MD) by email recruitment and online completion (web-based survey-WBS) and by in person recruitment and paper-and-pencil completion (paper-based survey-PBS), gives different results. METHODS During 2 consecutive academic years, a self-reported questionnaire consisting of questions about personal characteristics and three tests for the evaluation of ON (ORTO-15), MD (MDDI-ITA), and EDs (EAT-26) were administered to two groups of undergraduates, respectively, as a WBS and a PBS. RESULTS The WBS response rate was 6.7% (N = 137), and the PBS response rate was 86.5% (N = 372). The WBS group showed a statistically significant higher prevalence of students with eating disordered behaviours (21.2% vs 5.4%) and registered a higher mean score on the EAT-26 test (13.5 ± 11.1 vs 6.0 ± 8.0); no differences between the two groups emerged for ON and MD prevalence and test scores. Moreover, in the WBS group, the number of students with one or more tests with test scores above the cut-off values was significantly higher (46.0% vs 32.3%). CONCLUSION The choice of the approach to administer a questionnaire to assess the diffusion of EDs and related issues must take into account all the factors that can result in selection bias and that can affect the reliability of the results. LEVEL OF EVIDENCE Level V, descriptive cross-sectional survey.
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de Carvalho PHB, Bagolin V, Junqueira ACP, Nagata JM, Cattle CJ, Murray SB, Compte EJ, Costa TMB, Almeida SS, Laus MF. Validation and measurement invariance of the muscularity-oriented eating test among Brazilian men and women. Int J Eat Disord 2022; 56:708-720. [PMID: 35277978 DOI: 10.1002/eat.23702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Muscularity-Oriented Eating Test (MOET) is a 15-item unidimensional scale, designed to assess eating practices that occur in the pursuit of a muscular body. The aim of the present study was to describe the translation and cultural adaptation of the MOET to Brazilian Portuguese, to explore its factor structure and measurement invariance, and to evaluate its internal consistency, three-week test-retest reliability, and convergent validity in a community sample of Brazilian men and women. METHOD After the back-translation procedure, the Brazilian MOET was administered online to a sample of 1246 adults (634 men and 612 women), along with measures of drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating behaviors, and exercise dependence. RESULTS Findings from an exploratory factor analysis and a confirmatory factor analysis revealed a one-factor structure and adequate internal consistency for men (ω = 0.86; α = 0.86) and women (ω = .84; α = .83). Measurement invariance across gender was supported. In addition, the scale demonstrated good three week test-retest reliability for both men (ICC = .96; p < .001) and women (ICC = .92; p < .001), and the subscales revealed moderate to large associations with drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating, and exercise dependence. CONCLUSION This study supports the validity and reliability of the MOET in a community sample of Brazilian men and women and represents an advance in measures of muscularity-oriented disordered eating in Brazilian adults, allowing for future cross-cultural studies in this field. PUBLIC SIGNIFICANCE The Muscularity-Oriented Eating Test (MOET) is a measure of muscularity-oriented disordered eating, which assess strict adherence to diet rules, including the food's macronutrient content, regulation of protein intake, and eating less or more to influence muscle gain. This study evaluated the validity and reliability of the MOET in a community sample of Brazilian men and women. Our findings represent an advance in measures of muscularity-oriented disordered eating in Brazilian adults.
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Affiliation(s)
- Pedro Henrique Berbert de Carvalho
- NICTA, Body Image and Eating Disorders Research Group, Federal University of Juiz de Fora, Governador Valadares, Brazil.,AMBULIM, Eating Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Vitoria Bagolin
- Department of Nutrition, University of Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Chloe J Cattle
- Department of Pediatrics, University of California, San Francisco, California, USA
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Emilio J Compte
- Eating Behavior Research Center, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile.,Research Department, Comenzar de Nuevo Treatment Center, Monterrey, Mexico
| | - Telma Maria Braga Costa
- Department of Nutrition, University of Ribeirão Preto, Ribeirão Preto, Brazil.,Department of Psychology, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Maria Fernanda Laus
- Department of Nutrition, University of Ribeirão Preto, Ribeirão Preto, Brazil.,Department of Psychology, University of São Paulo, Ribeirão Preto, Brazil
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Compte EJ, Nagata JM, Sepúlveda AR, Silva BC, Cortes C, Bidacovich G, Brown TA, Blashill AJ, Lavender JM, Mitchison D, Mond JM, Castillo I, López PL, Muiños R, Rutsztein G, Torrente F, Murray SB. Development and validation of a multicultural Spanish-language version of the Muscularity-Oriented Eating Test (MOET) in Argentina. Eat Behav 2021; 43:101542. [PMID: 34492593 DOI: 10.1016/j.eatbeh.2021.101542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022]
Abstract
The utility of traditional eating disorder measures in the assessment of muscularity-oriented disordered eating has been questioned. To address this limitation, the Muscularity-Oriented Eating Test (MOET) was recently developed and validated in a sample of U.S. college men. We aimed to develop a multicultural Spanish-language version of the MOET for use in Latin American samples and validate its use in a sample of Argentinian college men. Combined translation procedures were used to develop a version suitable for different Spanish-speaking populations. A total of 235 students (Mage = 23.47, SD = 5.61) participated in this study by completing a survey including the MOET. A sub-sample (n = 121) completed the MOET again after 1 week. A confirmatory factor analysis of a re-specified model of the original single-factor MOET, allowing for residual correlation between items associated to dietary rules (items 4-12), resulted in an adequate fit (χ2/df = 2.10, CFI = 0.94, TLI = 0.93, RMSEA 0.05 [90% CI = 0.04, 0.06] SRMR = 0.08). Further, the multicultural Spanish-language version of the MOET yielded evidence of internal consistency (omega = 0.83, 95% CI [0.79, 0.88], Cronbach's α = 0.83), a 1-week Intraclass Correlation Coefficient was considered for test-retest reliability (ICC = 0.82), item analysis, convergent validity with measures of eating disorder psychopathology, body dissatisfaction and weight-related behaviors, as well as for divergent validity with an unrelated construct. The availability of a multicultural Spanish-language version of the MOET may have utility in both clinical and research efforts related to muscularity-oriented disordered eating among Latino men.
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Affiliation(s)
- Emilio J Compte
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; School of Human and Behavioral Science, Favaloro University, Buenos Aires, Argentina; Eating Behavior Research Center (CECA), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile; Research Department, Comenzar de Nuevo Treatment Center, Monterrey, Mexico
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Ana R Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - B Camila Silva
- School of Human and Behavioral Science, Favaloro University, Buenos Aires, Argentina
| | - Camila Cortes
- School of Human and Behavioral Science, Favaloro University, Buenos Aires, Argentina
| | - German Bidacovich
- School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, CA, USA; San Diego State/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Metis Foundation, San Antonio, TX, USA
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia; Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Jonathan M Mond
- Center for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Irais Castillo
- Nutrition Program, Nursing School, Autonomous University of Zacatecas, Mexico
| | - Pablo L López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Roberto Muiños
- School of Psychology, University of Buenos Aires, Buenos Aires, Argentina; School of Statistics - National University of Tres de Febrero, Buenos Aires, Argentina
| | | | - Fernando Torrente
- Center for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA.
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14
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de Moraes CEF, Appolinário JC, Mourilhe C, de Freitas SR, da Veiga GV. Reliability of the Brazilian version of the questionnaire on eating and weight patterns-5 (QEWP-5). Eat Weight Disord 2021; 26:2463-2470. [PMID: 33479922 DOI: 10.1007/s40519-020-01072-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/12/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The Questionnaire on Eating and Weight Patterns-5 (QEWP-5) is a self-report instrument developed to screen individuals for binge eating disorder (BED) and bulimia nervosa (BN) as diagnosed by the DSM-5. This instrument was cross-culturally adapted for the Brazilian Portuguese and well understood by the target sample. The present study aimed to assess the test-retest reliability of the Brazilian version of QEWP-5 in a sample of undergraduate students from Dietitian and Psychology courses. METHODS The Brazilian version of QEWP-5 was administered to a sample of 345 male and female undergraduate students, from dietitian (n = 179) and psychology (n = 166) courses. The instrument was applied twice with a time interval of 2 weeks between the applications. The kappa coefficient was used to assess the temporal stability of the questionnaire in the screening of BED and BN. RESULTS Overall, the kappa coefficient for the screening of BED was .48, and for the screening of BN was .71. In the dietitian course, the temporal stability was .60 (for the assessment of BED) and .80 (for BN). In the psychology course, the kappa values for the assessment of BED and BN were .27 and .60, respectively. All values were statistically significant (p < .001). CONCLUSION In general, the stability of the Brazilian version of QEWP-5 was considered moderate to assess BED and substantial for the screening of BN in undergraduate students. Stratifying by course, the questionnaire had higher stability for the assessment of BED and BN in dietitian students. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. .,Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil.
| | - José Carlos Appolinário
- Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil
| | - Carla Mourilhe
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil
| | - Sílvia Regina de Freitas
- Psychiatry Institute (IPUB), Group of Obesity and Eating Disorders (GOTA), Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 fundos, Campus Praia Vermelha, Botafogo, Rio de Janeiro, 22290-140, RJ, Brazil.,State Institute of Diabetes e Endocrinology (IEDE), Rio de Janeiro, RJ, Brazil
| | - Glória Valéria da Veiga
- Josué de Castro Nutrition Institute (INJC), Department of Social and Applied Nutrition (DNSA), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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15
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Caliskan G, Alim NE. Validity and Reliability of the Muscularity Oriented Eating Test (MOET) in Turkish. Am J Health Behav 2021; 45:856-866. [PMID: 34702433 DOI: 10.5993/ajhb.45.5.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: In this study, we determine the validity and reliability of the Muscularity Oriented Eating Test (MOET) among Turkish university students, thereby creating the MOET-TR. Methods: First, the MOET was translated by using the translation-back translation method for cultural equivalence. Then, the validity and reliability analyses were performed on 460 university students. To analyze the stability of the scale over time, the MOET-TR was applied to approximately 20% of the sample number for a second time after 2-4 weeks. Results: The one-factor structure of the MOET-TR demonstrated a good agreement with the fix index values. Cronbach's for the MOET-TR was 0.88, and the ICC value was 0.84. In addition, we found a positive statistically significant relationship between the total scores obtained from the DMS, EAT-40, REZZY, and IPAQ-Short forms used to evaluate the convergent divergent validity of the MOET-TR (p < .05). Conclusions: The MOET-TR is suitable for the Turkish culture and can be used to identify individuals who have muscularity oriented eating disorders, who are uncomfortable with their body shape, and who turn their body shapes into a social phobia.
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Affiliation(s)
- Gozde Caliskan
- Gozde Caliskan, Research Assistant, Mus Alparslan University, Department of Nutrition and Dietetics, Mus, Turkey;,
| | - Nural Erzurum Alim
- Nural Erzurum Alim, Assistant Professor, Ankara Yildirim Beyazit University, Department of Nutrition and Dietetics, Ankara, Turkey
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16
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Mulrooney KJD, Collins R, Darkes J. Testosterone, identity and the body: Exploring cultural definitions of disorder. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 95:103366. [PMID: 34412937 DOI: 10.1016/j.drugpo.2021.103366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 05/17/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022]
Abstract
Medically-sanctioned testosterone administration has seen increasingly widespread application in the treatment of gender dysphoria (GD). Yet, by comparison, this approach is not medically accepted for those who are experiencing muscle dysmorphia (MD), a specifier of body dysmorphic disorder (BDD), despite both conditions reflecting incongruences between self-perception, identity and phenotype, and both currently being classified as mental health disorders. Rather, by stark contrast, those with MD are largely treated with psychological intervention to accept themselves as they physically are and the illicit use of testosterone for muscle-related body perception purposes is generally subject to criminal justice enforcement actions. In this commentary, we examine attempts to distinguish between the use of testosterone for gender-affirming hormone therapy in the case of GD and for aesthetic (muscle enhancement) use in the case of MD, as well as explore the implications of this disparity. Moreover, we consider how such disparity in policy and practice may be understood, in part, as an example of a bias reflecting the selective pathologizing of anabolic-androgenic steroid (AAS) use, socio-cultural evolutions in gender identity and expression and, more broadly, the manner in which culture defines disorder and its appropriate response.
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Affiliation(s)
- Kyle J D Mulrooney
- Human Enhancement Drugs Network (HEDN), NSW, Australia; School of Humanities, Arts, Social Sciences and Education, University of New England, Armidale, NSW 2350, Australia.
| | - Rick Collins
- Collins Gann McCloskey & Barry PLLC, New York, United States
| | - Jack Darkes
- Department of Psychology, University of South Florida, United States
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17
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Gorrasi ISR, Bonetta S, Roppolo M, Abbate Daga G, Bo S, Tagliabue A, Ferraris C, Guglielmetti M, Arpesella M, Gaeta M, Gallé F, Di Onofrio V, Liguori F, Liguori G, Gilli G, Carraro E. Traits of orthorexia nervosa and muscle dysmorphia in Italian university students: a multicentre study. Eat Weight Disord 2020; 25:1413-1423. [PMID: 31529388 DOI: 10.1007/s40519-019-00779-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study aimed to evaluate the prevalence of traits of orthorexia nervosa (ON) and muscle dysmorphia (MD) in a group of undergraduates, investigate the associations between the risk of these conditions and the type of university course attended, the individual characteristics (gender, BMI, amount of physical activity, supplements and medicines use, dieting) and the risk of eating disorders (EDs). METHODS A self-reported questionnaire consisting of a socio-demographic section and three tests validated for the evaluation of a risk of ON (ORTO-15), MD (MDDI-ITA) and EDs (EAT-26) was completed by 918 students from three Italian universities. RESULTS 29.0% of participants demonstrated traits of ON and 5.0% of MD, without differences in prevalence in the three areas of study investigated (health-scientific, economic-humanistic, sport sciences); students of sport sciences exhibited a significantly higher score for MDDI-ITA (F = 6.493, p = 0.002). Participants with ON and MD traits were more on a diet (OR = 0.47, p ≤ 0.001 and OR = 0.428, p = 0.020, respectively) and showed a higher prevalence of EDs risk (OR = 3.55, p < 0.001 and OR = 10.23, p ≤ 0.001, respectively). The simultaneous presence of ON, MD, and EDs traits was seen in 5.4% of the students and the three test scores were correlated. CONCLUSIONS The prevalence of ON and MD traits was found similar to that reported in the literature on undergraduates. Some associations observed improvement in the knowledge about these conditions, especially the association of participants with ON and MD traits with dieting and EDs traits and the correlation of the three test scores suggests a connection among these potential conditions. LEVEL OF EVIDENCE Level V, descriptive cross-sectional survey.
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Affiliation(s)
| | - Silvia Bonetta
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Mattia Roppolo
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Giovanni Abbate Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Simona Bo
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - Anna Tagliabue
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Cinzia Ferraris
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Monica Guglielmetti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Marisa Arpesella
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100, Pavia, Italy
| | - Francesca Gallé
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina, 40, 80133, Naples, Italy
| | - Valeria Di Onofrio
- Department of Sciences and Technologies, University of Naples "Parthenope", Business District, Block C4, 80143, Naples, Italy
| | - Fabrizio Liguori
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina, 40, 80133, Naples, Italy
| | - Giorgio Liguori
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina, 40, 80133, Naples, Italy
| | - Giorgio Gilli
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Turin, Via Santena 5bis, 10126, Turin, Italy
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18
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Duran S, Çiçekoğlu P, Kaya E. Relationship between orthorexia nervosa, muscle dysmorphic disorder (bigorexia), and self-confidence levels in male students. Perspect Psychiatr Care 2020; 56:878-884. [PMID: 32227487 DOI: 10.1111/ppc.12505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/27/2020] [Accepted: 03/18/2020] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Songül Duran
- Vocational School of Health Services, Elderly Care Program, Izmir Demokrasi University, Izmir, Turkey
| | - Pınar Çiçekoğlu
- Department of Nursing, Faculty of Health Sciences, Muğla Sıtkı Koçman University Fethiye, Muğla, Turkey
| | - Erdi Kaya
- Department of Recreation, Faculty of Sport Sciences, Akdeniz University, Antalya, Turkey
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19
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Cooper M, Eddy KT, Thomas JJ, Franko DL, Carron-Arthur B, Keshishian AC, Griffiths KM. Muscle dysmorphia: A systematic and meta-analytic review of the literature to assess diagnostic validity. Int J Eat Disord 2020; 53:1583-1604. [PMID: 32737999 DOI: 10.1002/eat.23349] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Although muscle dysmorphia (MD) is a new addition to DSM-5 as a specifier of body dysmorphic disorder (BDD), previous studies have treated MD as a stand-alone diagnosis. We aimed to assess the validity of MD as a stand-alone diagnosis via systematic and meta-analytic review of MD literature using both Robins and Guze criteria and additional criteria from Kendler. METHOD We performed a systematic search of ProQuest, PsycInfo, and PubMed databases for the period of January 1993 to October 2019 resulting in 40 papers to examine Robins and Guze's criteria (clinical picture) as well as those added by Kendler (antecedent validators; concurrent validators; predictive validators). RESULTS We identified two distinct symptomatic presentations of MD using cluster analysis, a behavioral type and cognitive/behavioral type. For examining the concurrent validators, quantitative meta-analyses differentiated MD populations from controls; however, results were inconclusive in delineating MD from existing disorders. For assessing antecedent and predictive validators, the symptomatic profiles, treatment response, and familial links for MD were similar to those for BDD and for eating disorders. DISCUSSION We found preliminary support for MD as a clinically valid presentation, but insufficient evidence to determine whether it is best categorized as a specifier of BDD or unique psychiatric condition.
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Affiliation(s)
- Marita Cooper
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Northeastern University, Boston, Massachusetts, USA
| | - Bradley Carron-Arthur
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia
| | - Ani C Keshishian
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Kathleen M Griffiths
- Research School of Psychology, Australian National University, Canberra, Australia
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20
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Riccobono G, Pompili A, Iorio C, Carducci G, Parnanzone S, Pizziconi G, Iannitelli A, Pacitti F. An instrument for the evaluation of muscle dysmorphia: The Italian validation of the adonis complex questionnaire. Brain Behav 2020; 10:e01666. [PMID: 32469110 PMCID: PMC7375086 DOI: 10.1002/brb3.1666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/21/2020] [Accepted: 04/25/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIMS Muscle dysmorphia (MDM), or bigorexia, is a subcategory of body dysmorphic disorder (BDD), also known as "Adonis Complex" in nonscientific contexts. One of the most used tools to investigate MDM is the Adonis Complex Questionnaire (ACQ). The ACQ is a 13-item US questionnaire, designed for male subjects only, related to the dissatisfaction and concerns about physical appearance. The aim of the current study was to evaluate the validity of the Italian version of the ACQ. METHODS The instrument was administered to a sample of 322 male adults, recruited from the general population. We used the maximum-likelihood confirmatory factorial analysis (CFA), analyzing the covariance matrices with AMOS 24.0, to evaluate the different factorial models proposed in the literature. RESULTS The evaluation of the factorial structure of the Italian version of the ACQ demonstrates the greater stability and internal consistency of the two-factor model, compared to the original three-factor model. The factors have no correlation with the demographic characteristics of the sample. CONCLUSIONS The present study confirms the validity and the reliability of the Italian two-factor version of the ACQ and highlights the general tendency, among Italian males, to have concerns about their own physical appearance with recurring thoughts and eating behaviors finalized to improve it. Our study represents an advance in the use of adequate and reliable instruments to assess concerns about physical appearance in the Italian male population.
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Affiliation(s)
- Giulia Riccobono
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Assunta Pompili
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Carla Iorio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Giorgio Carducci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Serena Parnanzone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Giulia Pizziconi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Angela Iannitelli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Coppito (AQ), Italy
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21
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Hirsch KE, Blomquist KK. Community-Based Prevention Programs for Disordered Eating and Obesity: Updates and Current Limitations. Curr Obes Rep 2020; 9:81-97. [PMID: 32445131 DOI: 10.1007/s13679-020-00373-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW To review the status of community-based disordered eating and obesity prevention programs from 2014 to 2019. RECENT FINDINGS In the last 5 years, prevention programs have found success in intervening with children and parental figures in wellness centers, physical activity centers, childcare centers, workplaces, online, and over-the-phone through directly reducing disordered eating and obesity or by targeting risk factors of disordered eating and obesity. Community-based prevention programs for disordered eating and programs targeting both disordered eating and obesity were scarce, highlighting the critical need for the development of these programs. Qualities of the most effective programs were those in which parents and children were educated on physical activity and nutrition via multiple group-based sessions. Limitations of current prevention programs include few programs targeting high-risk populations, a dearth of trained community members serving as facilitators, inconsistent reporting of adherence rates, and few direct measurements of disordered eating and obesity, as well as few long-term follow-ups, precluding the evaluation of sustained effectiveness.
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Affiliation(s)
- Katherine E Hirsch
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada
| | - Kerstin K Blomquist
- Department of Psychology, Furman University, 3300 Poinsett Highway, Greenville, SC, 29613, USA.
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22
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Murray SB, Brown TA, Blashill AJ, Compte EJ, Lavender JM, Mitchison D, Mond JM, Keel PK, Nagata JM. The development and validation of the muscularity-oriented eating test: A novel measure of muscularity-oriented disordered eating. Int J Eat Disord 2019; 52:1389-1398. [PMID: 31343090 DOI: 10.1002/eat.23144] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Body dissatisfaction is intricately linked to the development of disordered eating. However, as male body dissatisfaction appears more oriented toward muscularity, versus thinness per se, existing measures of eating disorder psychopathology may lack sensitivity in capturing disordered eating that is muscularity-focused. The aim of the present study was to develop a specific measure of muscularity-oriented disordered eating-the muscularity-oriented eating test (MOET). METHOD Candidate items were generated and refined in consultation with eating disorder-focused researchers and focus groups of men with eating disorders. Examination of the MOET comprised two studies, consisting of 511 undergraduate men, divided into two component samples. In Study 1 (n = 307), candidate items were generated and refined via exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was then used to confirm the single factor structure in Study 2 (n = 204). RESULTS EFA revealed a 15-item single factor structure, which was later confirmed through CFA in a separate sample of undergraduate men. Furthermore, the MOET yielded evidence of internal consistency (Study 1: omega = 0.93, 95% CI [0.91, 0.94]; Study 2: omega = 0.92, 95% CI [0.90, 0.93]), 7-day (Study 1) and 21-days (Study 2) test-retest correlation (rs = .75, for Study 1 and 2) and convergent and divergent validity. DISCUSSION The MOET represents a psychometrically sound, novel measure of muscularity-oriented disordered eating. Future research should examine its utility in clinical samples and research into muscularity-oriented disordered eating.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Tiffany A Brown
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, California.,San Diego State/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Emilio J Compte
- Department of Psychiatry, University of California, San Francisco, San Francisco, California.,School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina.,Eating Disorders Team, Fundación Foro, Buenos Aires, Argentina
| | - Jason M Lavender
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.,Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jonathan M Mond
- Center for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California
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23
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Compte EJ, Nagata JM, Sepúlveda AR, Rivas A, Sbdar LS, Menga S, Rica R, Torrente F, Murray SB. Assessment and validation of a Spanish version of the Muscle Dysmorphia Disorder Inventory in Argentinian men who exercise: Inventario de Dismorfia Muscular. Body Image 2019; 31:24-34. [PMID: 31430602 DOI: 10.1016/j.bodyim.2019.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 12/19/2022]
Abstract
Despite an increase in body dissatisfaction and muscularity concerns among Latin American men, there is a paucity of research relating to muscle dysmorphia in this population. In this study we aimed to evaluate, for the first time in Latin America, the factor structure of the Muscle Dysmorphic Disorder Inventory (MDDI; Hildebrandt, Langenbucher, & Schlundt, 2004). A sample of 551 men who exercise completed measures of body dissatisfaction, disordered eating, and the MDDI. Exploratory factor analysis in a first split-half sample revealed a 3-factor solution similar to the original version, which was then tested through confirmatory factor analysis (CFA) in a second split-half sample. A re-specified model (allowing for error correlations between Items 10-13 and 11-13) presented adequate fit. Omega coefficients revealed adequate internal consistency (> .80) for the Drive for Size and Functional Impairment subscales. The internal consistency for the Appearance Intolerance subscale was .74 and .72 across subset samples. Associations with body dissatisfaction, disordered eating, body mass index, and frequency of training and rest days are presented as evidence of construct validity. Finally, multi-group CFA indicated that the model was invariant across type of exercise. Overall, these data suggest that the MDDI is suitable for use in Spanish-speaking Latin American male populations.
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Affiliation(s)
- Emilio J Compte
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina; DBT-Eating Disorders Team, Fundación Foro, Buenos Aires, Argentina.
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Ana R Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Andrés Rivas
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Lara S Sbdar
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Sol Menga
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Robin Rica
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Fernando Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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24
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Arellano-Pérez OG, Vázquez-Cervantes MJ, Fernández Cortés TL, Saucedo-Molina TDJ. Drive for muscularity and disordered eating behaviors and its relationship with anthropometric indicators and physical activity in Mexican adolescent men. Eat Weight Disord 2019; 24:661-670. [PMID: 31243740 DOI: 10.1007/s40519-019-00736-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 06/13/2019] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Adolescent men have been identified as a risk population to develop eating disorders and other psychopathologies as drive for muscularity (DM) recently considered as muscularity-oriented disordered eating. It is important to identify risk factors as precursors of these pathologies. The aim of this study was to determine the risk of developing disordered eating behaviors (DEB) and DM and its relationship with anthropometric indicators and physical activity (PA) in adolescent men (high-school students, age 15-19) from Hidalgo, Mexico. METHODS A cross sectional, descriptive, and correlational field study was carried out in a non-probabilistic sample of 267 Mexican adolescents aged 15-19 years. Participants completed measures of DM, DEB, and PA. Each subject was weighted and heighted to calculate body mass index (BMI), body fat percentage, and fat-free mass index (FFMI). RESULTS Adolescents in the DM risk category (OR 8.28, CI 2.71-25.22) had significantly greater odds of developing DEB, while adolescents with higher BMI scores (OR 1.28, CI 1.14-1.45) tended to be more likely of developing DEB. The results showed that DEB and moderate PA were associated with DM; adolescents who engaged in DEB had an 8.64 times (CI 3.05-24.52) higher risk of developing DM. Participants classified in the category of highest moderate PA (OR 2.66, CI 1.26-5.59) had significantly greater odds of developing DM. CONCLUSION Important percentages of the risk of developing DEB and DM were determined in Mexican adolescent men. In agreement with other findings, there were no associations between anthropometric indicators and DM. LEVEL OF EVIDENCE V, descriptive cross-sectional study.
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Affiliation(s)
- Orquidea Galdina Arellano-Pérez
- Área Académica de Nutrición, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Abasolo # 600 Colonia Centro, 42000, Pachuca de Soto, Hidalgo, Mexico
| | - Michelle Jhovana Vázquez-Cervantes
- Área Académica de Nutrición, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Abasolo # 600 Colonia Centro, 42000, Pachuca de Soto, Hidalgo, Mexico
| | - Trinidad Lorena Fernández Cortés
- Área Académica de Nutrición, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Abasolo # 600 Colonia Centro, 42000, Pachuca de Soto, Hidalgo, Mexico
| | - Teresita de Jesús Saucedo-Molina
- Área Académica de Nutrición, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Abasolo # 600 Colonia Centro, 42000, Pachuca de Soto, Hidalgo, Mexico.
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25
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Compte EJ, Nagata JM, Sepúlveda AR, Schweiger S, Sbdar LS, Silva BC, Bressan M, Rivas A, Menga S, Cortes C, Bidacovich G, López PL, Muiños R, Rutsztein G, Torrente F, Murray SB. Confirmatory factor analysis and measurement invariance of the eating disorders examination-questionnaire across four male samples in Argentina. Int J Eat Disord 2019; 52:740-745. [PMID: 30912863 DOI: 10.1002/eat.23075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/09/2019] [Accepted: 03/10/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The eating disorder examination-questionnaire (EDE-Q) is among the most widely used instruments in eating disorder research and clinical practice. However, the underlying structure remains a source of confusion, and contradictory results have emerged in studies among male populations. In the current study, we examined previously proposed models of EDE-Q structure in four community samples of Argentinian men. METHOD A series of confirmatory factor analyses (CFAs) were performed for five previous factor structure models of the EDE-Q among 232 Argentinian male university students, 277 weightlifters, 275 cross-fit users, and 202 athletes. A multigroup CFA was conducted in the model we retained, to assess measurement invariance across groups. RESULTS A respecified model of the brief eight-item one-factor proposal provided acceptable fit to the data over the original four-factor structure and three other proposed models. Results from the multigroup CFA showed that the retained model was invariant across samples. CONCLUSION Our results provide support for retaining a one-factor EDE-Q structure over a multifactor solution for research purposes among male community samples in Argentina. These data underscore the importance of undertaking psychometric assessment of eating disorder symptom measures before their utilization in specific populations.
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Affiliation(s)
- Emilio J Compte
- Department of Psychiatry, University of California, San Francisco, California.,School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina.,DBT-Eating Disorders Team, Fundación Foro, Buenos Aires, Argentina
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California
| | - Ana R Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Sofia Schweiger
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Lara S Sbdar
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Bárbara Camila Silva
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Michelle Bressan
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Andrés Rivas
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Sol Menga
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Camila Cortes
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - German Bidacovich
- School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - Pablo L López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Roberto Muiños
- School of Psychology, University of Buenos Aires, Buenos Aires, Argentina.,School of Statistics - Department of Scientific Methodology and Epistemology, National University of Tres de Febrero, Buenos Aires, Argentina
| | | | - Fernando Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, California
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26
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Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr 2019; 109:1402-1413. [PMID: 31051507 DOI: 10.1093/ajcn/nqy342] [Citation(s) in RCA: 582] [Impact Index Per Article: 116.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/30/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern. OBJECTIVES The aim of this study was to give an exhaustive view of the studies reporting the prevalence of the different EDs or total EDs and to study their evolution. METHODS A literature search following PRISMA Guidelines and limited to studies in English or French published between 2000 and 2018 was performed and relevant studies were included in this systematic review on the prevalence of EDs. The literature search revealed 94 studies with accurate ED diagnosis and 27 with broad ED diagnosis. RESULTS In 94 studies with accurate ED diagnosis, the weighted means (ranges) of lifetime ED were 8.4% (3.3-18.6%) for women and 2.2% (0.8-6.5%) for men. The weighted means (ranges) of 12-month ED prevalence were 2.2% (0.8-13.1%) for women and 0.7% (0.3-0.9%) for men. The weighted means (ranges) of point prevalence were 5.7% (0.9-13.5%) for women and 2.2% (0.2-7.3%) for men. According to continents, the weighted means (ranges) of point prevalence were 4.6% (2.0-13.5%) in America, 2.2% (0.2-13.1%) in Europe, and 3.5% (0.6-7.8%) in Asia.In addition to the former, 27 other studies reported the prevalence of EDs as broad categories resulting in weighted means (ranges) of total point prevalence of any EDs of 19.4% (6.5-36.0%) for women and 13.8% (3.6-27.1%) for men. CONCLUSIONS Despite the complexity of integrating all ED prevalence data, the most recent studies confirm that EDs are highly prevalent worldwide, especially in women. Moreover, the weighted means of point ED prevalence increased over the study period from 3.5% for the 2000-2006 period to 7.8% for the 2013-2018 period. This highlights a real challenge for public health and healthcare providers.
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Affiliation(s)
- Marie Galmiche
- TargEDys SA, Rouen, France.,Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,Department of Nutrition, Rouen University Hospital, Rouen, France
| | - Pierre Déchelotte
- Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,Department of Nutrition, Rouen University Hospital, Rouen, France
| | | | - Marie Pierre Tavolacci
- Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,ClC-CRB 1404, Rouen University Hospital, Rouen, France
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27
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Zeeck A, Welter V, Alatas H, Hildebrandt T, Lahmann C, Hartmann A. Muscle Dysmorphic Disorder Inventory (MDDI): Validation of a German version with a focus on gender. PLoS One 2018; 13:e0207535. [PMID: 30444914 PMCID: PMC6239320 DOI: 10.1371/journal.pone.0207535] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022] Open
Abstract
Muscle dysmorphia (MD) is a condition that is characterized by body image disturbance, a drive for muscularity and excessive exercising. It leads to considerable functional impairment. Most previous studies focused on male samples. The study aimed to validate a German version of the Muscle Dysmorphic Disorder Inventory (MDDI) in order to make the instrument available in German speaking countries. We further aimed to explore for gender differences in the MDDI factors (measurement invariance) and to assess the relationship between MD and positive dimensions of body experience as well as exercise dependence. 394 participants (53% females, mean age 24.3 years) took part in an internet-based survey. The three-factor structure of the English version of the MDDI was replicated, independent of gender (multi group CFA; Base model TLI = .961; CFI = .970). Cronbach´s alpha was .81-.84 for the subscales and .75 for the MDDI total score. MD was associated with exercise dependence and negatively correlated with dimensions of positive body experience, which can be considered relevant for satisfying relationships and a positive sense of self: e.g. body contact and sexual fulfillment. Men and women showed differences in two subscales of the MDDI (appearance intolerance, drive for size). Testing for measurement invariance resulted in weak invariance: Equivalent factor structure for men and women, but significantly different loadings and coefficients. No statistically significant difference in the MDDI total score was found. The findings suggest good psychometric properties of the German version of the MDDI. Future studies should address the question of cut-off scores and norms for different samples as well as a possible overlap between MD and eating disorder psychopathology in women.
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Affiliation(s)
- Almut Zeeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Viola Welter
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hasan Alatas
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tom Hildebrandt
- Eating and Weight Disorders Program Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Armin Hartmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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28
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Cuadrado J, Morin J, Hernandez P, Yubero E, Bégin C, Michel G. Psychopathologie de la dysmorphie musculaire : analyse critique de la littérature internationale. ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2018.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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29
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Trindade AP, Appolinario JC, Mattos P, Treasure J, Nazar BP. Eating disorder symptoms in Brazilian university students: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2018; 41:179-187. [PMID: 30328965 PMCID: PMC6781688 DOI: 10.1590/1516-4446-2018-0014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/19/2018] [Indexed: 12/14/2022]
Abstract
Objective: To synthesize the risk of eating disorder (ED) symptoms in Brazilian university students through a systematic review and meta-analysis. Secondary goals were to analyze whether any specific majors were related to higher ED risk and whether any regions of Brazil had higher proportions of college students at risk of ED. Methods: The procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and a search was conducted in three electronic databases (MEDLINE, LILACS, and SciELO). Results: Thirty-three studies were included in the analysis, of which 14 were included in the meta-analysis. All included studies used self-report questionnaires, the most frequent of which was the Eating Attitudes Test (EAT-26). None of the studies used a structured interview to diagnose ED. A meta-analysis of studies with a cutoff ≥ 20 for the EAT-26 (n=5) found 14.9% (95%CI 12.8-17.2%) positive screenings, while those with a cutoff of t ≥ 21 (n=9) found 13.3% (95%CI 11.3-15.6%) positive screenings. There was a significantly higher proportion of positive screenings among nutrition majors than all other majors combined (26.5 and 20.5%, respectively). Conclusion: Nutrition students seem to be at higher risk of ED. Further research should investigate whether positive screenings translate to actual ED diagnoses.
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Affiliation(s)
- Amanda P Trindade
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Jose C Appolinario
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil
| | - Paulo Mattos
- Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Bruno P Nazar
- Grupo de Obesidade e Transtornos Alimentares, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, RJ, Brazil.,Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil
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30
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Compte EJ, Murray SB, Sepúlveda AR, Schweiger S, Bressan M, Torrente F. What position do you play? Eating disorder pathology among rugby players, and the understudied role of player position. Int J Eat Disord 2018; 51:1015-1019. [PMID: 30070382 DOI: 10.1002/eat.22933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/03/2018] [Accepted: 07/08/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Male athletes appear to be at high risk for Eating Disorders (ED), given sport-related pressures. Although in some sports weight loss confers a competitive advantage, men also participate in sports where a large body is considered to enhance performance. In rugby a heavier body has been associated with sports success, however, physical demands vary given the position in the field (forward or back). We aimed to investigate whether ED pathology varied as a function of player position. METHOD A cross-sectional study was conducted among 203 rugby players (Mage = 21.78, SD = 3.54) in order assess associations between elevated eating pathology given the players' position, and with ED mediating mechanisms (physical comparison and exercise dependence). RESULTS 8.9% (95% CI: 4.9, 12.8) of the participants presented elevated eating pathology. Players' position, physical comparison and exercise dependence were associated with elevated eating pathology. Forwards tended to endorse binge eating more frequently, and showed higher levels of eating concerns. DISCUSSION Our findings suggest that ED symptoms differ as a function of player position, and that elevated eating pathology in rugby players is associated with appearance comparison and exercise dependence. Despite the possible implications for prevention and treatment efforts, the clinical validity of the current findings must be confirmed with further research.
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Affiliation(s)
- Emilio J Compte
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina.,DBT-Eating Disorders Team, Fundación Foro, Buenos Aires, Argentina
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Ana R Sepúlveda
- Department of Biological and health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Sofia Schweiger
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Michelle Bressan
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
| | - Fernando Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), Buenos Aires, Argentina
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31
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Murray SB, Griffiths S, Nagata JM. Community-Based Eating Disorder Research in Males: A Call to Action. J Adolesc Health 2018; 62:649-650. [PMID: 29784111 DOI: 10.1016/j.jadohealth.2018.03.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 02/26/2018] [Accepted: 03/06/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, California.
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, University of California, San Francisco, California
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32
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Klimek P, Murray SB, Brown T, Gonzales Iv M, Blashill AJ. Thinness and muscularity internalization: Associations with disordered eating and muscle dysmorphia in men. Int J Eat Disord 2018; 51:352-357. [PMID: 29473192 DOI: 10.1002/eat.22844] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/23/2018] [Accepted: 01/31/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The tripartite influence model of body image identifies internalization of societal body ideals as a risk factor for developing body dissatisfaction, and subsequent disordered eating behavior. In men, internalization of two dimensions of body image ideals, thinness and muscularity, is associated with body dissatisfaction and eating concerns. However, it is unknown how thinness and muscularity internalization interact in predicting muscle dysmorphia and disordered eating in men. METHOD Data were collected online from 180 undergraduate men, with ages ranging from 18 to 33 years (19.6, SD = 2.6). Regression models were used to test the interactive effects of thinness and muscularity internalization on (a) muscle dysmorphia symptoms and (b) disordered eating. Subsequent simple slope analyses probed effects at the mean, and ±1 standard deviation of thinness internalization. RESULTS Muscularity and thinness internalization were independently positively related to muscle dysmorphia symptoms and disordered eating. Additionally, a significant interaction revealed that muscularity internalization was increasingly related to muscle dysmorphia symptoms as thinness internalization decreased. DISCUSSION Men who internalized the muscular ideal had higher levels of muscle dysmorphia when they did not highly internalize the thin ideal. However, greater internalization of both the muscularity and thin ideal independently may be most relevant in the development of disordered eating in men. Future research is needed to explore variability in experiences of muscle dysmorphia compared with disordered eating in males.
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Affiliation(s)
- Patrycja Klimek
- Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego State University/University of California, San Diego, California
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, California
| | - Tiffany Brown
- Department of Psychiatry, University of California, San Diego, California
| | - Manuel Gonzales Iv
- Department of Psychology, San Diego State University, San Diego, California
| | - Aaron J Blashill
- Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego State University/University of California, San Diego, California.,Department of Psychology, San Diego State University, San Diego, California
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33
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Sandgren SS, Lavallee D. Muscle Dysmorphia Research Neglects DSM-5 Diagnostic Criteria. JOURNAL OF LOSS & TRAUMA 2018. [DOI: 10.1080/15325024.2018.1428484] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sebastian S. Sandgren
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough Leicestershire, UK
| | - David Lavallee
- School of Social and Health Sciences, Abertay University, Dundee, UK
- Department of Physical Education and Sports Sciences, University of Limerick, Ireland
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34
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Screening Tool to Determine Risk of Having Muscle Dysmorphia Symptoms in Men Who Engage in Weight Training at a Gym. Clin J Sport Med 2018; 28:168-173. [PMID: 29271781 DOI: 10.1097/jsm.0000000000000422] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although 2 screening tests exist for having a high risk of muscle dysmorphia (MD) symptoms, they both require a long time to apply. Accordingly, we proposed the construction, validation, and implementation of such a test in a mobile application using easy-to-measure factors associated with MD. DESIGN Cross-sectional observational study. SETTING Gyms in Alicante (Spain) during 2013 to 2014. PARTICIPANTS One hundred forty-one men who engaged in weight training. ASSESSMENT OF RISK FACTORS The variables are as follows: age, educational level, income, buys own food, physical activity per week, daily meals, importance of nutrition, special nutrition, guilt about dietary nonadherence, supplements, and body mass index (BMI). A points system was constructed through a binary logistic regression model to predict a high risk of MD symptoms by testing all possible combinations of secondary variables (5035). The system was validated using bootstrapping and implemented in a mobile application. MAIN OUTCOME MEASURES High risk of having MD symptoms (Muscle Appearance Satisfaction Scale). RESULTS Of the 141 participants, 45 had a high risk of MD symptoms [31.9%, 95% confidence interval (CI), 24.2%-39.6%]. The logistic regression model combination providing the largest area under the receiver operating characteristic curve (0.76) included the following: age [odds ratio (OR) = 0.90; 95% CI, 0.84-0.97, P = 0.007], guilt about dietary nonadherence (OR = 2.46; 95% CI, 1.06-5.73, P = 0.037), energy supplements (OR = 3.60; 95% CI, 1.54-8.44, P = 0.003), and BMI (OR = 1.33, 95% CI, 1.12-1.57, P < 0.001). The points system was validated through 1000 bootstrap samples. CONCLUSIONS A quick, easy-to-use, 4-factor test that could serve as a screening tool for a high risk of MD symptoms has been constructed, validated, and implemented in a mobile application.
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35
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The enigma of male eating disorders: A critical review and synthesis. Clin Psychol Rev 2017; 57:1-11. [DOI: 10.1016/j.cpr.2017.08.001] [Citation(s) in RCA: 338] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/20/2017] [Accepted: 08/01/2017] [Indexed: 01/05/2023]
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Longobardi C, Prino LE, Fabris MA, Settanni M. Muscle dysmorphia and psychopathology: Findings from an Italian sample of male bodybuilders. Psychiatry Res 2017. [PMID: 28646788 DOI: 10.1016/j.psychres.2017.06.065] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The aim of this study is to investigate the relationship between the risk of muscle dysmorphia and psychopathological symptoms in an Italian sample of male bodybuilders. METHOD The sample was recruited online (145 men with a mean age of 30.0 years) and participants were asked to fill out the Muscle Dysmorphic Disorder Inventory (MDDI), Symptom Cheklist-90-R (SCL-90-R), Dissociative Experiences Scale (DES-II), and to provide other socio-demographic data. Bodybuilders at risk of muscle dysmorphia display greater global psychopathology and present higher scores on all SCL-90-R dimensions when compared to bodybuilders not at risk of muscle dysmorphia. Furthermore, risk of muscle dysmorphia is positively associated to dissociative symptoms. The Competitiveness dimension and anabolic steroid intake were not related to muscle dysmorphia, while age appeared to be more significant. Findings are discussed based upon previous studies and directions for future research are suggested.
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Mitchell L, Murray SB, Hoon M, Hackett D, Prvan T, O'Connor H. Correlates of muscle dysmorphia symptomatology in natural bodybuilders: Distinguishing factors in the pursuit of hyper-muscularity. Body Image 2017; 22:1-5. [PMID: 28535445 DOI: 10.1016/j.bodyim.2017.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/13/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
Abstract
Muscle dysmorphia (MD) is characterized by the pathological pursuit of muscularity and leanness, which includes eating- and exercise-related practices. The aim of this cross-sectional study was to identify correlations of MD symptomatology in natural bodybuilders. An online survey assessing diet, supplementation and training practices, and MD and eating disorder symptoms was completed by male bodybuilders with recent experience competing in a drug-tested competition. Sixty participants (age 29.6±7.1 years) completed the survey. Eating disorder scores (β=.298), rate of pre-competition weight loss (β=.307) and number of competitions (β=-.257) were significant predictors of MD. The association between the EAT-26 and MDDI underscores the salience of disordered eating pathology in presentations of MD. Supporting this, greater rate of pre-competition weight loss, which may reflect disordered eating practices, is also associated with MD symptomatology. The inverse association of competition experience suggests novice bodybuilders may display increased MD symptomatology.
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Affiliation(s)
- Lachlan Mitchell
- Discipline of Exercise and Sport Science, University of Sydney, Lidcombe, NSW, Australia.
| | - Stuart B Murray
- Department of Psychiatry, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Matthew Hoon
- School of Exercise Science, Australian Catholic University, Canberra, ACT, Australia.
| | - Daniel Hackett
- Discipline of Exercise and Sport Science, University of Sydney, Lidcombe, NSW, Australia.
| | - Tania Prvan
- Department of Statistics, Macquarie University, Macquarie Park, NSW, Australia.
| | - Helen O'Connor
- Discipline of Exercise and Sport Science, University of Sydney, Lidcombe, NSW, Australia.
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Lavender JM, Brown TA, Murray SB. Men, Muscles, and Eating Disorders: an Overview of Traditional and Muscularity-Oriented Disordered Eating. Curr Psychiatry Rep 2017; 19:32. [PMID: 28470486 PMCID: PMC5731454 DOI: 10.1007/s11920-017-0787-5] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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. 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.
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Affiliation(s)
- Jason M Lavender
- Eating Disorders Center for Treatment & Research, Department of Psychiatry, University of California, San Diego, 4510 Executive Drive, Suite 315, San Diego, CA, 92121, USA.
| | - Tiffany A Brown
- Eating Disorders Center for Treatment & Research, Department of Psychiatry, University of California, San Diego, 4510 Executive Drive, Suite 315, San Diego, CA, 92121, USA
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, 3333 California Street, San Francisco, CA, 94118, USA
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Cunningham ML, Griffiths S, Mitchison D, Mond JM, Castle D, Murray SB. Muscle Dysmorphia: An Overview of Clinical Features and Treatment Options. J Cogn Psychother 2017; 31:255-271. [DOI: 10.1891/0889-8391.31.4.255] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An increasing public and empirical focus on male body image indicates that muscularity is a preeminent concern among boys and men. For some, these concerns develop into a complex and disabling psychiatric disorder termedmuscle dysmorphia(MD), the hallmark of which is an intense preoccupation regarding one’s (subjectively) insufficient muscularity. Treatment of MD is critical; however, evidence to inform treatment approaches is sorely lacking. The purpose of this article is twofold. First, we provide an overview of the clinical features of MD, drawing particular attention to the preoccupation, functional impairment and psychiatric comorbidity associated with the disorder. Second, we discuss and recommend potential treatment directions for MD, including techniques that have demonstrated efficacy in the treatment of related disorders, namely, body dysmorphic disorder and eating disorders (and anorexia nervosa in particular). Psychotherapeutic techniques, including cognitive restructuring of deleterious perfectionistic and egosyntonic beliefs, and dialectical behavioral techniques to improve the repertoire of emotion regulation skills available to afflicted individuals, are discussed, in addition to psychopharmacological approaches.
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Abstract
PURPOSE OF REVIEW Eating disorders are currently not considered to be limited to Western culture. We systematically reviewed the existing literature on the prevalence of eating disorders in Latin America. RECENT FINDINGS Of 1583 records screened, 17 studies from Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela were included in the analysis. Most studies reported point-prevalence rates and only three studies provided lifetime and 12-month prevalence rates. We found a mean point-prevalence rate of 0.1% for anorexia nervosa, 1.16% for bulimia nervosa, and 3.53% for binge-eating disorder (BED) in the general population. Heterogeneity for bulimia nervosa and BED was large. This meta-analysis indicates that the prevalence of anorexia nervosa seems to be lower, whereas the prevalence of bulimia nervosa and especially of BED seems to be higher in Latin America than in Western countries. SUMMARY Our findings show that eating disorders are common mental disorders in Latin America. However, some facets of Latin American culture might be protective for the development of anorexia nervosa and increase the risk for bulimia nervosa and BED. Further studies investigating the epidemiology of eating disorders and their relation to culture in Latin America are needed. VIDEO ABSTRACT SPANISH ABSTRACT.
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Abstract
Since 1997, there has been increasing research focusing on muscle dysmorphia, a condition underpinned by people’s beliefs that they have insufficient muscularity, in both the Western and non-Western medical and scientific communities. Much of this empirical interest has surveyed nonclinical samples, and there is limited understanding of people with the condition beyond knowledge about their characteristics. Much of the existing knowledge about people with the condition is unsurprising and inherent in the definition of the disorder, such as dissatisfaction with muscularity and adherence to muscle-building activities. Only recently have investigators started to explore questions beyond these limited tautological findings that may give rise to substantial knowledge advances, such as the examination of masculine and feminine norms. There is limited understanding of additional topics such as etiology, prevalence, nosology, prognosis, and treatment. Further, the evidence is largely based on a small number of unstandardized case reports and descriptive studies (involving small samples), which are largely confined to Western (North American, British, and Australian) males. Although much research has been undertaken since the term “muscle dysmorphia” entered the psychiatric lexicon in 1997, there remains tremendous scope for knowledge advancement. A primary task in the short term is for investigators to examine the extent to which the condition exists among well-defined populations to help determine the justification for research funding relative to other public health issues. A greater variety of research questions and designs may contribute to a broader and more robust knowledge base than currently exists. Future work will help clinicians assist a group of people whose quality of life and health are placed at risk by their muscular preoccupation.
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Affiliation(s)
- David Tod
- School of Sport and Exercise Science, Faculty of Science, Liverpool John Moores University, Liverpool, Merseyside
| | - Christian Edwards
- Institute of Sport and Exercise Science, University of Worcester, Worcester, Worcestershire, UK
| | - Ieuan Cranswick
- School of Sport and Exercise Science, Faculty of Science, Liverpool John Moores University, Liverpool, Merseyside
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O'Connor C, McNamara N, O'Hara L, McNicholas F. Eating disorder literacy and stigmatising attitudes towards anorexia, bulimia and binge eating disorder among adolescents. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/21662630.2015.1129635] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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