The relation between body dysmorphic disorder symptoms and photo-based behaviors: is body appreciation a protective factor?

Body image and social media use seem to be significantly associated. In particular, photo-based behaviors (i.e., photo investment and manipulation) seemed to have a positive relation with negative body image dimensions. On the other hand, positive body image dimensions could demonstrate the role of moderators. However, current available studies did not support these findings consistently. Moreover, available studies did not assess Body Dysmorphic Disorder (BDD) and Muscle Dysmorphia (MD) symptoms. To address these issues, the associations between BDD/MD symptoms and photo-based behaviors and the possible moderation of body appreciation were examined in a sample of 485 social media users (71.1 % women). Findings from hierarchical multiple regressions highlighted that BDD symptoms were significantly associated with photo investment and manipulation, and MD symptoms were significantly associated with photo investment only. Body appreciation demonstrated a moderating role in the relation involving photo investment and BDD symptoms. Current findings supported that photo-based behaviors are significantly associated with negative body image dimensions, while positive body image demonstrated only a marginal protective role.

Dissonance-Based Eating Disorder Prevention for Body-Dissatisfied Brazilian Cisgender Gay and Bisexual Men: A Randomized Controlled Trial With a 1-Year Follow-Up.

OBJECTIVE: Gay and bisexual men are at an increased risk for eating disorders (EDs) and muscle dysmorphia (MD) compared with their heterosexual counterparts. Existing dissonance-based (DB) EDs prevention programs for this population have been evaluated in the United States; however, these programs have not been evaluated in the Brazilian context. Thus, we investigated the feasibility, acceptability, and efficacy of a DB ED prevention program (i.e., the PRIDE Body Project) among Brazilian cisgender gay and bisexual men. METHOD: Eligible men were randomly assigned to either a DB intervention (n = 74) condition or an assessment-only control (AOC) condition (n = 75). Participants completed measures assessing ED and MD risk and protective factors at baseline, post-intervention, 1-month, 6-month, and 1-year follow-up. Those in the intervention condition also completed acceptability measures. RESULTS: Feasibility and acceptability ratings were highly favorable. Regarding efficacy, post-intervention results were not significant, except for self-objectification, which showed a significantly greater decrease in the DB condition compared with the AOC condition at all time-points of follow-ups (Cohen's d = -0.31 to -0.76). At follow-up, the DB condition showed significantly greater decreases in appearance-ideal internalization, drive for muscularity, self-objectification, ED and MD symptoms at 1-month, 6-month, and 1-year follow-ups (d = -0.33 to -0.92) compared with the AOC condition. Significant increases were observed in the DB compared with the AOC condition for body appreciation at 1-month, 6-month, and 1-year follow-ups (d = 0.31-0.81). DISCUSSION: Results support the feasibility, acceptability, and efficacy of the PRIDE Body Project up to 1-year in Brazilian cisgender gay and bisexual men. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC; available at http://www.ensaiosclinicos.gov.br/) number of registration: RBR-62fctqz.

Muscle Dysmorphia in Gym-Going Men: The Role of Narcissism Vulnerability and Perfectionism.

Objective: Muscle dysmorphia (MD) refers to a pathological preoccupation with the idea that one's body is not lean and muscular enough. Literature suggests that vulnerable facet of narcissism and perfectionism are strongly related to the risk of developing MD symptoms. However, until now, there is a paucity of research exploring their relationship, which is the primary aim of this study. Method: Participants were 135 gym-going Turkish males (Mage=24.99, SD=5.38; range=18-43 years) who completed a packet of self-report questionnaires. Results: Out of the sample, 51 (37.8%) were at risk for MD. A mediation model analysis revealed that vulnerable narcissism has an indirect relationship with the MD risk that is likely to be expressed via perfectionism. Conclusions: Our results showed a higher risk for MD among gym-going males and provided new insight into MD's understanding. It appears that a narcissistic flaw and perfectionistic traits may be particularly salient factors to consider in both preventing and treating MD symptomatology within high-risk populations.

Muscle dysmorphia: an under-recognised aspect of body dissatisfaction in men.

Although men and women both experience eating disorders such as anorexia nervosa and bulimia nervosa, there are differences in the way their eating disorder may present. Body dissatisfaction or body dysmorphia in men may be more related to a drive for muscularity as opposed to thinness. Muscle dysmorphic disorder (also known as muscle dysmorphia) is a form or subtype of body dysmorphia that is characterised by an extreme desire for muscularity and a preoccupation with the idea that one's physique is too small or not sufficiently muscular. It is more common in men than women and is associated with body image distortion, excessive exercise routines, muscularity-orientated disordered eating and the use of appearance- and performance-enhancing drugs such as anabolic androgenic steroids. Risk factors for muscle dysmorphic disorder include social pressure (including to conform to gender stereotypes) and low self-esteem. The condition has negative psychological, physical, relational and financial effects. Nurses can play a role in health promotion as well as in the assessment, care and referral of men with muscle dysmorphic disorder.

Use of photo filters is associated with muscle dysmorphia symptomatology among adolescents and young adults.

It has been documented in the literature that the use of photo filters to alter one's appearance may negatively impact body image and increase the risk for thinness-oriented disordered eating behaviors. However, the prior research has neglected to investigate the association between use of photo filters and muscle dysmorphia symptomatology, which was the aim of this study. Data from the Canadian Study of Adolescent Health Behaviors (2022; N = 912), a national study of adolescents and young adults in Canada, were analyzed. Linear regression analyses revealed that the use of photo filters was associated with greater muscle dysmorphia symptomatology, including total symptomatology and Appearance Intolerance, among the overall sample. Gender significantly moderated the association between photo filter use and muscle dysmorphia symptomatology, whereby boys and young men, compared to girls and young women, who reported photo filter use had greater Drive for Size and Functional Impairment symptomatology. Findings expand prior research by emphasizing that photo filter use is related to muscularity-oriented body image concerns and behaviors. Future research is needed to elucidate the mechanisms that underpin this association.

Exploring the Role of Discrepancy Stress and Muscle Dysmorphia in the Association Between Gender Role Discrepancy and Masculine Depression in Israeli Men.

Guided by the dynamic model of masculinity and men's psychopathology, the current study aimed to explore the mediating role of masculine discrepancy stress and each of the muscle dysmorphia dimensions (drive for size, appearance intolerance, and functional impairments) in the association between masculine gender role discrepancy and masculine depression. For the present study, 936 Israeli men completed a structured self-report questionnaire. Masculine discrepancy stress and some of the muscle dysmorphia dimensions were found to partially mediate the association between masculine gender role discrepancy and masculine depression. The findings demonstrate how the internalization of social gender expectations and men's gender role discrepancy is reflected in the gap between perception of self and the typical man, which is eventually related to mental health outcomes. In turn, men attempt to mitigate the stress through what they perceive as masculine, reflecting muscle dysmorphia: drive for size, appearance intolerance, and functional impairments, which in turn predict masculine depression. Therefore, mental and physical health professionals are advised to be aware of these mechanisms, in order to recognize the negative mental health outcomes arising from traditional societal gender role expectations and provide specific solutions for them.

Body evaluation in men: the role of body weight dissatisfaction in appearance evaluation, eating, and muscle dysmorphia psychopathology.

BACKGROUND: Body image dissatisfaction is a significant concern among men, influencing appearance evaluation, eating behaviors, and muscle dysmorphia psychopathology. However, research on these correlations is notably deficient in men, largely because body image concerns are unevenly distributed between genders. Therefore, this study aims to assess the various dimensions of concerns about body image in men and explore their associations with characteristics such as sexual orientation. METHODS: A cross-sectional study was conducted with 251 adult men from fitness centers in the Veneto Region, Italy. Participants completed self-report questionnaires, including the Eating Attitudes Test (EAT-26), the Appearance Schemas Inventory-Revised (ASI-R), and the Muscle Dysmorphic Disorder Inventory (MDDI). Body weight perception and dissatisfaction were evaluated using a Figure Rating Scale (FRS) with 12 male biometric silhouettes. RESULTS: Participants were divided into three subgroups based on the experienced levels of body weight dissatisfaction: those who rated a smaller body (BWsmaller), those who rated a larger body (BWlarger) more highly relative to their own estimated body size, and those who reported implicit neutrality with their current weight (BWneu). BWsmaller participants reported higher levels of eating-related concern, while BWlarger participants exhibited higher levels of muscle dysmorphia. Additionally, the BWlarger group showed the highest degree of quantitative perceptual underestimation of their body weight. Sexual orientation was found to have an impact on body weight dissatisfaction, with bisexual men more likely to desire an increase in weight and gay men more likely to desire a decrease. CONCLUSIONS: Body weight dissatisfaction significantly impacts appearance evaluation, eating behaviors, and muscle dysmorphia psychopathology in males. Tailored interventions that consider individual differences can support the well-being of men. The study provides useful insight into male body image issues, warranting further exploration to inform effective interventions and promote positive body image and mental health in this population.

This study delved into how males feel about their bodies and the impact it has on their thoughts and behaviors. We surveyed adult males and found three groups based on body weight satisfaction: those who wanted to lose, gain, or maintain their weight. Men wanting to lose weight reported more concern about eating, while those wanting to gain weight showed higher levels of muscle dysmorphia, a desire for more muscle mass. Interestingly, sexual orientation influenced these feelings, with bisexual men wanting weight gain and gay men preferring weight loss. This study highlights the importance of tailored support for males based on their unique needs to improve their well-being.

Associations between muscle dysmorphia symptomatology and sleep duration and difficulty in the Canadian Study of Adolescent Health Behaviors.

OBJECTIVES: Prior research has shown links between mental health symptomatology and poor sleep. However, associations between muscle dysmorphia symptomatology and poor sleep remain unknown, which was the aim of this study. METHODS: Data from the Canadian Study of Adolescent Health Behaviors (2021-2022) were analyzed (N = 912). Multinomial logistic regression analyses and logistic regression analyses were used to determine the association between muscle dysmorphia symptomatology and average sleep duration (5 hours or less, 6 hours, 7 hours, and 8 or more hours) and difficulty falling or staying asleep over a 2-week period. RESULTS: Findings indicated significant associations between muscle dysmorphia symptomatology and shorter sleep duration and greater sleep difficulty in both cross-sectional and prospective analyses. CONCLUSIONS: The findings from this study underscore poor sleep as a correlate of muscle dysmorphia symptomatology among adolescents and young adults, emphasizing the need for screening and interventions in healthcare settings.

Going deeper into eating and body image pathology in males: Prevalence of muscle dysmorphia and eating disorders in a university representative sample.

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.

Does the interpersonal theory of suicide explain relationships between muscle dysmorphia symptoms and suicidal ideation?

Muscle dysmorphia (MD) symptoms are robustly associated with suicidal thoughts/behaviors. Risk factors for suicidal ideation, such as perceived burdensomeness and thwarted belongingness, may help explain the relationship between MD symptoms and suicidal ideation. The current study extended past cross-sectional research by testing if perceived burdensomeness and/or thwarted belongingness mediated longitudinal relationships between MD symptoms and suicidal ideation. Two hundred and sixty-nine U.S. men recruited from Prolific completed self-report measures at three timepoints separated by one month each. Analyses used an adapted version of a longitudinal three-wave mediation model to test study hypotheses. Perceived burdensomeness mediated longitudinal relationships between MD symptoms and suicidal ideation. Thwarted belongingness did not show significant relationships with MD symptoms or suicidal ideation. Results extend past research by demonstrating that perceived burdensomeness may be a mechanism underlying longitudinal relationships between MD symptoms and suicidal ideation while establishing temporal ordering. Clinicians may consider targeting perceived burdensomeness in cases of comorbid MD/suicidality by using techniques that promote interpersonal effectiveness.

Muscle dysmorphia symptomatology is prospectively associated with suicidal thoughts, suicidal behaviors, and non-suicidal self-injury among a sample of Canadian adolescents and young adults.

INTRODUCTION: Limited, primarily cross-sectional research has identified associations between muscle dysmorphia and suicidal thoughts suicidal behaviors, and non-suicidal self-injury (NSSI). This study aimed to investigate the associations between muscle dysmorphia and suicidal thoughts, suicidal behaviors, and NSSI prospectively over a 1-year period among a large, diverse sample of Canadian adolescents and young adults. METHODS: Data from wave one (2021) and wave two (2022) of the Canadian Study of Adolescent Health Behaviors were analyzed (N = 912). Multiple modified Poisson regression analyses were used to determine the associations between muscle dysmorphia symptomatology at wave one and three items of suicidal thoughts and behaviors and one item of NSSI at wave two. Unadjusted models and adjusted models were estimated. RESULTS: Total muscle dysmorphia symptomatology and symptoms of Appearance Intolerance were prospectively associated with suicidal ideation and suicide planning at 12-month follow-up. These findings were significant across unadjusted and adjusted models. CONCLUSIONS: Findings from this study expand prior research and underscore the clinical complexity of muscle dysmorphia. Future research should investigate mechanisms explaining the association between muscle dysmorphia and suicide and develop interventions to prevent suicide among people with muscle dysmorphia.

At the Crossroads between Eating Disorders and Body Dysmorphic Disorders-The Case of Bigorexia Nervosa.

Bigorexia nervosa (BN) is a controversial nosological entity, considered either a feeding/eating disorder (FED) or a subtype of body dysmorphic disorder (BDD). This rapid review aims to explore the characteristic features of BN and identify evidence-based therapeutic interventions for this condition. Three electronic databases (PubMed, Cochrane, and Google Scholar) were searched for relevant information about BN, and 26 reports were reviewed in detail. The results showed that bodybuilders, weightlifters, and other populations involved in athletic activities are the most vulnerable to the onset of this disorder. Patients with BN should also be screened for physical and psychiatric comorbidities and complications, such as anabolic steroid use disorder, physical exercise addiction, and depressive or anxiety disorders. The main differential diagnoses for BN are schizophrenia spectrum disorders, depressive disorders, anxiety disorders, bodily distress disorder, and obsessive-compulsive disorders. Using validated screening instruments is considered very important from a clinical perspective, with the aim of providing early identification of this disorder. Therapeutic interventions for patients with BN are still in the early phases of development, and no specific pharmacological treatment has yet been identified. Since it is similar to the obsessive-compulsive spectrum, cognitive behavioral therapy has been suggested as a useful intervention; however, it has not yet been validated in large-scale clinical trials. In conclusion, based on the reviewed data, clarifying the concept of BN is of practical importance for constructing adequate prevention strategies and validating proper therapeutic interventions.

Food insecurity is associated with muscle dysmorphia symptomatology among a sample of Canadian adolescents and young adults.

Prior research has documented the association between food insecurity and eating disorders, disordered eating behaviors, and body dissatisfaction. No known research has investigated whether food insecurity is associated with muscle dysmorphia symptomatology, which was the aim of this study. Data from 912 adolescents and young adults in Canada were analyzed. Linear regression analyses were used to determine the association between experiencing past year food insecurity and current muscle dysmorphia symptomatology. Among the sample, 15.7% reported experiencing any food insecurity. In regression analyses, food insecurity was significantly associated with greater overall muscle dysmorphia symptomatology and symptoms of Functional Impairment and Appearance Intolerance. Nearly one in five (18.5%) participants who reported food insecurity were at clinical risk for muscle-dysmorphia. Findings add to the growing literature on the adverse correlates of food insecurity and underscore the need for more research and intervention efforts to address the relationship between food insecurity and muscle dysmorphia symptomatology.

Adaptation and validation of the muscle dysmorphic disorder inventory in a population of French athletes (MDDI-Fr).

INTRODUCTION: Muscle dysmorphia, a theme mainly investigated by Anglo-Saxon research, is a specific body dysmorphic disorder that characterizes individuals who think they are insufficiently muscular and lean. Understudied in francophone countries, tools translated and validated in French to measure the symptomatology of muscle dysmorphia remain rare. OBJECTIVES: The aim of this study was the translation into French and the psychometric validation of a tool evaluating muscle dysmorphia, the Muscle Dysmorphic Disorder Inventory (MDDI-Fr), through 13 items divided into three dimensions: the "Drive For Size" (DFS), the "Appearance Intolerance" (AI) and the "Functional Impairment" (FI). METHODOLOGY: A first translation step was conducted, followed by two cross-sectional studies conducted in France. In both of the latter studies, a sociodemographic questionnaire and the Muscle Dysmorphic Disorder Inventory - French version (MDDI-Fr) were administered. The first study included 342 university students (Mage=20.9; SDage=2.9), and 1822 athletes for the second study (Mage=23.9; SDage=5.9). Validation was performed using internal consistency measures and confirmatory factor analysis. RESULTS: The correlation matrices showed good significant results between items and dimensions. The three dimensions appeared distinct from each other with significant intra-dimension correlations. The internal consistency of the tool and its three dimensions show valid Cronbach's alphas (study 1: DFS=0.79, AI=0.74, FI=0.75, MDDI=0.74; study 2: DFS=0.72, AI=0.75, FI=0.83, MDDI=0.75). In addition, the tri-factor analysis shows significant and promising scores for the tool in three dimensions and 13 items for study 1 (χ2/df=4.67, CFI=0.85, TLI=0.83, RMSEA=0.10, SRMR=0.00), as for study 2 (χ2/df=16.08, CFI=0.87, TLI=0.84, RMSEA=0.09, SRMR=.06). Gender analyses were conducted on study 2, which showed that the DFS subscale (items 1, 4, 5) and the AI subscale (items 6 and 9) presented the greatest differences in factor loadings between genders. CONCLUSION: The translation, as well as the validation of the MDDI-Fr structured with 13 items and three dimensions, showed significantly satisfying results for its adaptation in French in a population of French men and women practicing weight training. However, the "Appearance Intolerance" dimension shows moderate links with the global tool, which should be investigated in future studies. Although the psychometric properties of the MDDI-Fr are promising, additional research is needed to gain a better understanding of gender differences in the results, especially for the DFS dimension.

Associations between violent victimization and symptoms of muscle dysmorphia: Findings from the Canadian Study of Adolescent Health Behaviors.

This study aimed to determine the associations between violent victimization and symptoms of muscle dysmorphia (MD) among a sample of Canadian adolescents and young adults. Data from 2538 adolescents and young adults (16-30 years) from the Canadian Study of Adolescent Health Behaviors were analyzed. Violent victimization assessed included experiences of rape, sexual assault, emotional abuse, and physical abuse occurring in the past 12 months. A violent victimization sum score was also created. Symptoms of MD were assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Linear regression analyses were conducted, stratified by gender, to determine the associations between violent victimization and MDDI total score and subscale scores. Among women and men, experiencing sexual assault, physical abuse, and emotional abuse in the past 12 months were significantly associated with a higher MDDI total score. Additionally, as the number of forms of violent victimization experienced increased, the likelihood of a higher MDDI total score also increased, with the strongest association among women and men who reported experiencing three or more victimizations. Findings expand the limited prior research suggesting associations between violent victimization and MD by assessing these associations via multiple forms of victimization and amongst a sample of Canadian adolescents and young adults.

Testing the longitudinal relationship between muscle dysmorphia symptoms and suicidality: A network analysis investigation.

Research on suicidality in muscle dysmorphia is limited despite the high rates of suicidal thoughts and behaviors in related disorders. This study employed network analysis to examine the longitudinal relationships between muscle dysmorphia symptoms, as well as the relations between MD symptoms and suicide risk factors. Fifty individuals (Mage = 30.6 years, 63 % male) meeting criteria for muscle dysmorphia received four daily surveys for three weeks. Multi-level vector autoregression analysis was used to estimate associations between muscle dysmorphia- and suicide-related thoughts, emotions, and behaviors. The most central nodes in the muscle dysmorphia networks related to assessing muscle size, dieting, using muscle-building supplements, experiencing body dissatisfaction, seeking reassurance, and avoiding others due to concerns about appearance. In the comorbidity networks, the most central suicide-related factors were feelings of burdensomeness, feeling disgusted, and dwelling on the past. Our findings indicated that various intrusive thoughts (body dissatisfaction, dieting), compulsions (seeking reassurance, body checking, supplement use), and beliefs (burden to others, disgust with oneself) predicted future engagement in muscle dysmorphia and suicide-related symptomology. Targeting intrusive thoughts and compulsions, as well as feelings of disgust and burdensomeness, may reduce the severity of these conditions.

A descriptive analysis of scoring patterns on clinically relevant questionnaires in 26 adults with diagnosed muscle dysmorphia.

OBJECTIVE: Few studies have recruited adults with a formal diagnosis of muscle dysmorphia (MD), a psychological illness defined by preoccupation that one lacks muscularity and/or leanness, combined with significant functional impairment. This study presented descriptive statistics for a range of clinically relevant questionnaires in one of the largest samples of adults with confirmed diagnoses of MD. METHOD: We recruited 29 adults who met diagnostic criteria for MD as determined by semi-structured diagnostic interviews and administered a battery of questionnaires assessing MD symptomology, compulsive exercise, and disordered eating. Descriptive statistics were calculated for both total and subscale scores for each questionnaire. Raincloud plots are included to show the distribution of total scores. RESULTS: Of the 29 participants, 26 completed all questionnaires. Mean scores were high across all questionnaires and broadly consistent with results in past studies that also recruited a clinical MD sample. Most participants scored above proposed clinical cut-off scores for questionnaires assessing compulsive exercise and disordered eating. CONCLUSIONS: This study adds to the small body of published questionnaire data in clinical MD samples. We stress that questionnaire scores should not be used alone to infer the presence of MD, but could be considered as a useful adjunct to a comprehensive clinical interview.

Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis among male weightlifters.

BACKGROUND: Anabolic-androgenic steroid (AAS) dependence has numerous adverse health consequences, and may be driven in part by body image concerns, primarily muscle dysmorphia. This study aims to further understand and identify potential clinical targets using network analyses of AAS dependence and muscle dysmorphia symptoms in males who used AAS and weightlifting controls. METHODS: A sample of 153 men who currently or previously used AAS and 88 weight-lifting controls were recruited through social media and relevant online forums, and via posters and flyers distributed in select gyms in Oslo, Norway. Symptoms of AAS dependence and muscle dysmorphia were assessed using clinical interviews and standardized questionnaires. Severity of muscle dysmorphia symptoms were compared between the groups using independent samples t-tests. The following symptom networks were computed using Gaussian graphical modeling or mixed graphical modeling: (1) AAS dependence symptoms among men with AAS use (2) muscle dysmorphia symptoms among men with AAS use and weight-lifting controls in two separate networks, which were compared using a network comparison test, and (3) AAS dependence and muscle dysmorphia symptoms among men with AAS use. RESULTS: In a network of AAS dependence symptoms, continuing use despite physical and mental side effects, using longer than planned, tolerance, and work/life interference were the most central symptoms. When comparing symptom structures of muscle dysmorphia between those who used AAS and controls, the most central symptoms in each group were exercise dependence and size/symmetry concerns, respectively. Men with AAS use demonstrated elevated muscle dysmorphia symptoms compared to controls, indicating that both the severity and structure of symptoms differ between these groups. In a network including both AAS dependence and muscle dysmorphia symptoms, no significant connections between symptom groups were identified. CONCLUSIONS: AAS dependence is complex, with correlated somatic and psychological challenges driving the symptom network, indicating that alleviating physical and mental health concerns during both AAS use and cessation is an important clinical target. Muscle dysmorphia symptoms related to taking action (diet, exercise, and supplement use) appear to cluster together more for those who use AAS than those who do not.

Conformity to masculine norms, interoceptive dysfunction, and changes in muscle dysmorphia symptoms.

Muscle dysmorphia (MD) is a psychiatric illness characterized by preoccupation and compulsive behaviors to increase muscle size/definition. Despite its severity, few risk factors/mechanisms for MD have been identified. Conformity to masculine norms may be a MD risk factor. Furthermore, interoceptive dysfunction may facilitate MD. symptoms, as well as underlie relationships between conformity to masculine norms and MD symptoms. However, research has yet to test the mediating role of interoceptive dysfunction for said relationships. The current study tested if interoceptive dysfunction underlies relationships between conformity to masculine norms and MD symptoms among 269 US men who completed three surveys separated by one month that contained measures of focal constructs. Our sample was majority White, heterosexual, and non-Hispanic. A three-wave autoregressive mediation model was tested in which conformity to masculine norms predicted interoceptive dysfunction, which then predicted MD symptoms. Results indicated that conformity to specific masculine norms predicted both interoceptive dysfunction and MD symptoms over time. Furthermore, our hypothesized mediation pathways were not discovered. Conformity to masculine norms appears to be a risk factor for MD symptoms and interoceptive dysfunction. If clinicians can reduce rigid adherence to masculine stereotypes, this may increase connection with one's body and reduce subsequent MD symptoms.

Cognitive rigidity and restrictive eating disorders: Delineating the impact of low weight, low fat, weight suppression, acute negative energy balance, and chronic restriction.

Restrictive eating disorders such as anorexia nervosa (AN) are characterized by extremely rigid cognitive and behavioral patterns, understood to underpin the chronic nature of these disorders. Interrogating the mechanisms contributing to and maintaining the rigid cognitive styles and limited behavioral repertoires, particularly in terms of restrictive eating and excessive exercise is of critical importance. Dietary restriction is overall understood to underpin this rigidity to a large extent, however, to date little is understood regarding the relative contributions of different aspects of restriction including low body weight, low fat mass, weight suppression, acute negative energy balance, and chronic restriction. Clarifying the respective roles of these different factors would be useful for both the better targeting intervention efforts in AN. Extending research to other disorders such as muscle dysmorphia, avoidant restrictive food intake disorders, or atypical AN, that may present similar features to AN but differ from it on other critical dimensions, may offer unique opportunities to identify clinical elements specific to these cognitive patterns. Doing so may inform interventions and pave the way towards more effective treatment approaches.