Development and initial validation of the Multifaceted Instrument for Body Image Disturbance (MI-BoD).

Specific facets of body image disturbance have an important role in eating disorder (ED) onset and maintenance yet have been assessed with single items and/or questionnaires predominantly developed in female samples to capture desire for a thinner body. The aim of this multipart study was to develop the multifaceted instrument for body image disturbance (MI-BoD) that will assess body image disturbance across gender and body size. In Study 1, interviews were conducted with 31 ED lived experience experts (45% females) to develop an initial item pool which was then rated for relevance and clarity by 59 international field experts, shortened and refined by the research team, and then rerated by 20 field experts and 91 ED lived experience experts. Of the 477 items developed from interviews, 46 were retained for the initial validation study. In Study 2, the MI-BoD was administered to undergraduate students (N = 937; 84% females), community adolescents (N = 208; 58% females), and individuals with self-reported ED diagnosis (N = 410; 77% females) to assess its preliminary psychometric properties. Exploratory factor analysis revealed six underlying factors, namely, Dissatisfaction, Overvaluation, Preoccupation, Fear of Weight Gain, Body Checking, and Body Exposure. No differential item functioning was detected for most MI-BoD items across gender, weight status, and ED status (symptomatic vs. asymptomatic). Overall, the MI-BoD showed good internal consistency, convergent and divergent validity, concurrent validity, and test-retest reliability. In conclusion, the MI-BoD is a promising tool for assessment of important facets of body image disturbance across gender, body size, and ED symptomatology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

On liking how you look and feeling sexy: Quantifying the overlap between sexual desirability and body satisfaction in a sample of Australian Grindr users.

The body image field aims to cultivate positive body image. To do so, it must appreciate factors contributing to positive body image. Sexual desirability is one such factor. Using experience sampling data from Australian Grindr users, we aimed to quantify the overlap between sexual desirability and body satisfaction. We found sexual desirability and body satisfaction correlated strongly between- (r = .90) and within-persons (rMedian =.60). Using dynamic structural equation modeling, we analyzed 238 participants' data (T = 9058), finding that sexual desirability and body satisfaction were bidirectionally related - previous sexual desirability predicted current body satisfaction (ß = 0.22) and vice versa (ß = 0.17). Participants' average body satisfaction tended to be higher when sexual desirability contributed more to body satisfaction (r = .31) and was more stable across time (r = .19). We found sexual desirability and body satisfaction overlap considerably and that sexual desirability may contribute more to body satisfaction than vice versa. Our results suggest that (1) sexual desirability and its dynamics across time influence body satisfaction, and (2) research on sexual desirability and its relationship with body image should be a focus for the field. We discuss avenues for future research on sexual desirability.

How intrasexual competitiveness shapes attitudes towards cosmetic surgery recipients.

Cosmetic surgery is extremely popular. Despite this, negative attitudes towards cosmetic surgery recipients prevail. Across two pre-registered studies, we examined whether intrasexual competitiveness explains these negative attitudes. Participants in Study 1 were 343 (mean age = 24.74) single heterosexual American women and participants in Study 2 were 445 (mean age = 19.03) single heterosexual Australian women. Participants in both studies were primed for either low or high intrasexual competitiveness. Contrary to our predictions, we found that priming condition did not influence participants' derogation and social exclusion of cosmetic surgery recipients. We did, however, find evidence for a 'relative attractiveness' halo effect: participants engaged in less derogation and social exclusion when they assumed cosmetic surgery recipients were more attractive than themselves. This suggests that 'pretty privilege' extends not only to women who meet conventional beauty standards, but also to those who are perceived as relatively closer to meeting these standards than the individual with whom they are engaging. Overall, we concluded that intrasexual competitiveness does not encourage the stigmatisation of cosmetic surgery recipients and examined alternative explanations for this phenomenon.

Appearance and performance factors associated with muscle building supplement use and favourable attitudes towards anabolic steroids in adolescent boys.

Introduction: The demand for appearance and performance enhancing substances, including muscle building supplements and anabolic androgenic steroids, is increasing in Australia. However, little is known about the associations between appearance and performance-based factors and appearance and performance enhancing substances (APES), particularly among adolescent boys. This study sought to examine (a) the prevalence of muscle building supplement use in a sample of adolescent boys and (b) how both performance and appearance factors relate to muscle building supplement use and favourable attitudes towards anabolic androgenic steroids in this sample. Method: N = 488 adolescent boys aged 13-16 (Mage = 14.59) from nine Australian schools completed measures of supplement use, favourable attitudes towards using steroids, muscle dissatisfaction, body fat dissatisfaction, mesomorphic ideal internalisation, weight training, and sports participation. Hierarchical logistic regressions were used to examine cross-sectional correlates of muscle building supplement use and favourable attitudes towards using anabolic androgenic steroids. Results: In the past three months, 12.7% of the sample had used muscle building supplements. Both appearance and performance-related factors - mesomorphic ideal internalisation and weight training - were related to muscle building supplement use. Only one appearance-related factor - body dissatisfaction - was related to favourable attitudes towards anabolic androgenic steroids. Discussion: The findings from this study are important as they may help to guide intervention strategies regarding appearance and performance enhancing substance use by Australian adolescent boys, with the ultimate goal of ensuring this population's safety.

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.

Impact of harm reduction practice on the use of non-prescribed performance and image-enhancing drugs: The PUSH! Audit.

METHOD: The PUSH! Audit was a cross-sectional study performed from May 2019 to May 2021. With each audit submitted, general practitioners (GPs) were asked about the impact of their engagement with their patients. RESULTS: In all, 144 audit responses were collected, with 81.6% of audits showing a change in behaviour. The changes noted were better monitoring (71.3%), treatment of adverse effects (64.4%), modified use (44.4%) and stopped use (12.2%). DISCUSSION: This study asking GPs about outcomes with each of their patients using non-prescribed PIEDs has shown significant changes in behaviour. There has been no previous work done to evaluate the potential impact of such engagement. The findings of this exploratory study of the PUSH! Audit suggest harm reduction for people who use non-prescribed PIEDs when engaged with GP clinics.

Why do queer men experience negative body image? A narrative review and testable stigma model.

Queer men (i.e., men who are not heterosexual; sexual minority men) are disproportionately affected by negative body image - they experience greater body dissatisfaction are more likely to develop eating disorders than heterosexual men. While existing literature has examined individual-level predictors of negative body image for queer men, less is known about why queer men as a group are disproportionately affected by negative body image. By synthesising existing theoretical frameworks, research, policy, and media reporting, this narrative review moves towards an understanding of systemic-level negative body image for queer men. Through the lens of hegemonic masculinity, we explain how systemic experiences of stigma work to inform unattainable appearance standards for queer men, and how these standards then contribute to pervasive negative body image concerns among this community. Next, we describe how systemic stigma works to exacerbate negative health outcomes for queer men with body image concerns. Finally, we present a synthesized model of the processes outlined in this review, articulate testable predictions for future studies, and describe practical implications that could be widely employed to improve body image for queer men. Our review is the first to propose a comprehensive explanation of systemic negative body image for queer men.

Beyond the genomes of Fulvia fulva (syn. Cladosporium fulvum) and Dothistroma septosporum: New insights into how these fungal pathogens interact with their host plants.

Fulvia fulva and Dothistroma septosporum are closely related apoplastic pathogens with similar lifestyles but different hosts: F. fulva is a pathogen of tomato, whilst D. septosporum is a pathogen of pine trees. In 2012, the first genome sequences of these pathogens were published, with F. fulva and D. septosporum having highly fragmented and near-complete assemblies, respectively. Since then, significant advances have been made in unravelling their genome architectures. For instance, the genome of F. fulva has now been assembled into 14 chromosomes, 13 of which have synteny with the 14 chromosomes of D. septosporum, suggesting these pathogens are even more closely related than originally thought. Considerable advances have also been made in the identification and functional characterization of virulence factors (e.g., effector proteins and secondary metabolites) from these pathogens, thereby providing new insights into how they promote host colonization or activate plant defence responses. For example, it has now been established that effector proteins from both F. fulva and D. septosporum interact with cell-surface immune receptors and co-receptors to activate the plant immune system. Progress has also been made in understanding how F. fulva and D. septosporum have evolved with their host plants, whilst intensive research into pandemics of Dothistroma needle blight in the Northern Hemisphere has shed light on the origins, migration, and genetic diversity of the global D. septosporum population. In this review, we specifically summarize advances made in our understanding of the F. fulva-tomato and D. septosporum-pine pathosystems over the last 10 years.

The differential effects of state and trait masculinity and femininity on body satisfaction among sexual minority men.

Masculine men are more likely to idealise being tall, muscular, and lean. Feminine men, on the other hand, are more likely to idealise leanness. At the trait level, masculinity and femininity have been linked with an unhealthy striving for these idealised traits and body dissatisfaction. However, it is unclear how feeling masculine or feminine in the moment might be associated with body satisfaction. Is feeling masculine and/or feminine associated with a boost in body satisfaction? In the first large-scale experience sampling study of masculinity and femininity (nobservations=25,133; Nparticipants=530), we find that state masculinity and femininity, but not trait, are associated with increased body satisfaction among sexual minority men. We also find a gender congruence effect whereby the positive associations between state masculinity/femininity on body satisfaction are more pronounced when these feelings align with trait levels of masculinity/femininity. Exploratory analyses revealed a moderating effect of eating disorder history. The associations between masculinity and femininity on body satisfaction were amplified for people who had been diagnosed with an eating disorder. This study presents the first evidence that the links between masculinity and femininity and body satisfaction can be delineated based on whether they are measured as traits or states.

Goodform: A cluster randomised controlled trial of a school-based program to prevent body dissatisfaction and muscle building supplement use among adolescent boys.

Although body dissatisfaction is common among adolescent boys, few intervention programs specifically developed for boys have been shown to be effective for reducing body dissatisfaction. Our study aim was to evaluate Goodform, a 4-session, teacher delivered intervention program specifically developed for boys to reduce body dissatisfaction and muscle building supplement use. The Goodform program was based on cognitive dissonance, social learning theory, and a social norms approach, and drew from two existing body image intervention programs that have shown promise among males: The Body Project- More than Muscles, and the Athletes Training and Learning to Avoid Steroids Program (ATLAS). A sample of 488 boys in grades 9 and 10 (Mage = 14.81, SDage = 0.51) at nine secondary schools in Australia were randomly assigned to Goodform (n = 244) or control (n = 244) at the school level. Self-reported body image, supplement use, anabolic androgenic steroid (AAS) use, and attitudes around using AAS and muscle building supplements were measured at baseline, post-intervention, and eight-week follow-up. Analyses with multi-level, mixed-effect regression models revealed no changes over time attributable to the intervention. Our results have implications for researchers in the body image and eating disorder prevention fields. Lessons learned in this study can inform future school-based efforts for reducing muscle building supplement use.

A qualitative investigation of the phenomenology of muscle dysmorphia: Part 2.

Muscle dysmorphia (MD) is a mental disorder characterised by preoccupation that one lacks muscularity and/or leanness, leading to substantial functional impairment. This article is the second of a two-part qualitative study examining the phenomenology of MD among 29 adults with diagnosed MD. We used reflexive thematic analysis to generate five themes which capture the role of exercise in the lives of people with MD. In summary, participants were highly motivated by a constant desire to progress their strength and appearance, and bad or missed workouts which threatened to derail their progress were associated with acute mental health impairment. Most participants scheduled rest days and modified workouts, both for muscle building-related goals and to reduce the risk of injuries, but often continued to exercise when sick. Alongside appearance-driven motivations, participants reported exercising for a variety of non-appearance-related reasons, including to structure their daily lives, boost self-esteem, regulate affect, and gain a sense of control from being able to manipulate their body composition. Exercise was often regarded as a core part of one's identity and overwhelmingly perceived as a net positive behaviour. Sample participant resistance training and cardio routines are described in detail within this article.

Difficulties with emotion regulation and weight/shape concerns as predictors of eating disorder behaviors among adolescents.

BACKGROUND: Difficulties with emotion regulation are a proposed key transdiagnostic factor of mental health difficulties, including eating disorders. However, it remains unclear whether difficulties with emotion regulation prospectively predict engagement in eating disorder behaviors. The current study examined whether difficulties with emotion regulation were associated with eating disorder behaviors after 1 year, in addition to weight and shape concerns. METHOD: A community sample of high school students (n = 3,074; 53.2% girls) completed self-report measures of eating behaviors, weight/shape concerns, and difficulties with emotion regulation at two timepoints, 1 year apart. RESULTS: Findings indicated that greater difficulties with emotion regulation were uniquely associated with engaging in binge eating, fasting, and purging after 1 year. However, only greater weight and shape concerns, not difficulties with emotion regulation, were uniquely associated with engaging in driven exercise. Limited associations were detected for the frequency of eating disorder behaviors. Additionally, exploratory analyses were conducted to examine potential onset and persistence of eating disorder behaviors. Few gender differences were observed across analyses, with the exception of driven exercise, which was linked to difficulties with emotion regulation only among adolescent boys, but not girls. CONCLUSIONS: Findings suggest that difficulties with emotion regulation are a distinct factor in the occurrence of some eating disorder behaviors among adolescents. Exploratory findings further suggest that difficulties with emotion regulation appear to be particularly involved in the persistence of these behaviors in adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Twenty-year associations between disordered eating behaviors and sociodemographic features in a multiple cross-sectional sample.

BACKGROUND: Disordered eating behaviors (DEB) impact on health and wellbeing worldwide. This study aimed to examine sociodemographic trends in the prevalence of DEB over 20 years in the Australian general population. METHODS: Data were derived from five sequential cross-sectional surveys (1998, 2008, 2009, 2016 and 2017) with population-representative samples of adults and adolescents residing in South Australia (N = 15 075). DEBs investigated were objective binge eating (OBE), strict dieting/fasting, and purging. Sociodemographic data included gender, age, educational level, work and marital status, and residence. RESULTS: OBE prevalence increased significantly. Strict dieting/fasting also increased from 1998 to 2008/9 but remained stable between 2008/9 and 2016/7. Purging prevalence did not change significantly over time. All survey years were associated with a significantly higher odds of OBE, and strict diet/fasting compared to 1998. Lower age, a higher Accessibility Remoteness Index of Australia (ARIA) score, higher body mass index (BMI), higher educational attainment, and not being in a married or de facto relationship were independently associated with greater adjusted odds for endorsing OBE. Younger age, female gender, and higher BMI were also independently associated with greater adjusted odds for endorsing strict dieting/fasting. CONCLUSIONS: The increased prevalence of DEBs in various strata of Australian society has both public health and clinical implications. The results refute the stereotype that eating disorders (EDs) predominantly affect young women. They build impetus for future research on EDs among men and older individuals, with a view to developing tailored public health and clinical interventions for these populations.

A qualitative investigation of the phenomenology of muscle dysmorphia: Part 1.

Muscle dysmorphia (MD) is a psychological disorder defined by preoccupation with one's perceived lack of muscularity and/or leanness, causing significant functional impairment. Studies of individuals with diagnosed MD are rare and no large-scale qualitative studies of the disorder exist. We conducted a qualitative study exploring the lived experiences of 29 individuals with diagnosed MD. Using reflexive thematic analysis, we generated five themes capturing the core features of MD. We identified two distinct phenotypes of MD: a "muscular/lean phenotype" focused on both gaining muscle and remaining lean, and a "muscular phenotype" with a sole preoccupation of increasing muscle mass. Participants also described their physique goals as never-obtained "moving goalposts", differed in their desire for muscularity versus leanness, and experienced fluctuations in body dissatisfaction during "cutting" versus "bulking" phases, and pre- versus post-workout. Almost all participants reported avoiding public body exposure and compulsively mirror-checking. Most were rigorous dieters who meticulously tracked their caloric and macronutrient intake, and were obsessive about meeting protein targets. Disruptions to dieting and training were often minimised by compromising their social lives. Low self-esteem appeared a predisposing factor for MD, while social comparison, body image distortion, and integration of MD into one's self-identity may represent maintaining factors. Additional clinically valuable insights into MD's phenomenology are discussed in detail.

Aboriginal and/or Torres Strait Islander women's body image: A qualitative study.

Aboriginal and/or Torres Strait Islander peoples refer to the traditional owners of Australia and have the oldest continuing culture in the world. Body image has scarcely been investigated among adult Aboriginal and/or Torres Strait Islander (Indigenous) women, despite evidence that racism and colourism broadly contribute to adverse psychological outcomes for this population. Therefore, we conducted a qualitative study investigating Indigenous womens' body image with specific focus on racism, colourism, and cultural identity. Sixteen Indigenous women completed individual interviews or took part in group yarns - a culturally sanctioned method of information sharing. A reflexive thematic analysis generated three themes: (i) Dominant beauty ideals in Australia exclude Indigenous women and are informed by colonisation and stereotypes of what Indigenous women "should" look like, (ii) Variations in Indigenous women's identities and appearances influences the types of discrimination that they receive and impacts their sense of belonging, and (iii) A change journey occurs over time towards body acceptance which is informed by changes in understandings of body image and cultural identity. Broadly, participants described racism and colourism as negatively impacting their body image. Importantly, developing a strong cultural identity mitigated these impacts by facilitating both a sense of belonging and body acceptance - highlighting a potential protective factor.

Sexual racism and colourism among Australian men who have sex with men: A qualitative investigation.

Sexual racism, referring to discrimination in the context of sexual and romantic partner-seeking, is pernicious among men who have sex with men (MSM). Two gaps exist in the literature on sexual racism among MSM: the potential role of colourism, wherein non-White MSM experience additional discrimination due to their skin tone; and the lack of current qualitative data about how Australian MSM construe sexual racism and colourism. We qualitatively investigated the manifestations and construals of sexual racism and colourism within an Australian sample of MSM (N = 39, 64% non-White) recruited via Grindr. Reflexive thematic analysis identified three themes: Manifestations of sexual racism; Recognising the racial hierarchy of desirability; and Diverse understandings of sexual racism. Participants recognised a racial hierarchy of desirability that privileges Whiteness and gives rise to multiple manifestations of sexual racism that harm non-White MSM. Notably, this hierarchy is intertwined with a skin colour hierarchy that favours lighter complexions among non-White men. Construals of sexual racism and colourism were diverse and ranged from beliefs that race-based sexual preferences are sacrosanct and beyond the purview of moral critique, through to beliefs that race-based sexual preferences are inherently political and entail a moral obligation for individuals to introspect and modify.

Body image as a multidimensional concept: A systematic review of body image facets in eating disorders and muscle dysmorphia.

Body image disturbance is core to the psychopathology of eating disorders (EDs), and related disorders such as muscle dysmorphia (MD). Global measures of body image fail to quantify specific aspects of body image disturbance that characterizes EDs, and may be differentially associated to outcomes. The aim of this systematic review was to provide an overview of specific body image facets and synthesize findings from controlled studies that compared clinical ED/MD and control-comparison groups in body image disturbance. One-hundred sixty-seven studies met inclusion criteria, and reported on comparisons among 30,584 individuals in 28 body image facets, which were more broadly grouped into evaluative, perceptual, cognitive-affective and motivational categories for the purpose of the present review. Effect sizes were calculated as Cohen's d for every comparison between ED and control groups. Body dissatisfaction (evaluative category) was the most prevalent facet assessed across studies (62 %), and differences between clinical and control groups were the largest in this category, especially for bulimia nervosa (d = 1.37). Scarcity of studies with male and MD clinical samples, and use of single-item and non-validated measures, should encourage development of instruments for body image facets pertinent to EDs and MD that can be validly applied across gender.

A randomized controlled trial of a brief self-compassion intervention designed to improve the body image of sexual minority men.

Self-compassion involves reflecting on shared human experiences, expressing self-kindness, and responding to feelings in a kind and non-judgmental way. Self-compassion interventions seem to be effective for women's body dissatisfaction, however, such interventions have not been trialed with men, including sexual minority men, who are particularly vulnerable. We conducted a randomized controlled trial of a brief self-compassion intervention designed to reduce body dissatisfaction among sexual minority men (N = 605). We used a 3 (condition: self-compassion, self-esteem, and a benign recollection control) × 5 (time) repeated measures design, whereby participants completed a brief writing task and completed body image measures at multiple time-points. Participants in both the self-compassion and self-esteem conditions showed improved body image and self-compassion following the intervention whereas participants in the control condition did not. Increases in self-compassion mediated body image measures for participants in the self-compassion but not self-esteem or control conditions. Participants in the self-compassion condition also showed increased self-compassion at three-weeks follow-up. While several caveats to our results were noted, our overall interpretation is that self-compassion and self-esteem interventions might be effective for sexual minority men's body image, and more research is necessary. The challenge of inculcating a self-compassionate mindset among men is also discussed.

The 'not-so-healthy' appearance pursuit? Disentangling unique associations of female drive for toned muscularity with disordered eating and compulsive exercise.

Today, many women are driven to subscribe to a more athletically oriented appearance ideal hallmarked by muscle tone (referred to as athletic- or fit-looking). However, the constellation of unhealthy eating and exercise behaviors that may accompany the pursuit of toned muscularity among women is not yet well characterized. To address this knowledge gap, our study evaluated the associations among the female drive for toned muscularity and both thinness-oriented disordered eating behaviors (e.g., dietary restriction) and muscularity-oriented disordered eating behaviors (e.g., excessive scrutiny of macro-nutrient values of food), as well as dimensions of compulsive exercise. Participants were 388 Australian undergraduate women who completed an online questionnaire including self-report measures of said constructs. Hierarchical regression models were used to determine whether the drive for toned muscularity accounted for unique variance in eating and exercise behaviors after adjusting for theoretically relevant covariates. Results indicated independent relationships between the drive for toned muscularity and several facets of thinness- and muscularity-oriented disordered eating, as well as compulsive exercise (e.g., exercise rigidity). Our findings further contribute to an emerging literature illustrating that women driven to attain a toned appearance may be vulnerable to engaging in a wide range of maladaptive eating and exercise practices.