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

Prnjak, Katarina; Jukić, Ivan; Mitchison, Deborah; Griffiths, Scott; Hay, Phillipa

doi:10.1016/j.bodyim.2022.07.006

Cited by 28 publications

(28 citation statements)

References 120 publications

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“…Each participant spoke with the lead researcher about their body image disturbance via a one-on-one videoconference interview using Zoom, which was auto-transcribed and then edited for corrections by the first author. A total item pool of 477 items were extracted as statements from the participants’ narratives by the first author, as done in previous studies (e.g., Piran et al, 2020), and informed by dimensions of body image disturbance (perceptual, cognitive, affective, body dissatisfaction, and behavioral component) identified from existing literature and a recent systematic review (Prnjak et al, 2022). The items were independently reviewed by the coauthors, who provided feedback on whether each item should be retained, reformulated, or removed.…”

Section: General Methodsmentioning

confidence: 99%

“…While in ED research, the use of umbrella terms for body image disturbance, such as “weight and shape concerns,” has been a prevailing approach, recent empirical findings support the contention that body image disturbance is a multidimensional construct, whose facets have a unique role in explaining ED symptoms concurrently (Linardon et al, 2018; Mitchison et al, 2017), ED onset prospectively (Prnjak et al, 2021), as well as change in ED psychopathology throughout treatment (Calugi et al, 2018). Indeed, in a recent systematic review of studies examining specific body image facets across EDs, 28 distinct facets were reported, with body dissatisfaction being the most investigated facet that was most consistently able to differentiate ED clinical and nonclinical samples (Prnjak et al, 2022). Although body dissatisfaction seems to be a fairly prevalent experience in the community (Mitchison et al, 2017), it has in fact been associated with impairment in quality of life (Mond et al, 2013) and higher rates of depressive symptoms (Goldfield et al, 2010).…”

Section: Single Item Measuresmentioning

confidence: 99%

“…Although body dissatisfaction seems to be a fairly prevalent experience in the community (Mitchison et al, 2017), it has in fact been associated with impairment in quality of life (Mond et al, 2013) and higher rates of depressive symptoms (Goldfield et al, 2010). This systematic review also identified salient group differences in cognitive–affective facets of body image, that were the least represented facets of body image across included studies (Prnjak et al, 2022). This includes weight/shape overvaluation, defined as excessive influence of weight and/or shape on self-evaluation.…”

Section: Single Item Measuresmentioning

confidence: 99%

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

Prnjak,

Mitchison,

Griffiths

et al. 2024

Psychological Assessment

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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.

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Section: General Methodsmentioning

confidence: 99%

Section: Single Item Measuresmentioning

confidence: 99%

Section: Single Item Measuresmentioning

confidence: 99%

See 1 more Smart Citation

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

Prnjak,

Mitchison,

Griffiths

et al. 2024

Psychological Assessment

Self Cite

View full text Add to dashboard Cite

show abstract

“…As outlined in the last domain of the S Axis, ED patients tend to subjectively experience a wide range of bodily sensations and body image-related symptoms that are primarily associated with negative and/or altered perceptions, thoughts, feelings, attitudes, and beliefs toward the body. Within the multidimensional construct of body image, the most investigated facets in EDs are distorted body image, body shape/weight dissatisfaction, discomfort and detachment feelings toward one's body, and specific concerns about particular body parts, shapes or functions, which may induce avoidance or checking attitudes [98]. Additionally, ED patients may report feeling that their body changes continuously and unpredictably [99,100].…”

Section: Do Bodily Experiences and Feelings About The Body Contribute...mentioning

confidence: 99%

From symptoms to subjective and bodily experiences: the contribution of the Psychodynamic Diagnostic Manual (PDM-2) to diagnosis and treatment monitoring in eating disorders

Mirabella

Muzi

Franco³

et al. 2023

Eat Weight Disord

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Purpose Atheoretical and descriptive conceptualizations of eating disorders (EDs) have faced substantial criticism due to their limited ability to assess patients’ subjective characteristics and experiences, as needed to determine the most appropriate treatment options. The present article provides an overview of the clinical and empirical literature supporting the potential contribution of the Psychodynamic Diagnostic Manual (PDM-2) to both diagnostic assessment and treatment monitoring. Methods Following a discussion of the most relevant shortcomings of current diagnostic models of EDs and a description of the rationale and structure of the PDM-2, evidence supporting the core PDM-2 dimensions of ED patients’ subjective experiences (i.e., affective states, cognitive processes, relational patterns, somatic/bodily experiences and states) are examined, alongside their relevance to ED diagnosis and treatment. Results Overall, the reviewed studies support the diagnostic importance of these patterns of subjective experiences in EDs, highlighting their potential role as either predisposing or maintaining factors to target in psychotherapy. A growing body of multidisciplinary evidence also shows that bodily and somatic experiences are central to the diagnosis and clinical management of ED patients. Moreover, there is evidence that a PDM-based assessment may enable closer monitoring of patient progress during treatment, with regard to both subjective experiences and symptom patterns. Conclusions The study suggests that current diagnostic frameworks for EDs would benefit from the addition of a person-centered perspective that considers not only symptoms, but also patients’ full range of functioning—including their deep and surface-level emotional, cognitive, interpersonal, and social patterns—to improve patient-tailored interventions. Level of evidence Level V, narrative review.

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“…Among such factors are body image concerns and pressure to perform and/or look a certain way 8. Although insufficiently addressed in the literature, body image concerns of athletes and non-athletes alike are multifaceted and do not always display as drive for thinness or preoccupation with low body weight 9. Muscularity concerns and drive for size underlie what has been referred to as muscle dysmorphia 10.…”

Section: Introductionmentioning

confidence: 99%

Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes

Vardardottir,

Olafsdottir,

Gudmundsdottir

2023

BMJ Open Sport Exerc Med

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ObjectivesDisordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its relationship with REDs are unknown. This cross-sectional study aimed to evaluate associations of all three with REDs symptoms.MethodsElite and subelite Icelandic athletes (n=83, 67.5% females) answered the Low Energy Availability in Females/Males Questionnaires (LEAF-Q/LEAM-Q), Eating Disorder Examination–Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI) and Muscle Dysmorphic Disorder Inventory (MDDI). Body composition was assessed via dual-energy X-ray absorptiometry; resting metabolic rate via indirect calorimetry; and blood samples were drawn for analysis of nutrition and hormonal status. Females were compared based on LEAF-Q total score (≥8 (at risk) vs <8). Simple linear regression was applied to evaluate associations of (a) testosterone with other objective measures and LEAM-Q scores in males; and (b) LEAF-Q/LEAM-Q scores with EDE-QS, EAI and MDDI scores.ResultsIn total, 8.4% of participants scored above cut-off on EDE-QS, 19.3% on EAI and 13.3% on MDDI. Females with LEAF-Q total score ≥8 had higher median scores on EDE-QS, EAI and MDDI compared with those scoring <8. Testosterone was positively associated with iron and inversely with total iron-binding capacity but was not associated with scoring on any of the administered questionnaires.ConclusionDrive for muscularity and aesthetic physique may play a role in the complex presentation of REDs. Screening for muscle dysmorphia, in addition to disordered eating and compulsive exercise, could therefore facilitate early detection of REDs.

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

Cited by 28 publications

References 120 publications

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

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

From symptoms to subjective and bodily experiences: the contribution of the Psychodynamic Diagnostic Manual (PDM-2) to diagnosis and treatment monitoring in eating disorders

Body dissatisfaction, disordered eating and exercise behaviours: associations with symptoms of REDs in male and female athletes

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