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RESUME DE NOTRE ARTICLE (Fr)

L’objectif de cette présente étude était d’examiner si des facteurs tels que l’alexithymie, le sentiment d’auto-efficacité concernant la régulation de l’alimentation et l’acceptation de son image corporelle, la consultation de contenus fitspiration ainsi que des comportements de pratique problématique de l’activité physique pourraient constituer des prédicteurs significatifs de la dysmorphie musculaire, et de pouvoir identifier un profil de sportifs à risque de cette pathologie. Ainsi, 342 étudiants pratiquant la musculation à l’université (Mage = 20,9 ans, ET = 2,9) ont été recrutés pour répondre à un questionnaire sociodémographique (âge, sexe, façon de pratiquer la musculation, consultation réseaux sociaux, consommation de produits améliorant l’apparence et la performance (APEDs) puis à des auto-questionnaires visant à évaluer la symptomatologie de la dysmorphie musculaire (MDDI), le sentiment d’auto-efficacité concernant la régulation de l’alimentation et l’acceptation de son image corporelle (EDRSQ), ainsi que l’alexithymie (TAS-20). Dans la population investiguée, les résultats montrent une prévalence de 18,7 % (n = 64) pour la dysmorphie musculaire. L’identification des émotions, le sentiment d’acceptation de son image corporelle, la pratique des activités physiques avec la recherche d’une sensation de douleur et de congestion, la consommation de substances améliorant l’apparence et la performance (APEDs), l’objectif de recherche de construction musculaire et de maintien de sa forme, la comparaison aux modèles fitness et les comportements de vérification dans le miroir à la salle (gym-mirror checking) se sont montrés prédicteur pour la dysmorphie musculaire (R2 = 0,379, pour le modèle multivarié final). Cette étude met en évidence le réseau complexe de déterminants de la dysmorphie musculaire et les comportements de pratique des activités physiques qui peuvent se montrer à risque de cette pathologie, facilement repérables pour les professionnels concernés.

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ABSTRACT (En)

The aim of this study was to examine whether factors such as alexithymia, self-efficacy in food and body, exposure to fitspiration content, as well as problematic behaviors related to problematic physical activity, could be significant predictors of muscle dysmorphia and to identify a profile of athletes at risk. Thus, 342 students practicing bodybuilding at the university (Mage = 20.9; SD = 2.9) were recruited to answer a sociodemographic questionnaire (age, sex, way of practicing bodybuilding, social network consultation, use of appearance and performance enhancing drugs) and self-questionnaires used to assess the symptomatology of muscle dysmorphia (MDDI), the feeling of self-efficacy in food and body (EDRSQ), as well as the alexithymia (TAS-20). The results show a prevalence of muscle dysmorphia of 18.7 % (n = 64) in the population. Moreover, using univariate logistic regressions and multivariate linear regressions, the identification of emotions, the feeling of self-efficacy in the body, the practice of physical activities with the search for a sensation of pain and congestion “the pump”, the consumption of appearance and performance enhancing drugs (APEDs), muscle building objective and maintenance of one’s form, the comparison to fitness models and the gym-mirror checking behaviors were shown to be predictor for muscle dysmorphia (R2 = 0.379 for the final multivariate model). This study highlights the complex network of determinants of muscle dysmorphia and the problematic behaviors related to physical activity that may contribute to this condition, which can be easily identified by relevant professionals.

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Pour lire notre article, vous pouvez le retrouver ici : https://www.mov-sport-sciences.org/articles/sm/abs/first/sm210039/sm210039.html

Dr. Jérôme CUADRADO

RÉFÉRENCES

Arbour, K. P., & Martin Ginis, K. A. (2006). Effects of exposure to muscular and hypermuscular media images on young men’s muscularity dissatisfaction and body dissatisfaction. Body Image, 3(2), 153‑161. https://doi.org/10.1016/j.bodyim.2006.03.004

Blashfield RK, Sprock J, Fuller AK. Suggested guidelines for including or excluding categories in the DSM-IV. Compr Psychiatry. 1990 Jan-Feb;31(1):15-9. doi: https://doi.org/10.1016/0010-440x(90)90049-x. PMID: 2297982.

Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23‑32. https://doi.org/10.1016/0022-3999(94)90005-1

Baghurst, T., Hollander, D. B., Nardella, B., & Haff, G. G. (2006). Change in sociocultural ideal male physique : An examination of past and present action figures. Body Image, 3(1), 87‑91. https://doi.org/10.1016/j.bodyim.2005.11.001

Baghurst, T., & Lirgg, C. (2009). Characteristics of muscle dysmorphia in male football, weight training, and competitive natural and non-natural bodybuilding samples. Body Image, 6(3), 221‑227. https://doi.org/10.1016/j.bodyim.2009.03.002

Bardone-Cone AM, Abramson LY, Vohs KD, Heatherton TF, Joiner TE Jr. Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status. Behav Res Ther. 2006 Jan;44(1):27-42. doi: https://10.1016/j.brat.2004.09.009. PMID: 16301012.

Barkoukis, V., Kartali, K., Lazuras, L., & Tsorbatzoudis, H. (2016). Evaluation of an anti- doping intervention for adolescents : Findings from a school-based study. Sport Management Review, 19(1), 23‑34. https://doi.org/10.1016/j.smr.2015.12.003

Berman ES. The relationship between eating self-efficacy and eating disorder symptoms in a non-clinical sample. Eat Behav. 2006 Jan;7(1):79-90. doi: https://10.1016/j.eatbeh.2005.07.004. Epub 2005 Aug 8. PMID: 16360626.

Blomeley, D., Phillipou, A., & Castle, D. J. (2016). Sizing it up : A Systematic Review of the Nosology of Muscle Dysmorphia. 1(1), 11.

Boepple, L., Ata, R. N., Rum, R., & Thompson, J. K. (2016). Strong is the new skinny : A content analysis of fitspiration websites. Body Image, 17, 132‑135. https://doi.org/10.1016/j.bodyim.2016.03.001

Boepple, L., & Thompson, J. K. (2016). A content analytic comparison of fitspiration and thinspiration websites : FITSPO THINSPO COMPARISON. International Journal of Eating Disorders, 49(1), 98‑101. https://doi.org/10.1002/eat.22403

Brockmeyer T, Holtforth MG, Bents H, Kämmerer A, Herzog W, Friederich HC. Starvation and emotion regulation in anorexia nervosa. Compr Psychiatry. 2012 Jul;53(5):496-501. doi: https://10.1016/j.comppsych.2011.09.003. Epub 2011 Oct 29. PMID: 22036318.

Cafri, G., Olivardia, R., & Thompson, J. K. (2008). Symptom characteristics and psychiatric comorbidity among males with muscle dysmorphia. Comprehensive Psychiatry, 49(4), 374‑379. https://doi.org/10.1016/j.comppsych.2008.01.003

Chandler, C. G., Derryberry, W. P., Grieve, F. G., & Pegg, P. O. (2009). Are Anxiety and Obsessive-Compulsive Symptoms Related to Muscle Dysmorphia? International Journal of Men’s Health, 8(2), 143‑154. https://doi.org/10.3149/jmh.0802_143

Cooper, M., Eddy, K. T., Thomas, J. J., Franko, D. L., Carron‐Arthur, B., Keshishian, A. C., & Griffiths, K. M. (2020). Muscle dysmorphia : A systematic and meta‐analytic review of the literature to assess diagnostic validity. International Journal of Eating Disorders, 53(10), 1583‑1604. https://doi.org/10.1002/eat.23349

Corcos M, Guilbaud O, Speranza M, Paterniti S, Loas G, Stephan P, Jeammet P. Alexithymia and depression in eating disorders. Psychiatry Res. 2000 Apr 10;93(3):263-6. doi: https://10.1016/s0165-1781(00)00109-8. PMID: 10760385  

Couture, S., Lecours, S., Beaulieu-Pelletier, G., Philippe, F. L., & Strychar, I. (2010). French adaptation of the eating disorder recovery self-efficacy questionnaire (EDRSQ) : Psychometric properties and conceptual overview. European Eating Disorders Review, 18(3), 234‑243. https://doi.org/10.1002/erv.996

Cuadrado, J., Morin, J., Hernandez, P., Yubero, E., Bégin, C., & Michel, G. (2018). Psychopathologie de la dysmorphie musculaire : Analyse critique de la littérature internationale. Annales Médico-psychologiques, revue psychiatrique, 176(9), 919‑927. https://doi.org/10.1016/j.amp.2018.09.005

Cuadrado, J., Hernandez-Comte, A., Narbaits-Jaureguy, M., & Michel, G. (2021). Les « Drive for » dans la dysmorphie musculaire : Critique de la littérature internationale. Annales Médico- psychologiques, revue psychiatrique. https://doi.org/10.1016/j.amp.2020.12.006

Cuadrado, J., Reynaud, D., Legigan, C., O’Brien, K., & Michel, G. (2022). “Muscle Pics”, a new body-checking behavior in muscle dysmorphia? L’Encéphale, S0013700622000045. https://doi.org/10.1016/j.encep.2021.11.004

Cuadrado, J., Meyer, É., Chadapeaud, L., Cheval, Y., Cornet, C., Hernandez-Comte, A., & Michel, G. (2022). Comment évaluer la dysmorphie musculaire ? Un état de l’art international. Annales Médico-psychologiques, revue psychiatrique, 180(6), 554‑565. https://doi.org/10.1016/j.amp.2022.04.001

Cuadrado, J., Hanne-Poujade, S., & Michel, G. (2023). Adaptation and validation of the muscle dysmorphic disorder inventory in a population of French athletes (MDDI-Fr). L’Encéphale. https://doi.org/10.1016/j.encep.2023.05.003

Dawes, J., & Mankin, T. (2004). Muscle dysmorphia. Strength and Conditioning Journal, 26, 24-. 25. (s. d.). https://doi.org/10.1519/00126548-200404000-00004

Devrim, A., Bilgic, P., & Hongu, N. (2018). Is There Any Relationship Between Body Image Perception, Eating Disorders, and Muscle Dysmorphic Disorders in Male Bodybuilders? American   Journal of            Men’s  Health, 12(5),  1746‑1758. https://doi.org/10.1177/1557988318786868

de Sousa Fortes, L., Ferreira, M. E. C., de Carvalho, P. H. B., & Miranda, R. (2016). Is drive for muscularity related to body checking behaviors in men athletes? Revista Brasileira de Ciências Do Esporte. https://doi.org/10.1016/j.rbce.2016.08.001

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 & New Zealand Journal of Psychiatry, 50(4), 322‑333. https://doi.org/10.1177/0004867415614106

Dryer, R., Farr, M., Hiramatsu, I., & Quinton, S. (2016). The Role of Sociocultural Influences on Symptoms of Muscle Dysmorphia and Eating Disorders in Men, and the Mediating Effects of Perfectionism.            Behavioral      Medicine,       42(3),  174-182. https://doi.org/10.1080/08964289.2015.1122570

Espina Eizaguirre, A., Ortego Saenz de Cabezón, A., Ochoa de Alda, I., Joaristi Olariaga, L., & Juaniz, M. (2004). Alexithymia and its relationships with anxiety and depression in eating disorders. Personality and Individual Differences, 36(2), 321‑331. https://doi.org/10.1016/S0191-8869(03)00099-0

Fayollet, D. C. B., Kern, L., & Thevenon, D. C. (2019). Activités physiques en santé mentale. Dunod.

Foster, A., Shorter, G., & Griffiths, M. (2015). Muscle dysmorphia : Could it be classified as an addiction to body image? Journal of Behavioral Addictions, 4(1), 1‑5. https://doi.org/10.1556/JBA.3.2014.001

Galioto, R., & Crowther, J. H. (2013). The effects of exposure to slender and muscular images on male body dissatisfaction. Body Image, 10(4), 566‑573. https://doi.org/10.1016/j.bodyim.2013.07.009

Goldberg, L., MacKinnon, D. P., Elliot, D. L., Moe, E. L., Clarke, G., & Cheong, J. (2000). The Adolescents Training and Learning to Avoid Steroids Program : Preventing Drug Use and Promoting Health Behaviors. Archives of Pediatrics & Adolescent Medicine, 154(4), 332. https://doi.org/10.1001/archpedi.154.4.332

Goodrick GK, Pendleton VR, Kimball KT, Carlos Poston WS, Reeves RS, Foreyt JP. Binge eating severity, self-concept, dieting self-efficacy and social support during treatment of binge eating disorder. Int J Eat Disord. 1999 Nov;26(3):295-300. doi: https://10.1002/(sici)1098-108x(199911)26:3<295::aid-eat7>3.0.co;2-7. PMID: 10441245.

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 & New Zealand Journal of Psychiatry, 49(9), 812‑820. https://doi.org/10.1177/0004867415572412

Griffiths, S., & Murray, S. B. (2017). Muscle Dysmorphia : Clinical Presentation and Treatment Strategies. In L. K. Anderson, S. B. Murray, W. H. Kaye, L. K. Anderson, S. B. Murray, & W. H. Kaye (Éds.), Clinical Handbook of Complex and Atypical Eating Disorders (p. 0). Oxford University Press. https://doi.org/10.1093/med-psych/9780190630409.003.0014

Hale, B. D., Diehl, D., Weaver, K., & Briggs, M. (2013). Exercise dependence and muscle dysmorphia in novice and experienced female bodybuilders. Journal of Behavioral Addictions, 2(4), 244‑248. https://doi.org/10.1556/JBA.2.2013.4.8

Halliwell, E., Dittmar, H., & Orsborn, A. (2007). The effects of exposure to muscular male models among men : Exploring the moderating role of gym use and exercise motivation. Body Image, 4(3), 278‑287. https://doi.org/10.1016/j.bodyim.2007.04.006

Haynos, A. F., & Fruzzetti, A. E. (2011). Anorexia nervosa as a disorder of emotion dysregulation: Evidence and treatment implications. Clinical Psychology: Science and Practice, 18(3), 183–202. https://doi.org/10.1111/j.1468-2850.2011.01250.x

Hildebrandt, T., Langenbucher, J., & Schlundt, D. G. (2004). Muscularity concerns among men: development of attitudinal and perceptual measures. Body Image, 1(2), 169‑181. https://doi.org/10.1016/j.bodyim.2004.01.001

Hildebrandt, T., Harty, S., & Langenbucher, J. W. (2012). Fitness supplements as a gateway substance for anabolic-androgenic steroid use. Psychology of Addictive Behaviors, 26(4), 955‑962. https://doi.org/10.1037/a0027877

Juarez, L., Soto, E., & Pritchard, M. E. (2012). Drive for Muscularity and Drive for Thinness : The Impact of Pro-Anorexia Websites. Eating Disorders, 20(2), 99‑112. https://doi.org/10.1080/10640266.2012.653944

Kanayama, G., Hudson, J. I., & Pope, H. G. (2008). Long-Term Psychiatric and Medical Consequences of Anabolic-Androgenic Steroid Abuse. Drug and alcohol dependence, 98(1‑2), 1‑12. https://doi.org/10.1016/j.drugalcdep.2008.05.004

Kanayama, G., Brower, K. J., Wood, R. I., Hudson, J. I., & Pope Jr., H. G. (2010). Treatment of anabolic–androgenic steroid dependence : Emerging evidence and its implications. Drug and Alcohol Dependence, 109(1‑3), 6‑13. https://doi.org/10.1016/j.drugalcdep.2010.01.011

Keating, L., Tasca, G. A., & Hill, R. (2013). Structural relationships among attachment insecurity, alexithymia, and body esteem in women with eating disorders. Eating Behaviors, 14(3), 366‑373. https://doi.org/10.1016/j.eatbeh.2013.06.013

Kelley, C. C. (Galliger), Neufeld, J. M., & Musher-Eizenman, D. R. (2010). Drive for thinness and drive for muscularity : Opposite ends of the continuum or separate constructs? Body Image, 7(1), 74‑77. https://doi.org/10.1016/j.bodyim.2009.09.008

Kern, L., Carrer, M., Marsollier, E., Gully-Lhonoré, C., & Bernier, M. (2020). Activité physique, quand trop c’est trop : État des connaissances sur l’activité physique problématique. La Presse Médicale Formation, 1(5), 511‑514. https://doi.org/10.1016/j.lpmfor.2020.10.018

Leit, R. A., Gray, J. J., & Pope, H. G. (2002). The media’s representation of the ideal male body : A cause for muscle dysmorphia? International Journal of Eating Disorders, 31(3), 334‑338. https://doi.org/10.1002/eat.10019

Leone JE, Sedory EJ, Gray KA. Recognition and treatment of muscle dysmorphia and related body image disorders. J Athl Train. 2005 Oct-Dec;40(4):352-9. PMID: 16404458; PMCID: PMC1323298.

Leone, J. E., Wise, K. A., Mullin, E. M., Harmon, W., Moreno, N., & Drewniany, J. (2015). The Effects of Pubertal Timing and Alexithymia on Symptoms of Muscle Dysmorphia and the Drive for Muscularity in Men. Psychology of Men & Masculinity, 16(1), 67‑77. https://doi.org/10.1037/a0035920

Linde JA, Jeffery RW, Levy RL, Sherwood NE, Utter J, Pronk NP, Boyle RG. Binge eating disorder, weight control self-efficacy, and depression in overweight men and women. Int J Obes Relat Metab Disord. 2004 Mar;28(3):418-25. doi: https://10.1038/sj.ijo.0802570. PMID: 14724662.

Loas G, Fremaux D, Marchand MP. Etude de la structure factorielle et de la cohérence interne de la version française de l’échelle d’alexithymie de Toronto à 20 items (TAS-20) chez un groupe de 183 sujets sains. Encéphale 1995 Mar-Apr;21(2):117-22. French. PMID: 7781582.

Loas G, Otmani O, Fremaux D, et al. Etude de la validité externe, de la fidélité et détermination des notes seuils des échelles d’alexithymie de Toronto (TAS et TAS-20) chez un groupe de malades alcooliques. Encéphale 1996 ;22 :35—40.

Loas G, Parker JD, Otmani O, Verrier A, Fremaux D. Confirmatory factor analysis of the French translation of the 20-item Toronto Alexithymia Scale. Percept Mot Skills. 1997 Dec;85(3 Pt 1):1018. doi: https://10.2466/pms.1997.85.3.1018. PMID: 9399312.

Longobardi, C., Prino, L. E., Fabris, M. A., & Settanni, M. (2017). Muscle dysmorphia and psychopathology : Findings from an Italian sample of male bodybuilders. Psychiatry Research, 256, 231‑236. https://doi.org/10.1016/j.psychres.2017.06.065

Martenstyn, J. A., Maguire, S., & Griffiths, S. (2022). A qualitative investigation of the phenomenology of muscle dysmorphia : Part 1. Body Image, 43, 486‑503. https://doi.org/10.1016/j.bodyim.2022.10.009

Martenstyn, J. A., Maguire, S., & Griffiths, S. (2023). A qualitative investigation of the phenomenology of muscle dysmorphia : Part 2. Body Image, 44, 78‑92. https://doi.org/10.1016/j.bodyim.2022.12.001

Mitchell, L., Murray, S. B., Cobley, S., Hackett, D., Gifford, J., Capling, L., & O’Connor, H. (2016). Muscle Dysmorphia Symptomatology and Associated Psychological Features in Bodybuilders and Non-Bodybuilder Resistance Trainers : A Systematic Review and Meta- Analysis. Sports Medicine. https://doi.org/10.1007/s40279-016-0564-3

Murray, S. B., Maguire, S., Russell, J., & Touyz, S. W. (2012). The emotional regulatory features of bulimic episodes and compulsive exercise in muscle dysmorphia : A case report. European Eating Disorders Review, 20(1), 68‑73. https://doi.org/10.1002/erv.1088

Murray, Stuart B., Rieger, E., Hildebrandt, T., Karlov, L., Russell, J., Boon, E., Dawson, R. T., & Touyz, S. W. (2012). A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa. Body Image, 9(2), 193‑200. https://doi.org/10.1016/j.bodyim.2012.01.008

Murray, Stuart B., Griffiths, S., Hazery, L., Shen, T., Wooldridge, T., & Mond, J. M. (2016). Go big or go home : A thematic content analysis of pro-muscularity websites. Body Image, 16, 17‑20. https://doi.org/10.1016/j.bodyim.2015.10.002

Nagata, J. M., Compte, E. J., McGuire, F. H., Lavender, J. M., Murray, S. B., Brown, T. A., Capriotti, M. R., Flentje, A., Lubensky, M. E., Obedin-Maliver, J., & Lunn, M. R. (2022). Psychometric validation of the Muscle Dysmorphic Disorder Inventory (MDDI)          among U.S. transgender men. Body Image, 42, 43 49.             https://doi.org/10.1016/j.bodyim.2022.05.001

Nieuwoudt, J. E., Zhou, S., Coutts, R. A., & Booker, R. (2012). Muscle dysmorphia : Current research and potential classification as a disorder. A Sport Psychology Perspective on Olympians       and      the            Olympic         Games,            13(5),  569‑577. https://doi.org/10.1016/j.psychsport.2012.03.006

Nieuwoudt, J. (2015). Commentary on : Muscle dysmorphia: Could it be classified as an addiction to body image? Journal of Behavioral Addictions, 4(1), 8‑10. https://doi.org/10.1556/JBA.3.2014.020

Olivardia, R., Pope, H. G., & Hudson, J. I. (2000). Muscle Dysmorphia in Male Weightlifters : A Case-Control Study. American Journal of Psychiatry, 157(8), 1291‑1296. https://doi.org/10.1176/appi.ajp.157.8.1291

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. https://doi.org/10.1080/10673220127900

Pinto, A. M., Guarda, A. S., Heinberg, L. J., & DiClemente, C. C. (2006). Development of the Eating Disorder Recovery Self-Efficacy Questionnare. International Journal of Eating Disorders, 39(5), 376‑384. https://doi.org/10.1002/eat.20256

Pope HG Jr, Katz DL, Hudson JI. Anorexia nervosa and « reverse anorexia » among 108 male bodybuilders. Compr Psychiatry. 1993 Nov-Dec;34(6):406-9. doi: https://10.1016/0010-440x(93)90066-d. PMID: 8131385.

Pope HG Jr, Gruber AJ, Choi P, Olivardia R, Phillips KA. Muscle dysmorphia. An underrecognized form of body dysmorphic disorder. Psychosomatics. 1997 Nov-Dec;38(6):548-57. doi: https://10.1016/S0033-3182(97)71400-2. PMID: 9427852.

Pope, H. G., Olivardia, R., Gruber, A., & Borowiecki, J. (1999). Evolving ideals of male body image as seen through action toys. The International Journal of Eating Disorders, 26(1), 65‑72. https://doi.org/10.1002/(sici)1098-108x(199907)26:1<65::aid-eat8>3.0.co;2-d

Pope, H. G., Kanayama, G., & Hudson, J. I. (2012). Risk factors for illicit anabolic-androgenic steroid use in male weightlifters : A cross-sectional cohort study. Biological Psychiatry, 71(3), 254‑261. https://doi.org/10.1016/j.biopsych.2011.06.024

Pourshahbaz, A., Nonahal, S., Dolatshahi, B., & Omidian, M. (2014). The Role of the Media, Perfectionism, and Difficulties in Emotion Regulation in Prediction of Muscle Dysmorphia Symptoms. http://jpcp.uswr.ac.ir/article-1-166-fa.html

Rizk, M., Kern, L., Godart, N., & Melchior, J.-C. (2014). Anorexie mentale, activité physique et nutrition : Quelles potentialisations ? Nutrition Clinique et Métabolisme, 28(4), 287‑293. https://doi.org/10.1016/j.nupar.2014.10.008

Rizk M, Lalanne C, Berthoz S, Kern L, EVHAN Group, et al. (2015) Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions. PLOS ONE 10(11): e0143352. https://doi.org/10.1371/journal.pone.0143352

Schneider, C., Rollitz, L., Voracek, M., & Hennig-Fast, K. (2016). Biological, Psychological, and Sociocultural Factors Contributing to the Drive for Muscularity in Weight-Training Men. Frontiers in Psychology, 7. https://doi.org/10.3389/fpsyg.2016.01992

Skemp, K. M., Mikat, R. P., Schenck, K. P., & Kramer, N. A. (2013). Muscle Dysmorphia : Risk May Be Influenced by Goals of the Weightlifter. Journal of Strength and Conditioning Research, 27(9), 2427‑2432. https://doi.org/10.1519/JSC.0b013e3182825474

Thomas LS, Tod DA, Lavallee DE. Variability in muscle dysmorphia symptoms: the influence of weight training. J Strength Cond Res. 2011 Mar;25(3):846-51. doi: https://10.1519/JSC.0b013e3181c70c17. PMID: 20613653.

Varangis E, Folberth W, Hildebrandt T, Langenbucher J. (2007). Confirmatory factor analysis for the Muscle Dysmorphic Disorder Inventory among male appearance and performance enhancing drug users. International Conference on Eating Disorders, Austin (poster ID 3793) http://members.aedweb.org/AM/Template.cfm?Section=Conference_Archive&Template=/CM/ContentDisplay.cfm&ContentID=3793.

Walker, D. C., Anderson, D. A., & Hildebrandt, T. (2009). Body checking behaviors in men. Body Image, 6(3), 164‑170. https://doi.org/10.1016/j.bodyim.2009.05.001