Body image disturbance in 1000 male appearance and performance enhancing drug users

Abstract

Body image disturbance (BID) among men has only recently become a phenomenon of clinical significance with noted heterogeneity in the behavioral consequences of these disturbances. The degree of heterogeneity among appearance and performance enhancing drug (APED) users is unknown and an empirically derived framework for studying BID is necessary. 1000 APED users were recruited via the Internet and they completed a comprehensive online assessment APED use patterns, motivations, consequences, and BID. Data were evaluated using latent trait, latent class, and factor mixture models. Model results were validated using a range of covariates including cycle characteristics, age, APED history, and APED risk. A 1-Factor, 4-Class model provided the best fit to the data with Class 1 scoring the highest on all measures of BID and Class 4 the lowest on all measures. Class 2 differed in their preference for being lean over muscular and Class 3 preferred adding mass and size. Each class was associated with unique risks, APED history, and training identity. Not all APED users suffer from significant BID and there are unique profiles for those with elevated BID. Future research on male BID should account for this structure in order to better define relevant diagnostic categories and evaluate the clinical significance of BID.

Concerns related to eating, weight, and shape: Typologies and transitions in men during the college years

“…e.g.,10,11,29 With the EDDS, Stice and colleagues 29 found greater elevations in depressive symptoms and emotionality for bulimia nervosa relative to cases not classified as eating disordered. Considering CREWS more unique to men, Hildebrandt and colleagues' 10,11 found support for an association between their most pervasively severe class and the greatest level of impairment, with the most extreme co-occurring tendencies (e.g., willingness to sacrifice the greatest number of years of life to achieve performance or appearance goals) occurring with the most pervasive appearance- and performance-enhancing drug use typology. Yet, LO had the highest average BMI of the three classes, a distress level between the levels for NOPE and the Pervasive class, and a level of Neuroticism indistinguishable from that of the Pervasive class.…”

“…In particular, we did not examine CREWS more unique to men (e.g., muscle dissatisfaction and weight gain behavior), which could produce greater heterogeneity. e.g.,7,8,10–12 Moving beyond college samples of men would also permit a more comprehensive depiction of CREWS typologies in men. Examining predictors of classes and transitions is also warranted, and considering individual CREWS dimensionally rather than categorically would likely provide a more nuanced picture.…”

The influence of age of onset and acute anabolic steroid exposure on cognitive performance, impulsivity, and aggression in men.

“…Due to the small sample, even the robust effects should be interpreted with caution because of the reduced participant variability in population typically considered to be largely heterogeneous (Hildebrandt, Alfano, & Langenbucher, 2010; Hildebrandt et al, 2007). Furthermore, the between-subjects design does not allow us to quantify if the magnitude of individual cycle effects, which will be a necessary next step in this research.…”

Exercise reinforcement, stress, and β-endorphins: An initial examination of exercise in anabolic–androgenic steroid dependence

“…It has been validated in weightlifting men and used to study body image disturbance in AAS users (Hildebrandt et al, 2010). Participants also completed the Profile of Mood States (POMS; McNair et al, 1992) three times during the WFE task.…”