肌肉上瘾综合征:一种新型的心理障碍?

Muscle Dysmorphia: A New Form of Psychological Disorder?

肌肉上瘾综合征是指个体对于缺乏大块肌肉的错误认知的先占观念,是近二十年来西方学者的研究热点之一。已有研究从肌肉上瘾的诊断和测量,与体象障碍等心理障碍和行为异常的关系,以及形成机制等方面进行了深入的研究。然而,目前关于其临床诊断、产生机制等方面还存在争议。肌肉上瘾综合征在我国,甚至是亚洲尚缺乏足够的关注度。肌肉上瘾综合征的诊断依据、病征的文化差异、共患疾病、形成机制等将成为今后研究的焦点问题。

Muscle dysmorphia （MD） is a preoccupation with the idea that one＇s body is insufficiently lean and muscular, which has newly become a prominent issue in psychological and psychiatric literatures. MD is a collection of the extreme attitudes and behaviors of becoming more muscular~ It has newly been categorized as a form of body dysmorphic disorder occurring mostly in males, who usually participate in weightlifting and body- building. The purpose of the present study is to introduce and discuss the existing studies on MD to highlight the essence and importance of exploring MD in an Asian environment, especially in China. Symptoms of individuals with MD were found by earlier research in terms of aspects of cognition, behavior and social activities. Although MD is now introduced as a subcategory of body dysmorphic disorder due to the relationship and co-morbidity with eating disorder and other disorders, there are still disputes on MD＇s categorization. Some researchers suggest that MD be a new form of psychological disorder. According to the criteria suggested by Blashfield, Sprock and Fuller （1990）, MD only meets two criteria of the five and cannot been listed as a new disorder. Therefore, it is an essence for further studies conducted to examine the unique characteristics of MD. Moreover, in recent years, various questionnaires assessing MD symptoms have been developed by researchers in several western countries. The cultural diversity of MD is still being studied by researchers. Nowadays, researchers have outlined two main theoretical models in the previous studies, i.e., the six-factor psycho-behavioral model and conceptual model （Grieve, 2007; Lantz, Rhea, ＆ Cornelius, 2002）. However, there is a lack of empirical research related to these theories, and the predictive validity of these models has not yet been verified. Some studies have argued that other cognitive factors excluded in these two models, such as attention bias and cognitive mode, may also contribute to the pathogenesis of MD. The mechanism of MD is not well understood, and it is necessary for further studies. With the development of globalization, the pursuit for the ＂big＂ appearance prominent in Western cultures has appeared to grow among men in Asia. A recent study revealed that insufficient muscles was the third most frequently mentioned concern among Chinese male students （Liao et al., 2010）. Coincidentally, the population of weightlifters and body-builders has been increasing rapidly in China. The increasing popularity of weightlifling in Chinese men suggests the presence of MD. It is therefore important to investigate this new syndrome in China. MD still lacks enough attention in China and even in Asia. As a relatively new syndrome, many aspects are disputed, such as the relationship between MD and other disorders, specific clinical diagnosis, the mechanisms and cultural difference of MD. We suggest that in future research, researchers could further explore MD in the following ways： （a） Further examine the guidelines of categorizing a new disorder; （b） Make clear the relationship of MD and body dismorphic disorder, eating disorder or other co-morbidity; （c） Explore the mechanisms of MD, especially the roles of cognitive factors; （d） Pay attention to the characteristics of cultural differences; and （e） Focus more on the high risk population （such as bodybuilders and weightliflers） and develop effective intervention studies.