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

Abstract

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.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40337-023-00737-8.

Plain English Summary

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.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40337-023-00737-8.