A reliability generalization meta‐analysis of self‐report measures of muscle dysmorphia

Adaptation and validation of the muscle dysmorphic disorder inventory in a population of French athletes (MDDI-Fr)

INTRODUCTION

Muscle dysmorphia, a theme mainly investigated by Anglo-Saxon research, is a specific body dysmorphic disorder that characterizes individuals who think they are insufficiently muscular and lean. Understudied in francophone countries, tools translated and validated in French to measure the symptomatology of muscle dysmorphia remain rare.

OBJECTIVES

The aim of this study was the translation into French and the psychometric validation of a tool evaluating muscle dysmorphia, the Muscle Dysmorphic Disorder Inventory (MDDI-Fr), through 13 items divided into three dimensions: the "Drive For Size" (DFS), the "Appearance Intolerance" (AI) and the "Functional Impairment" (FI).

METHODOLOGY

A first translation step was conducted, followed by two cross-sectional studies conducted in France. In both of the latter studies, a sociodemographic questionnaire and the Muscle Dysmorphic Disorder Inventory - French version (MDDI-Fr) were administered. The first study included 342 university students (Mage=20.9; SDage=2.9), and 1822 athletes for the second study (Mage=23.9; SDage=5.9). Validation was performed using internal consistency measures and confirmatory factor analysis.

RESULTS

The correlation matrices showed good significant results between items and dimensions. The three dimensions appeared distinct from each other with significant intra-dimension correlations. The internal consistency of the tool and its three dimensions show valid Cronbach's alphas (study 1: DFS=0.79, AI=0.74, FI=0.75, MDDI=0.74; study 2: DFS=0.72, AI=0.75, FI=0.83, MDDI=0.75). In addition, the tri-factor analysis shows significant and promising scores for the tool in three dimensions and 13 items for study 1 (χ2/df=4.67, CFI=0.85, TLI=0.83, RMSEA=0.10, SRMR=0.00), as for study 2 (χ2/df=16.08, CFI=0.87, TLI=0.84, RMSEA=0.09, SRMR=.06). Gender analyses were conducted on study 2, which showed that the DFS subscale (items 1, 4, 5) and the AI subscale (items 6 and 9) presented the greatest differences in factor loadings between genders.

CONCLUSION

The translation, as well as the validation of the MDDI-Fr structured with 13 items and three dimensions, showed significantly satisfying results for its adaptation in French in a population of French men and women practicing weight training. However, the "Appearance Intolerance" dimension shows moderate links with the global tool, which should be investigated in future studies. Although the psychometric properties of the MDDI-Fr are promising, additional research is needed to gain a better understanding of gender differences in the results, especially for the DFS dimension.

'The day you start lifting is the day you become forever small': Bodybuilders explain muscle dysmorphia

Muscle dysmorphia (MD) is a pathological preoccupation with muscularity characterised by negative body image, compulsive behaviours, and obsessive thoughts. Since its first identification academics have suggested that it is caused by sociocultural factors. Despite this there has been very little research exploring the role of sociocultural factors in the development and maintenance of MD, and no research that examines MD from within its cultural context. Instead the medical model of MD has dominated understanding. This model presents professionals as the experts on this disorder, and sufferers as pathological individuals in need of expert treatment. This renders cultural context largely irrelevant to understandings of MD. In this paper we present a different kind of expertise with regards MD. We describe the expertise of those most likely to suffer from MD, and upon whom medical descriptions of MD are based: bodybuilders. Specifically, we describe how bodybuilders explain MD (their definition, theory of aetiology and experience of MD, as well as their suggested management strategies), and compare these explanations to the dominant medical model. Through a consideration of the expertise of bodybuilders we break the tunnel vision of medicine, and suggest ways we can move beyond our current under-developed understanding of MD. This paper examines MD from within its cultural context, and in so doing it lays the foundation for a sociocultural explanatory model of MD. If we are to significantly reduce the harms of this disorder we cannot rely solely on treating the few individuals who present to clinicians. Rather we must develop ways to help sufferers to manage their disorder, and to prevent the development of this disorder among those at risk in the first place. To do this we must understand the sociocultural dimensions of MD, and collaborate with bodybuilding communities.

The Adult Prosocialness Behavior Scale: A reliability generalization meta-analysis

The Adult Prosocialness Behavior Scale (APBS) is most often used to measure adult prosociality. We conducted a reliability generalization meta-analysis to compute the average APBS reliability and examine the heterogeneity among reliability estimations and the influence of moderator variables. An exhaustive search identified 74 articles that applied the APBS with 16 items assessed on a 5-point Likert-type scale. Of these, 58 had reliability coefficients with the current data, and 76 reliability estimates were provided. Random- and mixed-effects models were used. The average reliability coefficient was .903 for Cronbach’s alpha, .896 for McDonald’s omega, and .674 for test–retest. Moderator analyses were used to create a predictive model in which the target population and study language accounted for 48.7% of the total variability among Cronbach’s alpha coefficients. Although the APBS has shown satisfactory internal consistency, it can vary as a function of several factors.

Reliability Generalization Meta-Analysis of Internet Gaming Disorder Scale

The objective of this study was to carry out a reliability generalization meta-analysis of the Internet Gaming Disorder Scale (IGDS) to find out if it presents adequate values that justify its application in its four versions: original and abbreviated with dichotomous or ordinal response. A systematic review including 26 studies that apply this instrument from 2015 to June 2022 was conducted. For each version, a reliability generalization meta-analysis was performed with the random coefficients (RC) and varying coefficients (VC) model. Results showed reliability levels > 0.80 in the ordinal versions (IGDS9P and IGDS27P) and in the dichotomous 27-item version (IGDS27D), while the dichotomous 9-item version (IGDS9D) produced levels > 0.70. High heterogeneity was found in all versions (I2 > 95%; Rb > 90%). Cronbach’s α means with both models (RC-VC) did not differ significantly except for the IGDS9D version. It is concluded that, considering the dependence of the results on sample size, abbreviated versions do not guarantee that reliability remains acceptable, and dichotomous versions may provide limited but acceptable reliability. Finally, IGDS27P version is recommended in contexts where high precision is required.

The association between social media addiction and eating disturbances is mediated by muscle dysmorphia-related symptoms: a cross-sectional study in a sample of young adults

PURPOSE

Although the association between problematic use of the internet and eating disorders (EDs) in young adults has been previously established, its underlying mechanisms have not been completely clarified. It has been suggested that exposure to idealized very thin and toned body images (e.g., "thinspiration" and "fitspiration" trends) on social media might lead to increased feelings of body dissatisfaction which, in turn, can represent a trigger for EDs. We have tested this hypothesis in a sample (N = 721) of young adults (504 females, mean age: 24.13 ± 3.70 years; range 18-34).

METHODS

Self-report measures investigating symptoms related to social media addiction (SMA), muscle dysmorphia (MD), and EDs were used. A mediational model analyzing the direct and indirect effects of SMA-related symptoms on ED-related symptoms through the mediating role of MD-related symptoms was performed controlling for confounding factors (e.g., socio-demographic variables, substances use, body mass index, psychopathological distress).

RESULTS

The model showed that the total effect of SMA-related symptoms on ED-related symptoms was significant (B = 0.213; p = 0.022) and that this association was mediated by MD-related symptoms (B = 0.083; p = 0.021).

DISCUSSION

Our findings support the possibility that MD-related symptoms play a relevant role in mediating the association between SMA severity and ED pathology.

LEVEL OF EVIDENCE

Level III, evidence obtained from well-designed cohort or case-control analytic studies.

California Critical Thinking Disposition Inventory: Reliability Generalization Meta-Analysis

The aims of this reliability generalization study were to provide the overall alpha values of the California critical thinking disposition inventory (CCTDI) total score and subscales scores and investigate the characteristics of the studies that may be associated with the variability in the reliability values of the CCTDI total score and subscales scores. This study was carried out with 98 alpha values from 87 unique studies for total CCTDI scores. In the random effects model, total CCTDI was found to be reliable across samples with alpha value of 0.83. Also, the general alpha coefficients were 0.65, 0.56, 0.64, 0.66, 0.74, 0.72, and 0.61 for TS-scale, OM-scale, A-scale, S-scale, SC-scale, I-scale, and M-scale, respectively. Examination of study characteristics indicated that sample type was a significant predictor for alpha value of total CCTDI and all subscales. Samples with university students reported larger Cronbach’s alpha estimates for total CCTDI and all subscales. Also, while language was found to moderate the general alpha coefficient of total CCTDI, OM-scale, A-scale, S-scale, and I-scale, it was not a significant moderator on the general alpha value of TS-scale, SC-scale, and M-scale. Total CCTDI and all subscales showed higher Cronbach’s alpha values for the English-language administrations. Besides, country of the study was a significant moderator on the general alpha coefficient of total CCTDI, S-scale, and I-scale. However, subgroup of discipline was not a significant moderator on the general alpha coefficient of total CCTDI and its subscales. The mean of the test scores significantly explained %5 of the variance of alpha values of the total CCTDI. SD of the test scores significantly explained %10, %55, and %54 of the variance of alpha values of the total CCTDI, A-scale, and S-scale, respectively. It was found that gender and ethnicity significantly moderated the alpha values for M-scale.

Prevalence and Co-Occurrence of Different Types of Body Dysmorphic Disorder Among Men Having Sex with Men

Body dysmorphic disorder (BDD) is a relatively common psychiatric condition of which the prevalence has not been fully investigated in the non-clinical population, and in particular among men having sex with men (MSM). MSM have proven to be more inclined to develop body dissatisfaction and body image disorders compared to non-MSM. Our study investigates the prevalence of BDD and the prevalence and co-occurrence of muscle dysmorphia (MD) and penile dysmorphic disorder (PDD) in a sample of 261 Italian MSM recruited online. From our data, gathered through self-report measures, the prevalence of BDD, MD, and PDD in our populations was 5.4%, 8.8%, and 4.2%, respectively. Compared to their elders, younger adults (ages 18-34) appear to be at higher risk of BDD and especially of MD. Non-significant differences have been observed for the prevalence of PDD depending on the age range. Our study shows that the risk of body image disorders among MSM is quite common, especially among young adults, and higher than what is found among heterosexual men.

Basic Empathy Scale: A Systematic Review and Reliability Generalization Meta-Analysis

The Basic Empathy Scale (BES) has been internationally used to measure empathy. A systematic review including 74 articles that implement the instrument since its development in 2006 was carried out. Moreover, an evidence validity analysis and a reliability generalization meta-analysis were performed to examine if the scale presented the appropriate values to justify its application. Results from the systematic review showed that the use of the BES is increasing, although the research areas in which it is being implemented are currently being broadened. The validity analyses indicated that both the type of factor analysis and reliability are reported in validation studies much more than the consequences of testing are. Regarding the meta-analysis results, the mean of Cronbach's α for cognitive empathy was 0.81 (95% CI: 0.77-0.85), with high levels of heterogeneity (I2 = 98.81%). Regarding affective empathy, the mean of Cronbach's α was 0.81 (95% CI: 0.76-0.84), with high levels of heterogeneity. It was concluded that BES is appropriate to be used in general population groups, although not recommended for clinical diagnosis; and there is a moderate to high heterogeneity in the mean of Cronbach's α. The practical implications of the results in mean estimation and heterogeneity are discussed.

Reliability Generalization Study of the Person-Centered Care Assessment Tool

The so-called Person-Centered Care (PCC) model identifies three fundamental principles: changing the focus of attention from the disease to the person, individualizing care, and promoting empowerment. The Person-Centered Care Assessment Tool (P-CAT) has gained wide acceptance as a measure of PCC in recent years due to its brevity and simplicity, as well as its ease of application and interpretation. The objective of this study is to carry out a reliability generalization meta-analysis to estimate the internal consistency of the P-CAT and analyze possible factors that may affect it, such as the year of publication, the care context, the application method, and certain sociodemographic properties of the study sample. The mean value of α for the 25 samples of the 23 studies in the meta-analysis was 0.81 (95% CI: 0.79-0.84), with high heterogeneity (squared-I = 85.83%). The only variable that had a statistically significant relationship with the reliability coefficient was the mean age of the sample. The results show that the P-CAT gives acceptably consistent scores when its use is oriented toward the description and investigation of groups, although it may be affected by variables such as the age of participants.

The Medical Outcome Study-HIV Health Survey: A systematic review and reliability generalization meta-analysis

The Medical Outcome Study-HIV Health Survey (MOS-HIV) is one of the most used questionnaires for the evaluation of the health-related quality of life (HRQoL) in people living with HIV (PLWHIV) in both medical settings and research studies. This study aimed to estimate the average reliability of the MOS-HIV scores and to evaluate the characteristics of the studies that could explain the variability between reliability estimates. Furthermore, the study aimed to estimate the induction rate of the reliability of the MOS-HIV. A systematic review of the previous literature, including studies that reported α and/or test-retest coefficients with the data at hand for the total score of the MOS-HIV and the subscales, was conducted. Fifty studies (52 samples; N = 14,132) were included in the reliability generalization meta-analysis. The average α coefficient for the total score of MOS-HIV was .91 and above .80 for all of the subscales, except for role functioning, which had an average coefficient of .76. Different study dimensions were related to the heterogeneity of reliability between studies. Reliability induction was found to be 76.1%. The results obtained in the present study indicate that the MOS-HIV is a reliable instrument for HRQoL evaluation in PLWHIV, for clinical and research purposes. In the clinical practice of health services, nurses could employ this gold standard for reliable evaluations of HRQoL in PLWHIV.