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BACKGROUND: Adolescent males are more likely to sustain intentional and unintentional injuries, be involved in a physical confrontation, and be successful in suicide attempts. Body image dissatisfaction (BID) has been linked as a possible contributing factor to these negative health behaviors and risks; however, research is limited with males. The interaction of intrapersonal, interpersonal, and social variables in a holistic model has yet to be explored for males. Variables precipitating adolescent males to develop an unhealthy body image and act on negative health behaviors, such as body image drug use, were the impetus for this study. METHODS: A randomized cross-sectional sample of 330 adolescent males answered questions concerning body image using the Adolescent Body Image Satisfaction Scale (ABISS). Pearson product moment correlations and stepwise regression analyses identified the strongest predictive variables of BID. RESULTS: The strongest contributing variables accounting for 56.7% of model variance were desire for the body of another person (r = .571, p < .001), teasing (r = .490, p < .001), satisfaction with their body when they were younger (r = .450, p < .001), and difficulty coping with criticism (r = .443, p < .001). No statistically significant differences were found for racial/ethnic background (p < .822, n.s.). CONCLUSIONS: Educators and school districts should consider the confluence of psychosocial variables affecting body image and adolescent male health risk behaviors based on a statistically sound predictive model as provided by the ABISS. Targeted programming to enhance body image and address teasing/bullying behaviors is strongly recommended.

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We attempted to qualitatively investigate why men of 2 age categories have chosen not to use androgenic-anabolic steroids (AASs). Twelve men (22.28 +/- 1.38 years [group I] and 53.00 +/- 13.28 years [group II]) were selected on the basis of specific inclusion criteria, including age and fitness levels (i.e., "do you weight train?"). Subjects were classified in 1 of 2 categories-younger or older precluders-and were asked to complete 2 survey instruments before their participation. The Drive for Muscularity Scale (reliability 0.85) and Body Image Questionnaire were used to gain a better understanding of perceptions and motivations regarding health, fitness, and body image. A series of semistructured questions were used to enhance focus group discussion regarding attitudes. Questions were validated by a panel of experts in qualitative methods. Member checks were conducted to enhance trustworthiness of the data. Data were transcribed verbatim and analyzed with thematic open-coding techniques. Various behaviors were reported regarding body image. Emerging themes showed a clear demarcation between age categories. Younger subjects cited power, control, body image, and narcissism, whereas older subjects viewed AAS use as more of an athletic-based phenomenon, such as with performance enhancement, when asked about steroids. Groups were in agreement that media trends and perceptions of the ideal male body are becoming "superhuman" and unattainable without chemical means. Understanding attitudinal perspectives might help complement national data on AAS trends. Future investigations could help coaches and allied health professionals collaborate with each other, as well as with national groups and foundations, to devise more appropriate strategies in addressing this growing athletic and public health concern.

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Thousands of youth participate in residential substance abuse treatment each year. After completing treatment, many of these youth return to school. This study analyzed the process of substance abuse treatment at the Generations Youth Program, and identified opportunities for collaboration with school health personnel. A qualitative case study design was employed. Analysis of the treatment process revealed the primary goal of treatment was to assist youth in developing a belief in their ability to remain sober. This goal was achieved through a peer support network, development of self-control, and acquisition of treatment knowledge. Youth who develop these skills are successfully discharged from treatment and return to home and school. Opportunities exist for collaboration between school health and substance abuse treatment personnel to enable discharged youth to remain drug free.

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