Anorexia nervosa with excessive exercise: A phenotype with close links to obsessive-compulsive disorder

Davis, Caroline; Kaptein, Simone

doi:10.1016/j.psychres.2005.11.006

Cited by 100 publications

(107 citation statements)

References 59 publications

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“…A anorexia nervosa (AN) e a bulimia nervosa (BN) são os transtornos mais comuns 17 . A AN é caracterizada por perda de peso intensa e intencional devida a dietas rígidas, busca desenfreada pela magreza e grave distorção do aspecto perceptivo da imagem corporal 18 . Já a BN é caracterizada por grande ingestão de alimentos com sensação de perda de controle, preocupação excessiva com o peso e a imagem corporal, bem como a utilização de métodos compensatórios inadequados para controle do peso como vômitos, medicamentos, dietas e exercícios físicos 19 .…”

Section: Introductionunclassified

Adaptação transcultural: tradução e validação de conteúdo da versão brasileira do Commitment Exercise Scale

Teixeira¹,

Hearst²,

Matsudo³

et al. 2011

Rev. psiquiatr. clín.

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Contexto:O Commitment Exercise Scale (CES) avalia o comprometimento, o comportamento e a atitude de pacientes com transtornos alimentares em relação ao exercício físico. Objetivo: Tradução e adaptação transcultural do CES para o idioma português (BRA), validação de conteúdo e análise da consistência interna. Métodos: Envolveu cinco etapas: (1) tradução; (2) retradução; (3) revisão técnica e avaliação semântica; (4) validação de conteúdo por profissionais da área -juízes; (5) avaliação do instrumento por uma amostra de estudantes, por meio da avaliação do grau de compreensão e análise da consistência interna do instrumento pelo coeficiente a de Cronbach. Resultados: A escala foi traduzida e adaptada, sendo considerada de fácil compreensão (grau de compreensão de 4,3 a 4,9), e demonstrou valores do coeficiente aceitáveis (a de Cronbach: 0,60 a 0,79). Conclusão: A partir do processo de adaptação transcultural, os resultados satisfatórios possibilitam a recomendação da versão brasileira do CES. São necessárias análises de validação de construto, fatorial e de reprodutibilidade.Teixeira PC, et al. / Rev Psiq Clín. 2011;38(1):24-28 Palavras-chave: Tradução, escalas, estudos de validação, transtornos alimentares, exercício físico. AbstractBackground: The Exercise Commitment Scale (CES) evaluates commitment, attitude and behavior regarding exercise in eating disorders patients. Objective: Translation and cultural adaptation of the CES for Portuguese (BRA), content validation and analysis of internal consistency. Methods: This study involved five steps: (1) translation, (2) re-translation, (3) technical review and evaluation semantics, (4) content validation by professionals -judges, (5) assessment of the instrument in a sample of students, by assessing the degree of understanding and analysis of internal consistency by Cronbach's a coefficient. Results: The scale was translated and adapted. It was considered easy to understand (degree of understanding from 4.3 to 4.9) and showed acceptable consistency coefficients (Cronbach's a: 0.60 to 0.79). Discussion: Satisfactory results of this adaptation process allow the recommendation of the CES Brazilian version. Analysis is needed of construct and factorial validation, and of reproducibility.

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Section: Introductionunclassified

Adaptação transcultural: tradução e validação de conteúdo da versão brasileira do Commitment Exercise Scale

Teixeira¹,

Hearst²,

Matsudo³

et al. 2011

Rev. psiquiatr. clín.

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“…In clinical practice, a variety of methods has been used to evaluate hyperactivity: retrospective analysis of medical records (Crisp, Hsu, Harding, & Hartshorn, 1980), self-reports by means of activity diaries, experience sampling (Vansteelandt et al, 2004), questionnaires (Slade, 1973) or self-ratings using visual analogue scales (Exner et al, 2000), expert ratings using semi-structured interviews (Brewerton, Lydiard, Herzog, Brotman, O'Neil, & Ballenger, 1995;Davis & Kaptein, 2006;Davis, Kaptein, Kaplan, Olmsted, & Woodside, 1998;Davis, Kennedy, Ravelski, & Dionne, 1994) or scales of physical activity and motor restlessness and devices such as acto-and pedometers to measure movement (Blinder, Freeman, & Stunkard, 1970;Falk, Halmi, & Tryon, 1985). Although there has been no specific research on the reliability of hyperactivity self-reporting, many authors as far back as Gull (1888) have pointed out the paradoxical and ego-dystonic qualities of this symptom, even in children (Blinder et al, 1970;Davis et al, 1997;Fosson, Knibbs, Bryant-Waugh, & Lask, 1987).…”

Section: Introductionmentioning

confidence: 99%

Nurse evaluation of hyperactivity in anorexia nervosa: a comparative study

Elburg

Hoek

Kas

et al. 2007

Euro Eating Disorders Rev

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Up to 80% of patients with anorexia nervosa (AN) manifest elevated levels of physical activity or hyperactivity. A variety of methods have been used to evaluate activity levels, mostly questionnaires but also expensive and invasive methods such as actometry or other measurements of energy expenditure. Nurse observations have heretofore not been tested for validity and reliability. In this study, 18 patients with AN under treatment in a specialized eating disorder centre simultaneously rated their own physical activity levels, used an actometer, and were observed for physical activity by trained nurses. We found that nurse ratings of activity correlated significantly with the average actometer activity score (r = 0.61, p < 0.01). Patients could not rate their own activity levels accurately. Nurse observation of activity levels of AN patients during treatment is a reliable and useful monitoring tool.

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“…Extent of physical exercise was correlated with trait reward sensitivity, engagement and attentional orienting. However, the finding, in AN patients, of a positive relationship between excessive exercise and obsessive compulsive disorder is unsettling [43,44], have implied that excessive habit formation, the exercise habit, may be construed as a mechanism through which initially rewarding weight loss behavior in AN may develop a compulsiveness over time, with supervised exercise training deemed as 'safe' [45]. AN has been shown to cooccur with obsessive-compulsive disorder and depression [46].…”

Section: Discussionmentioning

confidence: 99%

Emotional Well-Being in Anorexia Nervosa: Negative Affect, Sleeping Problems, Use of Mood-enhancing Drugs and Exercise Frequency

Archer¹

2015

Arch Depress Anxiety

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The purpose of this study was to ascertain emotional well-being among patients presenting ninety anorexia nervosa (AN) and healthy age-matched controls using the Positive Affect and Negative Affect Schedule and the Emotional Well-Being Scale together with background health information. The results indicated that AN patients displayed higher levels of negative affect and negative emotions, more stress and depression, greater sleeping problems, pain, and use of analgesics and mood-enhancing drugs, as well as lower levels of positive affect and positive emotions, compared to the age-matched healthy controls. Despite their negative self-report, on the variables pertaining to affect, sleep and pain, the AN patients reported a higher frequency of physical exercise. Regression analysis indicated that the AN condition, from diagnosis, was predicted from negative affect, sleeping problems, use of moodenhancing drugs and exercise frequency. Hence, suggesting that excessive exercise together with depression, anxiety, obsessive-compulsive, additive behaviors and sleep problems represent AN from a perspective of multiple comorbidities.compared with healthy volunteers, assessed on Estonian versions of the Eating Disorder Inventory-2, positive affect and negative affect (measured by the Positive Affect and Negative Affect Schedule), and Neuroticism made the largest contribution to Eating Disorder-2 subscales, with Openness to Experience and Conscientiousness (measured by the NEO Personality Inventory), predisposing individuals to eating problems [5]. It has been shown also that patients with AN inhibit expressions of both positive and negative emotions, even after controlling for neuroticism, with higher levels of hostility and neuroticism; they were less aware of their inner thoughts and feelings, "private self-consciousness", and had a heightened awareness of the thoughts and expectations of others, "public selfconsciousness", [6]. Patients presenting eating disorders often report alexithymia, an inability to identify and describe their emotions and affective status [7,8]. They show a paucity of words expressing feelings and demonstrate difficulties in identifying and distinguishing feeling of physical sensations. Alexithymia and personal distress seem to predict the vulnerability features of Anorexia Nervosa (AN) with higher levels of personal distress in the latter linked to poor selfregulation and emotional awareness [9].There is a high comorbidity between AN and anxiety and/or alexithymia disorders [10], moreover, AN patients display certain features similar to those abusing substances/exercise, through a 'narrowed' behavioral repertoire such that weight loss, food intake restriction, and excessive exercise interfere with other activities in a similar fashion to substance/exercise abuse [11]. Further, comorbidity between AN, anxiety, depression and psychoactive substance use has been described [12]. It is likely that the disorder elevates anxiety, depression with stress presenting a predisposing factor to poorer ...

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Anorexia nervosa with excessive exercise: A phenotype with close links to obsessive-compulsive disorder

Cited by 100 publications

References 59 publications

Adaptação transcultural: tradução e validação de conteúdo da versão brasileira do Commitment Exercise Scale

Adaptação transcultural: tradução e validação de conteúdo da versão brasileira do Commitment Exercise Scale

Nurse evaluation of hyperactivity in anorexia nervosa: a comparative study

Emotional Well-Being in Anorexia Nervosa: Negative Affect, Sleeping Problems, Use of Mood-enhancing Drugs and Exercise Frequency

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