Effect of muscle dysmorphia on image-and-performance-enhancement drugs use intentions in a non-clinical sample: The role of social cognition

Objectives The use of image-and-performance-enhancement drugs (IPEDs) among exercisers represents an emerging public health challenge, and muscle dysmorphia (MD) presents an important risk factor for this behavior. However, there is little evidence on the direct and indirect association of MD dimensions with IPEDs use, via the effects of more proximal, social cognitive variables. The present study used an integrative model that assessed the direct and indirect association between MD dimensions and intentions to use IPEDs via the effects of behavior-specific social cognitive variables. Method One hundred and ninety-seven recreational exercisers (M age = 24.5 years, 66.3% males) completed a survey including the Muscle Dysmorphia Inventory (MDI), social cognitive variables related to IPEDs use, and intentions to use IPEDs in the next year. Results Hierarchical linear regression analysis and regression-based mediation modelling showed that the MD dimensions of exercise dependence, drive for size/symmetry and pharmacological use were indirectly associated with intentions, via the effects of attitudes and situational temptation. Conclusions The present results indicate that MD dimensions may be differentially associated with intentions to use PEDs among recreational exercisers, and highlight the importance of social cognitive variables that are more closely related to IPEDs use. The theoretical and practical implications of the findings are discussed