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Case Reports
. 2025 Jul 21:16:1553997.
doi: 10.3389/fpsyg.2025.1553997. eCollection 2025.

Case Report: Physiological and psychological underpinnings of muscle dysmorphia using EEG, GSR, and eye-tracking

Metin Çınaroğlu  1 , Selami Varol Ülker  2 , Eda Yılmazer  3 , Gökben Hızlı Sayar  4
Affiliations
Case Reports

Case Report: Physiological and psychological underpinnings of muscle dysmorphia using EEG, GSR, and eye-tracking

Metin Çınaroğlu et al. Front Psychol. .

Abstract

Background: Muscle dysmorphia (MD), a subtype of Body Dysmorphic Disorder (BDD), involves an obsessive preoccupation with perceived insufficient muscularity despite an objectively muscular physique. While its psychological features are well-documented, physiological and attentional underpinnings remain underexplored.

Objective: This exploratory, proof-of-concept case series examines the psychological, physiological, and attentional characteristics of individuals with varying experiences of MD using a multimodal approach combining electroencephalography (EEG), galvanic skin response (GSR), and eye-tracking technologies.

Methods: Three male participants were purposefully selected to represent distinct clinical profiles: one with active MD and steroid use, one in sustained remission from MD, and one with no MD history. Participants completed validated psychological scales (MDDI, BIDQ, STAI, RSES) and were exposed to personalized visual stimuli (past, current, and idealized body images). A triangulated recording protocol was used to capture EEG, GSR, and eye-tracking data during stimulus exposure.

Results: Participants with current and past MD showed elevated beta wave activity, increased skin conductance, and attentional biases toward muscular regions, corresponding with higher self-reported distress and anxiety. In contrast, the control participant exhibited stable physiological responses and emotionally neutral reactions. Triangulated data revealed coherent patterns across subjective and physiological domains, supporting the internal validity of the findings despite the small sample.

Conclusion: These findings illustrate the potential of multimodal assessment in identifying candidate psychophysiological markers of MD. While not generalizable, this case-series provides a valuable framework for future hypothesis-driven research and supports the need for gender-specific diagnostic and intervention strategies in muscle dysmorphia.

Keywords: body dysmorphic disorder; case report; electroencephalography; eye-tracking; galvanic skin response; muscle dysmorphia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Gaze fixation heatmaps.
Figure 2
Figure 2
EEG beta wave activity.
Figure 3
Figure 3
Skin conductance response.
See this image and copyright information in PMC

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References

    1. Beilharz F., Phillipou A., Castle D. J., Rossell S. L. (2020). Saccadic eye movements in body dysmorphic disorder. J. Obsessive-Compuls. Relat. Disord. 25:100526. doi: 10.1016/j.jocrd.2020.100526 - DOI
    1. Bonnecaze A. K., O’Connor T., Burns C. A. (2021). Harm reduction in male patients actively using anabolic androgenic steroids (AAS) and performance-enhancing drugs (PEDs): a review. J. Gen. Intern. Med. 36, 2055–2064. doi: 10.1007/s11606-021-06751-3, PMID: - DOI - PMC - PubMed
    1. Cuadrado J., Laulan P., Sentenac C., Legigan C., Michel G. (2024). “Bigger, stronger, sicker”, integrative psychological assessment for muscle dysmorphia: case studies of two young women bodybuilders. Psychiatry Res. Case Rep. 3:100212. doi: 10.1016/j.psycr.2024.100212 - DOI
    1. Cunningham M. L., Griffiths S., Mitchison D., Mond J. M., Castle D., Murray S. B. (2017). Muscle Dysmorphia: an overview of clinical features and treatment options. J. Cogn. Psychother. 31, 255–271. doi: 10.1891/0889-8391.31.4.255, PMID: - DOI - PubMed
    1. Dal Brun D., Pescarini E., Calonaci S., Bonello E., Meneguzzo P. (2024). Body evaluation in men: the role of body weight dissatisfaction in appearance evaluation, eating, and muscle dysmorphia psychopathology. J. Eat. Disord. 12:65. doi: 10.1186/s40337-024-01025-9, PMID: - DOI - PMC - PubMed

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