The role of age, gender, mood states and exercise frequency on exercise dependence

The relationship between exercise commitment and college students' exercise adherence: The chained mediating role of exercise atmosphere and exercise self-efficacy

OBJECTIVE

This study aims to explore the mechanisms underlying exercise commitment, exercise atmosphere, exercise self-efficacy, and exercise adherence among college students, as well as the impact of gender differences on these mechanisms.

METHODS

Using a stratified cluster sampling method, 984 college students (aged 19.74 ± 1.25 years) from six universities in Anhui, Shandong, and Shaanxi provinces were randomly selected, with 403 male students and 581 female students. They had completed the Exercise Commitment Scale (ECC), Physical Exercise Atmosphere Scale (PEAS), Exercise Self-Efficacy Scale (ESES), and Exercise Adherence Scale (EPS). The study variables were analyzed in sequence for reliability and validity, correlation analysis, regression analysis, structural equation model testing, and bias-corrected percentile Bootstrap testing using SPSS 23.0 software and Hayes' (2013) Process plug-in.

RESULTS

Exercise commitment significantly positively predicted exercise adherence (β = 0.796, p < 0.01), exercise commitment significantly positively predicted exercise environment and exercise self-efficacy (β = 0.645, p < 0.01, β = 0.356, p < 0.01), exercise environment significantly positively predicted exercise self-efficacy and exercise adherence (β = 0.344, p < 0.01, β = 0.144, p < 0.01), and exercise self-efficacy significantly positively predicted exercise adherence (β = 0.934, p < 0.01). The mediating role of exercise environment in the relationship between exercise commitment and exercise adherence does not exist in male college students, while it exists in female college students.

CONCLUSIONS

Exercise atmosphere and exercise self-efficacy play a mediating role between exercise commitment and exercise adherence, with a total mediating effect value of 0.796. This study indicates that exercise commitment not only directly predicts exercise adherence, but also indirectly predicts exercise adherence through the chained mediating effects of exercise atmosphere and exercise self-efficacy. The above-mentioned mediating effect exists in female college students, while some mediating effects do not exist in male college students, thus gender has a significant impact on this mediating effect.

The Associations between Obsessive Compulsive Personality Traits, Self-Efficacy, and Exercise Addiction

Exercise addiction refers to maladaptive exercise patterns involving compulsivity and addiction-like behaviors. Exercise addiction has been found to relate to negative physical and mental health outcomes such as heart abnormalities, physical injuries, and interpersonal conflicts. Based on the social cognitive theory, this study investigated the extent to which the interplay of obsessive compulsive personality disorder (OCPD) traits and self-efficacy beliefs would influence the development and maintenance of exercise addiction. A total of 1228 college students in the United States responded to an online survey. Based on cut-off scores of the Revised Exercise Addiction Inventory, the prevalence estimates of exercise addiction were 4.0% for males and 1.8% for females. Results showed that males are more prone to exercise addiction than females. Also, OCPD traits and self-efficacy significantly predicted exercise addiction after controlling for age and sex. Self-efficacy acted as a moderator in influencing the relationship between OCPD traits and exercise addiction, especially for females. At high levels of self-efficacy, more OCPD traits were significantly associated with a higher risk of exercise addiction. However, at low levels of self-efficacy, there was no association between OCPD traits and exercise addiction. The findings suggest that public education and intervention for exercise addiction should attend to the interplay between personality factors and sex.

Exercise Dependence in Practitioners of Martial Arts and Combat Sports

BACKGROUND

The aim of this study was to analyse prevalence exercise dependence among practicing martial arts and combat sports.

METHODS

There were 166 respondents. The Exercise Dependence Scale-EDS was used.

RESULTS

The martial arts practitioners obtained a lower result in the 'intention effects' (p < 0.05; η² = 0.03), 'continuance' (p = 0.04; η² = 0.03), 'lack of control' (p < 0.05; η² = 0.03), 'reduction in other activities' (p = 0.04; η² = 0.03), and 'total score' (p = 0.04; η² = 0.03) than the combat sports athletes. Both the respondents with a high training rank (p < 0.05) and subjects with above 5 years of training experience (p = 0.03; η² = 0.03) achieved the higher mean in the 'time' subscale. Women obtained lower results in the case of 'tolerance' (p = 0.04; η² = 0.04). The regression coefficient indicates that the higher respondent's age, the lower total score she/he will achieve in the EDS.

CONCLUSIONS

The findings have practical implications for identifying subjects 'at-risk for exercise dependence' symptoms, and may aid coaches and individuals in the implementation of a prevention program, to seek suitable support.

Dances with Social Robots: A Pilot Study at Long-Term Care

Dance therapy can have significant physical, emotional and cognitive benefits for older adults. In particular, social robots can be developed to autonomously facilitate dance sessions to engage these individuals with the aim of improving quality of life. To successfully integrate and promote long-term use of social robots into long-term care homes for such recreational activities, it is important to explore both residents’ and staff’s perceptions of such robots. In this paper, we present the first pilot human–robot interaction study that investigates the overall experiences and attitudes of both residents and staff in a long-term care home for robot-facilitated dance sessions. In general, the questionnaire results from our study showed that both staff and residents had positive attitudes towards the robot-facilitated dance activity. Encouraging trends showed residents had higher ratings for statements on perceived ease of use, safety, and enjoyment than the staff. However, the staff had a statistically significantly higher rating for willingness to use the robots for dance facilitation. Some key statistical differences were also determined with respect to: (1) gender within the resident group (men had higher ratings for the robots being useful in helping facilitate recreational activities), as well as between staff and residents (resident men had higher perceived safety), and (2) prior robot experience (residents with limited prior experience had higher ratings on perceived ease of use and perceived enjoyment than staff with the same level of experience). The robot-facilitated dance activity was positively received by both older adults and staff as an activity of daily living that can enhance wellbeing while also being safe, easy to use and enjoyable.

Alexithymia, reward sensitivity and excessive exercise in non-binge-eaters versus severe binge eaters: Implications for primary and secondary exercise dependence

A distinction has been made between primary and secondary exercise dependence, with the latter defined as excessive exercise secondary to disordered eating and weight concerns. Based on theoretical considerations from research on the roles of trait factors in addictions, the present study used validated scales to assess alexithymia, sensitivity to reward and punishment, emotion regulation and interoception in relation to exercise dependence symptoms in Australian male and female non-binge eaters (n = 228) and severe binge eaters (n = 126) aged 18-30 yr. In both groups, exercise dependence symptoms were significantly positively associated with reward sensitivity and interoceptive awareness, with the latter two variables predicting exercise dependence symptoms in hierarchical regression models; punishment sensitivity was significantly negatively related to such symptoms. Alexithymia was significantly associated with exercise dependence symptoms only in non-binge eaters; in severe binge eaters, alexithymia explained 0% of unique variance. Male sex was associated with more exercise dependence symptoms in severe binge eaters only. Participants in the severe binge group scored significantly higher on measures of exercise dependence, alexithymia, risky alcohol use, and sensitivity to reward and punishment, and significantly lower on emotion regulation, compared to those in the non-binge group. Hierarchical regression models explained 25% of variance in exercise dependence symptoms in non-binge-eaters and 43% in severe binge eaters. Findings are discussed in terms of the distinction between primary and secondary exercise dependence, the role of alexithymia, study limitations including data collection during the COVID-19 pandemic in Australia, and suggestions for future research.

Exercise Dependence and Anxiety in Cross-Trainers, Bodybuilders and Gym Exercisers During COVID19

The World Health Organization declared the COVID-19 pandemic an international public health emergency in January 2020, and, soon thereafter, a worldwide adoption of quarantine and physical isolation measures restricted regular practitioners of indoor group physical exercise from many of their usual practices. Some, with exercise dependence (ED), may have experienced exercise withdrawal symptoms that triggered unhealthy anxiety levels. In February 2021, during Portugal’s second COVID-19 lockdown, we characterized and compared ED and anxiety levels among different groups of indoor exercise practitioners (cross trainers [CG], bodybuilders [BG] and gym practitioners [GG]). In this cross-sectional study, we recruited 234 adult participants through the internet. To assess participants’ ED and anxiety levels, we used Portuguese versions of the ED Scale-21 (EDS-21) and the State-Trait Anxiety Inventory (STAI-State; STAI-Trait). ED symptoms were evident in all participant subgroups, and we found no gender differences in ED. Anxiety was higher among women than men in CG and GG groups, and there were significant differences in ED between groups such that BG practitioners showed higher ED than GG and CG practitioners (small effect size). Bodybuilders reported most ED behavior, followed by CG and regular gym exercisers, but on some criteria BG and CG groups had similar ED levels. Our results are in line with prior ED prevalence reports conducted before COVID-19 restrictions among regular GG, but these are the first data to report a higher ED prevalence among BG and CG, relative to GG.

Benefits, Risks and Gender Differences in Sport, and Exercise Dependence: Key Role of Alexithymia

The literature has long highlighted the benefits of sport, but too much sport could indicate a dependence without a substance, namely exercise dependence. The literature has only recently investigated this issue and therefore several questions are open, particularly with regard to psychopathological significance and gender differences. The aim of this paper is to investigate whether young subjects (M = 20 years) with a risk of exercise dependency and non-dependent symptomatic display other behavioural and psychological suffering and discomforts, or whether such an investment in physical activity is compatible with a framework of relative well-being; and if there are differences related to gender. A total of 396 subjects were involved in this study. Exercise Dependence Scale, Toronto Alexithymia Scale, Subjective Happiness Scale, Satisfaction with Life Scale and an ad hoc questionnaire with information relating to the consumption of alcohol, soft and hard drugs, quality of sleep and nutrition, affective and friendship relationships, hobbies, presence of psychological or physical disorders, motivations for sporting activity, and any traumatic experiences were used. With regard to the Exercise Dependence Scale (EDS), the prevalence of subjects at risk of exercise dependence was 1.5% and that of non-dependents symptomatic was 31.3%. Considering only men, the percentage of subjects at risk of exercise dependence rose to 3% and that of non-dependents symptomatic to 47.9%. Our data support the hypothesis that the risk of exercise dependence and the symptomatic condition without dependence can occur in situations of relative well-being (happiness, satisfaction, relationships) without significant associations with other problematic behaviours. Modest consumption of soft drugs is reported in non-dependent symptomatic subjects. The hypothesis of increased levels of alexithymia is confirmed but limited to the male gender. Gender differences are confirmed in the frequency and motivation to practice sport and in the risk of dependence. It is important that the assessment of addiction risk is integrated with the assessment of alexithymia and personal and social resources over time.

Associations between Impulsivity and Exercise Addiction, Disordered Eating, and Alcohol Use Behaviors: A Latent Profile Analysis

BackgroundDespite the known negative consequences of exercise addiction and preliminary evidence suggesting that it may co-occur with other health risk behaviors, no studies to date have examined exercise addiction among college students in conjunction with disordered eating behaviors and alcohol use. The aim of this study was to describe which college students are most at-risk for co-occurring health risk behaviors to enhance the efficiency of health risk prevention efforts. Method: Guided by multidimensional theories of impulsivity and substance use models of comorbidity, this study used latent profile analysis to examine whether separate, conceptually meaningful profiles of risk for exercise addiction, disordered eating behaviors, and alcohol use would emerge among 503 college students from a large public university. Results: The best-fitting model supported three profiles. MANOVA results revealed significant profile differences based on exercise addiction, binge eating, purging, laxative/pill/diuretic use, exercising longer than 60 minutes, negative urgency, and problematic alcohol use. Profile 3 students (n = 29), labeled the Affect Driven Health Risk-Takers, demonstrated the highest levels of impulsivity (i.e., negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) and the most risk behaviors compared to the other two profiles. Profile membership was associated with distinct levels of negative urgency, exercise addiction, disordered eating behaviors, and problematic alcohol use. A small proportion of undergraduates demonstrated co-occurring exercise addiction, disordered eating behaviors, and problematic alcohol use. Profile membership also predicted the health outcomes of clinically significant exercise addiction and hazardous alcohol use. Conclusions: Findings illuminated how patterns of risk behavior engagement were associated with clinically significant exercise addiction and hazardous alcohol use and will inform prevention efforts and clinical interventions with at-risk college students.

Investigating Strategies for Robot Persuasion in Social Human-Robot Interaction

Persuasion is a fundamental aspect of how people interact with each other. As robots become integrated into our daily lives and take on increasingly social roles, their ability to persuade will be critical to their success during human-robot interaction (HRI). In this article, we present a novel HRI study that investigates how a robot's persuasive behavior influences people's decision making. The study consisted of two small social robots trying to influence a person's answer during a jelly bean guessing game. One robot used either an emotional or logical persuasive strategy during the game, while the other robot displayed a neutral control behavior. The results showed that the Emotion strategy had significantly higher persuasive influence compared to both the Logic and Control conditions. With respect to participant demographics, no significant differences in influence were observed between age or gender groups; however, significant differences were observed when considering participant occupation/field of study (FOS). Namely, participants in business, engineering, and physical sciences fields were more influenced by the robots and aligned their answers closer to the robot's suggestion than did those in the life sciences and humanities professions. The discussions provide insight into the potential use of robot persuasion in social HRI task scenarios; in particular, considering the influence that a robot displaying emotional behaviors has when persuading people.

Gender and Black-White Race Differences in Young Adult Exercise Dependence Prevalence and Associated Disordered Eating

Purpose: Exercise dependence, an unhealthy preoccupation with exercise that results in physiological and psychological symptoms, may be particularly prevalent among college students given sociocultural exercise and body ideals in this population. Yet few studies have examined this phenomenon in diverse college samples. The aims of the present study were to examine gender and Black-White race differences in the prevalence of exercise dependence and associated disordered eating. Method: Undergraduates (N = 839) completed online measures of exercise dependence and disordered eating. Chi square tests were used to test for differences in prevalence, and linear regression was used to examine race and gender moderating effects on the exercise dependence-disordered eating association. Results: More men reported exercise dependence symptoms than women. More White participants reported symptoms than Black participants. Of the four gender and race combinations examined, White men had the highest proportion and Black women the lowest proportion experiencing symptoms. Gender, but not race, moderated the exercise dependence-disordered eating association. Conclusions: Although more men experience exercise dependence symptoms, women experience stronger associations between exercise dependence symptoms and disordered eating. The number of students who reported exercise dependence symptoms underscores the need for further research in this population and the development of culturally sensitive interventions.

Alike and different: Associations between orthorexic eating behaviors and exercise addiction

OBJECTIVE

Symptoms of exercise addiction, a state of compulsively engaging in intense exercise, and orthorexic eating attitudes, the obsession with eating only healthy foods, often occur together. It is assumed that some more general psychological traits underlie this association. Main aim of this report was to examine similarities and differences between orthorexic eating and addictive exercising.

METHOD

Six hundred and eight individuals completed an online survey (mean age: 27.5, SD = 11.0 years; 76.5% women) measuring exercise addiction (Exercise Addiction inventory, EAI), orthorexic eating (Düsseldorfer Orthorexie Skala, DOS), personality domains (Big-Five Inventory-10), anxiety and depression (Hospital Anxiety and Depression Scale).

RESULTS

Correlations between the DOS and EAI were .43 in women and .62 in men. Structural equation models identified gender-specific as well as behavior-specific psychological correlates. Among women, anxiety correlated with both EAI and DOS. In addition, the DOS correlated with depression and neuroticism while the EAI correlated with conscientiousness. In men, both scales were associated with conscientiousness and the EAI also correlated with extraversion. Clusterability analysis provided no evidence for clusters based on DOS and EAI.

DISCUSSION

Present results showed a substantial correlation between addictive exercising and orthorexic eating, however, coefficients were smaller than expected and appeared higher in men. Both behaviors shared few psychological traits (anxiety in women, conscientiousness in men) thereby questioning the assumption of a similar origin. Additionally, gender-specific psychological correlates point to the need for different disease management approaches in women and men.

Different Effects of the COVID-19 Pandemic on Exercise Indexes and Mood States Based on Sport Types, Exercise Dependency and Individual Characteristics

Exercise indexes have been affected by the coronavirus disease 2019 (COVID-19) pandemic and its related restrictions among athletes. In the present study, we investigated the exercise frequency and intensity before and during the COVID-19 pandemic, and also current exercise dependency and mood state among non-contact individual, contact individual, and team sports athletes. A total of 1353 athletes from non-contact individual sports athletes (NCISA), contact individual sports athletes (CISA) and team sport athletes (TSA) participated; 45.4% of them were females that completed a series of self-rating questionnaires covering sociodemographic information, former and current exercise patterns, exercise dependency and mood states. NCISA had less exercise frequency than CISA, both before and during the COVID-19 pandemic, and NCISA had less exercise frequency than TSA during the COVID-19 pandemic. Regarding exercise intensity, CISA had higher scores than NCISA and TSA before the COVID-19 pandemic, and CISA had more exercise intensity than TSA during the COVID-19 pandemic. Frequency and intensity were reduced from before to during the COVID-19 pandemic in the three groups, except for TSA intensity. In addition, positive and negative mood states were correlated with exercise dependency. CISA were more discouraged and vigorous than NCISA and TSA, respectively. For NCISA, CISA, and TSA, ordinal regressions separately showed that adherence to quarantine and exercise dependency were better predictors of exercise indexes. Finally, exercise dependency subscales were different among sports, but it was not in exercise dependency itself. Although the decrease in exercise indexes was noticeable, there was no consistent pattern of change in exercise behavior in all sports. Additionally, during the COVID-19 pandemic, negative moods were predominant among all athletes. The results discussed are based on exercise nonparticipating, sport type, and affect regulation hypothesis.

Associations between Self-Esteem, Psychological Stress, and the Risk of Exercise Dependence

Body concerns and stress-related disorders are increasing in the younger population in a wide range of nations. Studies find links between both self-worth, exercise dependence, and self-esteem in relation to stress, but few have considered all three variables in relation to one another. The present study explored whether the co-appearance of high levels of psychological distress, and low levels of self-esteem may be a vulnerability factor for developing exercise dependence by studying the links between self-esteem, psychological stress, and exercise dependence. A standardized cross-sectional questionnaire was completed by 203 regular exercisers attending two gyms (mean age: 35.9 years). The variables self-esteem, psychological distress, and exercise dependence were all significantly correlated with each other, even after weekly exercise amount, age, and gender had been accounted for. Those who exercised for more than 9 h per week had a significantly higher score on stress and exercise dependence symptoms, and a lower score on self-esteem compared with the remaining groups. One could hypothesize that low self-esteem is a vulnerability factor and high psychological stress a maintenance factor for an exercise-dependent person. It is argued that more focus should be directed toward the negative consequences of excessive exercise.

Exercise and Use of Enhancement Drugs at the Time of the COVID-19 Pandemic: A Multicultural Study on Coping Strategies During Self-Isolation and Related Risks

Introduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance. Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown. Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs. Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise. Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses.

Relationships between incidental physical activity, exercise, and sports with subsequent mood in adolescents

Physical activity is beneficial for human physical health and well-being. Accordingly, the association between physical activity and mood in everyday life has been a subject of several Ambulatory Assessment studies. This mechanism has been studied in children, adults, and the elderly, but neglected in adolescents. It is critical to examine this mechanism in adolescents because adolescence plays a key role in human development and adolescents' physical activity behavior translates into their behavior in adulthood. We investigated adolescents' mood in relation to distinct physical activities: incidental activity such as climbing stairs; exercise activity, such as skating; and sports, such as playing soccer. We equipped 134 adolescents aged 12-17 years with accelerometers and GPS-triggered electronic diaries to use in their everyday life. Adolescents reported on mood repeatedly in real time across 7 days, and these data were analyzed using multilevel-modeling. After incidental activity, adolescents felt better and more energized. After exercise, adolescents felt better but less calm. After sports, adolescents felt less energized. Analyses of the time course of the effects confirmed our findings. Physical activity influences mood in adolescents' everyday life, but has distinct effects depending on the kind of physical activity. Our results suggest incidental and exercise activities entail higher post-bout valence compared to sports in competitive settings. These findings may serve as an important empirical basis for the targeted application of distinct physical activities to foster well-being in adolescence.

Validation of the Intuitive Exercise Scale in Patients With Eating Disorders

Unhealthy cognitive–emotional relationships with exercise can hinder positive treatment outcomes when left unaddressed. However, clinicians lack validated tools to monitor this aspect of treatment. This study examined the 14-item Intuitive Exercise Scale with 165 patients in the United States (Mage = 26.48 years) who were receiving treatment for an eating disorder. The original factor structure was inadequate for the current sample, and exploratory factor analysis generated three factors—emotional exercise, body intuition, and exercise variety. The three-factor solution yielded strong internal consistency and partial support for the scale’s validity. Furthermore, patients scored lowest in body intuition, confirming low awareness of bodily cues common in patients with eating disorders. This study informs how clinicians may integrate and monitor patients’ cognitive–emotional relationship with exercise as part of holistic and intuitive eating disorder treatment approaches.

A descriptive study of exercise dependence: a short report among Italian and Japanese runners

Background: Exercise dependence is a phenomenon characterized by behavioral, physiological and psychological symptoms similarly to substance use disorders. Although exercise addiction is not classified as a mental health disorder. A descriptive study of exercise dependence in two different countries, Italy and for the first time Japan was performed.Methods: We interviewed 229 Italian and 198 Japanese runners by using the exercise dependence scale-21 (EDS-R), a questionnaire to assess exercise dependence.Results: In Italy, 86.9% of subjects were nondependent symptomatic, 4.4% wxercise-dependent, and 8.7% were nondependent asymptomatic. In Japan, participants were classified as nondependent symptomatic (49%) and nondependent asymptomatic (51%), but none considered as at-risk. Significant differences were found in all the seven EDS-R categories between the two cohorts.Conclusions: Exercise dependence is a complex with many contributing factors such as neuroadaptation to protracted exposure to exercise, runner's features and contextual factors. The role of social and cultural factors of exercise dependence would need further investigations.

Psychological Determinants of Continued Obesity One-Year Postbariatric Surgery

OBJECTIVE

Bariatric surgery is an effective treatment for obesity; however, an estimated 20% of patients do not experience significant weight loss postsurgery. This study examined the interaction of potential psychological factors and their mediating effects on the emotional eating of individuals one-year postbariatric surgery.

METHOD

Three-hundred and sixty-six obese individuals (348 females; 95.1%) with a body mass index greater than 30 kg/m² (M = 39.14; SD = 7.67) completed the Patient Health Questionnaire, the Brief Cope, the Big-Five Mini-Marker of Personality, and the Three-Factor Eating Questionnaire R-18.

RESULTS

The variance accounted for in emotional eating by age and 12 psychological factors were assessed via a four-step hierarchical multiple regression. Avoidant coping and the personality traits of extraversion, agreeableness, and in contrast to that hypothesized, emotional stability were significant predictors of emotional eating. Avoidant coping partially mediated the relationships of extraversion and emotional stability with emotional eating and fully mediated the relationship of agreeableness.

CONCLUSION

Certain personality traits may influence the preferred coping style chosen by individuals who experience continued obesity after bariatric surgery. Additional supports and tailored interventions that are matched with the needs of this population may subsequently be necessary to overcome emotional eating and improve weight loss.

Prevalence and Correlates of Exercise Addiction in the Presence vs. Absence of Indicated Eating Disorders

Despite the many benefits of regular, sustained exercise, there is evidence that exercise can become addictive, to the point where the exerciser experiences negative physiological and psychological symptoms, including withdrawal symptoms upon cessation, training through injury, and the detriment of social relationships. Furthermore, recent evidence suggests that the etiology of exercise addiction is different depending on the presence or absence of eating disorders. The aim of this study was to explore to what extent eating disorder status, body dysmorphic disorder, reasons for exercise, social media use, and fitness instructor status were associated with exercise addiction, and to determine differences according to eating disorder status. The key findings showed that the etiology of exercise addiction differed according to eating disorder status, with variables including social media use, exercise motivation, and ethnicity being uniquely correlated with exercise addiction only in populations with indicated eating disorders. Furthermore, body dysmorphic disorder was highly prevalent in subjects without indicated eating disorders, and could be a primary condition in which exercise addiction is a symptom. It is recommended that clinicians and practitioners working with patients who present with symptoms of exercise addiction should be screened for eating disorders and body dysmorphic disorder before treatments are considered.

Prevalence of Risk for Exercise Dependence: A Systematic Review

BACKGROUND

Exercise dependence (EXD) can be considered an addictive behaviour because it presents signs typical of other addictive behaviours. Despite possible health problems related to EXD, the prevalence of risk for EXD has never been systematically reviewed.

OBJECTIVE

This article aimed to systematically review the prevalence of risk for EXD.

METHODS

Studies were identified from searches in the ERIC, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science electronic databases up to June 2018. Empirical studies were selected if (1) they included the outcomes of the prevalence of EXD; (2) participants were regular exercisers; and (3) they were published in either the English, French, Portuguese, or Spanish languages. A total of 34 articles met the inclusion criteria.

RESULTS

The prevalence of risk for EXD was estimated to be between 3 and 7% of regular exercisers and the university student population, and between 6 and 9% of the athlete population.

CONCLUSION

The results of this review indicated that the prevalence of risk for EXD varies with the characteristics of the exerciser, but an overall prevalence of 3-9% is estimated. Risk for EXD is a cause for concern and, from a public health point of view, is a problem that has to be addressed.

Do It, Don't Feel It, and Be Invincible: A Prolog of Exercise Addiction in Endurance Sports

The social relevance of endurance sports has increased people's motivation to engage in these particular physical activities, associating their practice with a particular lifestyle (e.g., feeling victorious and a feeling of self-improvement). Therefore, the dark personality traits (not because they are negative but because they are more hidden), understood as a personal and adaptive response to the psychosocial relationships that athletes establish while practicing these sports. Following these arguments, Grit has been used to trace the response of athletes in their quest to improve performance and endurance in the face of common setbacks suffered as a result of long hours of training. Empirical studies should help to discover how these personality traits can pose real challenges to their adaptation, and what the impact of their psychological response may be in a functional or dysfunctional way [e.g., exercise addiction (EA)], in order to classify them as risk or protective factors. Through transversal design, the present study sought to explore the relationship between Grit and Dark Traits of Personality regarding the appearance of EA in a sample (N = 241) of amateur endurance sport athletes (M age = 31.80; SD = 9.87). The results show that men not only score higher for addiction levels but also for narcissism (grandiosity feelings) and psychopathy (coldness) factors. If signs of narcissism and Machiavellianism increase, perseverance efforts grow too, and the likelihood of EA increases considerably. The conclusions drawn on the basis of the results allow us to place consistency of interest as a protective factor for the EA, whereas Dark Traits of personality - especially Machiavellianism - constitute a risk factor.

Risk of Dependence on Sport in Relation to Body Dissatisfaction and Motivation

The aim of this study was to investigate the risk of dependency on physical exercise in individual sportspeople and the relationship with body dissatisfaction and motivation. Two hundred and twenty-five triathletes, swimmers, cyclists, and athletics competitors aged 18 to 63 years old took part in the study, of which 145 were men (M = 35.57 ± 10.46 years) and 80 were women (M = 32.83 ± 10.31 years). The EDS-R (Exercise Dependence Scale-Revised) was used to study dependency on exercising, the Body Shape Questionnaire (BSQ) was used to study body dissatisfaction, the Behaviour Regulation in Exercise Questionnaire (BREQ-3) was used to determine the participants’ motivation and the BIAQ was used to analyse conducts of avoidance to body image. The obtained results show that 8.5% of the subjects have a risk of dependency on exercise and 18.2% tend to have corporal dissatisfaction, without meaningful differences in the kind of sport they practiced. However, there were important differences concerning the dependency on physical exercise (15% vs. 4.8%) and body dissatisfaction (31.1% vs. 11%) in relation to sex, with the higher percentages referring to women. Introjected regulation and the conduct of food restriction were predictor variables of the dependency on exercise and corporal dissatisfaction. Also, the number and duration of sessions; the age of the participants; the integrated, introjected, and external regulations surrounding social activities; and eating restraints could all predict dependence on physical exercise (DPE).

Examining the relationship between fitness-related self-conscious emotions, disordered eating symptoms, and morbid exercise behavior: An exploratory study

BACKGROUND AND AIMS

Theoretical models of morbid exercise behavior (MEB) suggest that it may emerge as a result of complex interactions between a range of psychosocial factors. However, in spite of fitness-related self-conscious emotions involving such factors, their relationship with the risk of MEB has never been investigated. Consequently, this study had two objectives. First, to explore the relationship that fitness-related self-conscious emotions have with (a) symptoms reflecting MEB as assessed by the Exercise Addiction Inventory (EAI) and the Exercise Dependence Scale-Revised (EDS-R) and (b) exercise frequency. Second, to examine whether these relationships might vary according to disordered eating symptoms.

METHODS

A sample of 646 undergraduate students (59% males; M_age = 21.25; SD_age = 2.94) completed a self-reported questionnaire.

RESULTS

After controlling for age, sex, and disordered eating symptoms, it was found that shame, hubristic pride, and authentic pride positively explained MEB; for their part, guilt (negatively) and authentic pride (positively) explained exercise frequency. The positive relationships between pride and MEB were weaker (in the case of the hubristic facet) or stronger (in the case of the authentic facet) under higher levels of disordered eating symptoms. The independent variables explained 29% (EAI), 28% (EDS-R), and 27% (exercise frequency) of the variance in dependent variables.

DISCUSSION

Tempering fitness-related emotions of shame, guilt, hubristic pride, and authentic pride may contribute to healthier exercise behavior.

When Passion Appears, Exercise Addiction Disappears

Abstract. There are approximately 1,000 published articles on exercise addiction, which is characterized by exaggerated training yielding adverse effects. In contrast, there are less than 20 identified cases of exercise addiction in the literature. Recently, it was reported that there is an association between exercise addiction and passion. To test the impact of the latter on exercise addiction, we reanalyzed the combined data from two recent studies. High- and low-exercise volume groups differed in exercise addiction even after controlling for age and sex ( p < .001). However, after adding obsessive and harmonious passion as continuous predictor variables, the statistical significance vanished, whereas both predictors emerged as significant ( p < .001). Further, when controlled for the effect of passion, the correlation between exercise addiction and weekly exercise volume turned out to be negative. Therefore, a conceptual confound between the presumed risk of exercise addiction and passion could render the results of several hundreds of published works questionable. The current findings send an important message to scholars in the field: Studying exercise addiction without controlling for passion may yield false results.

Which sports are more at risk of physical exercise addiction: A systematic review

INTRODUCTION

Excessive physical exercise may evolve into physical exercise addiction, a recently identified entity with many yet unclear aspects, such as global prevalence and variability according to different types of physical exercise.

METHODS

We systematically reviewed the current literature up to June 2018 to collect all studies screening exercise addiction with two of the most frequently used screening scales: the Exercise Addiction Inventory (EAI) and the Exercise Dependence Scale (EDS).

RESULTS

We detected forty-eight studies (20 using the EAI, 26 the EDS, and 2 both scales) reporting variable point prevalence of exercise addiction risk, depending on the target population and the investigated sport. The EAI identifies a higher proportion of people at risk for physical exercise addiction among endurance athletes (14,2%) followed by ball games (10,4%), fitness centre attendees (8,2%) and power disciplines (6,4%), while a frequency of 3,0% was reported in the general population. Studies using the EDS found discrepant results.

DISCUSSION

This systematic review suggests that sport disciplines are associated with different vulnerability for physical exercise addiction. Besides the different addictive potential of each sport, the heterogeneity of results may be also due to socio-demographic and cultural characteristics of the target populations. The EAI and the EDS identify different proportions of individuals at risk for exercise addiction both in general population and in specific sport categories. As the EAI screens a higher proportion of subjects at risk, especially in endurance disciplines, it could be more appropriate for early detection of at-risk subjects and/or disciplines.

CONCLUSION

Tailored prevention strategies for each discipline could help better preserving benefits of sports. More precision in research methods and the use of the most appropriate scale are required to allow a better comparability of prevalence among physical exercise disciplines and in general population.

The Love Addiction Inventory: Preliminary Findings of the Development Process and Psychometric Characteristics

Although the existence of dysfunctional love relationships is well known and the term “love addiction” dates back to the 1970s, empirical studies on this topic are still limited. The biggest problem is arguably is the lack of a clear definition of the love addiction construct and the lack of psychometric instruments for the assessment of its symptoms. The aim of the present study was to develop and examine the psychometric characteristics of a self-report scale assessing love addiction using the components model of behavioral addiction. Two studies based on the splitting of a total sample of 663 participants involved in an intimate relationship (for at least for 6 months) were recruited to examine the psychometric characteristics of the newly developed love addiction scale and its six-item short-form. In the first study, an exploratory factor analysis (EFA) was conducted with a sample of 329 participants. In the second study, a confirmatory factor analysis (CFA) approach was used with a sample of 334 participants engaged in a romantic relationship. In both studies, reliability and concurrent validity were also examined. Results suggested that the factor structure of the Love Addiction Inventory and its six-item short-form is in line with the theoretical framework and showed good reliability and concurrent validity. The LAI in both short and longer forms are psychometrically robust and can be used to assess love addiction in future studies.

Investigation of the Exercise Dependence of Athletes Doing Kickboxing, Taekwondo, and Muay Thai

Debates about the conditions in which the frequency and intensity principles of regular exercise, depending on the fact that a sports background can be accepted as extremism, are still a controversial topic. The purpose of this research was to investigate the exercise dependence of athletes who practice Kickboxing, Taekwondo, and Muay Thai. The study included 141 athletes, consisting of 87 men and 54 women. The Exercise Dependence Scale-21 (EDS-21), composed of 21 items developed by Hausenblas and Downs and adapted into the Turkish version by Yeltepe and İkizler, was applied to the athletes. As a result of the research, while athletes showed more sensitivity to the EDS (=71.41), this scale was also defined as symptomatic. It was found that five athletes (3.5%) were asymptomatic-nondependent, 117 athletes (83.0%) were symptomatic-nondependent, and 19 athletes (13.5%) were at risk for exercise dependence. It was determined that athletes were at risk for exercise dependence as follows: Eight athletes were doing Kickboxing, ten athletes were doing Taekwondo, and one athlete was doing Muay Thai. A significant difference was observed according to years of regular training and number of trainings per a day. Other variables presented no significant differences. It was possible to say that years of regular training could be effective in revealing exercise dependence.

Identifying the Incidence of Exercise Dependence Attitudes, Levels of Body Perception, and Preferences for Use of Fitness Technology Monitoring

Background: The study was focused on identifying the relationship between the incidence of exercise dependence attitudes, the level of body perception, and preferences for use of fitness technology monitoring. Methods: We investigated 241 students from physical education and sports specializations. We used a questionnaire structured in 5 parts: personal information (age, gender, weight, height, and institutional membership), Exercise Dependence Scale-R (EDS-21), the Compulsive Exercise Test (CET), Body perception questionnaire, and Fitness Monitoring Technology. Results: Application of EDS-21 revealed 8.3% with dependence and CET with 13.4%. Body mass index (BMI) in combination with self-image body: 18 (7.4%) of subjects over-estimated themselves, 18 (7.4%) of subjects underestimated themselves, 38.6% of the subjects were satisfied with their appearance, 17% were very satisfied and none were dissatisfied. A total of 36.1% thought they had the correct weight and 8.7% thought of losing weight. The most preferred monitoring technologies were the treadmill and the smartphone's fitness applications. A total of 11.6% of the subjects always used technologies, and 17% of subjects never did so. Conclusions: In order to identify the level of incidence of exercise dependence, body perception, and preference and frequency of use of monitoring technology, it is necessary to expand the level of knowledge about health and physical activities. The approach would diminish medical incidences of addiction, improve proactive behaviors, and correct prohealth.

Exercise dependence: Associations with capability for suicide and past suicidal behavior

OBJECTIVE

Exercise dependence has been linked to capability for suicide and suicidal behavior; however, less understood are which facets of exercise dependence confer risk for suicidal behavior and the potential mechanisms of this association. This study examined relationships between exercise dependence, capability for suicide, and past suicidal behavior.

METHODS

A sample of 540 individuals recruited via MTurk completed online measures of their exercise dependence, capability for suicide, and history of suicidal behavior.

RESULTS

Suicide attempters reported higher levels of continuance in exercise despite physical or psychological consequences, lack of control over exercise, and reductions in other activities due to exercise than nonattempters. Capability for suicide accounted for the relationship between continuance in exercise despite adverse consequences and lifetime number of suicide attempts.

CONCLUSIONS

When exercise becomes pathological in the form of exercise dependence, steps should be taken to reduce such engagement due to its observed association with suicidal behavior.

The Role of Ego Networks in Compulsive Exercise Behavior Among a Sample of College Sorority Women

Background: Compulsive exercise (CE) is a harmful form of exercise that elevates the risk of developing/sustaining clinical eating disorders. College-aged sorority women are especially prone to CE. Due to the pronounced impact social relationships have on college students’ behavior, this study aims to examine personal networks and CE among a sample of sorority women through an egocentric network analysis.Methods: A total of 204 women in a sorority from a large, private university in the southeastern United States completed a cross-sectional survey in spring 2015. Descriptive and regression analyses were conducted on demographic, attribute, and ego network data.Results: Relationships with siblings, significant others, and roommates were protective against CE in this sample. Conversely, body dissatisfaction and exercise frequency predicted CE.Conclusions: Findings suggest that social relationships can impact CE behaviors in this sample. Along with promoting body satisfaction and healthy exercise, public health efforts should focus on facilitating close interpersonal relationships, especially between sorority women and siblings, significant others, and roommates.

A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel

BACKGROUND AND AIMS

The aim of this study was to investigate the relationship between exercise addiction, abnormal eating attitudes, anxiety, and depression among competitive and amateur athletes.

METHODS

Participants were 100 athletes of mean age 28.3 years (18-62), of which there were 67 males and 35 females. The sample consisted of competitive and amateur athletes who participated in individual and group sports. They filled in the Exercise Addiction Inventory, Body Shape Questionnaire, a questionnaire assessing Eating Attitudes Test, Spielberger State-Trait Anxiety Inventory, and Beck Depression Inventory (BDI).

RESULTS

Ratings of exercise addiction were positively correlated with BDI scores across the study sample. Exercise addiction ratings were associated with abnormal eating attitudes, but not with trait or state anxiety. Athletes engaging in individual sports scored marginally higher on depression scores than group athletes but there was no difference in depression scores between competitive and amateur athletes. Multiple regression analysis revealed that abnormal eating attitudes contributed significantly to ratings of exercise addiction and explained 7.7% of the variance. According to the Sobel test, the difference in the association between exercise addiction and eating disorder was significant. Therefore, body shape was a mediating factor between eating disorder and exercise addiction.

DISCUSSION AND CONCLUSIONS

This study extends our preliminary findings of an association between exercise addiction and depression. Second, abnormal eating attitudes may explain most of the variance of exercise addiction. This is a further support for previous evidence of comorbidity between exercise addiction and eating disorders.

My mother told me: the roles of maternal messages, body image, and disordered eating in maladaptive exercise

PURPOSE

The current study examined the relevance of familial environment (negative maternal messages) to the phenomenon of maladaptive (obligatory) exercise, defined as exercise fixation. Weight/shape concerns and exercise frequency were examined as potential mediators, evaluated both with and without eating disorder symptoms as a covariate.

METHOD

Self-report data comprising sociodemographic details and measures of parental weight messages, body image, obligatory exercise, and disordered eating symptoms were completed by 298 young female attendees of health and fitness centres.

RESULTS

The frequency of negative maternal messages demonstrated significant associations with all of weight/shape concerns, exercise frequency, exercise fixation, and eating disorder symptoms. In the initial model, partial mediation of maternal messages to exercise fixation was evident as negative maternal messages continued to have a direct effect on exercise fixation. In the second model, with the inclusion of eating disorder symptoms as a covariate, this direct effect was maintained while mediation was no longer evident.

CONCLUSIONS

The data provide further support for the association between disordered eating symptoms and maladaptive exercise, as defined by exercise fixation. Nevertheless, the importance of negative maternal messages as a key environmental enabler of exercise fixation has been demonstrated, even after the effects of weight/shape concerns and exercise frequency were accounted for. Clinically, addressing weight-related talk in the family home may reduce the incidence of problematic cognitions and behaviours associated with both maladaptive exercise and disordered eating symptoms.

Development and validation of the intuitive exercise scale

Up to 80% of individuals with eating disorders engage in dysfunctional exercise, which is characterized by exercising in excessive quantities often past the point of pain as well as compulsive feelings and negative affect when exercise is disrupted (Cook, Hausenblas, Crosby, Cao, & Wonderlich, 2015). Intuitive exercise involves an awareness of the senses while moving and attending to one's bodily cues for when to start and stop exercise, rather than feeling compelled to adhere to a rigid program (Reel, 2015). The purpose of this study was to design a measurement tool to evaluate the construct of intuitive exercise in research, treatment, and prevention settings. The 14-item Intuitive Exercise Scale (IEXS) was developed and validated in the current study with completed surveys from 518 female and male adult participants. Exploratory factor analysis was used to identify four latent constructs, including emotional exercise, exercise rigidity, body trust, and mindful exercise, which were supported via confirmatory factor analysis (CFI=0.96; SRMR=0.06). The IEXS demonstrated configural, metric, and scalar invariance across women and men. Correlations with measures of intuitive eating, exercise dependence, and exercise motivation supported convergent and discriminant validity.

Maladaptive perfectionism as mediator among psychological control, eating disorders, and exercise dependence symptoms in habitual exerciser

Background and aims The current study examined the mediating role of maladaptive perfectionism among parental psychological control, eating disorder symptoms, and exercise dependence symptoms by gender in habitual exercisers. Methods Participants were 348 Italian exercisers (n = 178 men and n = 170 women; M age = 20.57, SD = 1.13) who completed self-report questionnaires assessing their parental psychological control, maladaptive perfectionism, eating disorder symptoms, and exercise dependence symptoms. Results Results of the present study confirmed the mediating role of maladaptive perfectionism for eating disorder and exercise dependence symptoms for the male and female exercisers in the maternal data. In the paternal data, maladaptive perfectionism mediated the relationships between paternal psychological control and eating disorder and exercise dependence symptoms as full mediator for female participants and as partial mediator for male participants. Discussion Findings of the present study suggest that it may be beneficial to consider dimensions of maladaptive perfectionism and parental psychological control when studying eating disorder and exercise dependence symptoms in habitual exerciser.

Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers

BACKGROUND AND AIMS

Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers.

METHODS

The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT).

RESULTS

7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender.

DISCUSSION

The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions.

Gender differences in exercise dependence and eating disorders in young adults: a path analysis of a conceptual model

The purpose of our study was to study the prevalence of exercise dependence (EXD) among college students and to investigate the role of EXD and gender on exercise behavior and eating disorders. Excessive exercise can become an addiction known as exercise dependence. In our population of 517 college students, 3.3% were at risk for EXD and 8% were at risk for an eating disorder. We used Path analysis the simplest case of Structural Equation Modeling (SEM) to investigate the role of EXD and exercise behavior on eating disorders. We observed a small direct effect from gender to eating disorders. In females we observed significant direct effect between exercise behavior (r = −0.17, p = 0.009) and EXD (r = 0.34, p < 0.001) on eating pathology. We also observed an indirect effect of exercise behavior on eating pathology (r = 0.16) through EXD (r = 0.48, r² = 0.23, p < 0.001). In females the total variance of eating pathology explained by the SEM model was 9%. In males we observed a direct effect between EXD (r = 0.23, p < 0.001) on eating pathology. We also observed indirect effect of exercise behavior on eating pathology (r = 0.11) through EXD (r = 0.49, r² = 0.24, p < 0.001). In males the total variance of eating pathology explained by the SEM model was 5%.

Association of symptoms of attention-deficit/hyperactivity disorder with symptoms of excessive exercising in an adult general population sample

BACKGROUND

An increasing number of studies suggest that physical activity can alleviate symptoms of ADHD in children. In adults there are currently insufficient data available on this subject. Interestingly, ADHD and forms of excessive exercising have both been shown to occur more frequently in adult athletes. The aim of the present study was to empirically investigate the association of ADHD and excessive exercising in the adult general population.

METHODS

For diagnosis of adult and childhood ADHD a large representative sample of the German general population (n = 1,615) completed a retrospective assessment of childhood ADHD and a self-report assessment of adult ADHD. Excessive exercising as well as putative mediating variables such as eating related psychopathology, depression, and anxiety were assessed using standardized self-rating instruments.

RESULTS

Individuals with childhood only ADHD had a significantly higher frequency of excessive exercising (9.0%) than individuals without ADHD (2.7%). Excessive exercising was significantly associated with childhood only ADHD compared to no ADHD with an odds ratio of 3.239 even after controlling for socio-demographic variables, BMI, eating related and general psychopathology.

CONCLUSIONS

Our data show that excessive exercising is significantly overrepresented in individuals in which ADHD symptoms in childhood have not persisted into adulthood. We thus hypothesize that a subgroup of individuals might suppress ADHD symptoms by excessive sporting activities. Although in healthy adults physical activity has been associated with immediate and long term improvements in cognitive functioning, studies empirically investigating associations between the effects of physical activity and adult ADHD are rare. Further studies are warranted to explore the potential role of physical activity in the treatment of ADHD in adults.