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|  Feride Gökben Hızlı Sayar Üsküdar Üniversitesi, Türkiye | 
|  Selami Varol Ülker Üsküdar Üniversitesi, Türkiye | 
|  Dr. Öğr. Üyesi Eda YILMAZER Beykoz Üniversitesi, Türkiye | 
| 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 |