مقایسه روان شناختی زنان مبتلا به بی اشتهایی عصبی با بدن سازان رقابتی مردان :شکل بدن ایده آل

There is accumulating evidence that young men have become as concerned with their physical appearance as young women. However, different from women who want to achieve an ultra-slender body shape, most men want to increase their muscle mass and body size. Women with anorexia nervosa (AN) and competitive male bodybuilders are those who have taken the cultural standards of bodily perfection to the extreme, and both use unhealthy behaviours such as severe food restriction, excessive exercise, and steroids in pursuit of their goals. Findings of this study confirmed our prediction that the psychological profile of bodybuilders would be very similar to that found in women with AN. Both groups were significantly more obsessional, perfectionistic, anhedonic, and pathologically narcissistic than the general population. However, the bodybuilders reported very positive perceptions of their self-worth while the AN patients had very negative perceptions. Results are interpreted in the framework of a speculative developmental model of AN and bodybuilding, which focuses on the role of personality in the initiation and maintenance of excessive behaviours.

During most of this century, concerns about body shape and efforts to enhance physical attractiveness have implicitly been the prerogative of women. However, in recent years, and with changing social values, we have seen an increased emphasis on appearance among men (Mishkind, Rodin, Silberstein, & Striegel-Moore, 1986). One indication of this is the significant increase in body-concern articles related to physical fitness and weight loss in popular men's magazines (Nemeroff, Stein, Diehl, & Smilack, 1994). There is also evidence that media exposure to socially prescribed body-image ideals can foster negative psychological consequences in men. A recently published study found that both men and women reported feeling fatter, less attractive, less sexy, and less toned after viewing images of fashion models that represented the stereotypic ideal for their gender (Ogden & Mundray, 1996). Other data have also indicated a positive relationship between dieting behaviours and media consumption in both men and women (Harrison & Cantor, 1997). We are becoming increasingly aware of the potentially unhealthy practices that are used by some women in their pursuit of the ultra-slender body ideal that is ubiquitous in fashion advertising and the entertainment media. Estimates suggest that at any one time, about 40% of adult women and at least 60% of adolescents girls restrict their food intake for the purpose of losing weight (e.g. Horm & Anderson, 1993, Middleman et al., 1998 and Serdula et al., 1993). These statistics are particularly disconcerting since it may be the wrong people who are preoccupied with their weight. In a recent study, 50% of the young women who were underweight on the basis of their Body Mass Index classified themselves in the overweight category (Haberman & Luffey, 1998). Among some women, the quest for the ideal body shape takes an extreme and aberrant form. The severe emaciation that defines anorexia nervosa (AN) is the pathological manifestation of a strong desire for thinness, and the use of self-starvation to achieve that goal. Because those who suffer from this condition are typically characterized by traits such as obsessionality, perfectionism, narcissism, and anhedonia, as well as by affective disturbances (e.g. Davis et al., 1999, Deep et al., 1995, Garner, 1981, Lilenfeld et al., 1998 and Mitzman et al., 1994), AN has been classified as a major psychiatric disorder. Although the media image of the sexually attractive male is also lean, it is — in contrast to its female counterpart — very muscular. Indeed, it could be said that on a continuum of body size, the gender-specific ideals represent polar opposites. Although men also engage in appearance-enhancing behaviours, they tend to employ different methods than women to alter their body shape. Studies have found that they are more likely to use strength training exercises, chaotic dietary regimens, and food supplements to reduce body fat content and enhance muscle mass Andersen et al., 1995 and Drewnowski et al., 1995. And it appears that these behaviours have been on the increase in recent years (Wroblewska, 1997). Of greater concern, however, is the increasing recreational use of anabolic–androgenic steroids for cosmetic muscle building. Prevalence rates among adolescent males range between 4% and 12% (Bahrke, Yesalis, & Brower, 1998). In addition to the medical risks associated with chronic steroid use, there are a number of psychological side effects. For example, during periods of drug taking, there tends to be increased irritability, aggressiveness, grandiosity, and recklessness, while depression and diminished libido are characteristic of withdrawal from these drugs (e.g. Pope & Katz, 1994 and Riem & Hursey, 1995). Among men, efforts to achieve the ideal body shape can also take an extreme form. Most would agree that the competitive male bodybuilder typifies the ultimate achievement of hypermuscularity and a low percentage of body fat. It is interesting to note, however, that different from the way we view the pursuit of excessive thinness in women, extreme muscle building is not viewed as a psychiatric disorder despite the potentially injurious dietary, exercise, and drug practices that are required to achieve this state (see Andersen et al., 1995). On the contrary, the competitively successful bodybuilder is mostly glorified in the media as the epitome of health, fitness, and sex appeal. He is the mythical Adonis personified. And in accord with public perception, bodybuilders themselves report very positive feelings about their bodies—indeed, in one study, significantly better than those reported by an age-matched group of men that included both active exercisers and non-exercisers (Schwerin et al., 1996). To date, only a handful of studies have investigated the psychological characteristics of competitive bodybuilders, and each has examined only a few selected variables. Nevertheless, the findings are suggestive of some disturbance. For example, steroid-using bodybuilders reported higher levels of pathological narcissism and a greater lack of empathy than those not using steroids (Porcerelli & Sandler, 1995). Others have found that a substantial number of bodybuilders report feelings of anxiety, depression, and isolation (Andersen et al., 1995), and that heightened perfectionism and ineffectiveness are greater in bodybuilders than in runners and martial artists (Blouin & Goldfield, 1995). Finally, Pope, Katz, and Hudson (1993) have identified a subgroup of bodybuilders who display a disturbance of body image that closely resembles Body Dysmorphic Disorder . This condition, which they have labelled “reverse anorexia”, is characterized by a pathological fear of being too small, and the perception of weakness and underdevelopment, even when one is large and very muscular. However, it is difficult to draw firm conclusions from these studies, not only because of their limited scope, but because most studies have not included an appropriate or meaningful reference group for comparison. Bodybuilders have either been compared to other groups of athletes, or comparisons have been made between steroid and non-steroid users within the sport (e.g. Blouin & Goldfield, 1995 and Porcerelli & Sandler, 1995). To improve on these earlier designs, the present study set out to examine, in a more comprehensive way, the psychological profile of the competitive male bodybuilder by using a broad range of psychometric measures in the assessment protocol. We reasoned that a relevant comparison group—by virtue of the centrality of body image motivations for both—would be women with AN. It was important, we also felt, to compare the data from both these groups to normative data from the general population. We were guided in our selection of study variables by our hypothesis that bodybuilders would display a similar psychological profile to patients with AN. Consequently, we assessed the traits that have most consistently been associated with AN. These were mentioned earlier in this Section, and are described in detail in Section 2.

Although the psychobiological model we have proposed is theoretically and empirically grounded, it must only be regarded as conjectural due to the cross-sectional nature of our data. Clearly, some of the psychopathological traits we observed may have been exacerbated by the physical condition of our subjects For example, it is important to keep in mind that many of the features of narcissism are also the common aspects of mania — a state that can be induced by the use of steroids (Pope & Katz, 1994). However, a large body of eating disorder research has indicated that the traits described in this study — in particular, obsessive–compulsive personality, perfectionism, and narcissism — are stable characteristics with etiological significance in AN (e.g. Rogers & Petrie, 1996, Steiger et al., 1997 and Strober, 1980). Only longitudinal research will determine whether this is also the case among bodybuilders. Finally, our findings highlight an interesting social contradiction, and raise an important health issue. In our society, individuals are labelled “disordered” if they have a strong drive for thinness and engage in extreme dieting. On the other hand, a strong drive for muscularity is typically valued and admired. It has been suggested that since the hypermesomorphic form conveys an appearance of great strength and physical fitness, both the bodybuilder and the general public tend to underappreciate the seriousness of the practices such as steroid use and excessive dieting that are necessary to achieve this condition (Schwerin et al., 1996).