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Schaumberg K, Pictor L, Frank M. Adaptive and Maladaptive Exercise in Eating Disorders. Curr Top Behav Neurosci 2024. [PMID: 39042250 DOI: 10.1007/7854_2024_499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
While exercise is generally associated with positive health outcomes, in the context of eating disorders, exercise has high potential to become maladaptive. Maladaptive exercise is compelled or compulsive in nature for the purposes of weight and shape control or to obtain/avoid other eating disorder-relevant consequences. A transdiagnostic eating disorder feature with moderate-to-high prevalence across restrictive- and bulimic-spectrum eating disorders, maladaptive exercise is often associated with negative mental and physical health sequalae. Several proposed threat- and reward-related biobehavioral mechanisms may initiate or perpetuate maladaptive exercise. While exercise is generally contraindicated during periods of acute medical concern, adaptive forms of exercise are also present among those with eating disorders, and facilitation of adaptive exercise has potential to promote physical and mental health benefits during eating disorder recovery. Detailed assessment and targeted interventions are needed to address the clinical conundrum of how and when to integrate exercise into eating disorder treatment.
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Affiliation(s)
| | - Lauren Pictor
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
| | - Max Frank
- Department of Psychiatry, University of Wisconsin, Madison, WI, USA
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Crichton M, Vu J, Fenesi B. Physical Activity Participation among Children and Youth with Mental Health Symptoms: Clinician Perspectives. CHILDREN (BASEL, SWITZERLAND) 2024; 11:880. [PMID: 39062329 PMCID: PMC11276529 DOI: 10.3390/children11070880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND/OBJECTIVES Physical activity supports mental health and well-being in children and youth. However, there are significant barriers to physical activity participation among individuals impacted by mental health disorders. This study investigates these barriers through the perspective of mental health clinicians who support children and youth. METHODS Fourteen mental health clinicians, including registered professional psychologists, psychotherapists, and social workers, were interviewed in a semi-structured format. Qualitative content analysis was performed to identify key themes, including both barriers and facilitators to physical activity. RESULTS Content analysis revealed that clinicians perceive both internal and external barriers and facilitators to their clients' participation in physical activity. Barriers included intrapersonal factors, such as the presence of depression, anxiety, or eating disorder symptoms; lack of motivation; and negative self-talk, as well as factors related to the influence of caregivers, financial limitations, screen time use, environmental and cultural factors, and lack of time. Facilitators included enjoyment of physical activity, knowledge about the benefits of physical activity, and caregiver participation. CONCLUSIONS Mental health clinicians demonstrated clear knowledge about the barriers to and facilitators of their clients' participation in physical activity. These findings provide valuable insights that can be used to support children and youth experiencing mental health difficulty to access the beneficial effects of physical activity.
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Affiliation(s)
| | | | - Barbara Fenesi
- Faculty of Education, Western University, London, ON N6G 1G7, Canada; (M.C.); (J.V.)
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Camacho-Barcia L, Sánchez I, Ibáñez-Caparrós A, Ohsako N, Granero R, Artero C, Crespo JM, Paslakis G, Jiménez-Murcia S, Fernández-Aranda F. The Impact of High Levels of Compensatory Exercise on Treatment Outcomes in Threshold and Subthreshold Bulimia Nervosa. Nutrients 2024; 16:2337. [PMID: 39064779 PMCID: PMC11279786 DOI: 10.3390/nu16142337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/18/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Bulimia nervosa (BN) and other specific feeding or eating disorders with subthreshold BN symptoms (OSFED-BN) are characterized by recurrent binge eating episodes accompanied by compensatory behaviors, including excessive exercise. We aimed to examine the role of compensatory exercise on several clinical disorder-related variables and the treatment outcomes. The sample included 478 patients diagnosed with either BN or OSFED-BN admitted for a 16-week eating disorder-specific treatment program. A battery of questionnaires was administered to evaluate eating and general psychopathology, and personality traits. Other clinical disorder-related data, including levels of compensatory exercise, were assessed through a semi-structured clinical interview. Between-group comparisons of compensatory exercise levels were analyzed, as a predictive model of risk of poor treatment outcomes. Path analysis was conducted using structural equation models to estimate the direct and indirect effects between the main variables. Higher levels of self-reported compensatory exercise were associated with greater eating psychopathology, general psychopathology, and more dysfunctional personality traits and were a predictor of poor treatment outcomes. Additionally, these levels achieved a mediating role in several paths contributing to a higher likelihood of a poor outcome. Further research is required to determine how psychotherapeutic approaches can be optimized to adequately include adaptive exercise for these patients.
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Affiliation(s)
- Lucía Camacho-Barcia
- Clinical Psychology Department, Bellvitge University Hospital, 08907 Barcelona, Spain; (L.C.-B.); (I.S.); (C.A.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 08908 Barcelona, Spain
| | - Isabel Sánchez
- Clinical Psychology Department, Bellvitge University Hospital, 08907 Barcelona, Spain; (L.C.-B.); (I.S.); (C.A.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 08908 Barcelona, Spain
| | - Ana Ibáñez-Caparrós
- Department of Psychiatry, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain;
- Institut Recerca Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
- Department of Psychiatrics and Legal Medicine, School of Medicine, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Noriaki Ohsako
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba 263-8522, Japan
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 08908 Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Cristina Artero
- Clinical Psychology Department, Bellvitge University Hospital, 08907 Barcelona, Spain; (L.C.-B.); (I.S.); (C.A.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
| | - José Manuel Crespo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain;
- Departament of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-Idibell, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Bellvitge Campus, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Psychiatry and Mental Health Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Ruhr-University Bochum, Medical Faculty, Campus East-Westphalia, 32312 Luebbecke, Germany;
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, 08907 Barcelona, Spain; (L.C.-B.); (I.S.); (C.A.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Bellvitge Campus, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Centre for Psychological Services, University of Barcelona (UB), 08035 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, 08907 Barcelona, Spain; (L.C.-B.); (I.S.); (C.A.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; (N.O.); (R.G.)
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Bellvitge Campus, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
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Anis N, Keski-Rahkonen A, Kaartinen S, Silén Y, Kaprio J, Aaltonen S. Adolescent leisure-time physical activity and eating disorders: a longitudinal population-based twin study. Eat Weight Disord 2024; 29:40. [PMID: 38850337 PMCID: PMC11162369 DOI: 10.1007/s40519-024-01670-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/26/2024] [Indexed: 06/10/2024] Open
Abstract
PURPOSE High levels of physical activity have been documented in eating disorder patients. Our aim was to examine whether adolescent leisure-time physical activity is prospectively associated with eating disorders in adolescence and young adulthood. METHODS Finnish twins born in 1983-1987 reported their physical activity frequency at ages 12, 14, and 17. A subsample of participants underwent structured, retrospective interviews for eating disorders at the mean age of 22.4 years. Associations between female twins' physical activity and future eating disorders (571-683 twins/wave) were investigated with the Cox proportional hazards model. To illustrate the physical activity similarity of the co-twins in a twin pair, we used cross-tabulation of eating disorder-discordant twin pairs (13-24 pairs/wave). RESULTS After adjusting for several covariates, we found no statistically significant longitudinal association between physical activity and eating disorders. This applied when all eating disorders were combined but also when assessed separately as restrictive and non-restrictive eating disorders. Co-twins' physical activity in adolescence tended to be similar irrespective of their future eating disorder, supporting the results of the regression analysis. CONCLUSION We observed no evidence of adolescent physical activity frequency being prospectively associated with eating disorders in female twins. Further longitudinal studies with larger sample sizes and more detailed physical activity data are needed. LEVEL OF EVIDENCE III, evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Nadja Anis
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland.
| | - Anna Keski-Rahkonen
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
| | - Sara Kaartinen
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
- Department of Physical Medicine and Rehabilitation, HUS Hyvinkää Hospital, P.O. Box 585, 05850, Hyvinkää, Finland
| | - Yasmina Silén
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
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Lampe EW, Hill NG, Schleyer B, Giannone A, Juarascio AS, Manasse SM. Subtypes of exercise are differentially associated with baseline eating disorder pathology and treatment outcome among individuals with bulimia nervosa. Int J Eat Disord 2024; 57:363-375. [PMID: 38065930 PMCID: PMC10922686 DOI: 10.1002/eat.24103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Individuals with bulimia nervosa (BN) engage in both maladaptive (i.e., compulsive and/or compensatory) and adaptive exercise (e.g., for enjoyment). No research has examined whether those who engage in adaptive, compulsive, and/or compensatory exercise exhibit differences in BN pathology or treatment outcome compared to those not engaging in exercise, limiting intervention efficacy. METHOD We examined associations of baseline exercise engagement with baseline and posttreatment BN pathology among 106 treatment-seeking adults (Mage = 37.4, SDage = 12.95, 87.74% female, 68.87% White) enrolled across four clinical trials of outpatient enhanced cognitive behavioral therapy for BN (range: 12-16 sessions). Analysis of covariances examined associations between baseline exercise type and baseline/posttreatment global eating pathology, dietary restraint, loss-of-control (LOC) eating, and purging frequency. RESULTS Those engaging in only adaptive exercise reported lower global eating pathology compared to those engaging in compulsive-only exercise (Est = -1.493, p = .014, Mdiff = -.97) while those engaging in baseline compulsive exercise reported less LOC eating compared to those not engaging in exercise (Est = -22.42, p = .012, Mdiff = -12.50). Baseline engagement in compulsive-only exercise was associated with lower posttreatment global eating pathology compared to baseline engagement in no exercise (Est = -.856, p = .023, Mdiff = -.64) and both compulsive and compensatory exercise (Est = .895, p = .026, Mdiff = -1.08). DISCUSSION Those engaging in compulsive, compensatory, adaptive, and no exercise exhibit different patterns and severity of BN pathology. Future research is needed to position treatments to intervene on maladaptive, while still promoting adaptive, exercise. PUBLIC SIGNIFICANCE STATEMENT No research to date has examined whether those who engage in adaptive, compulsive, and/or compensatory exercise exhibit differences in BN pathology or treatment outcome compared to those not engaging in exercise, limiting targeted intervention efforts. We found that those engaging in compulsive, compensatory, and adaptive exercise exhibit different patterns of BN pathology and that adaptive exercise engagement was related to lower cognitive eating disorder symptoms at baseline.
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Affiliation(s)
- Elizabeth W Lampe
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Naomi G Hill
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Brooke Schleyer
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
| | - Alyssa Giannone
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
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Coniglio KA, Davis L, Sun J, Loureiro N, Selby EA. Detecting pathological exercise in college men: An investigation using latent profile analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2258-2262. [PMID: 34415230 DOI: 10.1080/07448481.2021.1965612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Pathological exercise is a dangerous behavior often observed in eating disorders. Data investigating associated characteristics of pathological exercise in men are lacking, despite college men and women being at equally elevated risk for developing eating disorders. PARTICIPANTS Two hundred and twenty-four college men who exercise regularly completed a series of self-report questionnaires. METHODS Latent profile analysis was used to identify empirically-derived homogenous subgroups of regular exercisers based on severity of other eating disorder attitudes and behaviors. Profiles were also compared on differences in exercise motivation and general psychopathology (i.e., depression, anxiety). RESULTS Fit indices indicated a three-profile solution. Profiles described an eating psychopathology group, a low psychopathology group, and a high exercise frequency group without eating disorder features. CONCLUSIONS Pathological exercise cannot be identified using exercise frequency alone. Other features like body dissatisfaction and exercise motivation style are relevant in identifying pathological exercise behavior in college men.
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Affiliation(s)
- Kathryn A Coniglio
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Lauren Davis
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Jasmine Sun
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Natalia Loureiro
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
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White C, Bicaker E, Racine SE. Gender differences in compulsive exercise facets and their associations with eating disorder symptoms. Eat Behav 2023; 49:101737. [PMID: 37150095 DOI: 10.1016/j.eatbeh.2023.101737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/09/2023]
Abstract
Compulsive exercise (CE) is a core symptom of eating disorders (EDs) that is common in undergraduate men and women. Importantly, CE is a multidimensional construct, and certain facets of CE (i.e., exercise to control weight or to avoid negative affect associated with missed exercise) are more strongly associated with ED symptoms in undergraduate women than others. However, less is known about how CE facets relate to ED symptoms in men. This study examined: 1) gender differences in levels of CE facets, assessed using the Compulsive Exercise Test (CET); 2) whether specific CE facets independently relate to ED symptoms; and 3) whether gender moderates these relationships. Five hundred and ninety-one university students (58.5 % men) completed the CET and Eating Pathology Symptoms Inventory. Women reported significantly greater weight control exercise, exercise for mood improvement, lack of exercise enjoyment, body dissatisfaction, and purging than men, while men reported more muscle building than women. CE motivated by avoidance of negative emotions and performed in a rule-driven manner and weight control CE were associated with the greatest number of ED symptoms. Further, rigid exercise routines were associated with greater muscle building. Women with greater weight control CE experienced more body dissatisfaction, and women with more CE motivated by avoidance of negative emotions experienced more restriction, compared to men. Overall, specific CE facets relate to ED symptoms in men and women. Findings highlight the importance of interventions designed to target unhealthy exercise motivations and of cultivating healthy attitudes towards exercise across genders.
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Affiliation(s)
- Chloe White
- Department of Psychology, Simon Fraser University, Canada
| | - Ege Bicaker
- Department of Psychology, McGill University, Canada
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Wons O, Lampe E, Patarinski AG, Schaumberg K, Juarascio A. Change in adaptive and maladaptive exercise and objective physical activity throughout CBT for individuals with eating disorders. Eat Weight Disord 2023; 28:40. [PMID: 37079117 PMCID: PMC10115602 DOI: 10.1007/s40519-023-01566-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023] Open
Abstract
Maladaptive exercise (i.e., exercise that compensates for binge eating or is used to avoid negative consequences of not exercising-like weight gain) is a common eating disorder (ED) behavior, yet, some individuals with EDs only engage in adaptive exercise. CBT for EDs targets reducing maladaptive exercise but does not address adaptive exercise. Thus, research is limited on how adaptive and maladaptive exercise are impacted during CBT for EDs. The current study examined how assessor-rated adaptive and maladaptive exercise and objectively measured physical activity changed over a 12-week CBT treatment among adults with transdiagnostic binge eating and restrictive eating that did and did not engage in maladaptive exercise at the start of treatment (n = 13 non-maladaptive exercise group, n = 17 maladaptive exercise group). The overall amount of adaptive and maladaptive exercise was measured via the Eating Disorder Examination Interview and objectively measured physical activity (e.g., step count, minutes of moderate-to-vigorous physical activity [MVPA]) was measured via a wrist-worn fitness tracker. Throughout treatment, the overall amount of adaptive exercise did not significantly change for both groups, but the overall amount of maladaptive exercise significantly decreased in the maladaptive exercise group. Step count did not significantly change for both groups, but minutes of MVPA significantly increased over treatment for the non-maladaptive exercise group. Increases in step count and minutes of MVPA were not associated with ED symptom changes in either group. These results enhance an understanding of exercise changes during transdiagnostic CBT-based ED treatment for individuals with varying baseline exercise profiles.Level of evidence: Level 1, randomized controlled trial.
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Affiliation(s)
- Olivia Wons
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Elizabeth Lampe
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Anna Gabrielle Patarinski
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI, 53719, USA
| | - Adrienne Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
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The Mediating Role of Eating Attitudes in Sociocultural Attitudes toward the Body in Predicting Obligatory Exercise among Young People: A Polish and Chinese Comparison. Nutrients 2023; 15:nu15040952. [PMID: 36839311 PMCID: PMC9959386 DOI: 10.3390/nu15040952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
The main aims of this study were to determine which sociocultural predictors of obligatory exercise are universal for young men or women and which are specific to particular cultural conditions (Polish or Chinese culture) and to examine the mediating role of eating attitudes. A cross-sectional study was conducted among Poles (n = 259) and Chinese (n = 208) aged 18 to 30. Descriptive and comparative statistics, Spearman's rho, and multiple regression analysis were used. The main analyses showed that Internalization-Athlete was a common positive direct predictor of obligatory exercise among young Polish and Chinese women; Information and Internalization-Athlete were only specific direct positive predictors of obligatory exercise in young Chinese men; some variables in eating attitudes mediated the development of obligatory exercise in young Polish and Chinese men and women and indicated that there were cross-cultural differences. In understanding obligatory exercise among young people, attention should be paid to their sociocultural attitudes toward the body and eating, and cultural and gender differences need to be considered.
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Narducci DM. Black box warning: when exercise is not medicine. Br J Sports Med 2023; 57:134-136. [PMID: 36609351 DOI: 10.1136/bjsports-2022-106291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Dusty Marie Narducci
- Department of Family Medicine and Department of Sports Medicine, University of South Florida, Tampa, Florida, USA
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11
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Schultz A, Maurer L, Alexandrowicz RW. Strengths and weaknesses of the German translation of the Inflexible Eating Questionnaire and of eating disorder assessment in general. Front Psychol 2022; 13:1002463. [PMID: 36600707 PMCID: PMC9806356 DOI: 10.3389/fpsyg.2022.1002463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Objective The present article introduces the German translation of the Inflexible Eating Questionnaire (IEQ-G), performs a psychometric evaluation, and explores the relationship of Inflexible Eating to the subscales of the Eating Disorder Examination-Questionnaire (EDE-Q) and Obsessive-Compulsive (OC) symptoms. Methods The cross-sectional study was carried out in the German-speaking area. A paper and pencil survey was completed by 612 females and 442 males of the general population. Results SEM analyses showed that the IEQ-G allows for calculating a total score and invariance tests were mostly promising. As a side result, the original 4-factorial structure of the EDE-Q could not be replicated, but a 3 dimensional solution proved convincing. From a psychometric point of view, the IEQ-G outperformed the EDE-Q. On a latent level, Inflexible Eating was remarkably strong related to OC-symptoms and the EDE-Q subscales. Discussion The detail analyses revealed that Eating Disorder assessment in general lacks subgroup-specific aspects, for instance, regarding gender or dietary preferences, important for early diagnosis and screening of ED. The IEQ-G proved applicable in a German speaking adult population and recommends itself for cross-cultural studies.
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12
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Haltom CE, Halverson TF. Relationship between college lifestyle variables, eating disorder education, and eating disorder risk. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-9. [PMID: 36194243 DOI: 10.1080/07448481.2022.2122720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Objective: This study examined relationships between eating disorder risk (EDR), lifestyle variables (e.g., exposure to healthy eating media), and differences among male and female college students. Participants: College students (N = 323) completed survey questionnaires (Fall, 2016). Fifty-three participants retook the survey at a later time. Methods: Participants completed a survey measuring EDR using EDI-3 subscales and 10 college lifestyle variables. Female and male EDR and Time 1 and Time 2 EDR were compared. Relationships between EDR and college life-style variables were examined. Results: Exercise, fewer daily meals, less face-to-face interactions, more digital interactions, less exposure to healthy eating media, and having conversations about body image were associated with EDR risk. Male college students showed an increase in EDR over time. Conclusions: Several lifestyle factors predicted EDR in college females and males. These lifestyle factors are modifiable and may be addressed by colleges during orientation and within the campus environment.
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Affiliation(s)
- Cris E Haltom
- Department of Psychology, Ithaca College, Ithaca, New York, USA
| | - Tate F Halverson
- Durham VA Health Care System, Durham, North Carolina, USA
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
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13
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Staples C, Palermo M, Rancourt D. Intrinsic and extrinsic motivations as moderators of the association between exercise frequency and exercise behavior. Eat Weight Disord 2022; 27:2801-2809. [PMID: 35776380 DOI: 10.1007/s40519-022-01430-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/03/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Motivations underlying exercise may contribute to the extent to which exercise is maladaptive, independent of exercise frequency. Extrinsic and intrinsic exercise motivation may independently moderate associations between exercise frequency and 1) compulsive and 2) healthy exercise. It was expected that among individuals with high extrinsic motivation, greater exercise frequency would be associated with more compulsive exercise, whereas among individuals with high intrinsic motivation, greater exercise frequency would be associated with more healthy exercise. METHODS A total of 446 university students (50.9% female; 67.0% White) completed measures of intrinsic and extrinsic exercise motivations, exercise frequency, compulsive exercise, and healthy exercise. Intrinsic and extrinsic motivations for exercise were entered as simultaneous independent moderators of the associations between exercise frequency and 1) compulsive exercise and 2) healthy exercise in multiple linear regressions. RESULTS Moderation effects of exercise motivation were not supported for compulsive exercise. Only main effects of frequency (b = 0.04, p < 0.01) and extrinsic motivation (b = 0.27, p < 0.01) were observed. Intrinsic motivation moderated the association between frequency and healthy exercise (b = -0.02, p = 0.03). Among individuals with lower intrinsic motivation, greater frequency was related to more healthy exercise. This association was significantly weaker among individuals with high intrinsic motivation. CONCLUSION Consistent with theory and extant work, extrinsic motivation was associated with compulsive exercise, while intrinsic motivation was associated with healthy exercise. Clinically, assessing the extent to which exercise is intrinsically or extrinsically motivated may help identify whether individuals may be more likely to engage in compulsive versus healthy exercise. Results support the importance of exploring the exercise motivations as predictors of compulsive and healthy exercise. LEVEL OF EVIDENCE Level V, Descriptive Cross-Sectional Study.
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Affiliation(s)
- Cody Staples
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Madeline Palermo
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Ruiz-Turrero J, Massar K, Kwasnicka D, Ten Hoor GA. The Relationship between Compulsive Exercise, Self-Esteem, Body Image and Body Satisfaction in Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031857. [PMID: 35162878 PMCID: PMC8835063 DOI: 10.3390/ijerph19031857] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/05/2022] [Accepted: 02/05/2022] [Indexed: 02/01/2023]
Abstract
Purpose: In this study, we aimed to test the relationship between compulsive exercise and self-esteem, body image, and body satisfaction as potential predictors of eating disorders. Methods: Self-report measures of compulsive exercise beliefs and behaviors, self-esteem, body image, and body satisfaction, were completed by 120 female participants through an online questionnaire. Factor analyses with varimax rotation were performed to create exercise-frequency groups. ANOVA’s were performed on Body Mass Index (weight adjusted for height squared, BMI), current minus ideal weight, self-esteem, body image, and body satisfaction to determine if there were differences depending on these exercise groups. Results: Factor analysis revealed two factors for compulsive exercise beliefs and behaviors: (1) Exercise Fixation, and (2) Exercise Frequency and Commitment. Based on those factors, participants were subdivided into four clusters: (1) pathological obligatory exercisers, (2) exercise fixators, (3) committed exercisers, and (4) non-exercisers. No differences were found between these groups for BMI or current minus ideal weight. Pathological obligatory exercisers and committed exercisers spend significantly more hours on exercise weekly compared to exercise fixators or non-exercisers. No differences between pathological obligatory exercisers, exercise fixators, and non-exercisers were found on self-esteem or body satisfaction, where the committed exercisers scored significantly better. Both committed exercisers and non-exercisers scored significantly better on body image flexibility compared to pathological obligatory exercisers and exercise fixators. Conclusion: Compulsive exercise has both an exercise volume and an emotional component. The level of compulsive exercise is linked to one’s self-esteem, body image, and body satisfaction and those factors could be a target for future interventions.
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Affiliation(s)
- Juncal Ruiz-Turrero
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200MD Maastricht, The Netherlands; (J.R.-T.); (K.M.)
| | - Karlijn Massar
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200MD Maastricht, The Netherlands; (J.R.-T.); (K.M.)
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Aleksandra Ostrowskiego 30b, 53-238 Wrocław, Poland;
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, School of Population and Global Health, University of Melbourne, 333 Exhibition Street, Melbourne 3000, Australia
| | - Gill A. Ten Hoor
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200MD Maastricht, The Netherlands; (J.R.-T.); (K.M.)
- Correspondence:
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15
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Beeler JA, Mourra D, Zanca RM, Kalmbach A, Gellman C, Klein BY, Ravenelle R, Serrano P, Moore H, Rayport S, Mingote S, Burghardt NS. Vulnerable and Resilient Phenotypes in a Mouse Model of Anorexia Nervosa. Biol Psychiatry 2021; 90:829-842. [PMID: 32950210 PMCID: PMC7855473 DOI: 10.1016/j.biopsych.2020.06.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Increased physical activity is a common feature of anorexia nervosa (AN). Although high activity levels are associated with greater risk of developing AN, particularly when combined with dieting, most individuals who diet and exercise maintain a healthy body weight. It is unclear why some individuals develop AN while most do not. A rodent model of resilience and vulnerability to AN would be valuable to research. Dopamine, which is believed to play a crucial role in AN, regulates both reward and activity and may modulate vulnerability. METHODS Adolescent and young adult female C57BL/6N mice were tested in the activity-based anorexia (ABA) model, with an extended period of food restriction in adult mice. ABA was also tested in dopamine transporter knockdown mice and wild-type littermates. Mice that adapted to conditions and maintained a stable body weight were characterized as resilient. RESULTS In adults, vulnerable and resilient phenotypes emerged in both the ABA and food-restricted mice without wheels. Vulnerable mice exhibited a pronounced increase in running throughout the light cycle, which dramatically peaked prior to requiring removal from the experiment. Resilient mice exhibited an adaptive decrease in total running, appropriate food anticipatory activity, and increased consumption, thereby achieving stable body weight. Hyperdopaminergia accelerated progression of the vulnerable phenotype. CONCLUSIONS Our demonstration of distinct resilient and vulnerable phenotypes in mouse ABA significantly advances the utility of the model for identifying genes and neural substrates mediating AN risk and resilience. Modulation of dopamine may play a central role in the underlying circuit.
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Affiliation(s)
- Jeff A. Beeler
- Dept. of Psychology, Queens College and The Graduate Center, CUNY, Flushing, NY, 11367 USA
| | - Devry Mourra
- Dept. of Psychology, Queens College and The Graduate Center, CUNY, Flushing, NY, 11367 USA
| | - Roseanna M. Zanca
- Dept. of Psychology, Hunter College and The Graduate Center, CUNY, New York, NY, 10065 USA
| | - Abigail Kalmbach
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA
| | - Celia Gellman
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Molecular Therapeutics, NYS Psychiatric Institute, New York, NY 10032 USA
| | - Benjamin Y. Klein
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Developmental Neuroscience, NYS Psychiatric Institute, New York, NY 10031 USA,Dept. of Microbiology and Molecular Genetics, Hebrew University, Jerusalem, Israel
| | | | - Peter Serrano
- Dept. of Psychology, Hunter College and The Graduate Center, CUNY, New York, NY, 10065 USA
| | - Holly Moore
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Systems Neuroscience, NYS Psychiatric Institute, New York, NY 10032 USA,National Institute on Drug Abuse, Bethesda, MD
| | - Stephen Rayport
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Molecular Therapeutics, NYS Psychiatric Institute, New York, NY 10032 USA
| | - Susana Mingote
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Molecular Therapeutics, NYS Psychiatric Institute, New York, NY 10032 USA,Advanced Science Research Center, The Graduate Center, CUNY, New York, NY 10031 USA
| | - Nesha S. Burghardt
- Dept. of Psychology, Hunter College and The Graduate Center, CUNY, New York, NY, 10065 USA,Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA
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16
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Monserrat Hernández M, Arjona Garrido Á, Checa Olmos JC, Salguero García D. Relationship between Negative Running Addiction and Eating Disorder Patterns in Runners. Nutrients 2021; 13:4344. [PMID: 34959896 PMCID: PMC8708838 DOI: 10.3390/nu13124344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/17/2022] Open
Abstract
Current studies show an increase in the risk of eating disorders in runners. Since it is known that abusive exercise can be both a cause and a consequence of such developments, the main objective of the present study was to examine the risk and possible relationships between negative running addiction (NRA), as measured by the reduced and validated SAS-40 scale, and the tendency to be a compulsive eater (measured by YFAS 2.0), anorexia nervosa (AN), and/or bulimia nervosa (BN) (measured by EAT-40). This study highlights the novelty of researching the level of influence of NRA on each defined eating disorder. METHOD A total of 167 Spanish-speaking federated runners in cross-country and track running (42% women and 58% men), with an average age of 24 years and an average BMI of 21 kg/m2, responded to an online questionnaire that asked about sociodemographic data and the Spanish versions of the SAS-40, YFAS 2, YFAS 3, and YFAS 4. Through a quantitative methodology using logistic regressions-the coefficient of determination and Pearson's correlation coefficient-we created a sample analysis that related the significant items of the DSM-V to the results of the questionnaires administered, as well as their relationship with the practice of the sport in question and various variables of the environment. RESULTS The rates of CE, AN, and BN were 65, 11.4, and 16.2%, respectively. The tendency towards CE increased with a lower weight (r = 0.156, p < 0.05), not having been overweight in childhood (r = 0.151, p < 0.05), and being a long-distance runner (r = 0.123 p < 0.05). The risk of AN increased with the absence of menstruation for more than 3 months (r = 0.271 p < 0.01), having suffered from childhood obesity (r = 0.213 p < 0.05), and being underweight (r = 0.064 p < 0.05). The risk of BN increased with having suffered from childhood obesity (r = 0.194 p < 0.05), having a higher weight (r = 0.140, p < 0.05), and practicing athletics, especially the relay modality (r = 0.044 p < 0.05). CONCLUSIONS A considerable number of runners are at risk of suffering from some type of eating disorder. A significant relationship was observed between long-distance runners and the risk of eating disorders (AN, BN, and CE), and the association is stronger for CE than for AN and BN. Lastly, childhood experiences (such as being obese/a healthy weight) were notorious for increasing the risk of eating disorders. Further studies are needed to research each particular parameter and the relationships between the possible levels of dependence on exercise. LEVEL OF EVIDENCE Level III, cohort analytic study.
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Affiliation(s)
| | - Ángeles Arjona Garrido
- Faculty of Humanities, University of Almería, 04120 Almería, Spain; (M.M.H.); (J.C.C.O.); (D.S.G.)
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17
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Bergmeier HJ, Morris H, Mundell N, Skouteris H. What role can accredited exercise physiologists play in the treatment of eating disorders? A descriptive study. Eat Disord 2021; 29:561-579. [PMID: 31818224 DOI: 10.1080/10640266.2019.1701351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Including exercise alongside other therapeutic approaches may help to address dysfunctional exercise use and improve eating disorder treatment outcomes. However, traditional treatment teams often lack the expertise needed to safely prescribe exercise. The aims of this study were to explore the perceptions and experiences of Accredited Exercise Physiologists (AEPs) relating to working with clients diagnosed with eating disorders to identify the role they play in the treatment of eating disorders and identify future training needs. Individual semi-structured telephone interviews were conducted with 12 (n = 9 females) AEPs working in the eating disorders field. Thematic analysis was conducted to extract major themes from the interview transcripts. Five major themes were identified: (1) The role of AEPs in the treatment of individuals with eating disorders is comprehensive; (2) Treatment is more effective when all components are addressed; (3) The absence of therapeutic exercise within standard treatment protocols reflects limitations of traditional scope of practice and knowledge about the role of AEPs; (4) Methods of acquiring further knowledge are insufficient for those in current practice; and (5) Accredited comprehensive training is currently unavailable but needed. This qualitative study showed that AEPs believe they can play a major role in the treatment of eating disorders and that treatment outcomes for individuals are likely to be greatly enhanced when dysfunctional exercise is addressed. Multidisciplinary training is needed.
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Affiliation(s)
- Heidi J Bergmeier
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Heather Morris
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Niamh Mundell
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
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18
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Harrison AN, Rocke KD, James Bateman C, Bateman A, Chang SM. Physical activity and disordered eating behaviours: Are Caribbean adolescents at risk? INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 57:218-226. [PMID: 34398467 DOI: 10.1002/ijop.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 07/24/2021] [Indexed: 11/06/2022]
Abstract
Excessive physical activity (PA) has been linked to increased risk for disordered eating behaviours and eating disorders. This study investigates the relationship between PA and disordered eating behaviours and attitudes (DEBAs) among Jamaican adolescents. This cross-sectional study included 521 adolescents, 12-19 years. Anthropometric measurements were collected, and adolescents completed questionnaires on disordered eating behaviours (EAT-26), physical activity, self-esteem and affect. Associations were assessed using sex-specific mixed-effect linear and logistic regression models. Participants reported exercising an average of 3 days per week. Adolescents who exercised for a longer duration had greater odds of having elevated EAT-26 scores (at least 1 hour-OR = 2.04; 95% CI = 1.03, 4.06; p = .042), while a higher exercise frequency among males (3-5 days per week) was protective against DEBAs (OR 0.38; 95% CI = 0.16, 0.88; p = .025). Female adolescents reported higher prevalence of elevated EAT-26 scores than males (p < .01). Increased negative affect increased odds of an elevated EAT-26 score. Exercise duration and frequency play a role in disordered eating behaviours in Jamaican adolescents and vary by gender. Our findings have implications for weight management interventions and policies, encouraging healthcare providers to monitor PA levels as well as negative affect in adolescents who display disordered eating behaviours.
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Affiliation(s)
- Abigail N Harrison
- Department of Child and Adolescent Health, The University of the West Indies, Mona, Jamaica
| | - Kern D Rocke
- The George Alleyne Chronic Disease Research Centre, The University of the West Indies, Bridgetown, Barbados
| | - Caryl James Bateman
- Department of Sociology, Psychology and Social Work, The University of the West Indies, Mona, Jamaica
| | - Andre Bateman
- Department of Kinesiology, Michigan State University
| | - Susan M Chang
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica
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19
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Booker R, Novik M, Galloway R, Holmes ME. Relationship between physical activity intensities and drunkorexia severity among first-year college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:689-692. [PMID: 32045319 DOI: 10.1080/07448481.2019.1710151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/16/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
Investigate the relationship between intensities of physical activity and severity of drunkorexia behaviors. Participants: First-year college students living in residence halls (n = 127) completed an online survey comprising drinking, drunkorexia, and physical activity. Methods: Multiple hierarchical linear regressions were implemented to examine if physical activity intensity correlates to drunkorexia severity. Results: Vigorous physical activity was the only physical activity intensity significantly associated with severity of drunkorexia behaviors. Conclusions: First-year college students' duration of vigorous physical activity in relation to severity of drunkorexia behaviors may vary contingently on the motivation for vigorous physical activity. Practitioners need to consider physical activity can be a co-occurring risk behavior in combination with alcohol misuse.
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Affiliation(s)
- Robert Booker
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - Melinda Novik
- Department of Kinesiology, Missouri State University, Springfield, MO, USA
| | - Riley Galloway
- Department of Kinesiology, Missouri State University, Springfield, MO, USA
| | - Megan E Holmes
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
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20
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Abstract
Pathological exercise behavior is pervasive in eating disorder psychopathology, yet minimal treatment guidance exists for extinguishing it as little is known about how to differentiate pathological from healthy exercise. The purpose of this study was to characterize pathological exercise in terms of motivation to increase the specificity with which both pathological and healthy exercise is described and to inform treatment interventions. Latent profile analysis characterized homogenous groups based on exercise motivation in two samples: college women (n = 200) and women with eating psychopathology (n = 211). These profiles were compared on levels of eating and general psychopathology and emotion dysregulation. Three profiles emerged describing sedentary, pathological exercise, and athlete groups in the first sample, and five profiles describing neutral, sedentary, weight loss, athlete, and pathological exercise groups emerged in the second sample. Findings indicate that motivation style is salient in defining pathological exercise and may, therefore, be a clinically useful treatment target.
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21
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Vanzhula IA, Kinkel-Ram SS, Levinson CA. Perfectionism and Difficulty Controlling Thoughts Bridge Eating Disorder and Obsessive-Compulsive Disorder Symptoms: A Network Analysis. J Affect Disord 2021; 283:302-309. [PMID: 33578342 DOI: 10.1016/j.jad.2021.01.083] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/10/2021] [Accepted: 01/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Eating disorders (ED) and obsessive-compulsive disorder (OCD) are highly comorbid, but little is known about how this comorbidity is maintained. Prior research suggests that obsessive thoughts and perfectionism may be shared maintenance factors for EDs and OCD. METHODS The current study used network analysis to (1) identify bridge pathways in an ED-OCD comorbidity network and (2) test if perfectionism symptoms bridge between ED-OCD symptoms in a combined network model including ED, OCD, and Perfectionism symptoms. Participants (N = 1,619) were a mixed sample of undergraduate students and individuals diagnosed with EDs. RESULTS Difficulty controlling thoughts was the symptom with the highest bridge centrality in both models, connecting with ED-related worry and doubts. In the ED-OCD-Perfectionism comorbidity network, doubts about simple everyday things and repeating things over and over bridged between ED and OCD symptoms. Additionally, specific and distinct pathways were identified between OCD and two types of ED pathology: restricting (checking compulsions and rigidity around food) and binge eating (hoarding and binge eating symptoms). LIMITATIONS Due to the cross-sectional nature of the data, no directional inferences can be made. Due to a higher OCD symptom prevalence rate than reported in previous studies, our undergraduate sample may not be representative of other college populations. CONCLUSIONS The presence of intrusive cognitions and maladaptive perfectionism may contribute to the maintenance of co-occurring ED and OCD symptoms. These findings begin to delineate specific pathways among OCD and ED symptoms, which can be used in the development of interventions to disrupt connections among these disorders.
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Affiliation(s)
- Irina A Vanzhula
- University of Louisville, Department of Psychological & Brain Sciences
| | | | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences.
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22
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Strahler J, Wachten H, Mueller-Alcazar A. Obsessive healthy eating and orthorexic eating tendencies in sport and exercise contexts: A systematic review and meta-analysis. J Behav Addict 2021; 10:456-470. [PMID: 33650987 PMCID: PMC8997206 DOI: 10.1556/2006.2021.00004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/14/2020] [Accepted: 12/27/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON) and exercise addiction (ExAdd) are two phenomena believed to overlap. We conducted a meta-analysis exploring the link between ON and (addictive) exercise behaviors. METHODS A systematic review of major databases and gray literature was carried out for studies reporting on ON and (addictive) exercise behaviors. Random effects meta-analyses were undertaken calculating correlations between ON and (addictive) exercise behaviors. A sub-group analysis investigated gender differences. RESULTS Twenty-five studies with 10,134 participants (mean age = 25.21; 56.4% female) were included. Analyses showed a small overall correlation between ON and exercise (21 studies, r = 0.12, 95% CI |0.06-0.18|) and a medium overall correlation between ON and ExAdd (7 studies, r = 0.29, 95% CI |0.13-0.45|). Gender differences were negligible. CONCLUSIONS Orthorexic eating correlated slightly and moderately with exercise and ExAdd, respectively, expressing some unique and shared variance of these behaviors. While this does not suggest ON and addictive exercising to be independent, it does not indicate substantial comorbidity. Future research should focus on clinical relevance, underlying mechanisms, vulnerability, and risk factors.
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Affiliation(s)
- Jana Strahler
- Psychotherapy and Systems Neuroscience, Justus-Liebig-University Giessen, Giessen, Germany
| | - Hanna Wachten
- Psychotherapy and Systems Neuroscience, Justus-Liebig-University Giessen, Giessen, Germany
| | - Anett Mueller-Alcazar
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
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23
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Wahl CA, Harris BS, Langdon JL, Riggs AJ, Meyer BB. Goal orientation, motivational climate, and exercise as predictors of eating disorder risk factors among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:168-175. [PMID: 31498757 DOI: 10.1080/07448481.2019.1657431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 07/31/2019] [Accepted: 08/09/2019] [Indexed: 06/10/2023]
Abstract
Objectives: This study examined how goal orientation, motivational climate, and exercise could be used to predict college students' eating disorder symptomology. Participants: Recruited in February 2017, the participants included 275 college-aged students from a university in the southeastern United States. Methods: Using achievement goal theory as the framework to conceptualize motivations behind eating disorder behaviors, each participant filled out questionnaires related to goal mindsets, perceptions of the social climate in the university recreation center, and exercise habits. Data were analyzed using multiple regression analyses, with R coefficients being used to evaluate prediction models. Results: The results of the study suggested that goal orientation and ego-involving climate were the only significant predictors of eating disorder symptomology, accounting for 3.4% of the total variance. Conclusions: This study provided preliminary evidence of the importance of studying achievement goal theory-related variables that contribute to our understanding of eating disorder symptomology in the collegiate population.
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Affiliation(s)
- Carly A Wahl
- Health and Kinesiology, Georgia Southern University College of Health and Human Sciences, Statesboro, USA
| | - Brandonn S Harris
- Health and Kinesiology, Georgia Southern University College of Health and Human Sciences, Statesboro, USA
| | - Jody L Langdon
- Health and Kinesiology, Georgia Southern University College of Health and Human Sciences, Statesboro, USA
| | - Amy Jo Riggs
- Health and Kinesiology, Georgia Southern University College of Health and Human Sciences, Statesboro, USA
| | - Barbara B Meyer
- Department of Kinesiology-Integrated Health Care & Performance Unit, University of Wisconsin Milwaukee College of Health Sciences, Milwaukee, USA
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Stevens CJ, Baldwin AS, Bryan AD, Conner M, Rhodes RE, Williams DM. Affective Determinants of Physical Activity: A Conceptual Framework and Narrative Review. Front Psychol 2020; 11:568331. [PMID: 33335497 PMCID: PMC7735992 DOI: 10.3389/fpsyg.2020.568331] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/09/2020] [Indexed: 12/23/2022] Open
Abstract
The literature on affective determinants of physical activity (PA) is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework (AHBF), including: (1) affective response (e.g., how one feels in response to PA behavior) to PA; (2) incidental affect (e.g., how one feels throughout the day, unrelated to the target behavior); (3) affect processing (e.g., affective associations, implicit attitudes, remembered affect, anticipated affective response, and affective judgments); and (4) affectively charged motivational states (e.g., intrinsic motivation, fear, and hedonic motivation). After defining each category of affective construct, we provide examples of relevant research showing how each construct may relate to PA behavior. We conclude each section with a discussion of future directions for research.
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Affiliation(s)
- Courtney J. Stevens
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Austin S. Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Mark Conner
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Ryan E. Rhodes
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC, Canada
| | - David M. Williams
- Department of Behavioral and Social Sciences, Department of Psychiatry and Human Behavior, School of Public Health, Brown University, Providence, RI, United States
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Martin SJ, Schell SE, Srivastav A, Racine SE. Dimensions of unhealthy exercise and their associations with restrictive eating and binge eating. Eat Behav 2020; 39:101436. [PMID: 33069001 DOI: 10.1016/j.eatbeh.2020.101436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
Unhealthy exercise is a core symptom of eating disorders that predicts greater chronicity and risk of relapse. A detailed conceptualization of unhealthy exercise in the context of eating disorders is only beginning to emerge, and associations between specific dimensions of unhealthy exercise and eating disorder symptoms have received little attention. The aim of the current study was to examine associations between three key dimensions of unhealthy exercise - compulsive exercise (i.e., rule-driven exercise to avoid negative affect), exercise to control weight/shape, and exercise to compensate for recent food intake - with restrictive eating and binge eating. Participants were 239 women drawn from two separate studies of emotions and eating behavior; 126 (52.7%) endorsed restrictive eating and/or objective binge eating episodes in the past three months. Unhealthy exercise dimensions were measured using the Compulsive Exercise Test and investigator-designed items, and eating disorder symptoms were assessed using the Eating Pathology Symptoms Inventory. Restrictive eating was only associated with avoidance and rule-driven exercise, whereas binge eating was significantly correlated with all unhealthy exercise variables. Multiple regression results revealed that only compensatory exercise was uniquely associated with binge eating. Unhealthy exercise consists of partially distinct dimensions with differential relations to core eating disorder symptoms. Future research should examine unhealthy exercise dimensions in patients with eating disorder diagnoses and consider whether treatments for specific unhealthy exercise forms might be beneficial.
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Affiliation(s)
| | - Sarah E Schell
- Department of Psychology, McGill University, Montreal, Canada
| | | | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Canada.
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Kelly NR, Kosty D, Guerricabeitia L, Guidinger C, Williamson G. Evaluating components of existing theories for loss of control eating in a sample of young racially/ethnically diverse men. Body Image 2020; 35:63-70. [PMID: 32877842 DOI: 10.1016/j.bodyim.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/06/2020] [Accepted: 08/16/2020] [Indexed: 01/23/2023]
Abstract
The current study evaluated components of existing theoretical models for loss of control (LOC) eating in young men. The link between body image concerns, including concerns with fat and muscularity, and LOC eating frequency was evaluated in 1109 ethnically/racially diverse men (18-30y). Dietary restraint, compulsive exercise, and emotion dysregulation were evaluated as putative mediators. Body mass index (BMI) and race/ethnicity were examined as moderators. Participants completed online surveys. Path analyses in Mplus tested indirect paths using the bias-corrected bootstrap method. Higher body fat concerns were directly linked to LOC eating frequency and indirectly linked through greater dietary restraint, compulsive exercise, and emotional dysregulation (ps<.01). The link among fat concerns, restraint, and LOC eating frequency was moderated by body mass, such that this association was particularly strong for men with a low-to-average BMI relative to those with a high BMI (p < .001). Higher muscularity concerns were not directly linked to LOC eating frequency but were indirectly linked through greater emotion dysregulation (p < .001). Body image concerns are associated with LOC eating in young men. The pathways to LOC eating may differ depending on the nature of men's body image concerns (muscularity vs. thinness). Prospective data are needed to verify these findings.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States.
| | - Derek Kosty
- The Prevention Science Institute, University of Oregon, United States
| | | | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States
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Wons OB, Michael ML, Lin M, Juarascio AS. Characterizing rates of physical activity in individuals with binge eating disorder using wearable sensor technologies and clinical interviews. EUROPEAN EATING DISORDERS REVIEW 2020; 29:292-299. [PMID: 33247869 DOI: 10.1002/erv.2811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/19/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Research suggests physical activity (PA) improves behavioural, psychological and behavioural symptoms in individuals with binge eating disorder (BED), yet self-reported PA is notably low. Little remains known about objective rates of PA and subclinical levels of maladaptive PA (i.e., compensatory or driven PA), and few studies have attempted to understand the role that dissatisfaction and overvaluation with shape and weight plays in promoting PA in individuals with BED. We sought to characterize PA and investigate whether elevated rates of shape and weight concerns contribute to rates of PA in individuals with BED. METHOD Individuals meeting DSM-5 diagnosis of BED (N = 56) completed the Eating Disorder Examination and wore a Fitbit Flex 2 for 1 week. RESULTS On average, participants recorded 7621.12 (SD = 3034.20) daily steps and 194.30 (SD = 161.45) weekly moderate-to-vigorous PA minutes. About 21% of participants reported subclinical levels of maladaptive PA. Greater shape and weight overvaluation predicted lower duration of compensatory PA. CONCLUSION A small percentage of individuals with BED are engaging in subclinical levels of maladaptive PA, and there is a need to identify factors that influence rates of PA in individuals with BED.
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Affiliation(s)
- Olivia B Wons
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology & WELL Center, Drexel University, Philadelphia, Pennsylvania, USA
| | - Megan L Michael
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology & WELL Center, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mandy Lin
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology & WELL Center, Drexel University, Philadelphia, Pennsylvania, USA
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Håman L, Yring H, Prell H, Lindgren EC. Personal trainers' health advice in the fitness gym space from a gender perspective. Int J Qual Stud Health Well-being 2020; 15:1794364. [PMID: 33103635 PMCID: PMC7594759 DOI: 10.1080/17482631.2020.1794364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Purpose: This study aimed to describe and problematize the advice on exercise and diet that personal trainers (PTs) provide to their clients from a gender perspective.Method: The present study had an explorative design, and the interviews were analysed using an interpretative qualitative approach. Seven focus group discussions were conducted with 19 PTs (aged 23-47 years).Results: The findings indicated that the PTs had a gender-neutral health advice approach to both women and men, guiding them towards a relaxed attitude to exercise and diet, prioritizing and rationalizing their exercise and diet and eating a natural diet. PTs also had a gendered health advice approach as regards women who showed unhealthy exercise and eating behaviours; advising them to eat more and exercise less, to focus on performance rather than appearance and to avoid heavy weightlifting. Some PTs acted evasively and did not give advice to men.Conclusions: Both approaches include advice that reflect health as control and health as release. From a gender perspective, PTs health advice both challenged and reproduced the stereotypical male norm in the fitness gym space. However, PTs gendered health advice may create different opportunities for men and women to promote their health and well-being in the fitness gym.
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Affiliation(s)
- Linn Håman
- School of Health and Welfare, Halmstad University , Halmstad, Sweden
| | - Helena Yring
- School of Health and Welfare, Halmstad University , Halmstad, Sweden
| | - Hillevi Prell
- Department of Food and Nutrition, and Sport Science, University of Gothenburg , Gothenburg, Sweden
| | - Eva-Carin Lindgren
- School of Health and Welfare, Halmstad University , Halmstad, Sweden.,Department of Food and Nutrition, and Sport Science, University of Gothenburg , Gothenburg, Sweden
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Vanzhula IA, Sala M, Christian C, Hunt RA, Keshishian AC, Wong VZ, Ernst S, Spoor SP, Levinson CA. Avoidance coping during mealtimes predicts higher eating disorder symptoms. Int J Eat Disord 2020; 53:625-630. [PMID: 32112594 DOI: 10.1002/eat.23254] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Eating disorders (EDs) are characterized by significant anxiety during mealtime that contributes to food avoidance and weight loss. Individuals with EDs commonly use avoidance coping (e.g., distraction) to tolerate meals and comply with meal plans. Although this strategy may be effective short term, a large body of anxiety literature suggests that avoidance can lead to worsening of psychological symptoms long term. METHOD The current study (N = 66 individuals diagnosed with ED) used ecological momentary assessment (EMA) to examine the short-term and long-term associations of avoidance coping on ED symptoms. RESULTS Distraction during meals predicted a reduction in anxiety in the short term, and both distraction and avoidance of emotions predicted increases in excessive exercise in the short term. Distraction and avoidance of emotions predicted increases in bulimic symptoms 1 month after completion of EMA. DISCUSSION These results are consistent with prior literature on avoidance and suggest that avoidance coping during meals may contribute to the increase of ED behaviors in the long term. Coping strategies that encourage approach and tolerance of difficult thoughts and emotions (e.g., acceptance-based strategies) rather that avoidance coping may promote longer-term symptom reduction.
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Affiliation(s)
- Irina A Vanzhula
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | | | - Caroline Christian
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Rowan A Hunt
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Ani C Keshishian
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Valerie Z Wong
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah Ernst
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Samantha P Spoor
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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Brosof LC, Williams BM, Levinson CA. Exploring the contribution of exercise dependence to eating disorder symptoms. Int J Eat Disord 2020; 53:123-127. [PMID: 31424602 DOI: 10.1002/eat.23156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Exercise dependence is a set of cognitive and behavioral symptoms that constitute a reliance on exercise and is related to eating disorder (ED) symptoms. There are seven components of exercise dependence: tolerance, withdrawal, continuance, lack of control, reduction in other activities, time, and intention effects. Exercising in response to negative affect (NA) is a key feature of dysfunctional exercise in the EDs. However, it is unknown which specific components of exercise dependence relate to ED symptoms, above and beyond NA. METHOD The current study (N = 168 individuals with EDs) investigated which components of exercise dependence relate to ED symptoms both cross-sectionally and prospectively. RESULTS In cross-sectional data, we found that withdrawal, tolerance, and time were associated with ED symptoms, above and beyond NA. Prospectively over 1 month, when adjusting for baseline ED symptoms and NA, we found that lack of control, withdrawal, and time positively predicted ED symptoms. DISCUSSION These findings inform future research on how exercise dependence relates to ED symptoms, showing that withdrawal and time are uniquely associated with ED symptoms both cross-sectionally and over time.
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Affiliation(s)
- Leigh C Brosof
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - Brenna M Williams
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
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Factor structure and reliability of the Multidimensional Body-Self Relations Questionnaire in Chilean youth. Eat Weight Disord 2019; 24:339-350. [PMID: 28688050 DOI: 10.1007/s40519-017-0411-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 06/08/2017] [Indexed: 01/31/2023] Open
Abstract
The aim of this study was to ascertain the psychometric properties of the Multidimensional Body-Self Relations Questionnaire (MBSRQ) for a sample of youth in Chile. Cross-sectional survey was conducted with 451 participants. A non-clinical sample of adolescents and young adults between 15 and 25 years responded the MBSRQ and a sociodemographic questionnaire. Factorial analysis identified seven factors and provided empirical evidence that supports the use of these factors to evaluate body perception in Chilean youth. Scores exhibited good reliability in three factors (over 0.80) and acceptable reliability in the other four (over 0.70). Findings suggest that the Spanish MBSRQ was psychometrically sound, with 7 factors which are largely consistent with those identified in the original version and validation study of this scale. These factors possess sufficient internal consistency to make it plausible for use in research and screening with Chilean youth, and potentially useful as an adjunctive measure in the context of clinical decision making.
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Excessive physical activity in young girls with restrictive-type anorexia nervosa: its role on cardiac structure and performance. Eat Weight Disord 2018; 23:653-663. [PMID: 29058271 DOI: 10.1007/s40519-017-0447-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 09/25/2017] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the influence of hyperactivity on left ventricular mass (LVM) in Anorexia Nervosa restricting-type (AN-R) and the correlation between LVM and auxologic parameters/circulating hormones. METHODS Echocardiography was performed in 44 AN-R girls, subgrouped in 24 hyperactive (ANH+) and 20 non-hyperactive (ANH-), and in 20 controls (HC). LVM indexed to Body Surface Area (LVMi) and LVM indexed to height (LVMh) were calculated. RESULTS LVMi and LVMh were significantly lower in the AN-R subjects compared to HC. Moreover, both LVMi and LVMh were higher in the ANH+ than in the ANH-. In the HC, LVMi was higher when compared to the ANH- subjects than to the ANH+. Stepwise analysis revealed that in the ANH+ group, fT4 was the only independent predictor of LVMh, while in the ANH- group, height was the only independent predictors of LVMi. CONCLUSIONS Despite its negative influence on disease severity and outcome, hyperactivity from the standpoint of cardiac function makes the LVM of AN-R young girls more similar to HC. LEVEL OF EVIDENCE Level III, case-control study.
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Sumter SR, Cingel DP, Antonis D. “To be able to change, you have to take risks #fitspo”: Exploring correlates of fitspirational social media use among young women. TELEMATICS AND INFORMATICS 2018. [DOI: 10.1016/j.tele.2018.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lydecker JA, Shea M, Grilo CM. Driven exercise in the absence of binge eating: Implications for purging disorder. Int J Eat Disord 2018; 51:139-145. [PMID: 29215743 PMCID: PMC5796839 DOI: 10.1002/eat.22811] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/27/2017] [Accepted: 11/20/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Purging disorder (PD) is characterized by recurrent purging without objectively large binge-eating episodes. PD has received relatively little attention, and questions remain about the clinical significance of "purging" by exercise that is driven or compulsive (i.e., as extreme compensatory or weight-control behavior). The little available research suggests that individuals who use exercise as a compensatory behavior might have less eating-disorder psychopathology than those who purge by vomiting or laxatives, but those studies have had smaller sample sizes, defined PD using low-frequency thresholds, and defined exercise without weight-compensatory or driven elements. METHOD Participants (N = 2,017) completed a web-based survey with established measures of eating-disorder psychopathology, depression, and physical activity. Participants were categorized (regular compensatory driven exercise, PD-E, n = 297; regular compensatory vomiting/laxatives, PD-VL, n = 59; broadly defined anorexia nervosa, AN, n = 20; and no eating-disordered behaviors, NED, n = 1,658) and compared. RESULTS PD-E, PD-VL, and AN had higher eating-disorder psychopathology and physical activity than NED but did not significantly differ from each other on most domains. PD-VL and AN had higher depression than PD-E, which was higher than NED. DISCUSSION Findings suggest that among participants with regularly compensatory behaviors without binge eating, those who use exercise alone have similar levels of associated eating-disorder psychopathology as those who use vomiting/laxatives, although they have lower depression levels and overall frequency of purging. Findings provide further support for the clinical significance of PD. Clinicians and researchers should recognize the severity of driven exercise as a compensatory behavior, and the need for further epidemiological and treatment research.
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Affiliation(s)
| | - Megan Shea
- Department of Psychiatry, Yale School of Medicine,Amherst College
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da Luz FQ, Swinbourne J, Sainsbury A, Touyz S, Palavras M, Claudino A, Hay P. HAPIFED: a Healthy APproach to weIght management and Food in Eating Disorders: a case series and manual development. J Eat Disord 2017; 5:29. [PMID: 28824810 PMCID: PMC5558732 DOI: 10.1186/s40337-017-0162-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/14/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is a high prevalence of overweight or obesity in people with eating disorders. However, therapies for eating disorders, namely binge eating disorder and bulimia nervosa, do not address weight management. Conversely, weight loss treatments for people with overweight or obesity do not address psychological aspects related to eating disorders. Thus we developed a new treatment for overweight or obesity with comorbid binge eating disorder or bulimia nervosa, entitled HAPIFED (a Healthy APproach to weIght management and Food in Eating Disorders). This paper describes HAPIFED and reports a case series examining its feasibility and acceptability. METHODS Eleven participants with overweight or obesity and binge eating disorder or bulimia nervosa were treated with HAPIFED in two separate groups (with once or twice weekly meetings). Weight, body mass index (BMI) and eating disorder symptoms, as well as depression, anxiety and stress, were assessed at baseline and at the end of the 20-session HAPIFED intervention. RESULTS Eight of the 11 participants completed the intervention, with diverse results. Six of the 8 participants who completed HAPIFED reduced their weight between baseline and the end of the intervention. Median scores on the Eating Disorder Examination Questionnaire for binge eating, restraint, and concerns about eating or weight and shape, were reduced in the group overall between baseline and the end of the intervention. One participant, who at baseline was inducing vomiting and misusing laxatives in an attempt to lose weight, reduced these behaviors by the end of the intervention. Three participants at baseline were undertaking episodes of compulsive exercise, and they reduced or stopped this behavior, but one participant commenced episodes of compulsive exercise by the end of the intervention. All participants who completed the intervention rated the suitability and success of HAPIFED as 7 or more out of 10 (0 = not at all suitable/successful; 10 = extremely suitable/successful). CONCLUSION This case series supports the feasibility and acceptability of HAPIFED as a potential new treatment for overweight or obesity with comorbid binge eating disorder or bulimia nervosa. Clinical trials are necessary to examine the efficacy and effectiveness of HAPIFED. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (Universal Trial Number): U1111-1149-7766. Date of registration: 4th November 2013.
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Affiliation(s)
- Felipe Q da Luz
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, Camperdown, NSW 2006 Australia.,The University of Sydney, School of Psychology, Faculty of Science, Camperdown, NSW 2006 Australia.,CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70040-020 Brazil
| | - Jessica Swinbourne
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, Camperdown, NSW 2006 Australia
| | - Amanda Sainsbury
- The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Sydney Medical School, Charles Perkins Centre, Camperdown, NSW 2006 Australia.,The University of Sydney, School of Psychology, Faculty of Science, Camperdown, NSW 2006 Australia
| | - Stephen Touyz
- The University of Sydney, School of Psychology, Faculty of Science, Camperdown, NSW 2006 Australia
| | - Marly Palavras
- Program of Orientation and Attention of Eating Disorders, Federal University of São Paulo, São Paulo, Brazil
| | - Angelica Claudino
- Program of Orientation and Attention of Eating Disorders, Federal University of São Paulo, São Paulo, Brazil
| | - Phillipa Hay
- Centre for Health Research, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
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Bardone-Cone AM, Higgins MK, St George SM, Rosenzweig I, Schaefer LM, Fitzsimmons-Craft EE, Henning TM, Preston BF. Behavioral and psychological aspects of exercise across stages of eating disorder recovery. Eat Disord 2016; 24:424-39. [PMID: 27463591 PMCID: PMC5055812 DOI: 10.1080/10640266.2016.1207452] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined the relationship between behavioral and psychological aspects of exercise and eating disorder recovery. Participants were categorized as having an eating disorder (n = 53), partially recovered (n = 15), fully recovered (n = 20), or non-eating disorder controls (n = 67). Groups did not differ significantly in time spent exercising, but did differ in exercise intensity, guilt-related exercise, obsessive exercise cognitions, and appearance/weight management and stress/mood management motivations for exercise. Results support the importance of measuring psychological aspects of exercise in particular across the course of an eating disorder.
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Affiliation(s)
- Anna M Bardone-Cone
- a Department of Psychology and Neuroscience , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - M K Higgins
- a Department of Psychology and Neuroscience , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Sara M St George
- b Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , Florida , USA
| | - Ilyssa Rosenzweig
- a Department of Psychology and Neuroscience , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Lauren M Schaefer
- c Department of Psychology , University of South Florida , Tampa , Florida , USA
| | | | - Taylor M Henning
- a Department of Psychology and Neuroscience , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Brittany F Preston
- e Department of Psychological Sciences , University of Missouri-St. Louis , St. Louis , Missouri , USA
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Davis HA, Guller L, Smith GT. Developmental trajectories of compensatory exercise and fasting behavior across the middle school years. Appetite 2016; 107:330-338. [PMID: 27544806 DOI: 10.1016/j.appet.2016.08.098] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 08/07/2016] [Accepted: 08/15/2016] [Indexed: 02/06/2023]
Abstract
Compensatory exercise and fasting behavior, in the absence of binge eating and purging, appear to be important eating disorder behaviors that are associated with dysfunction, but little is known about these behaviors in youth. We studied the trajectories of their development in non-binge eating and non-purging girls during early adolescence. Using a longitudinal design, we assessed 564 girls six times over the three years of middle school (grades 6 through 8) and developed trajectories specifying different developmental patterns in relation to the behaviors. Prior to this period, when the girls were in 5th grade (elementary school), we assessed risk factors to predict girls' subsequent trajectory group membership. Compensatory exercise trajectory groups included a non-engagement group, a group that increased in the behavior, and a group that decreased in the behavior. There were two fasting trajectory groups, one consistently engaging in the behavior and the other consistently not. Elementary school levels of depression, eating expectancies, and thinness expectancies predicted subsequent trajectory group membership. Risk for compensatory exercise and fasting should be evaluated as early as in 5th grade. Targeted interventions should focus on girls in late elementary school or middle school, as this appears to be a critical developmental and maintenance period for compensatory exercise and fasting behavior.
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Dakanalis A, Clerici M, Caslini M, Gaudio S, Serino S, Riva G, Carrà G. Predictors of initiation and persistence of recurrent binge eating and inappropriate weight compensatory behaviors in college men. Int J Eat Disord 2016; 49:581-90. [PMID: 27062291 DOI: 10.1002/eat.22535] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 02/21/2016] [Accepted: 02/21/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The transition to college is considered as a risk period for the development of behavioral symptoms of eating disorders (BSEDs) and some evidence suggests that, amongst men, these symptoms occurring on a regular basis remain relatively stable over the college period. Nevertheless, little is known about factors associated with persistent engagement in and initiation of recurrent (or regular) binge eating and inappropriate weight compensatory behaviors in this population. The objective of this report was to address these research gaps. METHOD Data were examined from 2,555 male first-year college students who completed an assessment of potential vulnerability factors and BSEDs at the beginning of the autumn semester (baseline) and nine months later (end of the spring semester; follow-up). RESULTS Elevated negative affectivity, body dissatisfaction, self-objectification, and lower self-esteem at baseline were predictive of persistent engagement in regular binge eating and four compensatory behaviors (self-induced vomiting, laxative/diuretic abuse, fasting, exercise) at follow-up, as well as initiation of all these behaviors occurring regularly (i.e., at least weekly for 3 months). Self-objectification (thinking and monitoring the body's outward appearance from a third-person perspective) emerged as the largest contributor of both the initiation and persistence of all behavioral symptoms. DISCUSSION Data emphasize that the same psychological factors underlie initiation and persistence of recurrent BSEDs and should shape the focus of future interventions for college men. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:581-590).
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Affiliation(s)
- Antonios Dakanalis
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy
| | - Massimo Clerici
- Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy
| | - Manuela Caslini
- Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy
| | - Santino Gaudio
- Centre for Integrated Research, University Campus Bio-Medico, Rome, Italy.,Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Silvia Serino
- Department of Psychology, Catholic University, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Catholic University, Milan, Italy.,Applied Technology for Neuropsychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Carrà
- Department of Surgery and Interdisciplinary Medicine, University of Milan-Bicocca, Milan, Italy.,Division of Psychiatry, Faculty of Brain Sciences, University College of London, London, United Kingdom
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Achamrah N, Coëffier M, Déchelotte P. Physical activity in patients with anorexia nervosa. Nutr Rev 2016; 74:301-11. [DOI: 10.1093/nutrit/nuw001] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Noetel M, Miskovic-Wheatley J, Crosby RD, Hay P, Madden S, Touyz S. A clinical profile of compulsive exercise in adolescent inpatients with anorexia nervosa. J Eat Disord 2016; 4:1. [PMID: 26855778 PMCID: PMC4744387 DOI: 10.1186/s40337-016-0090-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/14/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The aim of the current study was to contribute to the development of a clinical profile of compulsive exercise in adolescents with Anorexia Nervosa (AN), by examining associations between compulsive exercise and eating and general psychopathology. METHOD A sample of 60 female adolescent inpatients with AN completed a self-report measure of compulsive exercise and a series of standardized self-report questionnaires assessing eating and general psychopathology. RESULTS Higher levels of compulsive exercise were associated with increased levels of eating disorder psychopathology and anxiety. Specifically, the avoidance aspect (negatively reinforced) of compulsive exercise was associated with elevated scores on measures of eating disorder, anxiety, depression, and obsessive compulsiveness psychopathology, as well as lower self-esteem scores. The mood improvement value (positively reinforced) of compulsive exercise, however, did not reflect such trends. CONCLUSIONS Compulsive exercise driven by avoidance of negative affect is associated with more severe psychological features in adolescent inpatients with AN. The current findings emphasize the need for research and clinical efforts in the development of treatments addressing avoidance of negative affect and compulsive exercise in adolescents with AN.
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Affiliation(s)
- Melissa Noetel
- />School of Psychology, The University of Sydney, Sydney, Australia
| | - Jane Miskovic-Wheatley
- />Eating Disorder Service at The Sydney Children’s Hospitals Network, Westmead, Australia
- />Westmead Clinical School, The University of Sydney, Sydney, Australia
| | - Ross D. Crosby
- />Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
- />Neuropsychiatric Research Institute, Fargo, USA
| | - Phillipa Hay
- />Centre for Health Research, School of Medicine, Western Sydney University, Penrith, Australia
| | - Sloane Madden
- />Eating Disorder Service at The Sydney Children’s Hospitals Network, Westmead, Australia
- />Discipline of Pediatrics, Faculty of Medicine, The University of Sydney, Sydney, Australia
| | - Stephen Touyz
- />School of Psychology, The University of Sydney, Sydney, Australia
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Forrest LN, Smith AR, Fussner LM, Dodd DR, Clerkin EM. Using implicit attitudes of exercise importance to predict explicit exercise dependence symptoms and exercise behaviors. PSYCHOLOGY OF SPORT AND EXERCISE 2016; 22:91-97. [PMID: 26195916 PMCID: PMC4505176 DOI: 10.1016/j.psychsport.2015.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
OBJECTIVES "Fast" (i.e., implicit) processing is relatively automatic; "slow" (i.e., explicit) processing is relatively controlled and can override automatic processing. These different processing types often produce different responses that uniquely predict behaviors. In the present study, we tested if explicit, self-reported symptoms of exercise dependence and an implicit association of exercise as important predicted exercise behaviors and change in problematic exercise attitudes. DESIGN We assessed implicit attitudes of exercise importance and self-reported symptoms of exercise dependence at Time 1. Participants reported daily exercise behaviors for approximately one month, and then completed a Time 2 assessment of self-reported exercise dependence symptoms. METHOD Undergraduate males and females (Time 1, N = 93; Time 2, N = 74) tracked daily exercise behaviors for one month and completed an Implicit Association Test assessing implicit exercise importance and subscales of the Exercise Dependence Questionnaire (EDQ) assessing exercise dependence symptoms. RESULTS Implicit attitudes of exercise importance and Time 1 EDQ scores predicted Time 2 EDQ scores. Further, implicit exercise importance and Time 1 EDQ scores predicted daily exercise intensity while Time 1 EDQ scores predicted the amount of days exercised. CONCLUSION Implicit and explicit processing appear to uniquely predict exercise behaviors and attitudes. Given that different implicit and explicit processes may drive certain exercise factors (e.g., intensity and frequency, respectively), these behaviors may contribute to different aspects of exercise dependence.
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Affiliation(s)
- Lauren N. Forrest
- Department of Psychology, Miami University, 90 N. Patterson Dr., Oxford, OH 45056
| | - April R. Smith
- Department of Psychology, Miami University, 90 N. Patterson Dr., Oxford, OH 45056
- Correspondence concerning this article should be addressed to April R. Smith, Department of Psychology, Miami University, Oxford, OH 45056, USA. Telephone: +001 513-529-3751; Fax: +001 513-529-2420;
| | - Lauren M. Fussner
- Department of Psychology, Miami University, 90 N. Patterson Dr., Oxford, OH 45056
| | - Dorian R. Dodd
- Department of Psychology, Miami University, 90 N. Patterson Dr., Oxford, OH 45056
| | - Elise M. Clerkin
- Department of Psychology, Miami University, 90 N. Patterson Dr., Oxford, OH 45056
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