Guy Cafri

Measuring Male Body Image: A Review of the Current Methodology

Much body image research has been directed toward the study of males (H. G. Pope, K. A. Phillips, & R. Olivardia, 2000). However, little attention has been devoted to consideration of which methods yield the most accurate measurement of this population. Based on numerous social psychological studies indicating the salience of a muscular appearance (e.g., H. G. Pope, R. Olivardia, A. Gruber, & J. Borowiecki, 1999), 3 guidelines were derived for assessing male body image. Existing methods of male body image assessment were evaluated based on their adherence to these guidelines and avoidance of methodological shortcomings. The most effective measures of male body image were the Drive for Muscularity Scale (D. R. McCreary & D. K. Sasse, 2000), somatomorphic matrix (A. J. Gruber, H. G. Pope, J. Borowiecki, & G. Cohane, 1999), and a modification to the somatomorphic matrix introduced here.

The muscular ideal : psychological, social, and medical perspectives

The muscular ideal is increasingly becoming the preferred body type for men, adolescent boys and even some women. Why is this body type the new ideal, and how did it develop? Why are some people driven to achieve heightened muscularity, and how do they do it? What risks to physical and mental health are involved when extreme behaviors are undertaken in the pursuit of the muscular ideal? This edited book draws on new research to provide an overview of the muscular ideal, including historical and present socioeconomic trends, assessment and measurement issues, and clinical presentation of disorders such as muscle dysmorphia. Chapters also cover related issues such as steroid use, repeated cosmetic surgery, and prevention issues. The target audience includes sport and health psychologists, clinical and counseling psychologists, and graduate students in psychology, sociology, gender roles, and health and sport science courses.

Psychometric Properties and U.S. National Norms of the Evidence-Based Practice Attitude Scale (EBPAS)

The Evidence-Based Practice Attitude Scale (EBPAS) assesses mental health and social service provider attitudes toward adopting evidence-based practices. Scores on the EBPAS derive from 4 subscales (i.e., Appeal, Requirements, Openness, and Divergence) as well as the total scale, and preliminary studies have linked EBPAS scores to clinic structure and policies, organizational culture and climate, and first-level leadership. EBPAS scores are also related to service provider characteristics, including age, education level, and level of professional development. The present study examined the factor structure, reliability, and norms of EBPAS scores in a sample of 1,089 mental health service providers from a nationwide sample drawn from 100 service institutions in 26 states in the United States. The study also examined associations of provider demographic characteristics with EBPAS subscale and total scores. Confirmatory factor analysis supported a second-order factor model, and reliability coefficients for the subscales ranged from .91 to .67 (total scale = .74). The study establishes national norms for the EBPAS so that comparisons can be drawn for U.S. local as well as international studies of attitudes toward evidence-based practices. The results suggest that the factor structure and reliability are likely generalizable to a variety of service provider contexts and different service settings and that the EBPAS subscales are associated with provider characteristics. Directions for future research are discussed.

Pursuit of Muscularity in Adolescent Boys: Relations among Biopsychosocial Variables and Clinical Outcomes.

Adolescent boys (n = 269) were assessed for levels of several risky behaviors related to the pursuit of muscularity, including substance use (anabolic steroids, prohormones, and ephedrine) dieting to gain weight, and symptoms of muscle dysmorphia (MD). The association between these behaviors and a variety of putative biological, psychological, and social risk factors were also evaluated. Concerning rates for lifetime use of steroids (2.6%), prohormones (4.5%), and ephedrine (6%) were found. Multiple regression analyses indicated that MD and sports participation significantly predicted substance use. Body dissatisfaction and body mass index were significant predictors of dieting to gain weight. Additionally, negative affect, media influence, and sports participation predicted symptoms of MD.

Investigating the role of appearance-based factors in predicting sunbathing and tanning salon use

UV exposure via sunbathing and utilization of sun lamps and tanning beds are considered important risk factors for the development of skin cancer. Psychosocial models of UV exposure are often based on theories of health behavior, but theory from the body image field can be useful as well. The current study examines models that prospectively predict sunbathing and indoor tanning behaviors using constructs and interrelationships derived from the tripartite theory of body image, theory of reasoned action, health belief model, revised protection motivation theory, and a proposed integration of several health behavior models. The results generally support a model in which intentions mediate the relationship between appearance attitudes and tanning behaviors, appearance reasons to tan and intentions mediate the relationship between sociocultural influences and tanning behaviors, and appearance reasons not to tan and intentions mediate the role of perceived threat on behaviors. The implications of these findings are considered.

Two Novel Treatments to Reduce Overeating in Overweight Children: A Randomized Controlled Trial

OBJECTIVE Our purpose in this study was to examine 2 treatments targeted at reducing eating in the absence of hunger in overweight and obese children. METHOD Thirty-six overweight and obese 8- to 12-year-old children (58% female; mean age = 10.3 years, SD = 1.3), with high scores on eating in the absence of hunger, and their parents were randomly assigned to an 8-week childrens appetite awareness training or cue exposure treatment-food. Children completed an eating in the absence of hunger (EAH) paradigm, an Eating Disorder Examination interview for children, and three 24-hr dietary recalls, and their height and weight were measured. Parents completed the EAH Questionnaire and the Binge Eating Scale, and their height and weight were measured. Assessments were conducted at baseline, posttreatment, and 6 and 12 months posttreatment. RESULTS Results showed that both treatments resulted in significant decreases in binge eating in children over time. Additionally, children in the food cue exposure treatment showed significant decreases in EAH posttreatment and 6 months posttreatment, but children in the appetite awareness training showed no change in EAH. Neither treatment produced significant effects on caloric intake in children or on any of the parent outcomes. CONCLUSIONS This study demonstrates that training in food cue responsitivity and appetite awareness has the potential to be efficacious for reducing EAH and binge eating in children. Because these data are preliminary, further treatment development and randomized controlled studies are needed.

Symptom characteristics and psychiatric comorbidity among males with muscle dysmorphia

OBJECTIVE Muscle dysmorphia has been described as a disorder in which individuals are pathologically preoccupied with their muscularity. This study was designed to further investigate the symptom characteristics and psychiatric conditions associated with the disorder. METHOD Weight lifting males meeting current criteria for muscle dysmorphia (n = 15), past muscle dysmorphia (n = 8), and no history of muscle dysmorphia (n = 28) responded to advertisements placed in gymnasium and nutrition stores. Structured and semistructured interviews were administered, as well as survey measures. RESULTS Relative to controls, males with current muscle dysmorphia experienced more aversive symptoms related to the appearance of their bodies, including more often thinking about their muscularity, dissatisfaction with appearance, appearance checking, bodybuilding dependence, and functional impairment. Higher rates of mood and anxiety disorders were found among individuals with a history of muscle dysmorphia relative to individuals with no history of muscle dysmorphia. CONCLUSIONS The findings suggest that muscle dysmorphia can be distinguished from normal weight lifting on a number of clinical dimensions. Muscle dysmorphia appears to be comorbid with other psychiatric conditions. Limitations of the current study and directions for future research are considered.

Parent-only treatment for childhood obesity: a randomized controlled trial.

Parent‐only (PO) treatments for childhood obesity are feasible, more cost‐effective and potentially easier to disseminate. The objective of this study was to determine whether a PO treatment is not inferior to a parent + child (PC) treatment for childhood obesity. Eighty parent‐child dyads with an 8–12 year old overweight or obese child (>85th BMI‐P) were recruited and randomized into PO or PC treatment for childhood obesity. Parents or parent‐child dyads attended 5‐month treatment groups. Child and parent body size, child caloric intake, and child physical activity were assessed at baseline, post‐treatment, and 6‐months follow‐up. Noninferiority testing using mixed linear models was used to compare PO treatment with PC treatment. Results showed that the PO group was not inferior to the PC group in terms of child weight loss. Results also showed that the PO group was not inferior to the PC group in terms of parent weight loss and child physical activity, but not child caloric intake. This study suggests that a PO treatment could provide similar results to PC in child weight loss and other relevant outcomes, and potentially could be more cost‐effective and easier to disseminate. Although further research is needed, this study suggests that PO groups are a viable method for providing childhood obesity treatment.

Steroid use among adolescents: Longitudinal findings from project EAT

OBJECTIVE. We examined the prevalence, persistence, secular and longitudinal trends, and predictors of steroid use in a diverse sample of adolescents. PARTICIPANTS AND METHODS. Data are from Project EAT-II (Eating Among Teens), a 5-year longitudinal study of eating, activity, weight, and related variables in 2516 middle and high school students. Data were collected in 1999 (time 1) and 2004 (time 2). RESULTS. Approximately 1.5% of adolescents reported steroid use at time 2. Use differed by ethnicity but not socioeconomic status. Steroid use was not stable across time, although the risk of use at time 2 was higher for girls and (marginally) for boys who used steroids at time 1. No secular trends were noted in middle adolescents’ steroid use between 1999 and 2004. Developmentally, steroid use decreased as adolescents grew older. Predictors of use for male adolescents included wanting to weigh more and reporting higher use of healthy weight-control behaviors. Female time 2 steroid users had higher BMIs and were less satisfied with their weight, had poorer nutrition knowledge and concern for health, and were marginally more likely to have participated in weight-related sports at time 1. CONCLUSIONS. The prevalence of steroid use in adolescents was low but of concern. Although use was not persistent over 5 years, time 1 use was a risk factor for time 2 use in female adolescents. There was no change in the prevalence of steroid use by middle adolescents between 1999 and 2004 despite a great deal of public interest in steroids during this time period. Steroid use decreased as adolescents grew older. Weight-related variables predicted adolescents’ steroid use 5 years later, and health and nutrition knowledge and concern and (marginally) participation in weight-related sports further predicted use in female adolescents. These findings suggest that early preventive efforts may be most useful.

Evaluating the Convergence of Muscle Appearance Attitude Measures

There has been growing interest in the assessment of a muscular appearance. Given the importance of assessing muscle appearance attitudes, the aim of this study was to explore the convergence of the Drive for Muscularity Scale, Somatomorphic Matrix, Contour Drawing Rating Scale,Male Figure Drawings, and the Muscularity Rating Scale. Participants were 76 men and 103 women who each completed four measures of body image that were meant to evaluate two distinct domainsof appearance attitudes: muscularity and body fat. For both genders, data indicated low convergence among muscularity measures, but high convergence among body fat measures. For men, the Drivefor Muscularity Body Image subscale exhibited the greatest concurrent validity with behaviors used to increase muscularity. The results are discussed in light of the selection of methods forthe assessment of muscle appearance attitudes.