Bullying victimization has several consequences for the psychological well-being of marginalized people, including body dysmorphic concerns and paranoid ideation, a relatively stable way of thinking characterized by suspiciousness and mistrust of others. Men who have sex with men (MSM) report a greater risk of homophobic bullying victimization (HBV), and previous research has indicated that MSM face a higher risk of body dysmorphic concerns, particularly in reference to their muscles. The aim of this study is to examine the association between HBV and muscle dysmorphic concerns in a sample of MSM, and to test the hypothesis that paranoid ideation mediates the association between HBV and muscle dysmorphic concerns. The sample consisted of 270 Italian-speaking MSM aged 18–64 years (M = 34.3; SD = 11.4). We administered an anonymous online questionnaire to collect data about sociodemographics, previous HBV experiences, muscle dysmorphic concerns and paranoid ideation using internationally validated instruments. Our results suggest that HBV positively predicts both higher levels of paranoid ideation and muscle dysmorphic preoccupation. Moreover, the results indicate that paranoid ideation is a mediator of the relationship between HBV and MD. Implications for research and clinical practice are discussed.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Ashford, C. D., Ashcroft, K., & Maguire, N. (2012). Emotions, traits and negative beliefs as possible mediators in the relationship between childhood experiences of being bullied and paranoid thinking in a non-clinical sample. Journal of Experimental Psychopathology, 3(4), 624–638. https://doi.org/10.5127/jep.020611.
Badenes-Ribera, L., Fabris, M. A., & Longobardi, C. (2018). The relationship between internalized homonegativity and body image concerns in sexual minority men: A meta-analysis. Psychology & Sexuality, 9(3), 251–268. https://doi.org/10.1080/19419899.2018.1476905.
Badenes-Ribera, L., Rubio-Aparicio, M., Sanchez-Meca, J., Fabris, M. A., & Longobardi, C. (2019). The association between muscle dysmorphia and eating disorder symptomatology: A systematic review and meta-analysis. Journal of Behavioral Addictions, 8(3), 351–371. https://doi.org/10.1556/2006.8.2019.44.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037//0022-35184.108.40.2063.
Basile, K. C., Espelage, D. L., Rivers, I., McMahon, P. M., & Simon, T. R. (2009). The theoretical and empirical links between bullying behavior and male sexual violence perpetration. Aggression and Violent Behavior, 14(5), 336–347. https://doi.org/10.1016/j.avb.2009.06.001.
Boroughs, M. S., Krawczyk, R., & Thompson, J. K. (2010). Body dysmorphic disorder among diverse racial/ethnic and sexual orientation groups: Prevalence estimates and associated factors. Sex Roles, 63(9–10), 725–737. https://doi.org/10.1007/s1119901098311.
Cafri, G., Olivardia, R., & Thompson, J. K. (2008). Symptom characteristics and psychiatric comorbidity among males with muscle dysmorphia. Comprehensive Psychiatry, 49(4), 374–379. https://doi.org/10.1016/j.comppsych.2008.01003.
Chaudhry, K. (2012). The relationship of childhood bullying and paranoid thinking in a clinical population: The role of mediators (Doctoral dissertation, University of Southampton).
Derogatis, L. (2011). In I. Sarno, E. Preti, A. Prunas, & F. Madeddu (Eds.), Manuale di somministrazione e scoring. Adattamento italiano di SCL-90-R. Firenze: Giunti, Organizzazioni Speciali.
Didie, E. R., Tortolani, C. C., Pope, C. G., Menard, W., Fay, C., & Phillips, K. A. (2006). Childhood abuse and neglect in body dysmorphic disorder. Child Abuse & Neglect, 30(10), 1105–1115. https://doi.org/10.1016/j.chiabu.2006.03.007.
Fabris, M. A., Longobardi, C., Prino, L. E., & Settanni, M. (2018). Attachment style and risk of muscle dysmorphia in a sample of male bodybuilders. Psychology of Men & Masculinity, 19(2), 273–281. https://doi.org/10.1037/men0000096.
Fabris, M. A., Longobardi, C., Badenes-Ribera, L., & Settanni, M., (2020). Journal of Homosexuality. Accepted for publication.
Fedewa, A. L., & Ahn, S. (2011). The effects of bullying and peer victimization on sexual-minority and heterosexual youths: A quantitative meta-analysis of the literature. Journal of GLBT Family Studies, 7(4), 398–418. https://doi.org/10.1080/1550428X2011592968.
Fenigstein, A., & Vanable, P. A. (1992). Paranoia and self-consciousness. Journal of Personality and Social Psychology, 62(1), 129–138. https://doi.org/10.1037//0022-35220.127.116.11.
Freeman, D., & Freeman, J. (2008). Paranoia: The 21st century fear. Oxford, UK: Oxford University Press.
Freeman, D., McManus, S., Brugha, T., Meltzer, H., Jenkins, R., & Bebbington, P. (2011). Concomitants of paranoia in the general population. Psychological Medicine, 41(5), 923–936. https://doi.org/10.1017/S0033291710001546.
Gilbert, P., Boxall, M., Cheung, M., & Irons, C. (2005). The relation of paranoid ideation and social anxiety in a mixed clinical population. Clinical Psychology & Psychotherapy, 12(2), 124–133. https://doi.org/10.1002/cpp.438.
Gracie, A., Freeman, D., Green, S., Garety, P. A., Kuipers, E., Hardy, A., Ray, K., Dunn, G., Bebbington, P., & Fowler, D. (2007). The association between traumatic experience, paranoia and hallucinations: A test of the predictions of psychological models. Acta Psychiatrica Scandinavica, 116(4), 280–289.
Jack, A. H., & Egan, V. (2017). Trouble at school: A systematic review to explore the association between childhood bullying and paranoid thinking. Psychosis, 9(3), 260–270. https://doi.org/10.1080/17522439.2017.1340503.
Jack, A. H., & Egan, V. (2018). Childhood bullying, paranoid thinking and the misappraisal of social threat: Trouble at school. School Mental Health, 10(1), 26–34. https://doi.org/10.1007/s123100179238.
Johns, L. C., Cannon, M., Singleton, N., Murray, R. M., Farrell, M., Brugha, T., Bebbington, P., Jenkins, R., & Meltzer, H. (2004). Prevalence and correlates of self-reported psychotic symptoms in the British population. The British Journal of Psychiatry, 185(4), 298–305.
Longobardi, C., Prino, L. E., Fabris, M. A., & Settanni, M. (2017). Muscle dysmorphia and psychopathology: Findings from an Italian sample of male bodybuilders. Psychiatry Research, 256, 231–236. https://doi.org/10.1016/j.psychres.2017.06.065.
Longobardi, C., & Badenes-Ribera, L. (2017). Intimate partner violence in same-sex relationships and the role of sexual minority stressors: A systematic review of the past 10 years. Journal of Child and Family Studies, 26(8), 2039–2049. https://doi.org/10.1007/s10826-017-0734-4.
Lopes, B. C. (2013). Differences between victims of bullying and nonvictims on levels of paranoid ideation and persecutory symptoms, the presence of aggressive traits, the display of social anxiety and the recall of childhood abuse experiences in a Portuguese mixed clinical sample. Clinical Psychology & Psychotherapy, 20(3), 254–266.
Marengo, D., Jungert, T., Iotti, N. O., Settanni, M., Thornberg, R., & Longobardi, C. (2018). Conflictual student–teacher relationship, emotional and behavioral problems, prosocial behavior, and their associations with bullies, victims, and bullies/victims. Educational Psychology, 38(9), 1201–1217. https://doi.org/10.1080/01443410.2018.1481199.
McFarland, M. B., & Kaminski, P. L. (2009). Men, muscles, and mood: The relationship between self-concept, dysphoria, and body image disturbances. Eating Behaviors, 10(1), 68–70. https://doi.org/10.1016/j.eatbeh.2008.10.007.
Nerini, A., Matera, C., Baroni, D., & Stefanile, C. (2016). Drive for muscularity and sexual orientation: Psychometric properties of the Italian version of the drive for muscularity scale (DMS) in straight and gay men. Psychology of Men & Masculinity, 17(2), 137–146. https://doi.org/10.1037/a0039675.
Neziroglu, F., Khemlani-Patel, S., & Yaryura-Tobias, J. A. (2006). Rates of abuse in body dysmorphic disorder and obsessive-compulsive disorder. Body Image, 3(2), 189–193. https://doi.org/10.1016/j.bodyim.2006.03.001.
Parmenter, J. G., Blume, A. K., Crowell, K. A., & Galliher, R. V. (2019). Masculine gender-role congruence among sexual minority men. Journal of LGBT Issues in Counseling, 13(2), 134–151.
Perugi, G., Giannotti, D., Frare, F., Vaio, S. D., Valori, E., Maggi, L., Cassano, G. B., & Akiskal, H. S. (1997). Prevalence, phenomenology and comorbidity of body dysmorphic disorder (dysmorphophobia) in a clinical population. International Journal of Psychiatry in Clinical Practice, 1(2), 77–82. https://doi.org/10.3109/13651509709024707.
Phillips, K. A., Kim, J. M., & Hudson, J. I. (1995). Body image disturbance in body dysmorphic disorder and eating disorders: Obsessions or delusions? Psychiatric Clinics, 18(2), 317–334. https://doi.org/10.1016/S0193-953X(18)30057-1.
Phillips, K. A. (2009). Understanding body dysmorphic disorder: An essential guide. Oxford: Oxford University Press.
Pope, H. G., Jr., Gruber, A. J., Choi, P., Olivardia, R., & Phillips, K. A. (1997). Muscle dysmorphia: An underrecognized form of body dysmorphic disorder. Psychosomatics, 38(6), 548–557. https://doi.org/10.1016/S0033-3182(97)71400-2.
Pope, C. G., Pope, H. G., Menard, W., Fay, C., Olivardia, R., & Phillips, K. A. (2005). Clinical features of muscle dysmorphia among males with body dysmorphic disorder. Body Image, 2(4), 395–400. https://doi.org/10.1016/j.bodyim.2005.09.001.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/BRM.40.3.879.
Preacher, K. J., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16(2), 93–115. https://doi.org/10.1037/a0022658.
Rivers, I. (2001). The bullying of sexual minorities at school: Its nature and long-term correlates. Educational and Child Psychology, 18(1), 32–46.
Santarnecchi, E., & Dèttore, D. (2012). Muscle dysmorphia in different degrees of bodybuilding activities: Validation of the Italian version of muscle Dysmorphia disorder inventory and bodybuilder image grid. Body Image, 9(3), 396–403. https://doi.org/10.1016/j.bodyim.2012.03.006.
Settanni, M., Prino, L. E., Fabris, M. A., & Longobardi, C. (2018). Muscle Dysmorphia and anabolic steroid abuse: Can we trust the data of online research? Psychiatry Research, 263, 288. https://doi.org/10.1016/j.psychres.2017.12.049.
Varjas, K., Dew, B., Marshall, M., Graybill, E., Singh, A., Meyers, J., & Birckbichler, L. (2008). Bullying in schools towards sexual minority youth. Journal of School Violence, 7(2), 59–86. https://doi.org/10.13000/j202v07n02_05.
Waite, F., & Freeman, D. (2017). Body image and paranoia. Psychiatry Research, 258, 136–140. https://doi.org/10.1016/j.psychres.2017.10.007.
Weingarden, H., Curley, E. E., Renshaw, K. D., & Wilhelm, S. (2017). Patient-identified events implicated in the development of body dysmorphic disorder. Body Image, 21, 19–25. https://doi.org/10.1016/j.bodyim.2017.02.003.
Wilson, B. D., Harper, G. W., Hidalgo, M. A., Jamil, O. B., Torres, R. S., Fernandez, M. I., & Adolescent Medicine Trials Network for HIV/AIDS Interventions. (2010). Negotiating dominant masculinity ideology: Strategies used by gay, bisexual and questioning male adolescents. American Journal of Community Psychology, 45(1–2), 169–185.
Wolke, D., & Sapouna, M. (2008). Big men feeling small: Childhood bullying experience, muscle dysmorphia and other mental health problems in bodybuilders. Psychology of Sport and Exercise, 9(5), 595–604. https://doi.org/10.1016/j.psychsport.2007.10.002.
Wolke, D., & Stanford, K. (1999). Bullying in school children. Developmental Psychology, 341–360.
Wright, L. W., Adams, H. E., & Bernat, J. (1999). Development and validation of the homophobia scale. Journal of Psychopathology and Behavioral Assessment, 21(4), 337–347. https://doi.org/10.1023/A:1022172816258.
Declaration of Conflicting Interests
The author(s) declare no potential conflicts of interest with regard to the research, authorship, and/or publication of this article.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Fabris, M.A., Badenes-Ribera, L., Longobardi, C. et al. Homophobic bullying victimization and muscle Dysmorphic concerns in men having sex with men: the mediating role of paranoid ideation. Curr Psychol (2020). https://doi.org/10.1007/s12144-020-00857-3
- Muscle dysmorphia
- Body dysmorphic disorder
- Homophobic bullying victimization
- Paranoid ideation