The Burden of the Perfect Frame: A Scoping Review on Personality and Muscle Dysmorphia

Research on muscle dysmorphia (MD), currently conceptualized as a clinical specifier for body dysmorphic disorder (BDD), is rapidly expanding. Although personality traits and disorders have been proposed as relevant risk factors for the development of BDD, their role in MD remains insufficiently understood. This scoping review aims to synthesize the existing empirical literature on the associations between MD and personality, while identifying key research gaps and clinical challenges. Following the PRISMA-ScR guidelines, a systematic search was conducted across PsycArticles, PubMed, Scopus, Web of Science, and Google Scholar between 1 October and 1 December 2024. A total of 15 studies met the inclusion criteria and were analyzed. Findings highlight the significant contribution of narcissism, neuroticism, and perfectionism to the development and severity of MD. In particular, traits associated with vulnerable narcissism consistently emerged as predictors of MD symptomatology. Sociocultural factors-such as the competitive environment of elite sports and early relational experiences-were also found to interact with personality-based vulnerabilities in shaping the onset and clinical expression of MD. However, most available studies relied on self-report measures, cross-sectional designs, and convenience samples predominantly composed of men, limiting the generalizability of the results. Despite these methodological limitations, this review emphasizes the importance of identifying personality-based vulnerabilities to enhance the understanding of MD and inform the development of person-centered prevention and intervention strategies.