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Cognitive Behavioral Therapy for Muscle Dysmorphia and Anabolic Steroid-Related Psychopathology: A Randomized Controlled Trial      
Yazarlar (3)
Feride Gökben Hızlı Sayar
Üsküdar Üniversitesi, Türkiye
Selami Varol Ülker
Üsküdar Üniversitesi, Türkiye
Dr. Öğr. Üyesi Eda YILMAZER Dr. Öğr. Üyesi Eda YILMAZER
Beykoz Üniversitesi, Türkiye
Devamını Göster
Özet
: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic-androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. : Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all < 0.01), indicating CBT's specific efficacy. : This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT's transdiagnostic applicability in addressing both the cognitive-behavioral and affective dimensions of MD. : In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes-Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG-were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired -tests were used to analyze time × group interactions. : CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts.
Anahtar Kelimeler
anabolic-androgenic steroid abuse | performance-enhancing drug misuse | body dysmorphic disorder | muscle dysmorphia | cognitive behavioral therapy
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayınlanan tam makale
Dergi Adı Pharmaceuticals
Dergi ISSN 12345
Dergi Tarandığı Indeksler SSCI
Dergi Grubu Q4
Makale Dili İngilizce
Basım Tarihi 07-2025
Cilt No 18
Sayı 8
Sayfalar 1081 / 0
Doi Numarası 10.3390/ph18081081
Makale Linki https://www.mdpi.com/1424-8247/18/8/1081