Interpersonal, affective and compulsive features of driven exercise in anorexia nervosa

Kolar, David R.; Kaurin, Aleksandra; Meule, Adrian; Schlegl, Sandra; Dittmer, Nina; Voderholzer, Ulrich

doi:10.1016/j.jad.2022.03.044

Cited by 6 publications

(4 citation statements)

References 57 publications

(72 reference statements)

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“…Results generally suggest that various maladaptive exercise scales cannot be used interchangeably across research and practice settings, and integration and replicability of studies using the variety of measurements of maladaptive exercise that are available may be difficult, if not impossible. Given the prevalence rates of maladaptive exercise across athlete (Gorrell & Anderson, 2018), college (Scharmer et al, 2020), community (Bircher et al, 2017), and clinical (Dittmer, Voderholzer, et al, 2018; Kolar et al, 2022) samples, careful consideration of how we measure this behavior is of great importance moving forward.…”

Section: Discussionmentioning

confidence: 99%

Working out measurement overlap in the assessment of maladaptive exercise

Lampe,

Schaumberg,

Kolar

et al. 2024

Intl J Eating Disorders

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ObjectiveAlthough exercise is generally considered healthy, many individuals engage in maladaptive exercise (e.g., compulsive in nature). Several definitions of maladaptive exercise exist, leading to multiple, varied assessment tools; assuming homogeneity across these assessments contributes to low consensus in etiological models.MethodWe used a Jaccard Index to quantify content overlap among 15 commonly‐used self‐report instruments measuring maladaptive exercise, with 31 features identified across 224 items.ResultsThe most common features were exercise to control weight/shape and to avoid negative affect (both included in 9/15 instruments), or compensate for calories consumed (8/15 instruments). Overlap among instruments was low (.206) and no features were common across all instruments.ConclusionsFindings generally support theoretical models of exercise in eating pathology. However, instruments most commonly used to assess maladaptive exercise measure heterogenous content. Careful consideration should be taken when comparing findings derived from differing instruments, when synthesizing literature on maladaptive exercise, and when selecting instruments to measure specific maladaptive exercise features.Public SignificanceMany, varied, tools exist for the assessment of maladaptive exercise (e.g., compulsive or compensatory) in the context of eating disorders. Assuming homogeneity across tools contributes to low consensus in the field. We used a Jaccard Index to quantify content overlap among 15 self‐report instruments measuring maladaptive exercise. The most commonly used instruments measure heterogenous content. Careful consideration should be taken when synthesizing literature and selecting instruments to use in research.

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Section: Discussionmentioning

confidence: 99%

Working out measurement overlap in the assessment of maladaptive exercise

Lampe,

Schaumberg,

Kolar

et al. 2024

Intl J Eating Disorders

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“…High interpersonal sensitivity, considered in clinical studies primarily as a psychopathological symptom (feeling of the fragility of one’s own Self, especially intensely experienced in relationships with others) also indicates an unfavorable prognosis. It has been found that individuals engaged in intense physical exercise have higher interpersonal sensitivity, and its influence increases as compulsive traits increase [38] . In addition, high interpersonal sensitivity among adolescents with anorexia nervosa indicates a risk of re-hospitalization after a year [39] .…”

Section: Discussionmentioning

confidence: 99%

Non-suicidal self-injuries and suicide risk in adolescent girls with eating disorders: associations with weight control, body mass index, and interpersonal sensitivity

Polskaya

Basova

Razvaliaeva

et al. 2023

Consortium Psychiatricum

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ABSTRACT BACKGROUND: Eating disorders (EDs) are associated with a risk of premature death, as well as suicidal and self-injurious behavior. A low or high body mass index (BMI) and weight control behavior can also have an impact on self-injurious and suicidal behavior. While some studies show that interpersonal sensitivity is a risk factor for EDs, affective disorders, and self-injurious behavior, in-depth studies of these issues have not been done. AIM: The present study investigates how self-injurious and suicidal behavior relate to weight control behavior, BMI, and interpersonal sensitivity in adolescent girls from a clinical population with diagnosed EDs compared with adolescent girls from the general population. METHODS: The main group was comprised of 31 girls with a diagnosis of ED (as the main diagnosis or cooccurring with affective disorders, Mage=15, SD=1.13), being treated in in the Eating Disorder Clinic of the Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva. The comparison group consisted of 27 adolescent girls recruited from Proton Educational Center (Mage=15.51, SD=1.09). The measures included a qualitative survey that yielded data on weight control behavior and self-injurious behavior, a Blitz questionnaire probing the suicide risk (used only in the clinical group) and the Interpersonal Sensitivity Measure. Height and weight data were also recorded for body mass index calculation. RESULTS: The qualitative analysis of weight control behavior yielded the following results: purging behavior, restrictive behavior, and corrective behavior. Participants in the clinical group used purging and restrictive behavior more often, whereas participants in the comparison group used strategies associated with a healthy lifestyle. The clinical group and participants who practiced purging and restrictive weight control behavior in the overall sample had the smallest BMI. Self-injurious behavior was approximately evenly distributed both amongst the clinical and comparison groups. Self-cutting was the most prevalent type of self-injury. In the clinical group, self-injury was associated with a smaller BMI, while in the comparison group it was associated with an increase in the fear of rejection and overall interpersonal sensitivity. Based on the assessment of the suicide risk, six participants in the clinical group were deemed high-risk; they also displayed increased fear of rejection, dependence on the assessments of others, and overall interpersonal sensitivity. All girls in the suicide risk subgroup had nonsuicidal self-injuries. CONCLUSION: The results of our study broaden our understanding of the risk factors of suicidal and self-injurious behavior in adolescent girls with EDs and reveal the characteristics of the type of weight control behavior used by this group in comparison with adolescent girls in the general population. Girls with EDs who were considered at the risk of committing suicide demonstrated high interpersonal sensitivity, which provides a rationale for further studying the general interpersonal mechanisms that underlie the pathogenesis of EDs, as well as that of self-injurious and suicidal behavior.

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“…Indeed, a recent study investigating the validity of the Compulsive Exercise Test in a large clinical sample suggests that theoretical models of compulsive exercise may need to be improved after finding that the total score of the CET likely does not measure the same construct in different eating disorder diagnoses [ 34 ]. Furthermore, additional factors such as trait compulsivity and interpersonal difficulties have recently been shown to play a role in compulsive exercise behaviour [ 35 ]. Other research has suggested that current models of compulsive exercise insufficiently address its function, do not discriminate between exercise in anorexia nervosa and other eating disorders, and fail to consider the influence of cultural attitudes towards body shape [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

Measuring exercise in eating disorder patients: a Delphi study to aggregate clinical and research knowledge

et al. 2022

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Background Exercise is a prominent feature of most eating disorders, and has been shown to have a number of detrimental effects on treatment outcome. There is some disagreement in the literature regarding the construct of compulsive exercise, and assessment and treatment varies significantly. This study therefore aimed to aggregate expert clinicians’ and researchers’ views on how to define and measure compulsive exercise in eating disorder patients. The expert panel was also asked about questionnaire design, and possible problems when measuring compulsive exercise. Method This study used the Delphi method to establish consensus amongst an expert panel. Three successive rounds of questionnaires were distributed to the panel over a period of six months. The first round consisted of four open-ended questions regarding the definition and measurement of compulsive exercise in eating disorder patients. For Round 2, 70 statements were derived from the answers, and panelists were asked to rate each item on a Likert-based scale. An 85% consensus level was chosen. In Round 3, 44 statements were re-rated by the panel. Results Seventeen of 24 participants completed all three rounds of the study. Consensus was achieved for 63% of the items, while 18.5% reached near consensus, and 18.5% did not reach consensus after Round 3. The panel agreed on a number of important aspects of compulsive exercise. Several suggestions regarding the format of a questionnaire assessing this behavior were also endorsed. The panel further identified common difficulties when assessing compulsive exercise in eating disorder patients, notably a lack of consensus still apparent in the literature. Conclusion The current findings constitute a further step towards a unified definition of compulsive exercise, and contribute important suggestions to the measurement of this behavior.

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Interpersonal, affective and compulsive features of driven exercise in anorexia nervosa

Cited by 6 publications

References 57 publications

Working out measurement overlap in the assessment of maladaptive exercise

Working out measurement overlap in the assessment of maladaptive exercise

Non-suicidal self-injuries and suicide risk in adolescent girls with eating disorders: associations with weight control, body mass index, and interpersonal sensitivity

Measuring exercise in eating disorder patients: a Delphi study to aggregate clinical and research knowledge

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