Development of a Model of Body Dysmorphic Disorder Based on Ideal Body Image and Social Physique Anxiety With the Mediating Roles of Cognitive Flexibility and Rumination in Male Bodybuilders

Milad  Cheraghi; Mohammad Reza Bayat; Mehdi  Moradi

Authors

Milad Cheraghi Department of Psychology, Ar.C., Islamic Azad University, Arak, Iran Author https://orcid.org/0009-0006-6713-9615
Mohammad Reza Bayat Department of Psychology, And.C., Islamic Azad University, Andimeshk, Iran https://orcid.org/0000-0002-6449-6514
Mehdi Moradi Department of Physical Education, Ar.C., Islamic Azad University, Arak, Iran Author https://orcid.org/0000-0002-0844-5800

Keywords:

body dysmorphic disorder, ideal body image, social physique anxiety, cognitive flexibility, rumination

Abstract

The present study aimed to develop a model of body dysmorphic disorder (BDD) based on ideal body image and social physique anxiety, with the mediating roles of cognitive flexibility and rumination, among male bodybuilding athletes in Arak, Iran. This correlational study employed a path analysis approach and was conducted among 200 male bodybuilding athletes in Arak during 2024–2025. Participants were selected using cluster sampling, and data were collected using the Body Image Questionnaire, Social Physique Anxiety Scale, Cognitive Flexibility Inventory, and Rumination–Reflection Questionnaire. Data were analyzed using Pearson correlation and regression analyses in SPSS and structural equation modeling in SmartPLS. The results indicated that ideal body image (β = .639) and social physique anxiety (β = .499) had significant positive effects on body dysmorphic disorder. Rumination (β = .608) also had a positive effect, whereas cognitive flexibility (β = −.366) had a negative effect on the disorder. Cognitive flexibility was confirmed as a mediator in the relationships of ideal body image (β = .280) and social physique anxiety (β = .267) with body dysmorphic disorder. Rumination also mediated the relationships of ideal body image (β = .254) and social physique anxiety (β = .288) with body dysmorphic disorder. The model fit indices (GFI, NFI, and CFI ≥ .90; RMSEA = .064) indicated an acceptable model fit. These findings highlight the key roles of ideal body image, social physique anxiety, cognitive flexibility, and rumination in explaining body dysmorphic disorder and may be useful in designing psychological interventions for athletes.

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