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Attentional engagement, appearance comparisons, and rumination as

predictors of body dissatisfaction: Evaluation of a serial mediation model in
men

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DOI: 10.1016/j.bodyim.2020.11.008

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Attentional engagement, appearance comparisons, and rumination as predictors of

body dissatisfaction: Evaluation of a serial mediation model in men

Laura Dondziloa, Caitlin Mills a, and Rachel F. Rodgersb,c

a
Elizabeth Rutherford Memorial Centre for the Advancement of Research on Emotion, School of

Psychological Science, University of Western Australia, Crawley, Western Australia, Australia.

b
APPEAR, Department of Applied Psychology, Northeastern University, Boston, United States
c
Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier,

France

Correspondence concerning this article should be addressed to Laura Dondzilo, School of

Psychological Science, University of Western Australia (M304), 35 Stirling Highway, Crawley WA

6009, Australia. Phone: +61 408 637 524. Email: laura.dondzilo@uwa.edu.au

2

Abstract

Elevated body dissatisfaction is underpinned by an attentional bias towards images

portraying appearance ideals. However, very little is known about the specific attentional

mechanisms and mediating factors involved in this relationship in the context of male body

dissatisfaction. The present study sought to replicate and extend on previous research among

women showing that the relationship between attentional engagement bias and body dissatisfaction

is mediated by appearance comparisons and rumination. Seventy undergraduate males completed an

attentional task capable of independently assessing biased attentional engagement with images of

muscular and non-muscular bodies followed by self-report measures of appearance comparisons,

eating disorder-specific rumination, and body dissatisfaction. Results revealed that a heightened

tendency to engage in appearance comparisons was associated with increased attentional

engagement with muscular bodies, relative to non-muscular bodies. Moreover, a serial mediation

analysis revealed that increased attentional engagement with muscular bodies was associated with

appearance comparisons, which in turn were associated with eating disorder-specific rumination

and consequently body dissatisfaction. The current findings replicate among men the serial

mediation model of body dissatisfaction previously described among women and implicate

heightened attentional engagement with idealized images as a potential pathway to body

dissatisfaction in men.

Keywords: Attentional Bias; Attentional Engagement; Appearance Comparisons;

Rumination; Body Dissatisfaction; Male Body Image

3

Introduction

Body dissatisfaction is becoming increasingly prevalent among the Western male population

(Frederick & Essayli, 2016). This is particularly concerning given its association with maladaptive

muscularity-oriented behaviours and disordered eating (Murray et al., 2017). Consequently,

researchers have been motivated to understand the cognitive mechanisms that contribute to male

body dissatisfaction. One candidate mechanism involves selective attentional processing of

appearance stimuli perceived as representing appearance ideals (Rodgers & DuBois, 2016). In

support of this, research has shown that body dissatisfied men selectively attend to lean-and-

muscular male bodies (Cho & Lee, 2013; Talbot et al., 2019). However, the mechanisms accounting

for this relationship are particularly poorly understood in the context of male body dissatisfaction.

Specifically, the attentional mechanisms (i.e., attentional engagement bias vs. attentional

disengagement bias) and potential mediating factors involved in this relationship have yet to be

identified.

Theoretical cognitive models of body dissatisfaction describe multiple processes implicated

in the development and maintenance of body image concerns (Williamson et al., 1999). In addition

to attentional bias, two other cognitive processes that have been highlighted are the tendency to

engage in appearance-based comparisons, as well as ruminative cognitive styles (Feinstein et al.,

2013; Rodgers et al., 2020). Both of these have been found to be associated with greater body

dissatisfaction among men (Hargreaves & Tiggemann, 2009; Karazsia & Crowther, 2009; Rivière et

al., 2018). Furthermore, evidence from mixed gender samples has suggested that social comparisons

predicts increases in rumination (Feinstein et al., 2013; Yang et al., 2019) and that eating disorder-

specific rumination exacerbates body dissatisfaction among men (Rivière et al., 2018). Thus, one

possible pathway underlying the relationship between attention bias towards muscular bodies and

body dissatisfaction among men, is that increased attention to muscularity leads to more frequent
4

upwards (unfavourable) appearance comparisons, which in turn exacerbate rumination related to

standards of muscularity, that then increase body dissatisfaction.

Recent research has supported such a pathway among women (Dondzilo et al., 2020),

utilizing a task enabling the independent assessment of attentional engagement bias as distinct from

other types of visual attention biases, i.e., the Attentional Response to Distal vs. Proximal

Emotional Information task (ARDPEI; Grafton & MacLeod, 2014). Unlike other commonly used

attentional measures (e.g., the dot probe task), the ARDPEI task has the capacity to adequately

discriminate between attentional engagement bias, the tendency for attentionally-distal stimuli to

selectively capture attention, that is how much a stimulus draws the gaze to itself, and attentional

disengagement bias, the tendency for attentionally-proximal stimuli to selectively hold attention,

that is the difficulty looking away from a stimulus.

Findings among women using this task revealed that the tendency to engage in appearance

comparisons was specifically associated with increased attentional engagement with thin-ideal

bodies (and not by reduced attentional disengagement from thin-ideal bodies; Dondzilo et al.,

2020). Moreover, in support of the proposed serial mediation model, the relationship between

attentional engagement bias and body dissatisfaction was mediated by appearance comparisons and

eating disorder-specific rumination. These results, as well as previous evidence for similar

relationships among men (Feinstein et al., 2013; Rivière et al., 2018), support the usefulness of

testing a parallel serial mediation model among men. Specifically, it was hypothesised that

preferential attentional engagement with muscular bodies would be associated with body

dissatisfaction through the serial indirect effect of first appearance comparisons, then eating

disorder-specific rumination.
5

Method

Participants and Procedures

Seventy undergraduate males from the University of Western Australia participated in

exchange for course credit. Ethical approval was provided by the University of Western Australia’s

Human Research Ethics Committee. Participants provided informed consent and completed a

practice version of the ARDPEI task (described below), followed by the test version of the task.

Next, participants completed self-report measures before height, weight, and body fat percentage

were measured to provide body mass index (BMI = kg/m2) and fat free mass index (FFMI = fat free

mass [kg]/ m2).

Materials and Measures

Appearance comparison. The 9-item Trait Physical Appearance Comparison Scale-3

(PACS-3) assessed physical appearance comparisons related to weight, shape, overall physical

appearance, and muscularity (Schaefer & Thompson, 2018). Items are scored on a 5-point Likert-

type scale (1 = never, 5 = almost always) with higher mean scores indicating greater tendency to

engage in appearance comparisons. Internal consistency in this sample was high (α = .91).

Eating disorder-specific rumination. The 9-item Trait Ruminative Response Scale for

Eating Disorders (RRS-ED) was used to assess eating disorder-specific rumination (Cowdrey &

Park, 2011). Items are rated on a 4-point Likert-type scale (1 = almost never, 4 = almost always)

with higher summed scores reflecting greater levels of eating disorder-specific rumination. Here,

internal consistency was high (α = .89).

Male body dissatisfaction. The 24-item Male Body Attitudes Scale (MBAS) was used to

capture dissatisfaction with muscularity, body fat, and height (Tylka et al., 2005). Items are scored

on a 6-point Likert-type scale (1 = never, 6 = always) with higher average scores reflecting higher

levels of body dissatisfaction. Internal consistency here was high (α = .93).

6

Stimulus Images

The ARDPEI task included images of both muscular bodies (n = 20) and non-muscular (n =

20) male bodies (Dondzilo et al., 2019). Each image focused on unclothed areas of the body that are

most reflective of body fat and muscle mass (i.e., abdomen, chest, biceps, and back). The ARDPEI

task additionally requires images devoid of representational content. In line with previous studies

we employed images (n = 40) depicting abstract art (Dondzilo et al., 2020; Grafton & MacLeod,

2014; Jonker et al., 2019; Rudaizky et al., 2014).

Attentional Response to Distal vs. Proximal Emotional Information (ARDPEI) Task

The ARDPEI task (Grafton & MacLeod, 2014) assesses engagement with, and

disengagement from, images of muscular bodies relative to images of non-muscular bodies. Task

specifications (i.e., stimulus presentation time, number of trials, counterbalancing, etc.) were

equivalent to Dondzilo et al. (2020). Each trial (Figure 1) commenced with the presentation of two

white rectangles on alternate sides of the screen. A smaller red rectangle appeared in either of the

white rectangles with equal frequency. Participants initially focused their attention on this red

rectangle. After 1000 ms a small red line briefly appeared (200 ms) within this region, and

participants noted its orientation. Immediately thereafter, an image pair consisting of one body

(muscular or non-muscular figure), and one abstract image replaced the two white rectangles. After

500 ms, the images disappeared, and a target probe (small red line) appeared in either of the two

screen regions with equal probability. Participants indicated, as quickly as possible, by pressing

either the left or right mouse button whether it matched the previous cue in terms of orientation,

(50% of the trials). The latency and accuracy of this probe discrimination response was recorded.

After 1000 ms the next trial commenced. In total, 320 trials were delivered across two blocks. In

one block (160 trials), participants were presented with the muscular bodies, in the other (160 trials)

the non-muscular bodies. The order of blocks was counterbalanced across participants. Within each

block, order of trial condition was randomised for each participant.

7

Calculation of engagement and disengagement bias index scores. Response times (RTs)

for correct responses to the target probe under the differing conditions of the ARDPEI task were

used to compute indices of engagement bias and disengagement bias.1 A higher index of

engagement bias, using RTs from those trials in which bodies were presented distally from initial

attentional focus, represented increased attentional capture by muscular relative to non-muscular

bodies.

Engagement bias index = (anchor cue distal from muscular image: RT for target probe in

locus of abstract image minus RT for target probe in locus of muscular image) minus (anchor cue

distal from non-muscular image: RT for target probe in locus of abstract image minus RT for target

probe in locus of non-muscular image)

Conversely, a higher index of disengagement bias, using probe discrimination RTs from

trials in which bodies were presented proximally to initial attentional focus, represented reduced

attentional disengagement from muscular relative to non-muscular bodies.

Disengagement bias index = (anchor cue proximal to muscular image: RT for target probe in

locus of abstract image minus RT for target probe in locus of muscular image) minus (anchor cue

proximal to non-muscular image: RT for target probe in locus of abstract image minus RT for target

probe in locus of non-muscular image).

Data Analysis

A serial mediation analysis was conducted to evaluate the proposed pathway, that is whether

attentional engagement bias was indirectly associated with body dissatisfaction, through appearance

comparisons and eating disorder-specific rumination. Percentile bootstrap confidence intervals (CI)

based on 5,000 bootstrap samples were calculated. The indirect effect is considered significant

when the upper and lower bound of the CI does not contain zero (Hayes, 2009).

1
Outlier probe discrimination latencies were handled in the same manner as Dondzilo et al., (2020).
8

Results

Data Screening and Descriptive Statistics

The data were screened for missing values and outliers. Data recording failures occurred for

two participants, one outlier was identified for probe discrimination accuracy, and one multivariate

outlier emerged based on Mahalanobis distance, thus these four participants were removed. The

final sample included 66 men (years of age; M = 20.65, SD = 4.93, range = 17-44). BMIs ranged

from 17.89 to 42.84 (M = 23.89, SD = 4.81) and FFMIs ranged from 17.51 to 24.45 (M = 19.92, SD

= 1.39).2 Descriptive statistics and Pearson correlation coefficients for the continuous study

variables are reported in Table 1.

Test of the Proposed Serial Mediation Pathway

As can be seen in Figure 2, pathways are consistent with the proposed serial mediation

model. Specifically, increased attentional engagement with muscular bodies relative to non-

muscular bodies was associated with an elevated tendency to engage in appearance comparisons (β

= .28, p = .022), which in turn was associated with elevated eating disorder-specific rumination (β =

.51, p < .001), and consequently, elevated body dissatisfaction (β = .56, p <.001). Critically,

bootstrapped analyses revealed that our hypothesised indirect effect (i.e., engagement bias →

appearance comparisons → eating disorder-specific rumination → body dissatisfaction) was

significant (β = .08, SE = .04, p = .048, 95% CI = .02, .16).3 A Monte Carlo power simulation

(Schoemann, Boulton, & Short, 2017) revealed that this serial mediation effect was detected with

65% power. Neither the total effect (β = .14, SE = .12, p = .268, 95% CI = -.11, .39), nor direct

effect (β = -.07, SE = .09, p = .449, 95% CI = -.25, .11), of engagement bias on body dissatisfaction

2
Body fat percentage data was missing for two participants.
3
After applying the Benjamin-Hochberg method, this p-value is no longer significant.
9

was significant.4 The model accounted for 55% of the variance in body dissatisfaction, F(3, 62) =

24.95, p < .001.

For sensitivity purposes, three alternative models were tested. First, when evaluating the

proposed serial mediation pathway with disengagement bias (M = -16.76, SD = 126.03) as the

antecedent, no serial mediation effect emerged (p = .441, CI = -.11, .04). Second, a variation of the

proposed serial mediation pathway, in which the order of the mediators was reversed, such that

engagement bias was predicted to be associated with first eating disorder-specific rumination,

followed by appearance comparison tendencies, and then body dissatisfaction, also did not yield a

serial mediation effect (p = .280, CI = -.01, .10). Third, a concurrent multiple mediator model was

tested, however, only the indirect effect via appearance comparison emerged as significant (β = .08,

SE = .05, p = 087, 95% CI = .01, .17). No indirect effect via rumination emerged (p = .097, CI = -

.02, .28).

Discussion

This study examined a proposed serial mediation model of the relationships among

increased attentional engagement bias with muscular bodies, as compared to non-muscular bodies,

appearance comparison tendencies, eating disorder-specific rumination, and body dissatisfaction.

Our findings supported the existence of such an indirect pathway among undergraduate men,

thereby replicating and extending previous findings among women (Dondzilo, 2020). In addition,

little support was found for the serial mediation pathway with disengagement bias as the antecedent,

the alternative indirect serial pathway via eating disorder-specific rumination, then appearance

comparison tendencies, or for a concurrently mediated pathway.

4
We refrain from labelling the observed serial mediation effect as “full mediation” given that such claims can
unnecessarily constrain theoretical developments (i.e., there might be additional mediating pathways; Rucker et al.,
2011).
10

Taken together, these results suggest that the relationship between increased attentional

engagement bias and higher body dissatisfaction among men may be to some extent accounted for

by the effects of allocation of visual attention to lean-and-muscular bodies in the environment,

including media images or peers, that then prompt upwards appearance comparisons and the

engagement in ruminations related to perceived failings to meet appearance standards that in turn

increase feelings of body dissatisfaction. These findings build upon previous work in women

(Dondzilo et al., 2017; Dondzilo, 2020) and in men (Cho & Lee, 2013; Talbot et al., 2019) and

underscore the usefulness of using cognitive models to ground investigations of the risk and

maintenance factors for body dissatisfaction (Vitousek & Hollon, 1990; Williamson et al., 1999).

The present study includes several limitations. First, the present study employed trait-level

measures of appearance comparisons, rumination, and body dissatisfaction. In future studies, it

would be interesting to include post-task state measures of these constructs to evaluate the extent to

which increased attentional engagement is capable of predicting state body dissatisfaction after the

task. A second issue worthy of future investigation concerns whether the pattern of attentional

engagement bias implicated in elevated body dissatisfaction reflects the operation of automatic or

controlled attentional processing. The current study cannot shed light on this issue, as attentional

selectivity observed 500 ms after stimulus onset could be influenced by both automatic and

controlled patterns of attentional selectivity (Mogg et al., 1995). Future researchers could more

directly investigate the involvement of automatic vs. controlled processing by employing

presentation procedures that eliminate conscious awareness of stimulus content (Van den Bussche

et al., 2009). Finally, it is important to acknowledge the small sample size (N = 66) and the

consequences of multiple testing on the observed serial mediation effect. Thus, both significant and

non-significant results should be interpreted with caution and replication of the current study in

larger samples is warranted.

11

Conclusion

For the moment, findings from the present study highlight the importance of different

cognitive processes, including allocation of visual attention and ruminative styles, in male body

dissatisfaction. Our results provide further support for cognitive models implicating selective

attentional processing of body shape-related information in the development and maintenance of

body image and eating disturbances (Vitousek & Hollon, 1990; Williamson et al., 1999) and more

broadly lend weight to the notion that attentional engagement biases may potentially contribute to

dysfunctional psychological experience (Grafton & MacLeod, 2014; Rudaizky et al., 2014). There

would be particular value in determining whether attentional engagement with muscular bodies

plays a causal role in indirectly driving body dissatisfaction through the presently observed

mediational pathway. The outcome of attentional bias modification studies designed to establish

causality will determine the potential value of interventions that discretely modify engagement bias,

with the aim of reducing body dissatisfaction.

Figure 1

Example of sequence of events on one of the trials which assesses biased attentional engagement. Attentional focus is initially anchored distally to the
body image depicting either muscular or non-muscular bodies.
 13

Figure 2

Serial mediation model representing the mediating effects of appearance comparisons and eating disorder-specific rumination on attentional
engagement bias with muscular bodies, relative to non-muscular bodies, and body dissatisfaction in a male undergraduate sample. All regression
coefficients are standardised. The bolded lines represent the hypothesised serial mediation effect. The dotted lines represent alternative pathways.
Table 1

Correlations, Means, and Standard Deviations for Continuous Study Variables

1 2 3 4 Mean Std Dev.

1. Engagement Bias Index a 1.0 -9.89 103.67

2. PACS-3 scores .28* .10 2.45 .95

3. RRS-ED scores .22 .54*** 1.0 13.65 5.40

4. MBAS scores .14 .57*** .70*** 1.0 3.14 .93

a. A higher Engagement Bias Index score indicates increased attentional engagement with muscular bodies, relative to non-muscular bodies, as assessed by the ARDPEI task.
PACS-3, Physical Appearance Comparison Scale-3; RRS-ED, Ruminative Response Scale for Eating Disorders; MBAS, Male Body Attitudes Scale.
*p < .05; **p <.01; ***p < .001
 Data availability statement

The original data associated with this work can be found in the following Open Science

Framework data deposit: https://osf.io/cqxzt/

Conflict of interest statement

The authors declare no conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public,

commercial, or not-for-profit sectors.

 16

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