Muscle dysmorphia: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous editNext edit →
Content deleted Content added
VisualWikitext
Removed "although" which implied that anorexia is easy to recognise - it is a mental disorder and can be well established without/before the stereotypical extreme weightloss
Line 1: Line 1:
'''Muscle dysmorphia''' is the obsessive preoccupation with a delusional or exaggerated belief that one's own body is too small, too skinny, insufficiently muscular, or insufficiently lean, although in most cases, the individual's build is normal or even exceptionally large and muscular already.<ref name=Phillips2009>Katharine A Phillips, ''Understanding Body Dysmorphic Disorder: An Essential Guide'' (New York: [[Oxford University Press]], 2009), pp [https://books.google.com/books?id=uRTcOYgWj9cC&pg=PA50&dq=muscle+dysmorphia 50–51].</ref><ref name=Leone-etal>James E Leone, Edward J Sedory & Kimberly A Gray, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1323298 "Recognition and treatment of muscle dysmorphia and related body image disorders"], ''Journal of Athletic Training'', 2005 Oct–Dec;'''40'''(4):352–359.</ref> Sometimes called '''"bigorexia"''', '''"megarexia"''', or '''"reverse anorexia"''', it is a subtype of [[body dysmorphic disorder]], but is often also grouped with [[eating disorders]].<ref name="Phillips2009"/><ref name=Monaghan-Atkinson>Lee F Monaghan & Michael Atkinson, ''Challenging Myths of Masculinity: Understanding Physical Cultures'' (Surrey: [[Ashgate]], 2014), [https://books.google.com/books?id=Ys-pBAAAQBAJ&pg=PA86&dq=dysmorphia+megarexia p 86].</ref> Muscle dysmorphia mostly affects males, particularly those participating in athletics. They experience a disordered fixation on gaining body mass and often devote inordinate time, attention and resources on exercise routines, dietary regimens, and nutritional supplements. The use of [[anabolic steroids]] is also common.<ref name="Phillips2009"/><ref name="Leone-etal"/> Other body-dysmorphic preoccupations that are not muscle-dysmorphic are also usually present.<ref name="Phillips2009"/>
'''Muscle dysmorphia''' is the obsessive preoccupation with a delusional or exaggerated belief that one's own body is too small, too skinny, insufficiently muscular, or insufficiently lean, although in most cases, the individual's build is normal or even exceptionally large and muscular already.<ref name=Phillips2009>Katharine A Phillips, ''Understanding Body Dysmorphic Disorder: An Essential Guide'' (New York: [[Oxford University Press]], 2009), pp [https://books.google.com/books?id=uRTcOYgWj9cC&pg=PA50&dq=muscle+dysmorphia 50–51].</ref><ref name=Leone-etal>James E Leone, Edward J Sedory & Kimberly A Gray, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1323298 "Recognition and treatment of muscle dysmorphia and related body image disorders"], ''Journal of Athletic Training'', 2005 Oct–Dec;'''40'''(4):352–359.</ref> Sometimes called '''"bigorexia"''', '''"megarexia"''', or '''"reverse anorexia"''', it is a subtype of [[body dysmorphic disorder]], but is often also grouped with [[eating disorders]].<ref name="Phillips2009"/><ref name=Monaghan-Atkinson>Lee F Monaghan & Michael Atkinson, ''Challenging Myths of Masculinity: Understanding Physical Cultures'' (Surrey: [[Ashgate]], 2014), [https://books.google.com/books?id=Ys-pBAAAQBAJ&pg=PA86&dq=dysmorphia+megarexia p 86].</ref> Muscle dysmorphia mostly affects males, particularly those participating in athletics. They experience a disordered fixation on gaining body mass and often devote inordinate time, attention and resources on exercise routines, dietary regimens, and nutritional supplements. The use of [[anabolic steroids]] is also common.<ref name="Phillips2009"/><ref name="Leone-etal"/> Other body-dysmorphic preoccupations that are not muscle-dysmorphic are also usually present.<ref name="Phillips2009"/>


Muscle dysmorphia can be distressing, distracting, and debilitating disorder and can provoke absences from school, work, and socializing.<ref name="Phillips2009"/><ref name=McCallum>Anonymous webpage author, [https://www.mccallumplace.com/muscle-dysmorphia.html "Muscle dysmorphia"], McCallum Place website, visited 21 May 2016.</ref> When compared to other body dysmorphic disorders, rates of suicide attempts are especially high among people who have muscle dysmorphia.<ref name="Phillips2009"/> Although likened to [[anorexia nervosa]] in females,<ref name="Monaghan-Atkinson"/><ref>Anthony J Cortese, ''Provocateur: Images of Women and Minorities in Advertising'', 4th edn (London: [[Rowman & Littlefield]], 2016), [https://books.google.com/books?id=TTaCCgAAQBAJ&pg=PA94 p 94].</ref> muscle dysmorphia is difficult to recognize, especially since males experiencing it typically look healthy to others.<ref name="Leone-etal"/>
Muscle dysmorphia can be distressing, distracting, and debilitating disorder and can provoke absences from school, work, and socializing.<ref name="Phillips2009"/><ref name=McCallum>Anonymous webpage author, [https://www.mccallumplace.com/muscle-dysmorphia.html "Muscle dysmorphia"], McCallum Place website, visited 21 May 2016.</ref> When compared to other body dysmorphic disorders, rates of suicide attempts are especially high among people who have muscle dysmorphia.<ref name="Phillips2009"/> Likened to [[anorexia nervosa]] in females,<ref name="Monaghan-Atkinson"/><ref>Anthony J Cortese, ''Provocateur: Images of Women and Minorities in Advertising'', 4th edn (London: [[Rowman & Littlefield]], 2016), [https://books.google.com/books?id=TTaCCgAAQBAJ&pg=PA94 p 94].</ref> muscle dysmorphia is difficult to recognize, especially since males experiencing it typically look healthy to others.<ref name="Leone-etal"/>


The incidence of Muscle dysmorphia is rising, in part due to recent popularization of extreme cultural ideals of men's bodies.<ref name="Leone-etal"/><ref name=Pope-etal>Harrison G Pope Jr, Katharine A Phillips & Roberto Olivardia, ''The Adonis Complex: The Secret Crisis of Male Body Obsession'' (New York: [[Free Press (publisher)|Free Press]], 2000) pp [https://books.google.com/books?id=Jo-LHyyIy_kC&pg=PA156 156], 160,197.</ref>
The incidence of Muscle dysmorphia is rising, in part due to recent popularization of extreme cultural ideals of men's bodies.<ref name="Leone-etal"/><ref name=Pope-etal>Harrison G Pope Jr, Katharine A Phillips & Roberto Olivardia, ''The Adonis Complex: The Secret Crisis of Male Body Obsession'' (New York: [[Free Press (publisher)|Free Press]], 2000) pp [https://books.google.com/books?id=Jo-LHyyIy_kC&pg=PA156 156], 160,197.</ref>

Revision as of 15:34, 27 July 2017

Muscle dysmorphia is the obsessive preoccupation with a delusional or exaggerated belief that one's own body is too small, too skinny, insufficiently muscular, or insufficiently lean, although in most cases, the individual's build is normal or even exceptionally large and muscular already.[1][2] Sometimes called "bigorexia", "megarexia", or "reverse anorexia", it is a subtype of body dysmorphic disorder, but is often also grouped with eating disorders.[1][3] Muscle dysmorphia mostly affects males, particularly those participating in athletics. They experience a disordered fixation on gaining body mass and often devote inordinate time, attention and resources on exercise routines, dietary regimens, and nutritional supplements. The use of anabolic steroids is also common.[1][2] Other body-dysmorphic preoccupations that are not muscle-dysmorphic are also usually present.[1]

Muscle dysmorphia can be distressing, distracting, and debilitating disorder and can provoke absences from school, work, and socializing.[1][4] When compared to other body dysmorphic disorders, rates of suicide attempts are especially high among people who have muscle dysmorphia.[1] Likened to anorexia nervosa in females,[3][5] muscle dysmorphia is difficult to recognize, especially since males experiencing it typically look healthy to others.[2]

The incidence of Muscle dysmorphia is rising, in part due to recent popularization of extreme cultural ideals of men's bodies.[2][6]

History

Muscle dysmorphia was first conceptualized as a health risk in the late 1990s.[7][8][9] Initially, the symptom profile was considered to be a reverse form of anorexia nervosa.[7] Instead of a person desiring to be small and thin, he or she desires to be large and muscular. Later research, however, indicated that the subjective experience of muscle dysmorphia was more closely related to that of body dysmorphic disorder.[8] This is still subject to debate.

Research has increased in recent years. As of 2016, 50% of all peer-reviewed studies on the topic had been published in the past 5 years.[9] The American Psychiatric Association first recognized muscle dysmorphia as a valid disorder in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. In the DSM-5, it is classified as a specifier for body dysmorphic disorder.[10] Muscle dysmorphia still remains absent from the International Statistical Classification of Diseases and Related Health Problems, the tenth issue of which was published in 1992.[11]

Alternative classifications

The classification of muscle dysmorphia has been widely debated and alternative DSM classifications have been proposed:

  • Eating Disorder: Eating disorders and muscle dysmorphia share many characteristics.[12] Many researchers have called for it to be reclassified as a type of eating disorder[12][13][9] due to the fact that preoccupation with body weight and shape, and its modification, underpin both disorders.[14] In general, body dysmorphic disorder does not typically include the food and exercise related psychopathology that characterize muscle dysmorphia and eating disorders.[12] Studies have shown that people with muscle dysmorphia score higher on measures of eating disorders, such as the Eating Attitudes Test and Eating Disorder Inventory, than the general population.[15][16] Also, individuals suffering from muscle dysmorphia and eating disorders typically experience high impairment while those suffering from body dysmorphia typically experience lower levels of impairment.[17][18] There is even some evidence that treatment for eating disorders is effective for muscle dysmorphia as well.[19] Muscle dysmorphia and anorexia nervosa share additional similarities such as diagnostic crossover with time and familial transmission.[20] From a practical standpoint, it is possible that reclassifying muscle dysmorphia as an eating disorder would further reduce the size of the DSM's "Feeding and Eating Conditions Not Elsewhere Classified" section.[21][18]
  • Behavioral Addiction: Others have argued for muscle dysmorphia it to be reclassified as a behavioral addiction.[9][12][18][14] It is argued that the addictive activity of muscle dysmorphia is the maintaining of body image through a number of different activities such as bodybuilding, exercise, eating and shopping for certain foods and food supplements, taking specific drugs, and purchasing and using physical exercise accessories.[18] Although their activities may cause them harm, and may continue to cause them harm in the future, individuals with muscle dysmorphia continue to engage in them. This is similar to how people suffering from behavioral addictions still continue to engage in the harmful activities to which they are addicted.[18] The typical behaviors that accompany muscle dysmorphia share many characteristics with behavioral addictions. For example, muscle building and dietary restriction in people who experience muscle dysmorphia hold high importance, can lead to mood modification, and can lead to interpersonal conflicts.[18] People can build up tolerance to their muscle building and dietary restriction practices and may need to increase levels in order to achieve the desired physiological and/or psychological effects.[18] They can also experience symptoms of withdrawal if they are unable to engage in the maintenance activities and even if they are able to stop these activities, they are susceptible to relapse.[13][18]

Signs and symptoms

According to the DSM-5, muscle dysmorphia can be diagnosed if an individual meeting the diagnostic criteria for body dysmorphic disorder is "preoccupied with the idea that his or her body build is too small or insufficiently muscular." This specifier is still used even if the individual is preoccupied with other body areas, which is often the case.[10]

Psychologists have expanded upon this basic framework and have found other clinical features often found in those with muscle dysmorphia. Individuals suffering from muscle dysmorphia are often consumed by activities aimed at increasing muscularity.[8] This can often lead to participation in unhealthy behaviors (e.g. the use of physique-enhancing drugs, dietary restriction, and excessive exercise).[8] People who suffer from muscle dysmorphia generally spend more than three hours per day thinking about becoming more muscular and believe that they have little control over their weightlifting activities.[9] They engage in body monitoring and camouflaging behaviors, such as wearing multiple layers of clothing to appear larger.[9]

These symptoms can be impairing. They experience severe distress regarding having their bodies viewed by others.[8] They experience impaired occupational and social functioning and often report that their diet regimes interfere at least moderately with their lives.[9] They often avoid activities, people, and places because of their embarrassment over their perceived lack of muscularity.[9] Approximately 50% of patients have little or no insight into their condition and its severity.[22][23]

They are also more likely to experience or have experienced a concurrent or past psychiatric diagnosis with eating disorders, mood disorders, anxiety disorders, and substance use disorder being the most common.[22][17][24] They are more likely to have attempted suicide than members of the general population.[9] Onset of muscle dysmorphia has been predicted to generally occur between 18 and 20 years of age.[9]

Prevalence

Prevalence estimates for muscle dysmorphia have been highly variable, with estimates ranging anywhere from 1-54% of men being affected.[9] Prevalence estimates are often found within more specific populations, with gym members, weightlifters, and bodybuilders showing higher prevalence rates than the general population.[9] Even higher rates have been found among members of these groups who also use anabolic steroids.[25][11] Onset of muscle dysmorphia has been predicted to generally occur between 18 and 20 years of age, but there may be significant prevalence rates in much younger populations since body dissatisfaction has been found in males as young as six years old.[9][26] Muscle dysmorphia is far less common in women, but still possible, especially in women who are victims of sexual assault.[9][25]

Cases cross cultural barriers, with clinical populations appearing in places such as China, South Africa, and Latin America.[24][27][28][29][16] Prevalence in these countries may be mediated by exposure to western ideals of muscularity. One study found that college-aged men in Austria, France, and the United States report a similar gap between current perceived and ideal levels of muscularity.[30] Meanwhile, populations that are less exposed to western ideals of muscularity tend to have lower prevalence rates.[31]

Causes

The causes of muscle dysmorphia are unclear, but several significant risk factors and theories have been proposed:

  • Muscle dysmorphia as a coping or defense mechanism: Many researchers have identified psychological predisposing factors associated with muscle dysmorphia. People suffering from muscle dysmorphia are more likely to have experienced or observed a traumatic event (e.g. sexual assault or domestic violence) than members of the general population.[9][25][23] The drive to become muscular has been theorized to be a way for people to cope psychologically with past trauma.[9] People suffering from muscle dysmorphia are also more likely to have been victimized, bullied, or ridiculed for perceived deficiencies (e.g. being small, weak, non-athletic, or intellectually inferior) as adolescents than the general population.[9][32] It is theorized that many of these people are driven to become more muscular because it would not only help them cope with their unpleasant past, but it would also allow them to defend themselves in the future or at least stop the harassment.[33][9]
  • Muscle dysmorphia as a result of low self-esteem and insecurities: Low self-esteem can contribute to muscle dysmorphia, with lower levels being linked to higher body dissatisfaction and higher levels of muscle dysmorphia[34] Individuals who develop beliefs that muscular appearance is important and have lower perceptions of themselves are at a heightened risk for developing muscle dysmorphia.[9] For people whose self-esteem is contingent upon appearance, this association is even more dangerous as they tend to spend even more time on appearance-related behaviors, such as lifting weights.[34][35] Muscle preoccupations may also develop as a way to address insecurities, such as insecurity about sexual capability.[9] Research has found a link between muscularity and feelings of reproductive success and have postulated that for people suffering from Muscle Dysmorphia, muscles may become a secondary sex characteristic, which indicate virility and the ability to provide safety and resources for partners and offspring.[36] Drive for muscularity is also correlated negatively with genital satisfaction, indicating that some men may develop muscularity preoccupations as a way to compensate for perceived deficiencies.[37]
  • The negative effects of media exposure and muscle dysmorphia: Other research has pointed towards the threat of popular culture and media exposure. Not only does media in western culture promote standards of attractiveness, but marketing campaigns have also begun to specifically target male body-image insecurities.[38][23][39][40][41] This generates social comparison and pressure for individuals to take measures to conform to the ideal.[34] Men exposed to muscular images show a significantly greater discrepancy between their own level muscularity and desired level of muscularity than men who are not exposed to muscular images.[42] Unfortunately, the number of fitness magazines directed at men and the number of partially-clothed well-muscled men in magazine advertisements have increased over the past 20 years, increasing the potential for men to be exposed to these images.[34][33] Studies have found that the strongest predictor of a drive for muscularity in college aged men is the extent to which they have internalized the ideal male body presented by the media.[43][44]
  • Participation in sports and Muscle Dysmorphia: A correlation has also been found between sports participation and muscle dysmorphia. The condition has been found to be positively correlated with involvement in sports such as football and wrestling – sports that emphasize size and strength and in which being large carries the notion of gaining an "edge" over the competition.[38][8][45] Sports can help expose individuals to the social ideal of muscularity and reinforce the obtainment and maintenance of this ideal.[34] In general, athletes are more critical of their bodies and body weight than those who do not regularly engage in planned exercise.[46] Athletes who are both critical of their bodies and fail to achieve performance standards may resort to the extreme measures associated with muscle dysmorphia to achieve a body ideal.[47] Athletes share many of the psychological factors that have been theorized to increase the likelihood of muscle dysmorphia such as high levels of competitiveness, high need for control, and perfectionist tendencies.[34] It is unclear if the sports serve as a gateway to muscle dysmorphia or if those predisposed to the condition are more likely to participate in such sports.[47]

Treatment

Treatment of muscle dysmorphia is complicated by the fact that many individuals who suffer from it do not recognize it or seek treatment.[47] It becomes the responsibility of healthcare professionals to identify the problem and intervene at the correct time. The first step is convincing the individual that he or she needs help.[47] Unfortunately, scientific research on the treatment of muscle dysmorphia is severely limited and largely based on anecdotes and case reports.[9] No specific treatment programs have been developed, although several general approaches have been successful.[47] Some research has supported the efficacy of family-based therapy, cognitive behavioural therapy, and the use of selective serotonin reuptake inhibitor (anti-depressant) medications in the treatment of muscle dysmorphia.[9][48] Like research on treatment, research on prognosis has been severely limited.[9]

Notes

  1. ^ a b c d e f Katharine A Phillips, Understanding Body Dysmorphic Disorder: An Essential Guide (New York: Oxford University Press, 2009), pp 50–51.
  2. ^ a b c d James E Leone, Edward J Sedory & Kimberly A Gray, "Recognition and treatment of muscle dysmorphia and related body image disorders", Journal of Athletic Training, 2005 Oct–Dec;40(4):352–359.
  3. ^ a b Lee F Monaghan & Michael Atkinson, Challenging Myths of Masculinity: Understanding Physical Cultures (Surrey: Ashgate, 2014), p 86.
  4. ^ Anonymous webpage author, "Muscle dysmorphia", McCallum Place website, visited 21 May 2016.
  5. ^ Anthony J Cortese, Provocateur: Images of Women and Minorities in Advertising, 4th edn (London: Rowman & Littlefield, 2016), p 94.
  6. ^ Harrison G Pope Jr, Katharine A Phillips & Roberto Olivardia, The Adonis Complex: The Secret Crisis of Male Body Obsession (New York: Free Press, 2000) pp 156, 160,197.
  7. ^ a b Pope, H. G., Katz, D. L., & Hudson, J. I. (1993). Anorexia nervosa and "reverse anorexia" among 108 male bodybuilders. Comprehensive Psychiatry, 34(6), 406-409.
  8. ^ a b c d e f Pope, H. G., Jr., Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997). Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics: Journal of Consultation and Liaison Psychiatry, 38(6), 548-557.
  9. ^ a b c d e f g h i j k l m n o p q r s t u v w Tod, D., Edwards, C., & Cranswick, I. (2016). Muscle dysmorphia: Current insights. Psychology Research and Behavior Management, 9, 10.
  10. ^ a b American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
  11. ^ a b dos Santos Filho, C. A., Tirico, P. P., Stefano, S. C., Touyz, S. W., & Claudino, A. M. (2016). Systematic review of the diagnostic category muscle dysmorphia. Australian and New Zealand Journal of Psychiatry, 50(4), 322-333.
  12. ^ a b c d Murray, S. B., & Touyz, S. W. (2013). Muscle dysmorphia: Towards a diagnostic consensus. Australian and New Zealand Journal of Psychiatry, 47(3), 206-207.
  13. ^ a b Griffiths, S., Mond, J. M., Murray, S. B., & Touyz, S. (2015). Positive beliefs about anorexia nervosa and muscle dysmorphia are associated with eating disorder symptomatology. Australian and New Zealand Journal of Psychiatry, 49(9), 812-820.
  14. ^ a b Russell, J. (2013). Commentary on: 'Muscle Dysmorphia: Towards a diagnostic consensus'. Australian and New Zealand Journal of Psychiatry, 47(3), 284-285.
  15. ^ Nieuwoudt, J. E., Zhou, S., Coutts, R. A., & Booker, R. (2012). Muscle dysmorphia: Current research and potential classification as a disorder. Psychology of Sport and Exercise, 13(5), 569-577.
  16. ^ a b Behar, R., & Molinari, D. (2010). Muscle dysmorphia, body image and eating behaviors in two male populations. Revista Médica de Chile, 138(11), 1386-1394.
  17. ^ a b Pope, C. G., Pope, H. G., Menard, W., Fay, C., Olivardia, R., & Phillips, K. A. (2005). Clinical features of muscle dysmorphia among males with body dysmorphic disorder. Body Image, 2(4), 395-400.
  18. ^ a b c d e f g h Foster, A.C., Shorter, G.W., & Griffiths, M.D. (2015). Muscle dysmorphia: could it be classified as an addiction to body image? J Behav Addict, 4(1), 1-5.
  19. ^ Greenberg, S. T., & Schoen, E. G. (2008). Males and eating disorders: Gender-based therapy for eating disorder recovery. Professional Psychology: Research and Practice, 39(4), 464-471.
  20. ^ Murray, S. B., Rieger, E., Touyz, S. W., & De la, G. G. (2010). Muscle dysmorphia and the DSM-V conundrum: Where does it belong? A review paper. International Journal of Eating Disorders, 43(6), 483-491.
  21. ^ Fairburn, C. G., & Cooper, Z. (2011). Eating disorders, DSM–5 and clinical reality. The British Journal of Psychiatry, 198(1), 8-10.
  22. ^ a b Cafri, G., Olivardia, R., & Thompson, J. K. (2008). Symptom characteristics and psychiatric comorbidity among males with muscle dysmorphia. Comprehensive Psychiatry, 49(4), 374-379.
  23. ^ a b c Olivardia, R., Pope, H.G., & Hudson, J.L. (2000). Muscle dysmorphia in male weightlifters: a case-control study. Am J Psychiatry, 157(8), 1291-1296.
  24. ^ a b Hitzeroth, V., Wessels, C., Zungu-Dirwayi, N., Oosthuizen, P., & Stein, D. J. (2001). Muscle dysmorphia: A south african sample. Psychiatry and Clinical Neurosciences, 55(5), 521-523.
  25. ^ a b c Gruber, A. J., & Pope, H. G. (1999). Compulsive weight lifting and anabolic drug abuse among women rape victims. Comprehensive Psychiatry, 40(4), 273-277.
  26. ^ McCabe, M. P., & Ricciardelli, L. A. (2004). Body image dissatisfaction among males across the lifespan: A review of past literature. Journal of Psychosomatic Research, 56(6), 675-685.
  27. ^ Ung, E.K., Fones, C.S., & Ang, A.W. (2000). Muscle dysmorphia in a young Chinese male. Annals of the Academy of Medicine, Singapore 29(1), 135-137.
  28. ^ Soler, P.T., Fernandes, H.M., Damasceno, V.O., et al. (2013). Vigorexy and levels of exercise dependence in gym goers and bodybuilders. Revista Brasileira de Medicina do Esporte, 19(5), 343-348.
  29. ^ Rutsztein, G., Casguet, A., Leonardelli, E., López, P., Macchi, M., Marola, M. E., & Redondo, G. (2004). Imagen corporal en hombres y su relación con la dismorfia muscular. Revista Argentina De Clínica Psicológica, 13(2), 119-131.
  30. ^ Pope, H. G., Jr., Gruber, A. J., Mangweth, B., Bureau, B., deCol, C., Jouvent, R., & Hudson, J. I. (2000). Body image perception among men in three countries. The American Journal of Psychiatry, 157(8), 1297-1301.
  31. ^ Yang, C. J., Gray, P., & Pope, H. G., Jr. (2005). Male body image in taiwan versus the west: Yanggang zhiqi meets the adonis complex. The American Journal of Psychiatry, 162(2), 263-269.
  32. ^ Edwards, C., Molnar, G., & Tod, D. (2016). Searching for masculine capital: Experiences leading to high drive for muscularity in men. Psychology of Men & Masculinity.
  33. ^ a b Olivardia, R. (2001). Mirror, mirror on the wall, who's the largest of them all? the features and phenomenology of muscle dysmorphia. Harvard Review of Psychiatry, 9(5), 254-259.
  34. ^ a b c d e f Grieve, F. G. (2007). A conceptual model of factors contributing to the development of muscle dysmorphia. Eating Disorders: The Journal of Treatment & Prevention, 15(1), 63-80.
  35. ^ Crocker, J. (2002). The costs of seeking self-esteem. Journal of Social Issues, 58(3), 597-615.
  36. ^ Frederick, D. A., & Haselton, M. G. (2007). Why is muscularity sexy? tests of the fitness indicator hypothesis. Personality and Social Psychology Bulletin, 33(8), 1167-1183.
  37. ^ Morrison, T. G., Morrison, M. A., & Bradley, B. A. (2007). Correlates of gay men's self-reported exposure to pornography. International Journal of Sexual Health, 19(2), 33-43.
  38. ^ a b Cohane, G. H., & Pope, H. G., Jr. (2001). Body image in boys: A review of the literature. International Journal of Eating Disorders, 29(4), 373-379.
  39. ^ Mangweth, B., Pope, H. G., J., Kemmler, G., Ebenbichler, C., Hausmann, A., De Col, C., . . . Biebl, W. (2001). Body image and psychopathology in male bodybuilders. Psychotherapy and Psychosomatics, 70(1), 38-43.
  40. ^ Pope, H. G., Jr., Olivardia, R., Borowiecki,John J., I.,II, & Cohane, G. H. (2001). The growing commercial value of the male body: A longitudinal survey of advertising in women's magazines. Psychotherapy and Psychosomatics, 70(4), 189-192.
  41. ^ Leit, R. A., Pope, H. G., Jr., & Gray, J. J. (2001). Cultural expectations of muscularity in men: The evolution of playgirl centerfolds. International Journal of Eating Disorders, 29(1), 90-93.
  42. ^ Leit, R. A., Gray, J. J., & Pope, H. G., Jr. (2002). The media's representation of the ideal male body: A cause for muscle dysmorphia? International Journal of Eating Disorders, 31(3), 334-338.
  43. ^ Daniel, S., & Bridges, S. K. (2010). The drive for muscularity in men: Media influences and objectification theory. Body Image, 7(1), 32-38.
  44. ^ Parent, M. C., & Moradi, B. (2011). His biceps become him: A test of objectification theory's application to drive for muscularity and propensity for steroid use in college men. Journal of Counseling Psychology, 58(2), 246-256.
  45. ^ Chung, B. (2001). Muscle dysmorphia: a critical review of the proposed criteria. Perspect Biol Med., 44(4), 565-574.
  46. ^ Davis, C., & Cowles, M. (1991). Body image and exercise: A study of relationships and comparisons between physically active men and women. Sex Roles, 25(1-2), 33-44.
  47. ^ a b c d e Leone, J. E., Sedory, E. J., & Gray, K. A. (2005). Recognition and treatment of muscle dysmorphia and related body image disorders. Journal of Athletic Training, 40(4), 352-359.
  48. ^ Murray, S. B., & Griffiths, S. (2015). Adolescent muscle dysmorphia and family-based treatment: A case report. Clinical Child Psychology and Psychiatry, 20(2), 324-330.

Retrieved from "https://en.wikipedia.org/w/index.php?title=Muscle_dysmorphia&oldid=792615009"