Psychometric evaluation of the Polish adaptation of the Body Appreciation Scale-2 for Children (BAS-2C)

Positive body image is crucial in fostering self-esteem, mental well-being, and positive social functioning. However, our understanding of its development and role in school-aged children remains limited due to a scarcity of measures available for this age group across various countries and cultures. To bridge this gap, the aim of this study was to adapt the Body Appreciation Scale-2 for Children (BAS-2C) for Polish children aged 8-13 years. A total of 206 children completed BAS-2C to measure positive body image, the Figures Rating Scale to measure body satisfaction, and the Self-Perception Profile for Children to measure self-esteem. Parents provided information about their child's weight and height, which enabled analysis of a child's BMI. The results showed that the Polish version of BAS-2C exhibited a unidimensional factor structure, invariance across sex and age groups, and also provided evidence of very good internal consistency, test-retest reliability, and construct validity. BAS-2C scores were correlated positively with Figures Rating Scale, physical appearance and global self-esteem and were related negatively to age and BMI index, and weight group. Moreover, our research indicates that in older children, there are stronger correlations between positive body image and both global and physical appearance self-esteem, compared to younger children. The Polish version of BAS-2C has excellent psychometric properties and is appropriate for use with children aged 8-13 years.

Men's use of cosmetic surgery and the role of traditional masculinity ideologies

In western countries, men are increasingly using cosmetic surgery. However, despite this trend, there remains a dearth of information on the prevalence, acceptance, and motivations behind men's use of cosmetic surgery. Furthermore, the potential association between men's use of cosmetic surgery and in particular male-specific cosmetic surgery procedures such as head hair transplant or penis enlargement and traditional masculinity ideologies (TMI) has not been investigated so far. For this purpose, a cross-sectional anonymous online survey was conducted among 241 self-identifying men aged 18 years or older from the German-speaking part of Europe. Participants responded to questions about cosmetic surgery use and experiences, and completed the Conformity to Masculine Norms Inventory-Short Form (CMNI-SF) and the Male Role Norms Inventory-Short Form (MRNI-SF) questionnaires to assess conformity with and endorsement of TMI. Of the 241 men investigated, 47 (19.5%) had undergone cosmetic surgery. The most common types of cosmetic surgeries reported were wrinkle treatment, eyelid correction, and head-hair transplant. Penis enlargement procedures were reported by three (6.4%) of the 47 men who had undergone cosmetic surgery. The main reasons for undergoing surgery were to feel better (72.3%) and look better (55.3%), while to increase sexual success (17.0%) and to increase manliness (14.9%) were also reported. Logistic regression models showed that higher conformity to TMI (CMNI-SF) was associated with higher odds of having undergone cosmetic surgery. The results highlight the overall increase in men's cosmetic surgery use and its specific characteristics. The significant positive association between conformity to TMI and men's use of cosmetic surgery suggests that men increasingly use cosmetic surgery as a means to assert power, success, dominance, and sexual success.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44202-024-00230-6.

Sociocultural influences on body image concerns in men of color - a structural equation modeling study

OBJECTIVE

There is a noticeable underrepresentation of Black, Indigenous, and People of Color (BIPOC) men in the existing empirical literature examining the sociocultural influences on body image concerns. To fill the gap, this study aimed to gain a better understanding of how sociocultural factors correlated with body dissatisfaction among BIPOC men living within the U.S.

DESIGN

Structural equation modeling was used to address this gap by examining how multiple sociocultural factors - interpersonal appearance pressure, media appearance pressure, ethnic-racial identity attitudes (including ethnic-racial salience, stereotype endorsement, and nationalistic assimilation) and ethnic self-hatred towards one's ethnic group - were linked to dissatisfaction with muscularity, body fat and height in a sample of 181 BIPOC men participants.

RESULTS

The proposed cross-sectional path model achieved satisfactory model fit and explained 31.9% in muscularity dissatisfaction, 36.2% in body fat dissatisfaction, and 26.4% in height dissatisfaction. Among direct relationships, interpersonal appearance pressure emerged most prominently associated with height dissatisfaction, whereas media appearance pressure and ethnic self-hatred were more related to muscularity and body fat dissatisfaction. Regarding the mediation effects, media appearance pressure was found to partially mediate the relationship between interpersonal appearance pressure and body dissatisfaction, as well as the relationship between ethnic self-hatred and body dissatisfaction. Furthermore, ethnic self-hatred was found to be predicted by ethnic-racial identity attitudes.

CONCLUSION

This research profoundly expands our understanding of the ethnic and racial complexities surrounding body dissatisfaction among BIPOC men and encourages health practitioners to acknowledge the unique sociocultural and systemic dynamics (ethnic-racial identities and associated stressors) when working with BIPOC men who present with body image concerns.

Understanding the Meat-Masculinity Link: Traditional and Non-Traditional Masculine Norms Predicting Men's Meat Consumption

Conformity to masculinity ideology predicts men's meat consumption and willingness to reduce their meat intake, but it is unknown which specific masculine norms account for these relationships. This study investigated which traditional and non-traditional masculine norms predict meat consumption, red and processed meat consumption, and willingness to reduce meat consumption in 557 Australian and English males. Men who support the use of physical violence and place high importance on sex ate more meat. Willingness to reduce was highest among men with gender egalitarian views. Targeting these specific masculine norms may be important for mitigating men's overconsumption of meat.

Positive Body Image and Psychological Wellbeing among Women and Men: The Mediating Role of Body Image Coping Strategies

This study aimed to examine the mediating role of body image coping strategies in the relationship between positive body image and wellbeing. Three hundred and seventy-two women and three hundred and seventy-seven men completed a questionnaire assessing body appreciation, body appreciation functionality, body compassion, body image coping strategies (appearance fixing, avoidance, positive rational acceptance), self-acceptance and overall psychological wellbeing. Path analysis showed that avoidance significantly mediated the relationship between body appreciation and overall psychological wellbeing among both women and men; its mediating role was confirmed for men's but not for women's self-acceptance. Positive rational acceptance was a significant mediator of the relationship between body compassion and both psychological wellbeing and self-acceptance among men but not among women. These findings show that higher body appreciation is associated with a lower tendency to avoid appearance-related cognitions or thoughts that are interpreted as threatening, with an indirect effect on women's and men's psychological wellbeing. Analogously, but only for men, body compassion is associated with mental activities and self-care behaviors that foster rational self-talk and the acceptance of one's experiences, which, in turn, are linked to higher wellbeing. These findings can help to plan programs aimed at fostering individuals' wellbeing by focusing on their positive body image considering gender differences.

Psychometric properties of an Arabic translation of the short 9-item drive for muscularity scale (DMS-9)

BACKGROUND

After the original 15-item Drive for Muscularity Scale developed by McCreary et al. in 2004, a more theoretically based scale that replicates the original DMS subscales with a better conceptual clarity and a shorter number of items, i.e., the DMS-9, has recently been developed by Chaba et al. in 2018. We sought to contribute to the literature especially under the Arab context, by investigating the psychometric properties of an Arabic translation of the DMS-9 in a sample of Arabic-speaking Lebanese university students of both genders.

METHODS

University students (N = 402; 55.2% females) from multiple universities in Lebanon were invited to fill the survey in this cross-sectional designed study (December 2022 and January 2023). Our sample was chosen using the snowball technique; a soft copy of the questionnaire was created using google forms software, and an online approach was conceived to proceed with the data collection.

RESULTS

Using an Exploratory Factor Analysis-to- Confirmatory Factor Analysis strategy, we found that the original two-factor model of the DMS proposed in the parent study was adequately replicated in our sample. The two DMS-9 factor scores showed very good McDonald's omega values (ω > 0.8). Findings also showed that gender invariance was achieved at the configural, metric, and scalar levels. Additionally, drive for muscularity scores correlated in the expected way with other study variables, providing support for the convergent and divergent validity of the Arabic DMS-9. Specifically, we found that greater drive for muscularity attitudes and behaviors significantly correlated with more severe muscle dysmorphic symptoms, inappropriate eating attitudes, muscle bias internalization, and lower body appreciation.

CONCLUSION

Findings preliminarily suggest that the Arabic DMS-9 is psychometrically sound and suitable tool to assess the drive for muscularity construct among Arabic-speaking community adults. Making the Arabic DMS-9 available will hopefully benefit the scientific community working in Arab settings, promote local and international research in this area, and offer descriptive data on how drive for muscularity may interfere with health indicators in the general Arab population.

Intercultural insights on the impact of different non-idealized models on men's body image and advertising perceptions

This experiment with 363 Irish and Flemish men aged 19 to 30 years (M = 23.56, SD = 2.36) investigated exposure to different male model ads (i.e. muscular, slim, plus-size, overall diversity, and no models) on well-being (i.e. body image, low body fat and muscularity attitudes, self-objectification, and self-esteem) and advertising outcomes (i.e. ad attitudes, brand attitudes, and purchase intent). Moderation effects of country and masculinity (i.e. dominance, winning) were investigated. The diversity condition generated more positive effects for low body fat attitudes than the muscular, slim, and no model conditions. Yet, no differences appeared for this outcome between the diversity and plus-size condition. No effects for the other well-being and advertising variables were found. Moderation analyses revealed higher purchase intent in the slim condition for men high in dominance. No effects were found for country and winning. Findings suggest that non-idealized models have protective effects for some men.

Attentional Biases Towards Body-Related Stimuli in Healthy Males: A Systematic Review

Recent literature has discussed the role of attentional biases towards body-related stimuli. Specific foci have been on those with high levels of body image concerns and female samples. Unfortunately, there has been limited focus on male samples within existing literature. The aim of the current study was to provide a critical synthesis of the findings of existing studies exploring attentional biases in adult males towards body-related stimuli. Critical synthesis of the findings of 20 studies explored four key methodologies: eye-tracking, dot-probe, visual search, and other methodologies (e.g. ARDPEI task). The current review provides evidence of specific attentional biases towards body-related stimuli in adult males experiencing body image concerns. Similar patterns of attentional biases are also demonstrated in males with body image pathologies. However, there appears to be distinct patterns of attentional biases for male and female participants. It is recommended that future research considers these findings and utilises measures developed specifically for male samples. Furthermore, additional variables require further attention, i.e. reasons for engaging in social comparison and/or engaging in physical activity.

Implications of Socio-Cultural Pressure for a Thin Body Image on Avoidance of Social Interaction and on Corrective, Compensatory or Compulsive Shopping Behaviour

This paper aims to discuss the implications of body talk and socio-cultural pressure for the internalisation of a thin body image in purchase decisions, shopping habits and other outcomes of body dissatisfaction, in particular the proneness to avoid human/social interaction in retail contexts and proneness to engage in corrective, compensatory or compulsive shopping behaviour. This paper conducted an online questionnaire that measured the following constructs: body mass index; Socio-cultural Attitudes Towards Appearance Scale-4 (SATAQ-4), Body Appreciation Scale (BAS-2), Acceptance of Cosmetic Surgery Scale (ACSS), Compulsive Buying Follow-up Scale (CBFS), proneness to avoid social interaction in retail contexts, and the intention to purchase a list of products and services as a compensation for body dissatisfaction. A structural equations model supported the hypotheses proposing the influence of BAS-2 and SATAQ-4 (the internalisation of thin/athletic body and the social comparison induced by family, peers and media) upon the outcomes of social-interaction avoidance, ACSS and CBFS. Nevertheless, BAS-2 only influences social-interaction avoidance. This paper provides several recommendations to brand managers highlighting the social responsibility role of brand advertising in enhancing positive body appreciation, mitigating the psychological damage caused by socio-cultural pressure and preventing the stigmatisation bias against obese people.

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 (n_observations=25,133; N_participants=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.

Performance-Enhancing Substance Use and Intimate Partner Violence: A Prospective Cohort Study

Research has shown that performance-enhancing substance (PES) use, including anabolic-androgenic steroids (AAS), is associated with interpersonal violence (e.g., fighting). This study aimed to determine whether legal PES use and AAS use are associated with intimate partner violence (IPV) involvement cross-sectionally and over seven-year follow-up in a nationally representative prospective cohort study. Data from the National Longitudinal Study of Adolescent to Adult Health (N = 12,288) were analyzed (2021). Logistic regression analyses were conducted to determine the associations between legal PES use and AAS use at Wave III (2001-2002; ages 18-26) and IPV victimization (five variables) and IPV perpetration (five variables) at Wave III and Wave IV (2008-2009; ages 24-32), adjusting for relevant demographic and confounding variables. Results from cross-sectional analyses showed that legal PES use and AAS use were associated with higher odds of both any IPV victimization and sexual IPV victimization, and both any IPV perpetration and physical IPV perpetration by pushing or shoving a partner. Results from prospective analyses showed that AAS use, but not legal PES use, was associated with higher odds of all five IPV victimization variables (any IPV victimization: adjusted odds ratio [AOR] 1.72, 95% confidence interval [CI]1.04-2.84; two forms of physical abuse: 1: AOR 2.01, 95% CI 1.15-3.50; 2: AOR 2.11, 95% CI 1.06-4.21; incurring an injury from IPV victimization: AOR 4.90, 95% CI 1.71-14.01; and sexual IPV victimization AOR 2.44, 95% CI 1.05-5.65), as well as three IPV perpetration variables (any IPV perpetration: AOR 2.11, 95% CI 105-4.23; one form of physical abuse perpetration: AOR 2.58, 95% CI 1.06-6.27; and sexual IPV perpetration: AOR 3.80, 95% CI 1.44-10.02). These results emphasize the adverse social and interpersonal risks associated with PES use. Continued research, health care, and public health prevention and intervention efforts to reduce the use of PES and occurrence of IPV are warranted.

A comic-based body image intervention for adolescents in semi-rural Indian schools: Study protocol for a randomized controlled trial

Adolescents in India experience body dissatisfaction, however, empirically supported interventions are lacking. This paper describes the protocol for the development, acceptability testing, and cluster randomized controlled trial (RCT) of a six-session comic-based intervention, which aims to improve body image and related outcomes among adolescents in semi-rural Indian schools. If found to be acceptable and effective, UNICEF will disseminate the intervention across schools in eight states of India. The acceptability study will be conducted with 24 students in Classes 6-8 (age 11-14) and nine teachers from Hindi-medium government schools using interviews and focus groups. The subsequent RCT will be conducted with 2400 students, with schools randomized to either the comic-based intervention or lessons-as-usual (control) groups. The primary outcome is body esteem, and secondary outcomes are disordered eating, appearance ideal internalization, body-image-related life disengagement, self-esteem, negative affect, and positive affect. Additional exploratory outcome measures are skin colour dissatisfaction, body hair dissatisfaction, appearance-based teasing, and endorsement of traditional gender roles. These outcomes will be examined at three timepoints: baseline (T1), 1 week-post-intervention (T2), and 12-weeks follow-up (T3). Analyses will compare outcomes in the intervention with the control group. This will be the first study to evaluate a body image intervention for adolescents in semi-rural Indian schools.

Media pressure and the process of Westernization in the context of body self-assessment among young heterosexual and gay Polish men

Mass media and social networks portray a unified image of the perfect male body. The intensity and universality of this influence is an important element of the process of Westernization, especially in traditional cultures such as that of Poland. The main aim of the present study was to investigate the differences between Polish gay and heterosexual men in terms of the role played by self-esteem and the level of internalization of sociocultural standards of body appearance as predictors of the development of their body images. The research study was conducted by reference to 19- to 29-year-old Polish heterosexual (n = 287) and gay (n = 97) men. The variables were measured using Polish versions of the Sociocultural Attitudes towards Appearance Scale-3, the Self-Esteem Scale, and the Multidimensional Body–Self Relations Questionnaire. Statistical analyses identified several variables as the main predictors of body image in both heterosexual and gay young men: self-esteem, information-seeking, perceived pressure and the internalization of sociocultural standards regarding an athletic body image drawn from mass media. The only significant difference between the two groups was the fact that self-esteem, perceived pressure and the internalization of sociocultural standards from mass media did not play a predictive role with respect to Appearance Orientation among the group of gay men.

For Exercise, Relaxation, or Spirituality: Exploring Participation Motives and Conformity to Masculine Norms among Male and Female Yoga Participants

Yoga is a traditional practice from India with the potential to promote physical activity and health. Participation worldwide remains low, particularly among men. To better understand yoga participation parameters, with a special focus on what influences male participation, this study examined gender differences in participation motives and conformity to masculine norms. It also explored these factors across three participant subgroups who differed in their engagement with the physical and the more psycho-spiritual aspects of yoga. A total of 546 yoga participants (138 males, 399 females, 9 others), 18–73 years old, completed an online survey that included an adapted version of the Exercise Motivation Inventory–2 and three subscales from the Conformity to Masculine Norms Inventory–46. Results showed significant gender differences in participation motives and conformity to masculine norms. Females were more motivated by positive affect, health/fitness, nimbleness, mind–body integration, and coping/stress management, whereas males were more motivated by supplementary activity and competition/social recognition. These differences should be considered in tailoring messages to promote uptake and continued participation. Furthermore, males were more likely than females to conform to emotional control and heterosexual self-presentation masculine norms. Future research may examine how differences in masculine norm adherence influences uptake, particularly among men.

Comics as a body image intervention among adolescents in Indian Hindi medium schools: insights from an acceptability study

BACKGROUND

Indian adolescents experience body dissatisfaction. However, empirically supported interventions are lacking, particularly in lower socio-economic regions of India. This paper describes the acceptability testing of a six-session teacher-led comics-based intervention, aiming to improve body image and related outcomes among adolescents in Indian Hindi medium schools.

METHODS

Thirty-five students (50% girls; M _{age, girls} = 12.3 years; M _{age, boys} = 13 years) and nine teachers (11% women) from Hindi medium schools in Rajasthan, India, completed a quantitative acceptability questionnaire regarding comics that target body dissatisfaction and associated risk factors. They also participated in online or telephone semi-structured interviews to share in-depth feedback, with teachers providing additional feedback on an accompanying teacher guide. The quantitative data were analysed descriptively, with the interviews analysed using qualitative codebook thematic analysis.

RESULTS

Quantitative analyses revealed that 73% of students felt the comics made them feel good about themselves. Qualitative analyses revealed four themes: (1) body dissatisfaction is a concern; (2) the comics are powerful; (3) increasing ease of understanding; (4) a teacher guide to aid delivery.

CONCLUSION

This study demonstrates acceptability of a novel teacher-led comics-based body image intervention for adolescents in Indian Hindi medium schools from lower socio-economic settings. These findings are currently informing intervention optimizations, which will be evaluated in a randomized controlled effectiveness trial. If found to be effective, this intervention will be disseminated across eight Indian states by UNICEF. Trial registration. This trial has been registered with ClinicalTrials.gov; a database of privately and publicly funded studies conducted around the world. Registration date: 2nd May 2020; Registration ID: (NCT04317755). https://clinicaltrials.gov/ct2/show/NCT04317755?term=NCT04317755&draw=2&rank=1.

The association of childhood physical abuse, masculinity, intoxication, trait aggression with victimization in nightlife districts

BACKGROUND

High-risk intoxication, trait aggression and conformity to masculine norms are associated with increased risk of barroom aggression; however, less is understood regarding the factors associated with victimization in the night-time environment.

OBJECTIVE

This study aimed to explore the influence of childhood physical abuse, high-risk intoxication, conformity to masculine norms and trait aggression on physical and/or verbal victimization in the night-time environment.

PARTICIPANTS AND SETTING

A sample of N = 490 patrons aged 18-50 years (M = 23.02, SD = 5.89, 58.8% female) were recruited in Fortitude Valley and West End district, Queensland.

METHOD

Participants completed a street interview, including breathalyser, and a follow-up online survey asking about experiences of aggression on the night of interview, experiences of childhood physical abuse and psychosocial correlates.

RESULTS

For males, but not females, childhood physical abuse (OR = 3.98) increased the risk of physical and/or verbal victimization. Conformity to the masculine norm of Winning (OR = 0.21) was protective against physical and/or verbal victimization for males, and trait aggression (OR = 1.51) was significantly associated with increased risk of physical and/or verbal victimization for females.

CONCLUSIONS

These findings add to the growing literature surrounding the long-term impacts of childhood physical abuse, demonstrating experiences of childhood physical abuse are significantly associated with victimization in the night-time economy. The current findings should be taken into consideration when constructing public policy or directed interventions, to help reduce aggression and violence in the night-time economy.

Gender compatibility and drive for muscularity among adolescent boys: Examining the indirect effect of emotion regulation difficulties

The drive for muscularity continues to be a prominent concern among adolescent boys. However, it is unknown how gender compatibility (gender typicality and gender contentedness) relates to this pursuit. The present study sought to examine the link between gender compatibility and drive for muscularity among male adolescents, and whether this is partially accounted for by emotion regulation difficulties. Participants were 903 male adolescents, aged 11-19 years, who completed self-report measures as part of the EveryBODY study. Using path analysis, a proposed mediation model was assessed, testing an indirect pathway of gender compatibility and drive for muscularity through emotion regulation difficulties. Findings showed an indirect pathway between gender compatibility and drive for muscularity through emotion regulation difficulties. That is, boys who were more content with their male gender and believed they were typical of their gender reported fewer emotion regulation difficulties and, in turn, exhibited a lower drive for muscularity. Findings support theoretical perspectives integrating masculinity and muscularity in boys, in that those who feel less compatible with their masculinity could be susceptible to developing a greater drive for muscularity to regulate distress deriving from perceptions of not being sufficiently masculine. This study sets the groundwork for future longitudinal studies.

Food and alcohol disturbance by athlete status: the roles of drive for thinness, drive for muscularity, and sex

OBJECTIVE

This study investigated the association between self-identified athlete status and Food and Alcohol Disturbance (FAD) behaviors, and whether this association was moderated by drives for thinness or muscularity, and sex.

PARTICIPANTS

575 individuals (77.6% female, 40.0% identifying as athletes) recruited from a large southeastern university.

METHODS

Participants completed online measures of athletic identity, drives for muscularity and thinness, FAD behaviors, and demographic variables.

RESULTS

Compared to non-athletes, male athletes with higher drive for muscularity endorsed more alcohol effects behaviors; female athletes endorsed the inverse relationship. Higher drive for thinness was associated with more diet and exercise behaviors among all participants, and extreme weight control behaviors among athletes.

CONCLUSIONS

Athlete status moderated the associations between drives for thinness/muscularity and FAD Alcohol Effects and Extreme Weight Control Behaviors. Regardless of athlete status, college students with higher drive for thinness are at risk for engaging in more FAD Diet & Exercise behaviors.

"Lift Big-Get Big": The Impact of Images of Hyper-Muscular Bodies and Training Information

Purpose: It has been suggested that the media influence beliefs regarding ideal body appearance and drive for muscularity whilst also offering recommendations for achieving this; most commonly heavy load free weight resistance training (RT). However, evidence for media effects are inconsistent in the literature. This study investigated this "lift big-get big" culture and effects of imagery on males' beliefs regarding RT. Method: An online survey was conducted with male participants (N = 110) randomized to different images (hyper-muscular/lean/control) and RT information ("lift big-get big"/"evidence based RT"/control). Results: Descriptive data suggested belief in necessity of heavy loads and free weights was pervasive. There was a small significant effect of condition for multivariate analysis of beliefs regarding RT. Univariate analyses showed significant effects of condition regarding the importance of free weights and heavy loads for strength, and free weights for hypertrophy. Small to moderate effects were found comparing "evidence-based RT" with a hyper-muscular physique to "lift big-get big" conditions with both hyper-muscular and lean physiques, the latter more likely to agree free weights and heavy loads are necessary for strength. A small effect was found comparing "lift big-get big" conditions with both hyper-muscular and lean physiques and the control condition, the former more likely to agree free weights are necessary for hypertrophy. Conclusions: Although hyper-muscular bodies alone did not influence RT beliefs, new information, i.e., "evidence-based RT" combined with a hyper-muscular physique had a small effect. The "lift big-get big" culture is perhaps pervasive enough that most conditions merely reinforced existing beliefs.

Body functionality: A review of the literature

Body functionality describes everything that the body is able to do, across diverse domains (e.g., bodily senses, creative endeavours). Nearly a decade ago, leading scholars identified research on body functionality as a priority for the body image field. The field has responded, as shown by the recent rise of body functionality research. We considered this an opportune time to (a) define body functionality (what it is and is not); (b) present theoretical frameworks of body functionality; (c) articulate first-generation and current measures relating to body functionality; (d) offer functionality-focused body image interventions that can improve appreciation for one's body functionality (and body image more broadly); (e) summarise additional areas of research related to body functionality and positive body image; and (f) provide considerations and directions for future research and interventions incorporating body functionality. Research has underscored body functionality as a valuable construct with respect to positive body image and well-being, particularly when individuals appreciate what their bodies can do and conceptualise their body functionality holistically. Yet, the experience of body functionality is nuanced across social identities. Overall, the field has greatly advanced knowledge about body functionality, and we are excited to see the next generation of research that emerges.

Embodiment: Cultural and gender differences and associations with life satisfaction

Although cultural factors have an important impact on individuals' experiences of living in their bodies, to date no studies have examined cross-cultural or gender differences in individuals' experience of embodiment. This study compared Swedish and Canadian women's experience of embodiment (and other body image related constructs), as well as Swedish men and women's experience of embodiment. Associations between embodiment, body esteem, and life satisfaction in men and women were also examined. Participants were 302 Swedish women, 242 Swedish men, and 216 Canadian women. Results showed that Swedish women had overall more positive experience of embodiment, more positive body esteem, lower thin-ideal internalization and lower levels of disordered eating than Canadian women. In comparison to Swedish men, however, Swedish women had more negative experience of embodiment in some ways, but similar experience of embodiment in other ways. Although associations between embodiment, body esteem, and life satisfaction were strong, embodiment was a better predictor of life satisfaction than body esteem for both men and women. Results are interpreted through the lens of the developmental theory of embodiment and consider cultural differences between Sweden and Canada, as well as Swedish society's both progress and problems in promoting gender equity.

Cross-Country Measurement Invariance and Effects of Sociodemographic Factors on Body Weight and Shape Concern-Related Constructs in Eight Countries

The aim of this study was to examine the cross-country invariance of five well-established measures of body weight and shape concern-related attitudes and behaviors (i.e., drive for leanness, drive for muscularity, strategies to increase muscle, strategies to lose weight, and weight and shape concerns). A secondary objective was to examine the effects of several sociodemographic factors (age, BMI, socioeconomic status, and gender) on item and latent factor scores of these constructs. A total of 6272 emerging adults (4218 women; M_age = 21.46, SD = 3.11) from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. completed a self-report online survey as part of a larger study. Overall, support for partial invariance both across countries and in terms of the considered sociodemographic factors was found for reduced versions of the five measures. Significant differences in latent means were found across countries, these being of greater magnitude for drive for leanness and strategies to lose weight. The considered sociodemographic factors (most notably BMI and gender) were associated with the latent mean scores of the assessed constructs. The present study contributes to current literature by providing cross-cultural invariant versions of several measures of relevance in the field of body image.

Legal Performance-Enhancing Substances and Substance Use Problems Among Young Adults

BACKGROUND

Legal performance-enhancing substance(s) (PES) (eg, creatine) are widely used among adolescent boys and young men; however, little is known about their temporal associations with substance use behaviors.

METHODS

We analyzed prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health, Waves I to IV (1994-2008). Logistic regressions were used to first assess adolescent substance use (Wave I) and use of legal PES (Wave III) and second to assess use of legal PES (Wave III) and subsequent substance use-associated risk behaviors (Wave IV), adjusting for potential confounders.

RESULTS

Among the sample of 12 133 young adults aged 18 to 26 years, 16.1% of young men and 1.2% of young women reported using legal PES in the past year. Adolescent alcohol use was prospectively associated with legal PES use in young men (odds ratio 1.39; 95% confidence interval [CI] 1.13-1.70). Among young men, legal PES use was prospectively associated with higher odds of problematic alcohol use and drinking-related risk behaviors, including binge drinking (adjusted odds ratio [aOR] 1.35; 95% CI 1.07-1.71), injurious and risky behaviors (aOR 1.78; 95% CI 1.43-2.21), legal problems (aOR 1.52; 95% CI 1.08-2.13), cutting down on activities and socialization (aOR 1.91; 95% CI 1.36-2.78), and emotional or physical health problems (aOR 1.44; 95% CI 1.04-1.99). Among young women, legal PES use was prospectively associated with higher odds of emotional or physical health problems (aOR 3.00; 95% CI 1.20-7.44).

CONCLUSIONS

Use of legal PES should be considered a gateway to future problematic alcohol use and drinking-related risk behaviors, particularly among young men.

A review and integrated theoretical model of the development of body image and eating disorders among midlife and aging men

Etiological models of the development of eating disorders among midlife and aging men are lacking. The present study provides a review and integration of existing theoretical frameworks and empirical data relevant to the examination of eating pathology in this population and introduces an integrated model of risk and protective factors for the development of eating disorder symptoms. Several etiological models of eating pathology that have gained some empirical support, or present relevance to this population, are briefly reviewed including sociocultural theory, objectification theory, social identity theory, positive body image and the developmental theory of embodiment, and existential and terror management theory, and finally biologically based theories. In addition, these frameworks were extended to account for developmental and gender-specific factors that may influence the development of eating disorders. An integrated model of risk and protective factors that brings together critical elements of these extended theoretical frameworks is presented, with the goal of guiding and stimulating research in this neglected group.

Psychological Pathway from Obesity-Related Stigma to Depression via Internalized Stigma and Self-Esteem among Adolescents in Taiwan

The objective of this research was to examine the pathway from public stigma, to perceived stigma, to depression in adolescents via internalized stigma. Adolescents in grade 7 through 9 from a junior high school in Changhua County in Taiwan completed self-administered surveys from March to July in 2018. Adolescents were asked questions regarding depressive symptoms, obesity-related perceived stigma, and internalized stigma. Structural equation modeling was used to fit the pathway model. The pathway was first analyzed with the full sample and then stratified by actual and perceived weight status. Our final analytic sample consisted of 464 adolescents. The pathway model suggested an acceptable model fit. Perceived weight stigma (PWS) was significantly associated with internalized stigma regardless of actual or self-perceived weight status. Internalized stigma was significantly associated with anxiety for both actual (β = 0.186) and self-perceived nonoverweight (non-OW) participants (β = 0.170) but not for overweight (OW) participants (neither actual nor self-perceived). For OW adolescents, perceived weight stigma was associated with anxiety. However, the internalization process did not exist. It may be that the influence of perceived weight stigma is larger than internalized stigma on anxiety. It may also be that the level of internalization was not yet high enough to result in anxiety.

Life after childhood bullying: Body image development and disordered eating in adulthood

Studies have demonstrated that being bullied in childhood may have long-term associations with lower psychological well-being in adulthood. However, although bullying incidents frequently target the victim’s body and appearance, research has overlooked studying victims’ long-term body image development and risk of engaging in disordered eating later in life. This 14-year longitudinal research project examined childhood bullying in relation to body image development and disordered eating in emerging adulthood. Growth curve analyses of participants’ body image at ages 10–21 years ( N = 960) revealed that more victimized children experienced more body dissatisfaction at baseline and maintained their negative body image throughout adolescence and into adulthood. Mediation analyses showed that childhood bullying (age 10 years) predicted more negative body image in adolescence (age 18 years), which in turn predicted more disordered eating in adulthood (age 24 years). The indirect effect was stronger for girls than for boys. The findings suggest that bullied children are likely to face both more body image problems and disordered eating as they evolve through adolescence and into adulthood, indicating the need for early and effective interventions. Incorporating components known to promote a more positive body image could be a valuable feature of future interventions. Thus, as children and adolescents are taught to cope with bullying situations, they could also be helped to deal with the appearance culture that permeates many of these situations.

The Strong, Silent Type(ology): Examining Intersections of Alexithymia and the Drive for Muscularity

This study used latent profile analysis to explore the interrelations of drive for muscularity (DM) and alexithymia among 505 men. Four unique classes of men emerged: (1) low endorsement of DM and alexithymia, (2) moderate endorsement of alexithymia and DM, (3) moderate endorsement of alexithymia and high endorsement of attitudinal and behavioral DM, and (4) high endorsement of DM attitudes and alexithymia, and low endorsement of DM behaviors. We explored relations between class membership and avoidant attachment, social pressure to be muscular, help-seeking attitudes, and body appreciation, using Class 1 as the reference group. Alexithymia and attitudinal DM, in the absence of behavioral DM, appear to be a particularly unhealthful constellation of alexithymia and DM.

From negative to positive body image: Men's and women's journeys from early adolescence to emerging adulthood

This study examined the developmental journeys of individuals who have overcome negative body image in early adolescence and developed positive body image on their way to emerging adulthood. Interviews were conducted with 15 women and 16 men (aged 26-27) recruited from a large longitudinal sample. Results demonstrated different patterns of positive body image development, but most participants had overcome their negative body image by age 18. Factors contributing to their negative body image in early adolescence included negative peer influence and discontent with life in general. Turning points included finding a new social context, experiencing agency and empowerment, and using cognitive strategies to improve body image. Characteristics of the participants' current positive body image coincided with established features of positive body image; novel findings were that the women were more likely to think of positive body image as needing constant work to maintain and were also more likely to have a feminist identity, whereas the men were more likely to try to improve their body shape and perceive their body as resembling the ideal. In conclusion, body image interventions need to target not only matters related to physical appearance but also adolescents' general sense of belonging, agency, and empowerment.

Psychosocial factors underlying symptoms of muscle dysmorphia in a non-clinical sample of men

Muscle dysmorphia is primarily characterized by an excessive preoccupation that one's body is not muscular or lean enough. Muscle dysmorphia has shown clinical similarities with eating disorders. The present study aims to explore the psychosocial factors underlying muscle dysmorphia symptoms by referring to Stice's dual pathway model (1994), a theoretical model of eating disorders. Three hundred and eighty-six men were recruited to complete an online survey including questionnaires assessing social pressures to reach a muscular body and internalization of the muscular body, drive for muscularity, muscular-enhancing behaviors, negative affect, narcissistic traits, and symptoms of muscle dysmorphia. Path analyses showed that the original model has a good fit, without, however, confirming a significant relationship between the drive for muscularity and negative affect. Thus, social pressure to reach a muscular body and its internalization were associated to a drive for muscularity and then, to muscle dysmorphia symptoms. The drive for muscularity was indirectly related to symptoms of muscle dysmorphia through muscle-enhancing behaviors as well as negative affect (although, only for individuals with higher levels of narcissistic vulnerability). Results supported the adaptation of the Stice's model to explain muscle dysmorphia symptoms and underlined the possible influence of narcissistic vulnerability traits in this condition.

Body appreciation in British men: Correlates and variation across sexual orientation

Investigations of positive body image among men and across various social identities are lacking, and could contribute to a more complete understanding of the construct, including how positive body image can be improved. This study addressed this gap by investigating correlates of body appreciation - a key facet of positive body image - in men, and testing whether levels of body appreciation vary across sexual orientation. Data from a British community sample of 439 men (M_age = 39.13) showed that body appreciation inversely correlated with conformity to masculine norms and upward appearance-based social comparisons, and positively correlated with physical activity. Body appreciation was lower among sexual minority compared to heterosexual men, and athletic appearance-ideal internalisation and upward appearance-based social comparisons mediated this relationship. Replicating prior research among men, body appreciation positively correlated with body satisfaction, and inversely correlated with perceived appearance pressures from media and eating pathology. These findings have implications for interventions addressing body image among men.

Male Weight Trainers' Body Dissatisfaction and Exercise Dependence: Mediating Role of Muscularity Drive

In considering that body image-related perceptions may be associated with weight trainers’ exercise dependence, the purpose of this study was to examine the (a) relationship between body dissatisfaction and drive for muscularity and (b) drive for muscularity as a mediator of the body dissatisfaction–exercise dependence relationship. In sum, 278 male weight trainers ( Mage =29.03 years, SD = 7.83) residing in a southern city of Taiwan completed scales of body dissatisfaction, drive for muscularity, and exercise dependence. Pearson correlation analysis found that body dissatisfaction, drive for muscularity, and exercise dependence were all correlated. Further, the indirect mediation model with bootstrapping found that drive for muscularity partially mediated the body dissatisfaction–exercise dependence relationship (c path: β = .51, SE = 0.07, p=.001: c′ path: β = .13, SE = 0.80, p = .03). We concluded that male weight trainers’ body image-related perceptions influence exercise behavior and suggested that body image-related perceptions might be considered in studying exercise dependence.

Cross-sectional associations between gender-linked personality traits and use of weight-loss and muscle-building products among U.S. young adults

This study examined the cross-sectional associations between gender-linked personality traits and use of products for weight loss and muscle building using data from young adults participating in Wave III of the National Longitudinal Study of Adolescent to Adult Health who completed the short-form Bem Sex-Role Inventory (n = 3,343). Among men, a higher score on the masculinity scale was associated with greater odds of diet pill use, legal performance-enhancing substance (PES) use, and illicit PES use, while a higher score on the femininity scale was associated with lower odds of illicit PES use. These findings can inform interventions for men with weight/shape concerns.

What Is More Important

The unnecessary question what a man is without his masculinity, is deeply ingrained into the socially established norms of strength, power, virility and machoism. Although the traditional male masculinity stereotype and its association with meat consumption are still undisputable for many “real” men, there is indication about a shift toward a new modern evolutionary masculinity which reflects more sustainability values. The chapter explores this based on a survey of Sydney men. It reveals the influence of new factors, such as environmental, health and animal welfare concerns, which shape the concept of the masculine. Meat-eating men will experience increasing pressure to defend their traditional masculinity. The Sydney study also explores the factors likely to influence Australian men to replace a meat-centred diet with more plant-based alternatives.

Swedish women's perceptions of and conformity to feminine norms

The relatively high gender equality in the Swedish society is likely to exert an influence on gender role construction. Hence, the present research aimed to investigate Swedish women's perceptions of and conformity to feminine norms. A mixed methods approach with two studies was used. In Study 1, young Swedish women's gender role conformity, as measured by the Conformity to Feminine Norms Inventory 45 (CFNI-45), was compared to the results from previously published studies in Canada, the United States, and Slovakia. Overall, Swedish women displayed less conformity than their foreign counterparts, with the largest difference on the subscale Sexual fidelity. In Study 2, focus group interviews with young Swedish women added a more complex picture of feminine norms in the Swedish society. For instance the results indicated that Swedish women, while living in a society with a strong gender equality discourse, are torn between the perceived need to invest in their appearances and the risk of being viewed as non-equal when doing so. In sum, despite the fact that traditional gender roles are less pronounced in Sweden, gender role conformity is still a pressing issue. Since attending to the potential roles of feminine norms in women's lives previously has been proposed to be useful in counseling and therapeutic work, the present research also offers valuable information for both researchers and practitioners. [Correction added on 5 May 2017, after first online publication in April 2017: An incorrect Abstract was inadvertently captured in the published article and has been corrected in this current version.].

Male Body Practices

The pressure on boys and men to engage in extensive body practices (e.g., closely monitored eating and exercise habits) and achieve ideal male bodies has grown significantly over the past 20 years. Central to the depiction of ideal male bodies and body practices are both the pursuit and achievement of lean and well-defined muscles. The labels “pitches,” “purchases,” and “performativities” were inductively derived from the literature, and used to describe the multifaceted connections between masculinities, muscularity, and idealized male body practices. “Pitches” distil how popular culture posture norms of masculinity, and manly bodies and behaviors attainable and necessary. “Purchases” refer to men’s diverse buy-in to dominant discourses about acceptable male bodies and practices. “Performativities” chronicle how men embody and navigate gender norms as they evaluate their own bodies, behaviors, and eating habits and those of their peers. Based on findings from the current scoping review, future research could benefit from fully linking masculinities with the drive for muscularity to address health and social risks associated with the pursuit of the idealized male body. In highlighting the plurality of masculinities and the complexity of men’s diverse identities, health care providers can better reach and support men. Focusing on, and celebrating, a wider range of male bodies could help recenter dominant discourses about how and whose bodies and experiences are idealized. The current scoping review article offers an overview of how masculinities and muscularity have been linked to male body practices, and recommendations to advance this emergent field.

Body Dissatisfaction Among Sexual Minority Men: Psychological and Sexual Health Outcomes

Body dissatisfaction is common among sexual minority (i.e., gay and bisexual) men; however, few studies have investigated the relationship between body dissatisfaction and psychosexual health variables among this population. The data that do exist are exclusively cross-sectional, casting uncertainty regarding temporal associations. Thus, the aims of the current study were to assess the prospective relationship between body dissatisfaction and psychological and sexual health outcomes. Participants were 131 gay and bisexual men who completed a battery of self-report measures across two time points (baseline and 3-month follow-up), including assessment of body dissatisfaction, depressive symptoms, and sexual health variables (sexual self-efficacy and sexual anxiety). Generalized linear modeling was employed to assess the prospective relationship between body dissatisfaction and outcomes variables, accounting for non-normal distributions. Body dissatisfaction significantly predicted elevated depressive symptoms (B = .21, p = .01), lower sexual self-efficacy (B = -.22, p = .04), and elevated sexual anxiety (B = .05, p = .03). Elevated body dissatisfaction is prospectively associated with negative psychological and sexual health outcomes. Given the high prevalence of body image concerns in sexual minority men, depression and/or HIV/STI prevention programs may benefit from routinely assessing for body dissatisfaction among this population, and addressing those who report concerns.

Psychometric properties of the Drive for Muscularity Scale in Malay men

The Drive for Muscularity Scale (DMS) is a widely used measure in studies of men's body image, but few studies have examined its psychometric properties outside English-speaking samples. Here, we assessed the factor structure of a Malay translation of the DMS. A community sample of 159 Malay men from Kuala Lumpur, Malaysia, completed the DMS, along with measures of self-esteem, body appreciation, and muscle discrepancy. Exploratory factor analysis led to the extraction of two factors, differentiating attitudes from behaviours, which mirrors the parent scale. Both factors also loaded on to a higher-order drive for muscularity factor. The subscales of the Malay DMS had adequate internal consistencies and good convergent validity, insofar as significant relationships were reported with self-esteem, body appreciation, muscle discrepancy, and body mass index. These results indicate that the Malay DMS has acceptable psychometric properties and can be used to assess body image concerns in Malay men.

Masculinities and ethnicities: Ethnic differences in drive for muscularity in British men and the negotiation of masculinity hierarchies

Although relatively little is known about ethnic differences in men's drive for muscularity, recent theoretical developments suggest that ethnic minority men may desire greater muscularity to contest their positions of relative subordinate masculinity. This study tested this hypothesis in a sample of 185 White, 180 Black British, and 182 South Asian British men. Participants completed self-report measures of drive for muscularity, need for power, adherence to traditional cultural values, and ethnic group affiliation. Taking into account between-group differences in body mass index, results indicated that White men had significantly lower drive for muscularity than Black and South Asian men, who were not significantly different from each other. In addition, greater need for power was significantly associated with higher drive for muscularity in ethnic minority, but not White, men. Greater adherence to traditional cultural values, but not ethnic group affiliation, was associated with lower drive for muscularity in all ethnic groups. These results suggest that ethnic minority men may desire greater muscularity as a means of negotiating masculinity and attendant ideals of appearance.

Internalization as a mediator of the relationship between conformity to masculine norms and body image attitudes and behaviors among young men in Sweden, US, UK, and Australia

We examined whether internalization of sociocultural body ideals mediated the relationship between conformity to masculine norms and drive for muscularity, leanness, and thinness in a sample of males from Sweden, US, UK, and Australia. Over six hundred young men [n=142 (Sweden); n=192 (US); n=141 (UK); n=160 (Australia)] completed an online survey that included assessments of masculine role norms, body image, and internalization of sociocultural body ideals. Path analyses confirmed internalization as a mediator between greater conformity to masculine norms and body image measures (drive for thinness, desire for leanness, and desire for muscularity) across the sample. However, significant cross-country differences in the strength of these mediation effects were found. Mediation effects among US, Australian, and Swedish males were comparable, whereas these effects were weaker in the UK sample. Findings confirmed the importance of internalization of sociocultural body ideals in the tested models.