Psychometric properties of the Compulsive Exercise Test in a large sample of female adolescent and adult inpatients with anorexia nervosa and bulimia nervosa

Schlegl, Sandra; Vierl, Larissa; Kolar, David R.; Dittmer, Nina; Voderholzer, Ulrich

doi:10.1002/eat.23694

Cited by 7 publications

(11 citation statements)

References 43 publications

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“…A sample item is "I enjoy exercising". The CET has established psychometric properties [28] and Cronbach's α in this study sample was 0.93 at baseline, 0.95 at the end of therapy, and 0.94 at six-month follow-up assessment.…”

Section: Compulsive Exercise Test (Cet) and Exercise Beliefs Question...mentioning

confidence: 76%

Impact of LEAP and CBT-AN Therapy on Improving Outcomes in Women with Anorexia Nervosa

Hay

Mohsin

Liu

et al. 2023

Behavioral Sciences

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Anorexia nervosa (AN) is a mental health disorder that has serious physical, emotional and social consequences. Whilst cognitive behavioural therapy for AN (CBT-AN) has demonstrated efficacy, there remains a global need to improve AN treatment. Compulsive exercise activity therapy (LEAP) is an active therapy consisting of the addition to CBT-AN of eight specific sessions that focus on exercise and motivation for behavioural change. This paper presents a secondary analysis of 74 female participants in a randomised control trial of LEAP plus CBT-AN versus CBT-AN alone. The main aim of this study was to explore putative predictors and to estimate the magnitude of changes due to LEAP for specific outcome measures. Participants (LEAP: n = 36; CBT-AN: n = 38) were assessed at three successive surveys: baseline, end of therapy, and 6 months post-therapy. The overall effect sizes for changes between baseline to end of therapy and baseline to 6-month follow-up assessment showed large effect sizes (Cohen’s d > = 0.80) for mental-health-related quality of life (MHRQoL), weight concern, dietary restraint, eating concern, AN stage change, and psychological distress (all p < 0.05). The results also indicated that several pre-treatment characteristics, including body mass index (BMI), level of eating disorder (ED) symptoms, and MHRQoL are important for identifying whether a treatment is likely to be effective. Future treatment programs should aim to optimise early improvements in BMI, ED symptoms, and MHRQoL.

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Section: Compulsive Exercise Test (Cet) and Exercise Beliefs Question...mentioning

confidence: 76%

Impact of LEAP and CBT-AN Therapy on Improving Outcomes in Women with Anorexia Nervosa

Hay

Mohsin

Liu

et al. 2023

Behavioral Sciences

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“…Identifying maintenance functions can inform both conceptualization and treatment of driven exercise. Previously described conceptualizations of driven exercise as exercise addiction or compulsive exercise were highly specific and did not replicate well across different contexts and stages of illness severity (Scharmer et al, 2020;Schlegl et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…It is widely used in ED research, however, the originally proposed factor structure with five subscale factors does not replicate well (for an overview, see Harris et al, 2020). We therefore only used the CET total score obtained with the German version by Schlegl et al (2022) as a measure of driven exercise severity.…”

Section: Methodsmentioning

confidence: 99%

“…rule-driven exercising) personality traits as main components of the behavior (Meyer et al, 2011). There is some agreement that the compulsive exercise model is a better fit to describe driven exercise especially in EDs (Scharmer et al, 2020), however, some model components did not fit well across different samples (Harris et al, 2020;Schlegl et al, 2022). Although these models are derived from distinct lines of research, both emphasize short-term affective consequences of driven exercise as key components in the maintenance of the behavior (for a comparison, see Kolar & Gorrell, 2020a, p. 2).…”

Section: Identification Of Affective and Social Reinforcement Functio...mentioning

confidence: 99%

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Identification of affective and social reinforcement functions of driven exercise: Evidence from three samples

Kolar¹,

Haynos²,

Wang³

et al. 2023

Preprint

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Driven exercise is a transdiagnostic maladaptive behavior, especially common in eating disorders (ED). We examined established 4- and 5-function models of reinforcement functions that might maintain driven exercise in three studies varying across developmental stages and clinical presentations (Study 1: N = 279 adolescents/adults oversampled for EDs; Study 2: N = 118 adolescent/adult inpatients with severe EDs; Study 3: N = 52 adults oversampled for athletes/EDs). Automatic positive reinforcement was most frequently endorsed, followed by control, automatic negative, social negative, and social positive reinforcement in all studies, except in inpatients (Study 2; control most endorsed). Automatic positive reinforcement was correlated with driven exercise episodes within last month in all studies, whereas associations with ED severity and psychopathology varied between functions and studies. Our findings suggest that driven exercise is maintained by both automatic and social functions. In samples with more severe EDs, control-related motivation might serve an additional maintenance function.

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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 ].…”

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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Psychometric properties of the Compulsive Exercise Test in a large sample of female adolescent and adult inpatients with anorexia nervosa and bulimia nervosa

Cited by 7 publications

References 43 publications

Impact of LEAP and CBT-AN Therapy on Improving Outcomes in Women with Anorexia Nervosa

Impact of LEAP and CBT-AN Therapy on Improving Outcomes in Women with Anorexia Nervosa

Identification of affective and social reinforcement functions of driven exercise: Evidence from three samples

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

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