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CORK Bibliography: Exercise Addiction

28 citations. 1997 to present

Prepared: March 2009

Adams J; Kirkby RJ. Excessive exercise as an addiction: A review. Addiction Research & Theory 10(5): 415-437, 2002. (65 refs.)

Theories regarding how exercise can become addictive and studies of withdrawal from exercise are reviewed. Several physiological mechanisms, including endogenous opioids, catecholamines, and dopamine pathways, have been implicated in exercise dependence. The higher levels of endogenous opioids found following strenuous exercise has prompted researchers to suggest that a form of auto-addiction to these hormones might be responsible for continued excessive exercising in humans. As well, investigators have suggested that, exercise dependence could be the result of a dependence on the exercise-stimulated release of catecholamines resulting in an overarousal of the sympathetic nervous system. Moreover, the increased stimulation of dopaminergic brain structures by exercise, and the likely involvement of these structures in behavioral and pharmacological addictions, could provide another explanation for exercise-dependent behavior. Finally, reports of withdrawal symptoms following cessation of regular exercise have led investigators to propose that exercise can, like pharmacological and other behavioral stimuli, become addictive.

Aidman EV; Woollard S. The influence of self-reported exercise addiction on acute emotional and physiological responses to brief exercise deprivation. Psychology of Sport and Exercise 4(3): 225-236, 2003. (51 refs.)

Objectives: To examine the association between self-reported exercise addiction among competitive runners and their emotional and physiological response to a one-day deprivation from scheduled training. Design: A controlled experiment was utilised with random selection to exercise-deprived and control groups to examine the causal link between acute exercise deprivation and the presence and magnitude of withdrawal symptoms. Method: Club-level runners (n = 60) who had been training at least five times weekly towards a major regional competition (30 women and 30 men, average age: 24.2 years) volunteered to abstain from a one-day training fixture with less than 24-hours' notice. All subjects completed the Profile of Mood States (POMS), Running Addiction Scale (RAS) and resting heart rate (RHR) measurements. From this group, 15 men and 15 women were randomly selected to miss the next scheduled training (exercise-deprived group), while the remaining 30 runners continued their training uninterrupted (controls). Both groups repeated POMS and RHR measures within 24 hours after the experiment. Results: The exercise-deprived group reported significant withdrawal-like symptoms of depressed mood, reduced vigour and increased tension, anger, fatigue and confusion (measured by POMS), as well as significantly elevated RHR, within 24 hours after the missed training session. The control group showed no changes in mood or RHR. More importantly, the observed negative mood changes and RHR response in the exercise-deprived group were moderated by self-reported exercise addiction. The sub-median RAS scorers experienced significantly less mood change and RHR shifts than the higher scoring half of the sample. Further, correlations between RAS scores and the magnitude of increases in tension, anger, confusion, depression and RHR ranged from 0.46 to 0.58. Conclusions: Self-reported exercise addiction in habitual exercisers moderates their emotional and physiological responses to a short-term controlled exercise deprivation, indicating that the magnitude of these responses may, in turn, serve as early markers of exercise dependence.

Bamber D; Cockerill IM; Carroll D. The pathological status of exercise dependence. British Journal of Sports Medicine 34(2): 125-132, 2000. (42 refs.)

Objectives-This study was concerned with the concept of exercise dependence. Levels of psychological morbidity, personality profiles, and exercise beliefs were compared among subjects screened for exercise dependence and eating disorders. Method-Adult female exercisers were allocated on the basis of questionnaire screening to one of the following groups: primary exercise dependence (n = 43); secondary exercise dependence, where there was the coincidence of exercise dependence and an eating disorder (n 27); eating disorder (n = 14); control, where there was no evidence of either exercise dependence or eating disorder (n = 110). Questionnaire assessment was undertaken of psychological morbidity, self esteem, weight and body shape dissatisfaction, personality, and exercise beliefs. Results-Aside from a higher incidence of reported menstrual abnormalities, the primary exercise dependence group was largely indistinguishable from the controls. In stark contrast, the secondary exercise dependence group reported higher levels of psychological morbidity, neuroticism, dispositional addictiveness, and impulsiveness, lower self esteem, greater concern with body shape and weight, as well as with the social, psychological, and aesthetic costs of not exercising than the controls, but differed little from the eating disorder group. Conclusions-In the absence of an eating disorder, women identified as being exercise dependent do not exhibit the sorts of personality characteristics and levels of psychological distress that warrant the construction of primary exercise dependence as a widespread pathology.

Bamber D; Cockerill IM; Rodgers S; Carroll D. "It's exercise or nothing": A qualitative analysis of exercise dependence. British Journal of Sports Medicine 34(6): 423-430, 2000. (34 refs.)

Objectives-To explore, using qualitative methods, the concept of exercise dependence. Semistructured interviews were undertaken with subjects screened for exercise dependence and eating disorders. Methods-Female exercisers, four in each case, were allocated a priori to four groups: primary exercise dependent; secondary exercise dependent, where there was a coincidence of exercise dependence and an eating disorder; eating disordered; control, where there was no evidence of either exercise dependence or eating disorder. They were asked about their exercise and eating attitudes and behaviour, as well as about any history of psychological distress. Their narratives were taped, transcribed, and analysed from a social constructionist perspective using QSR NUD*IST. Results-Participants classified as primary exercise dependent either showed no evidence of exercise dependent attitudes and behaviour or, if they exhibited features of exercise dependence, displayed symptoms of an eating disorder. Only the latter reported a history of psychological distress, similar to that exhibited by women classified as secondary exercise dependent or eating disordered. For secondary exercise dependent and eating disordered women, as well as for controls, the narratives largely confirmed the a priori classification. Conclusions-Where exercise dependence, was manifest, it was always in the context of an eating disorder, and it was this comorbidity, in addition to eating disorders per se, that was associated with psychological distress. As such, these qualitative data support the concept of secondary, but not primary, exercise dependence.

Beh HC; Mathers S; Holden J. EEG correlates of 'exercise dependency'. International Journal of Psychophysiology 23(1/2): 121-128, 1996. (29 refs.)

Jacobs' (1986) proposition that dependency is the result of two sets of predisposing factors (one of which is either an excessively depressed or excited resting physiological state) was examined in relation to exercise dependency by investigating EEG characteristics of subjects committed to fitness regimes. EEG records of three groups of subjects who differed in terms of degree of dependency were studied under resting conditions both pre- and post-exercise. The results indicated that although there were no differences between groups in terms of relative power in each of five EEG bandwidths covering the range 0 to 30 Hz, the power distribution within the alpha (7.5-13 Hz) bandwidth was significantly different for high dependent and non-dependent groups under both the pre- and post-exercise conditions. While the distribution was skewed toward the lower alpha frequencies for the low dependent group, it was skewed toward the higher frequencies for the high dependent group with the distribution for a group with high involvement but low dependency falling between these extremes. This finding is taken as partial support for Jacobs' notion that dependency is associated with greater physiological excitation in the resting state.

Bell DG; McLellan TM. Exercise endurance 1, 3, and 6 h after caffeine ingestion in caffeine users and nonusers. Journal of Applied Physiology 93(4): 1227-1234, 2002. (34 refs.)

The purpose of the present study was to examine the duration of caffeine's ergogenic effect and whether it differs between users and nonusers of the drug. Twenty-one subjects (13 caffeine users and 8 nonusers) completed six randomized exercise rides to exhaustion at 80% of maximal oxygen consumption after ingesting either a placebo or 5 mg/kg of caffeine. Exercise to exhaustion was completed once per week at either 1, 3, or 6 h after placebo or drug ingestion. Exercise time to exhaustion differed between users and nonusers with the ergogenic effect being greater and lasting longer in nonusers. For the nonusers, exercise times 1, 3, and 6 h after caffeine ingestion were 32.7 +/- 8.4, 32.1 +/- 8.6, and 31.7 +/- 12.0 min, respectively, and these values were each significantly greater than the corresponding placebo values of 24.2 +/- 6.4, 25.8 +/- 9.0, and 23.2 +/- 7.1 min. For caffeine users, exercise times 1, 3, and 6 h after caffeine ingestion were 27.4 +/- 7.2, 28.1 +/- 7.8, and 24.5 +/- 7.6 min, respectively. Only exercise times 1 and 3 h after drug ingestion were significantly greater than the respective placebo trials of 23.3 +/- 6.5, 23.2 +/- 7.1, and 23.5 +/- 5.7 min. In conclusion, both the duration and magnitude of the ergogenic effect that followed a 5 mg/kg dose of caffeine were greater in the nonusers compared with the users.

Blaydon MJ; Lindner KJ; Kerr JH. Metamotivational characteristics of eating-disordered and exercise-dependent triathletes: An application of reversal theory. Psychology of Sport and Exercise 3(3): 223-236, 2002. (48 refs.)

Objectives: To compare triathletes with exercise dependence and/or eating disorders on their metamotivational characteristics using the framework of Reversal Theory. Design: Participants were classified according to their scores on an eating disorder and an exercise dependence questionnaire into a primary, a secondary, an eating disorder, and a no dependence or disorder group. These groups were contrasted on measures derived from the Motivational Style Profile [(1998) Personal. Indiv. Diff., 24, 7]. Method: Triathletes (n=171) completed instruments at competitive events in either Hong Kong or Switzerland. MANOVA and follow-up ANOVA were applied to measures of dominances and saliences. Results: There were significant differences in dominances and saliences between the exercise dependent and other groups, while the secondary group was significantly more telic dominant than the primary group. The eating disordered groups were significantly more mastery dominant than the no dependence group. There was a significant group by status interaction effect.. Conclusions: The four groups were associated with different psychological profiles, but this association was moderated by the triathletes' status as professional or amateur. The appropriateness of the commonly used terms 'primary' and 'secondary' with regard to exercise dependence is questioned.

Cox R; Orford J. A qualitative study of the meaning of exercise for people who could be labelled as 'addicted' to exercise: Can 'addiction' be applied to high frequency exercising? Addiction Research & Theory 12(2): 167-188, 2004. (36 refs.)

This is a qualitative study exploring the meaning of exercise for individuals who could be labelled as 'addicted'. Sixty people originally volunteered to participate of whom twelve scored above the midpoint on the Exercise Dependence Questionnaire (Ogden, J., Veale, D. and Summers, Z., 1997 ). Ten people were subsequently interviewed. A grounded theory approach was employed to analyse the data (Strauss, A. and Corbin, J., 1990 ). Themes that emerged were centred around control, the body, the positive and negative consequences of high frequency exercise and whether exercise is a means to an end or an end in itself. The discussion concentrates on how addiction diminished in relevance and importance for the participants when exploring meanings behind their exercising.

Davis C. Exercise abuse. International Journal of Sport Psychology 31(2): 278-289, 2000. (54 refs.)

The paper describes the behavioural and psychological parallels between compulsive exercising and other more conventional addictive behaviours like drug taking or gambling. There is also a brief overview of the biological mechanisms underlying these activities. The point is made that habitual, even excessive exercising should not be termed an abuse or an addiction unless it satisfies the clinical criteria established for other addictions. A review of the research in this area indicates consistently that there are strong links between exercise abuse and body image concerns particularly among women. There is also evidence that for some individuals exercise becomes a compulsive activity because of its mood regulating properties.

De Bourdeaudhuij I; Van Oost P. A cluster-analytical approach toward physical activity and other health related behaviors. Medicine and Science in Sports and Exercise 31(4): 605-612, 1999. (30 refs.)

Purpose: The purpose of our study was to investigate, on the basis of cluster analysis, whether healthy behavior clusters in a healthy or unhealthy way, whether physical activity can discriminate among those clusters, and whether the groups identified could be characterized by demographic variables. Methods: The relationships between physical activity and other health related behaviors were studied in three age groups, ages 16-25, 35-45, and 50-65. Almost 2400 subjects from a medium-sized Belgian town were interviewed at home to assess their level of physical activity in the past year and to obtain information on other healthy behaviors. Results: The two-cluster solution was found to be most reliable in all three age groups. Smoking discriminated most among the clusters. Cluster analysis divided each age group into a healthy and a more unhealthy subgroup, in which the healthy subgroup is larger than the unhealthy one. Sex differences were found in all three age groups, with more men in the unhealthy cluster. Socio-economic differences are especially strong in the two youngest samples. Conclusions: The hypothesis that leisure time physical activity had discriminating power between healthy and unhealthy subgroups was not confirmed. Physical activity seems to be a unique factor in contrast to other health related behaviors. In the future, specific intervention directed at the promotion of physical activity in the population is necessary.

Draeger J; Yates A; Crowell D. The obligatory exerciser: Assessing an overcommitment to exercise. (review). Physician and Sportsmedicine 33(6): 13-+, 2005. (25 refs.)

A small group of patients are overly committed to their exercise routines, possibly to the detriment of their physical and psychological well-being. The concept of obligatory exercise is difficult to define, and its prevalence has not been extensively studied. Clinicians who are aware of behavioral and personality descriptors for obligatory exercisers can identify the problem and suggest treatment options. Treatment may follow guidelines similar to those for overtraining, addiction, compulsion, and eating disorders. Preventive measures lie in understanding exercisers' attitudes and beliefs about exercise and their bodies.

Estok PJ; Rudy E. The relationship between eating disorders and running in women. Research in Nursing and Health 19(5): 377-387, 1996. (42 refs.)

The purpose of this study was to determine the extent to which eating disorders in women are related to a general tendency toward addiction, addiction to running, and level of running intensity. A stratified sample of 265 women runners/nonrunners (ages 20-35) included 66 nonrunners, 69 low-level runners, 67 medium-level runners, and 63 high-intensity runners. The women were weighed, measured, and had body fat and 4-day nutritional intake assessed. A questionnaire included scales to assess psychological and behavior traits common in women with anorexia (AN) and/or bulimia, general addiction, and running addiction. ANCOVA with age and income as covariates and multiple regression analyses were used. There were significant differences among the groups on the eating disorder scores and percent body fat with higher level runners scoring higher on eating disorder measures and running addiction and lower on body fat. A major finding for those providing health care for women was that 25% of the women who ran >30 miles/week had Eating Attitude Test scores indicating a high risk for anorexia.

Fisher LA; Wrisberg CA. Sport psychology & counseling: Recognizing and dealing with exercise addiction. (editorial). Athletic Therapy Today 9(1): 36-37, 2003

Griffiths M. Exercise addiction: A case study. Addiction Research 5(2): 161-168, 1997. (20 refs.)

Exercise addiction is an area of great speculation with only limited evidence for its existence. Despite a growing body of such literature, there have been few empirical reports and very few case studies. This paper therefore outlines a case study of a female excessive exerciser. The case study has been modelled around Brown's (1993) addictive components of salience, tolerance, withdrawal, euphoria, conflict and relapse. It is demonstrated that in the case of this individual that exercise is addictive and fulfills all of Brown's addictive components.

Griffiths MD; Szabo A; Terry A. The Exercise Addiction Inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine 39(6): e30, 2005. (11 refs.)

Background: Exercise addiction is not routinely screened for probably because available instruments take a long time to administer, their scoring may be complicated, and their interpretation is not always obvious. A new psychometric instrument has been developed that is capable of identifying people affected by, or at risk of, exercise addiction: the Exercise Addiction Inventory (EAI). A preliminary report showed the EAI had good reliability and validity. Objectives: To test further the EAI's psychometric properties and show that it would be quick and simple to administer by general practitioners. Methods: A sample of 200 habitual exercisers were given the EAI and two existing exercise addiction scales (obligatory exercise questionnaire; exercise dependence scale). Two weeks later, another sample of 79 exercisers were administered the EAI to determine the test-retest reliability of the questionnaire. Results: The original data from the preliminary report were reanalysed to determine the split half correlation of the EAI. This was found to be 0.84 (Guttman split-half coefficient). A correlation between weekly frequency of exercising and EAI scores was also determined, and it was found that the two variables shared 29% of the variance (r(2) = 0.29). The test-retest reliability of the scale was found to be very good (0.85). Conclusions: The EAI is a valid and reliable tool which would be capable of helping general practitioners to quickly and easily identify people affected by, or at risk of, exercise addiction.

Hausenblas HA; Downs DS. Exercise dependence: A systematic review. (review). Psychology of Sport and Exercise 3(2): 89-123, 2002. (114 refs.)

Background and Purpose: The purpose of this paper was to review the equivocal literature examining exercise dependence and deprivation. Method: A comprehensive literature search yielded 77 exercise dependence and 11 exercise deprivation studies, spanning 29 years (range=1970 to 1999), were reviewed. Results and conclusions: The research was characterized by three general approaches: (a) comparing exercisers to eating disorder patients, (b) comparing "excessive" to "less excessive" exercisers, and (c) comparing exercisers to nonexercisers. Study results have been inconclusive due, in part, to a lack of experimental research, inconsistent or nonexistent control groups, discrepant operational criteria for exercise dependence, and/or invalidated or inappropriate measures of exercise dependence. More systematic theory based research is required to understand the precipitating and perpetuating factors associated with exercise dependence, as well as effective treatment regimens.

Hausenblas HA; Downs DS. How much is too much? The development and validation of the exercise dependence scale. Psychology & Health 17(4): 387-404, 2002. (59 refs.)

This paper presents five studies with 2,420 total participants on the development and validation of the Exercise Dependence Scale (EDS), which is conceptualized based on the Diagnostic and Statistical Manual-IV, (APA, 1994) criteria for substance dependence, and differentiates among at-risk, nondependent-symptomatic, and nondependent-asymptomatic exercisers. Results of the studies revealed evidence for the a priori hypothesized components, acceptable test- retest and internal consistency reliability, and content and concurrent validity of the EDS. Individuals at-risk for exercise dependence reported more strenuous exercise, perfectionism, and self- efficacy compared to the nondependent groups. The findings provide initial support for the EDS and indicate the need for a multifaceted approach to its conceptualization and measurement.

Hurst R; Hale B; Smith D; Collins D. Exercise dependence, social physique anxiety, and social support in experienced and inexperienced bodybuilders and weightlifters. British Journal of Sports Medicine 34(6): 431-435, 2000. (32 refs.)

Objectives-To investigate psychological correlates of exercise dependence in experienced and inexperienced bodybuilders and weightlifters. Secondary objectives included measuring social physique anxiety, bodybuilding identity, and social support among bodybuilders and weightlifters. Methods-Thirty five experienced bodybuilders, 31 inexperienced bodybuilders, and 23 weightlifters completed the bodybuilding dependence scale, a bodybuilding version of the athletic identity measurement scale, the social physique anxiety scale, and an adapted version of the social support survey-clinical form. Results-A between subjects multivariate analysis of variance was calculated on the scores of the three groups of lifters for the four questionnaires. Univariate F tests and follow up tests indicated that experienced bodybuilders scored significantly higher than inexperienced bodybuilders and weightlifters on bodybuilding dependence (p<0.001), social identity and exclusivity subscales of bodybuilding identity (p<0.001), and social support scales (p<.001), and significantly lower on social physique anxiety (p<0.001). Conclusion-Experienced bodybuilders exhibit more exercise dependence, show greater social support behaviour, and experience less social physique anxiety than inexperienced bodybuilders and weightlifters.

Keski-Rahkonen A. Exercise dependence: A myth or a real issue? (editorial). European Eating Disorders Review 9(4): 279-283, 2001. (10 refs.)

Klein DA; Bennett AS; Schebendach J; Foltin RW; Devlin MJ; Walsh BT. Exercise "addiction" in anorexia nervosa: Model development and pilot data. CNS Spectrums 9(7): 531-537, 2004. (45 refs.)

Background: Excessive exercise has long been observed to be a problematic behavior of many patients with anorexia nervosa (AN). However, many questions remain as to the exact role exercise plays in this disorder. In particular, it has been suggested that exercise holds "addictive" properties in persons with AN, but that remains to be demonstrated. Objective: The aim of this study was to adapt and apply a scale used in addictions research to determine whether symptoms of "dependence" to exercise could be measured in a group of women with AN. Results: Forty-eight percent of individuals assessed endorsed symptoms consistent with exercise dependence in the previous month. The number of criteria met for exercise dependence was directly correlated with a clinical measure of anxiety. Conclusion: Results support further investigation into addictive properties for exercise in individuals with AN and its relationship to anxiety.

Lejoyeux M; Avril M; Richoux C; Embouazza H; Nivoli F. Prevalence of exercise dependence and other behavioral addictions among clients of a Parisian fitness room. Comprehensive Psychiatry 49(4): 353-358, 2008. (20 refs.)

Aim of the Study: Exercise dependence is an inadequate pattern of exercise leading to clinically significant negative consequences. Subjects present loss of control of their physical activity, tolerance, and withdrawal symptoms when they do not practice sport. We studied the prevalence of exercise dependence among clients of a Parisian fitness room. We also assessed alcohol and nicotine use disorders, 2 other "socially tolerated" behavioral addictions (compulsive buying and Internet addiction), and 2 disorders related to anxiety focused on the body (bulimia and hypochondria). Method: All clients of the fitness room 18 years and older were invited to participate in the study. Three hundred subjects were included; 125 (42%) presented diagnostic criteria of exercise dependence. Unsurprisingly, exercise dependents spent more hours each day in the fitness center practicing (2.1 vs 1.5 hours per day). They went to the fitness center more often each week (3.5 vs 2.9 days per week). Exercise addicts smoked less; alcohol consumption was equivalent in both groups. Compulsive buying was significantly more frequent in exercise dependents (63% vs 38%), which means they scored higher in the compulsive buying scale (5.4 vs 4.1). Prevalence of hypochondria was equivalent in both groups, but scores in the Whiteley Index of Hypochondria were higher (4.1 vs. 3) in the exercise-dependent group. Bulimia was significantly more frequent among exercise dependents (70% vs 47%), who also presented a higher number of bulimic episodes each week (2.5 vs 1.3). Subjects with exercise dependence spent more time on their computer each day (3.9 vs 2.4 hours per day). We found no difference regarding time spent using Internet, the number of e-mails sent or received, and their time at speaking on a cellular phone. Conclusion: Our results lead to systematically study the addictive relation to exercise among regular clients of the fitness rooms. Exercise addicts are exposed to negative consequences for their excess of physical activity. Exercise addiction is also associated to compulsive buying, bulimia, and, in a lesser extent, hypochondria.

Mathers S; Walker MB. Extraversion and exercise addiction. Journal of Psychology 133(1): 125-128, 1999. (20 refs.)

Extraversion has been suggested as a factor associated with addiction. This claim was tested in relation to exercise addiction. Twelve exercise addicts were compared with 12 nonaddicted individuals who were committed to regular exercise and with 12 nonexercising individuals drawn from the same student population. Addicted exercisers did not differ from nonaddicted exercisers in extraversion, although exercisers as a group were more extraverted than nonexercisers. The results are interpreted as evidence against the claim that extraversion is a component of the addictive personality profile.

McCown WG. Nonpharmacological addictions. IN: Coombs RH, ed. Family Therapy Review: Preparing for Comprehensive and Licensing Examinations. Mahwah, NJ: Lawrence Erlbaum Associates, 2005. pp. 459-481

The concept that people can be addicted to behaviors or experiences fits many of our observations from life. Most of us know someone who spends too much time on the Internet, perhaps exercises too much, or is perpetually spending all his or her time watching "trashy" or campy movies. We may have already even labeled them, perhaps part humorously, as "addicts." However, as therapists and counselors, we need to know if these apparent behavioral excesses really are a variety of addictions. Can people be addicted to an experience, person, place, or object? Or, perhaps, should we reserve this emotionally-laden term for someone who ingests particular classes of substances, as traditional psychiatry suggests? A case study presents an overview for four arguments advanced in this chapter: First, nonpharmacological addictions, as my colleagues and I refer to this class of behaviors, are not only possible, but are common. Second, these addictions are often as serious in their consequences as any substance dependence. Third, nonpharmacological addictions are usually encountered within a family context and often seem to be fostered by family processes. Therefore, fourth, and as this chapter will argue in greater detail, family therapy is usually the first choice for treating the variety of nonpharmacological addictions that clinicians encounter.

O'Dea JA; Abraham S. Eating and exercise disorders in young college men. Journal of American College Health 50(6): 273-278, 2002. (36 refs.)

The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape, and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.

Rodgers WM; Hall CR; Blanchard CM; Munroe KJ. Prediction of obligatory exercise by exercise-related imagery. Psychology of Addictive Behaviors 15(2): 152-154, 2001. (14 refs.)

Obligatory exercise is a compulsive behavior pattern in which exercise dominates daily life at the expense of other activities and lack of exercise produces withdrawal symptoms. This study examined the hypothesis that obligatory exercise is motivated similarly to eating disorders (cf. S. P. Coen & B. M. Ogles, 1993) and would be predicted by appearance-related imagery. Obligatory exercise (J. K. Thompson & L. Pasman, 1991) and exercise imagery (H. A. Hausenblas, C. R. Hall, W. M. Rodgers, & K. J. Munroe, 1999) were assessed before and after a 10-week exercise program in 243 adult exercisers. Regression analyses revealed that imagery accounted for 20% of the variance in obligatory exercise. Appearance-related imagery did not predict significantly obligatory exercise. Energy-related imagery was the strongest predictor. Obligatory exercise may not be as associated with appearance-related concerns as eating disorders, suggesting different motivational bases for these 2 behavioral patterns.

Rosa DA; De Mello MT; Negrao AB; De Souza-Formigoni MLO. Mood changes after maximal exercise testing in subjects with symptoms of exercise dependence. Perceptual and Motor Skills 99(1): 341-353, 2004. (36 refs.)

Considering exercise has positive and negative reinforcing properties, the mood states of sedentary, nonexercise-dependent and exercise-dependent volunteers were compared after maximal exercise testing. Mood status was evaluated by the Beck Depression Inventory, Trait-State Anxiety Inventory, and Profile of Mood States (POMS). No differences were detected before the test or after it, indicating little possibility of positive reinforcement. However, a significant reduction in the POMS Tension-Anxiety scores was observed in both exerciser groups (greater in the exercise-dependent group) but not in the sedentary group. Only in the exercise-dependent group were significant reductions in Anger and Total Mood Disorders scores observed compared with their pre-exercise scores. These data suggest that exercising has stronger negative reinforcement properties for exercise-dependent volunteers and is a factor which could increase the odds of their becoming dependent on exercise.

Stetson BA; Beacham AO; Frommelt SJ; Boutelle KN; Cole JD; Ziegler CH et al. Exercise slips in high-risk situations and activity patterns in long-term exercisers: An application of the relapse prevention model. Annals of Behavioral Medicine 30(1): 25-35, 2005. (53 refs.)

Background: Key factors in successful long-term exercise maintenance are not well understood. The Relapse Prevention Model (RPM) may provide a framework for this process. Purpose: The purpose of this study was to examine the relationships among characteristics of exercise high-risk situations, components of the RPM relevant to exercise slips, and follow-up exercise outcomes in long-term community exercisers. Methods: We obtained long-term exercisers'(N = 65) open-ended responses to high-risk situations and ratings of obstacle self-efficacy, guilt, and perceived control. High-risk situation characteristics, cognitive and behavioral coping strategies, and exercise outcomes were examined. Results: High-risk situation characteristics included bad weather, inconvenient time of day, being alone, negative emotions, and fatigue. Being alone was associated with lower incidence of exercise slip. Positive cognitive coping strategies were most commonly employed and were associated with positive exercise outcome for both women and men. Guilt and perceived control regarding the high-risk situation were associated with exercise outcomes at follow-up, but only among the men (n = 28). Conclusions: Findings confirm and extend previous work in the application of the RPM in examining exercise slips and relapse. Measurement issues and integration approaches from the study of relapse in addiction research are discussed.

Terry A; Szabo A; Griffiths M. The Exercise Addiction Inventory: A new brief screening tool. Addiction Research & Theory 12(5): 489-499, 2004. (40 refs.)

Many attempts have been made to define and measure problem exercising but there has not been any successful attempt to produce a psychometrically sound assessment instrument. The aim of the present study was to develop a psychometric instrument (the Exercise Addiction Inventory, EAI) capable of identifying people at risk from exercise addiction. The intention was to develop a short form inventory that would be quick and simple to administer. The EAI was operationalised using the components of behavioural addiction proposed by Griffiths ( Griffiths, M.D. (1996) . Behavioural addiction: an issue for everybody? Journal of Workplace Learning , 8 (3), 19-25). The study presents the psychometric properties of the EAI, which are manifested in very good internal reliability, content validity, concurrent validity, and construct validity. It is concluded that the EAI could be a valid and reliable instrument capable of quickly and easily identifying individuals at risk from exercise addiction.

Yates A; Edman JD; Crago M; Crowell D. Eating disorder symptoms in runners, cyclists, and paddlers. (rapid communication). Addictive Behaviors 28(8): 1473-1480, 2003. (8 refs.)

Objective: To differentiate groups of highly conditioned, competitive athletes on the basis of Exercise Orientation Questionnaire (EOQ) scores and self-reported psychiatric symptoms. Method: A total of 99 runners, 36 cyclists, and 55 paddlers were administered the EOQ and a symptom checklist. Results: Analysis of variance and chi-square associated self-loathing subscale (SLSS) scores with self-reported eating disorder (ED) symptoms for the entire group [F(1)=4.83; P<.05] and for females only [F(1)=9.30; P<.001]. The paddler group reported more anxiety/panic symptoms than runners or cyclists (2=7.91; P<.01) and higher SLSS scores than cyclists [F(2)=6.91; P<.01]. The female-only paddler group reported more anxiety/panic [2(1)=10.27; P<.001] than the other groups. Although total group scores were comparable to controls, 12% runners, 14% cyclists, and 18% paddlers scored above previously established ED patient mean. Discussion: The paddler group appeared less healthy than runners or cyclists and were more likely to report ED symptoms. These differences could have been related to a dissimilar ethnic composition or particular social stress generated within paddling groups. In this study, SLSS was highly specific in its association with ED symptoms. This is of particular interest because SLSS is based on questions about exercise rather than eating pathology.