The indirect role of orthorexia nervosa and eating attitudes in the association between perfectionism and muscle dysmorphic disorder in Lebanese male University students - results of a pilot study.

BACKGROUND: The literature highly concentrates on disorders related to body image among women but only minimally when it comes to the male population; hence, in order to provide general practitioners, and primary care physicians in general, and psychiatrists in particular, with additional information concerning muscle dysmorphia among male university students in Lebanon, this study seemed essential, and was therefore conducted to (1) identify the prevalence of MDD, and (2) evaluate the indirect effect of eating attitudes in general and orthorexia nervosa in particular, in the association between perfectionism and muscle dysmorphic disorder (MDD) among a sample of male university students. METHODS: In this cross-sectional study conducted between September 2021 and May 2022, 396 male university students from multiple universities in Lebanon filled the online Arabic questionnaire. RESULTS: The results showed that 26 (6.6%) of the participants had MDD. Orthorexia nervosa and eating attitudes mediated the association between perfectionism and MDD; higher perfectionism was significantly associated with higher ON and more inappropriate eating; higher ON and more inappropriate eating were significantly associated with higher MDD, whereas perfectionism had a significant total direct effect on MDD. The high prevalence of MDD among male university students in Lebanon implies further investigation on the national level in the country. CONCLUSION: Awareness campaigns among the university students could be adopted at the national level to increase the level of knowledge on the concepts of obsessive self-destructive perfectionism, orthorexia nervosa and muscle dysmorphia.

Validation of the Arabic version of the Muscle Dysmorphic Disorder Inventory (Ar-MDDI) among Lebanese male university students.

BACKGROUND: To date, the vast majority of research on disordered eating symptomatology and body image disturbances from the Arab world have been performed exclusively among women; and mainly used thinness-oriented measures that are not sensitive to detect muscularity-oriented symptoms, which are more evident in males. Therefore, the objective of our study was to validate the Arabic version of the Muscle Dysmorphic Disorder Inventory (Ar-MDDI), in order to make it accessible for Arabic-speaking populations. METHODS: Using a snowball sampling technique, men university students (n = 396) from multiple universities in Lebanon filled the survey in this cross-sectional designed study (January-May 2022). A soft copy of the questionnaire was created using google forms software, and sent to participants through the different social media platforms such as Facebook, Instagram, and WhatsApp. We used the Muscle Dysmorphic Disorder Inventory to assess Muscle Dysmorphia, along with the Big Three Perfectionism Scale to assess perfectionism and Eating Attitude Test (EAT) to evaluate the inappropriate eating attitudes. To explore the factor structure of Ar-MDDI, we computed a principal-axis Exploratory Factor Analysis (EFA) with the first split-half subsample using the FACTOR software. We used data from the second split-half to conduct a Confirmatory Factor Analysis (CFA) using the SPSS AMOS v.29 software. Pearson correlation test was used to test the convergent and divergent validity of the Ar-MDDI scale with the other scores included in the study. RESULTS: The results of the EFA revealed three factors, which explained 57.68% of the common variance: Factor 1 = Appearance intolerance, Factor 2 = Drive for size, and Factor 3 = Functional impairment. The CFA fit indices of the three-factor model of the Ar-MDDI scale showed good results. Moreover, 254 (64.1%) of the participants had inappropriate eating attitudes (EAT scores ≥ 20). Indices suggested that configural, metric, and scalar invariance was supported according to eating attitudes. No significant difference between participants with appropriate versus inappropriate eating attitudes in terms of functional impairment, drive for size and appearance intolerance. Perfectionism scores correlated positively with the Ar-MDDI, which suggests divergent validity. CONCLUSION: Our findings revealed that the validation of the Arabic scale yielded excellent properties, preliminarily supporting its use for the assessment of muscle dysmorphia among Arabic-speaking university men. This would hopefully allow for its timely detection and management in Arab clinical settings and encourage cross-cultural research on this topic.

Muscle dysmorphic disorder (MDD) refers to an important muscularity-oriented dimension related to eating disorder (ED) symptoms and body image disturbances. One widely used self-report measure to assess the MDD construct is the Muscle Dysmorphic Disorder Inventory (MDDI). Despite its high clinical relevance, MDD has not been previously investigated in the Lebanese context and among the Arabic-speaking communities in general. Indeed, the multiple scales assessing ED symptomatology that have previously been translated to the Arabic language and adapted to the Lebanese population have been mainly focused on thinness-oriented ED; and no Arabic validation of muscularity-oriented body image and disordered eating symptoms measures, including the MDDI, exists so far to the best of our knowledge. To overcome this gap, the present study aimed to validate the Arabic version of the MDDI (Ar-MDDI) in a sample of Lebanese men university students. The findings showed that the AR-MDDI is robust in terms of reliability, factor structure, convergent and divergent validity. We, therefore, preliminarily recommend its use in clinical practice, preventive interventions and future research in Arab settings.

Computer Vision Syndrome in Lebanese Male Adolescents: Correlates With Mental Health and Mediating Effect of Stress.

Objective: To determine the prevalence of computer vision syndrome (CVS) and the relationship between CVS and depression, anxiety, insomnia, stress, and aggression among a sample of Lebanese male adolescents.Methods: This cross-sectional observational study enrolled 389 male Lebanese students (aged 13-17 years) between October and December 2019.Results: After adjusting for the covariates (age, body mass index, and House Crowding Index), those with CVS had significantly higher mean depression (P < .001), anxiety (P = .003), and insomnia (P = .007) scores compared to those without CVS. The presence of CVS was associated with significantly higher depression (B = 3.25), anxiety (B = 4.11), and insomnia (B = 4.49), but not aggression. Stress mediated the association between CVS and depression, anxiety, insomnia, and aggression (P < .001 for all).Conclusions: The findings of this study indicate the importance of recognizing CVS in adolescents and raising awareness of time spent daily using computers and other electronic devices.

Anxiety among Lebanese adolescents: scale validation and correlates.

BACKGROUND: The Lebanese population has undergone several conflicts and were the most afflicted by shelling and chaos during the civil war from 1975 to 1990, or even by displacement, bereavement, emigration, family separations, not to mention the economic crises that have hit the country since 2019 under which young adults are still succumbing. Our study aims to validate the Lebanese Anxiety Scale and assess correlates of anxiety among Lebanese adolescents. METHODS: A cross-sectional study was carried between January and May 2019, using a proportionate random sampling of schools from all five Lebanese governorates, among which 1810 adolescents aged 14 to 17 years. RESULTS: All LAS items remained in the model and formed one factor solution that explained 61.38% of the total variance (KMO = 0.873; pBartlett test < 0.001), with an excellent Cronbach's alpha of 0.93. Higher neglect (B = 0.38), insomnia (B = 0.21) and child psychological abuse (B = 0.08) were significantly associated with more anxiety. Those results were considered adjusted overall sociodemographic variables since the latter had no statistically significant association with anxiety. CONCLUSION: The study confirmed the association between anxiety and some variables such as psychological child abuse, neglect, and insomnia and emphasized the correlation between anxiety and these factors. Further, the LAS appears to be a short, valid and efficient tool for assessing anxiety among Lebanese adolescents. Further studies need to be carried to evaluate whether the LAS-10 gives a similar diagnosis to psychiatrists.