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29 - Measurement, Prevention, and Treatment of Exercise Addiction

from Part V - Ongoing and Future Research Directions

Published online by Cambridge University Press:  13 July 2020

Steve Sussman
Affiliation:
University of Southern California
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Summary

Exercise addiction is a controversial concept including whether excessive exercise is a positive or negative addiction and whether excessive physical activity could be harmful. The purpose of this chapter is to provide clarity to exercise addiction by reviewing the scientific literature examining its definition, measurement, correlates, prevention, and treatment. Exercise addiction is defined as a craving for leisure-time physical activity that results in uncontrollably excessive exercise behavior that manifests itself in physiological and/or psychological symptoms with two principal distinctions of primary and secondary addiction. Measuring exercise addiction involves the assessment of multidimensional characteristics that also consider symptoms of addiction and the ability to distinguish between low- and high-risk individuals for exercise addiction. Several risk factors for exercise addiction will be addressed including high levels of exercise identity, body dissatisfaction, neuroticism, extraversion and low levels of self-esteem and agreeableness. Finally, the scant literature on the prevention and treatment of exercise addiction will be reviewed. Given the lack of awareness in professional and lay communities about exercise addiction, healthcare professionals may not recognize the signs of exercise addiction even when its adverse health consequences are apparent.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Adams, J. & Kirkby, R. J. (2002). Excessive exercise as an addiction: A review. Addiction Research and Theory, 10, 415437.Google Scholar
Adams, J. M., Miller, T. W. & Kraus, R. F. (2003). Exercise dependence: Diagnostic and therapeutic issues for patients in psychotherapy. Journal of Contemporary Psychotherapy, 33, 93107.Google Scholar
American Psychiatric Association [APA] (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision). Washington, DC: American Psychiatric Publishing.Google Scholar
American Psychiatric Association [APA] (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edition). Washington, DC: American Psychiatric Publishing.Google Scholar
American Psychological Association [APA] (2017). Personality. www.apa.org/topics/personality/Google Scholar
Anandkumar, S., Manivasagam, K., Kee, T. V. S. & Meyding-Lamade, U. (2018). Effect of physical therapy management of nonspecific low back pain with exercise addiction behaviors: A case series. Physiotherapy Theory and Practice, 34, 316328. doi: 10.1080/09593985.2017.1394410Google Scholar
Andreassen, C. S., Griffiths, M. D., Gjertsen, S. R., et al. (2013). The relationship between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2, 9099. doi: 10.1556/JBA.2.2013.003Google Scholar
Anderson, S. J., Basson, C. J. & Geils, C. (1997). Personality style and mood states associated with a negative addiction to running. Sports Medicine, 4, 611.Google Scholar
Baekeland, F. (1970). Exercise deprivation. Sleep and psychological reactions. Archives of General Psychiatry, 22, 365369. doi: 10.1001/archpsyc.1970.01740280077014Google Scholar
Bamber, D., Cockerill, I. M. & Carroll, D. (2000). The pathological status of exercise dependence British Journal of Sports Medicine, 34, 125132. doi: dx.doi.org/10.1136/bjsm.34.2.125CrossRefGoogle ScholarPubMed
Berger, N., Muller, A., Brahler, E., Philipsen, A. & de Zwaan, M. (2014). Association of symptoms of attention-deficit/hyperactivity disorder with symptoms of excessive exercising in an adult general population sample. BMC Psychiatry, 14, 250. doi:10.1186/s12888-014-0250-7CrossRefGoogle Scholar
Besser, A., Flett, G. L. & Hewitt, P. L. (2004). Perfectionism, cognition, and affect in response to performance failure vs. successJournal of Rational-Emotive & Cognitive-Behavior Therapy22, 297324. doi:10.1023/b:jore.0000047313.35872.5cGoogle Scholar
Blaydon, M. J. & Lindner, K. J. (2002). Eating disorders and exercise dependence in triathletes. Eating Disorder, 10(1), 4960. doi: 10.1080/106402602753573559CrossRefGoogle ScholarPubMed
Carmack, M. A. & Martens, R. (1979). Measuring commitment to running: A survey of runners’ attitudes and mental states. Journal of Sport Psychology, 1, 2542. doi:10.1123/jsp.1.1.25Google Scholar
Chapman, C. L. & DeCastro, J. M. (1990). Running addiction: Measurement and associated psychological characteristics. The Journal of Sports Medicine and Physical Fitness, 30, 283290.Google Scholar
Coen, S. P. & Ogles, B. M. (1993). Psychological characteristics of the obligatory runner: A critical examination of the anorexia analogue hypothesisJournal of Sport & Exercise Psychology15, 338354. doi:10.1123/jsep.15.3.338Google Scholar
Cook, B. J. & Hausenblas, H. A. (2011). Eating disorder specific health-related quality of life and exercise in college females. Quality of Life Research, 20, 13851390. doi:10.1007/s11136-011-9879-6Google Scholar
Cook, B. J., Hausenblas, H. A., Crosby, R. D., Cao, L. & Wonderlich, S. A. (2015). Exercise dependence as a mediator of the exercise and eating disorders relationship: A pilot study. Eating Behaviors, 16, 912. doi: 10.1016/j.eatbeh.2014.10.012Google Scholar
Cook, B. J., Hausenblas, H. A., Tuccitto, D. & Giacobbi, P. (2011). Eating disorders and exercise: A structural equation modeling analysis of a conceptual model. European Eating Disorders Review, 19, 216225. doi: 10.1002/erv.1111Google Scholar
Cooke, L. M., Liardi, V. L. & Hall, C. R. (2011). Does the shoe FIT? An examination of the relationship of exercise identity with exercise frequency, intensity, and duration. Journal of Sport & Exercise Psychology, 33, 138148.Google Scholar
Costa, S. & Oliva, P. (2011). Attività fisica e benessere: percezione del sé fisico e motivazione all’esercizio. [Physical activity and well-being: Physical self-perception and exercise motivation]”. GIPS, 12, 37.Google Scholar
Costa, S., Hausenblas, H. A., Oliva, P., Cuzzocrea, F. & Larcan, R. (2013). The role of age, gender, mood states and exercise frequency on exercise dependenceJournal of Behavioral Addictions2, 216223. doi:10.1556/jba.2.2013.014Google Scholar
Cunningham, H. E., Pearman, S. & Brewerton, T. D. (2016). Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise. International Journal of Eating Disorders, 49(8), 778792. doi: 10.1002/eat.22551Google Scholar
Davis, C. & Fox, J. (1993). Excessive exercise and weight preoccupation in womenAddictive Behaviors18, 201211. doi:10.1016/0306-4603(93)90050-jGoogle Scholar
Di Nicola, M., Martinotti, G., Mazza, M., et al. (2010). Quetiapine as add-on treatment for bipolar I disorder with comorbid compulsive buying and physical exercise addiction. Progress in Neuropsychopharmacology and Biological Psychiatry, 34, 713714.Google Scholar
Di Nicola, M., Tedeschi, D., De Risio, L., et al. (2015). Co-occurrence of alcohol use disorder and behavioral addictions: Relevance of impulsivity and craving. Drug and Alcohol Dependence, 148, 118125. doi:10.1016/j.drugalcdep.2014.12.028Google Scholar
Egorov, A. Y. & Szabo, A. (2013). The exercise paradox: An interactional model for a clearer conceptualization of exercise addictionJournal of Behavioral Addictions2, 199208. doi:10.1556/jba.2.2013.4.2Google Scholar
Flett, G. L. & Hewitt, P. L. (2005). The perils of perfectionism in sports and exerciseCurrent Directions in Psychological Science14, 1418. doi:10.1111/j.0963-7214.2005.00326.xGoogle Scholar
Flett, G. L. & Hewitt, P. L. (2002). Perfectionism and maladjustment: An overview of theoretical, definitional, and treatment issues. In Flett, G. L. & Hewitt, P. L. (Eds.), Perfectionism: Theory, Research, and Treatment. American Psychological Association, pp. 531https://doi.org/10.1037/10458-001Google Scholar
Flett, G. L. & Hewitt, P. L. (2006). Positive versus negative perfectionism in psychopathologyBehavior Modification, 30, 472495. doi:10.1177/0145445506288026CrossRefGoogle ScholarPubMed
Flett, G. L., Pole-Langdon, L. & Hewitt, P. L. (2003). Trait perfectionism and perfectionistic self-presentation in compulsive exercise. Unpublished manuscript. York University, Toronto, Ontario, Canada.Google Scholar
Fairburn, C. G. & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363370. doi:10.1037/t03974-000Google Scholar
Freimuth, M. (2008). Addicted? Recognizing Destructive Behavior Before It’s Too Late. Lanham, MD: Rowman & Littlefield Publishers.Google Scholar
Freimuth, M., Moniz, S. & Kim, S. R. (2011). Clarifying exercise addiction: Differential diagnosis, co-occurring disorders, and phases of addiction. International Journal of Environmental Research and Public Health8, 40694081.CrossRefGoogle ScholarPubMed
Garner, D. M., Olmstead, M.P. & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 1534. doi:10.1002/1098-108x(198321)2:2<15::aid-eat2260020203>3.0.co;2-63.0.CO;2-6>CrossRefGoogle Scholar
Gayton, W. F., Loignon, A. C. & Porta, W. (2016). Exercise dependence: The dark side of exercise. Annals of Sports Medicine and Research, 3(7), 1085.Google Scholar
Glasser, W. (1976). Positive Addiction. New York, NY: Harper & Row.Google Scholar
Griffiths, M. (1996). Behavioural addiction: An issue for everybody? Employee Counselling Today, 8, 1925. doi: 10.1108/13665629610116872CrossRefGoogle Scholar
Griffiths, M., Szabo, A. & Terry, A. (2005). The exercise addiction inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39, 346347. doi: 10.1136/bjsm.2004.017020Google Scholar
Hagan, A. L. & Hausenblas, H. A. (2003). The relationship between exercise dependence symptoms and perfectionism. American Journal of Health Studies, 18, 133137.Google Scholar
Hailey, B. J. & Bailey, L. A. (1982). Negative addiction in runners: A quantitative approach. Journal of Sport Behavior, 5, 150154.Google Scholar
Hall, H. K., Hill, A. P., Appleton, P. R. & Kozub, S. A. (2009). The mediating influence of unconditional self-acceptance and labile self-esteem on the relationship between multidimensional perfectionism and exercise dependencePsychology of Sport and Exercise,10, 3544. doi:10.1016/j.psychsport.2008.05.003Google Scholar
Hart, E. A., Leary, M. R. & Rejeski, W. J. (1989). The measurement of social physique anxiety. Journal of Sport and Exercise Psychology, 11, 94104.CrossRefGoogle Scholar
Hausenblas, H. A. & Fallon, E. A. (2002). Relationship among body image, exercise behavior, and exercise dependence symptomsInternational Journal of Eating Disorders32, 179185. doi:10.1002/eat.10071CrossRefGoogle ScholarPubMed
Hausenblas, H. A. & Giacobbi, P. R. Jr. (2004). Relationship between exercise dependence symptoms and personality. Personality and Individual Differences, 36, 12651273. doi:10.1016/s0191-8869(03)00214-9Google Scholar
Hausenblas, H. A. & Symons Downs, D. (2002). Exercise dependence: A systematic review. Psychology of Sport and Exercise, 3, 8923. doi: 10.1016/s1469-0292(00)00015-7Google Scholar
Hausenblas, H. A., Cook, B. J. & Chittester, N. I. (2008). Can exercise treat eating disorders? Exercise and Sport Sciences Reviews, 36, 4347. doi: 10.1097/jes.0b013e31815e4040Google Scholar
Hausenblas, H. A., Schreiber, K. & Smoliga, J. M. (2017). Practice pointer: Exercise addiction. BMJ, 26, 357. doi: 10.1136/bmj.j1745Google Scholar
Hewitt, P. L. & Flett, G. L. (1996). Personality traits and the coping process. In Zeidner, M. & Endler, N. S. (Eds.), Handbook of Coping: Theory, Research, Applications. Oxford, England: John Wiley & Sons, pp. 410433.Google Scholar
Hewitt, P. L., Flett, G. L. & Ediger, E. (1996). Perfectionism and depression: Longitudinal assessment of a specific vulnerability hypothesisJournal of Abnormal Psychology105, 276280. doi:10.1037//0021-843x.105.2.276Google Scholar
Jee, Y.-S. (2016). Exercise addiction and rehabilitation. Journal of Exercise Rehabilitation, 12, 6768.Google Scholar
Jibaja-Rusth, M. L. (1989). The development of a psycho-social risk profile for becoming an obligatory runner. Unpublished doctoral dissertation, University of Houston, Houston.Google Scholar
Korolenko, T. P. (1991). Addictive behavior: Its general traits and regular developmentThe Bekhterev Review of Psychiatry and Medical Psychology, 1, 815.Google Scholar
Lejoyeux, M., Avril, M., Embouazza, H. & Nivoli, F. (2008). Prevalence of exercise dependence and other behavioral addictions among clients of a Parisian fitness room. Comprehensive Psychiatry, 49, 353358. doi: 10.1016/j.comppsych.2007.12.005Google Scholar
Lichtenstein, M. B., Christiansen, E., Elklit, A., Bilenberg, N. & Støving, R. K. (2014). Exercise addiction: A study of eating disorder symptoms, quality of life, personality traits and attachment stylesPsychiatry Research215, 410416. doi:10.1016/j.psychres.2013.11.010CrossRefGoogle ScholarPubMed
Lichtenstein, M. B., Hinze, C. J., Emborg, B., Thomsen, F. & Hemmingsen, S. D. (2017). Compulsive exercise: Links, risks and challenges faced. Psychology Research and Behavior Management, 30, 8595. doi: 10.2147/PRBM.S113093.CrossRefGoogle Scholar
Lu, F. J., Hsu, E. Y., Wang, J. M., et al. (2012). Exercisers’ identities and exercise dependence: The mediating effect of exercise commitment. Perceptual and Motor Skills, 115, 618631. doi:10.2466/06.13.21.pms.115.5.618-631CrossRefGoogle ScholarPubMed
Meulemans, S., Pribis, P., Grajales, T. & Krivak, G. (2014). Gender differences in exercise dependence and eating disorders in young adults: A path analysis of a conceptual model. Nutrients, 6, 48954905. doi: 10.3390/nu6114895Google Scholar
Miller, K. J. & Mesagno, C. (2014). Personality traits and exercise dependence: Exploring the role of narcissism and perfectionism. International Journal of Sport and Exercise Psychology12, 368381. doi:10.1080/1612197x.2014.932821CrossRefGoogle Scholar
Monok, K., Berczik, K., Urban, R., et al. (2012). Psychometric properties and concurrent validity of two exercise addiction measures: A population wide study. Psychology of Sport and Exercise, 13, 387404. doi:10.1016/j.psychsport.2012.06.003Google Scholar
Morgan, W. P. (1979). Negative addiction in runners. The Physician and Sportsmedicine, 7, 5777. doi:10.1080/00913847.1979.11948436Google Scholar
Murray, A. L., McKenzie, K., Newman, E. & Brown, E. (2013). Exercise identity as a risk factor for exercise dependence. British Journal of Health Psychology, 18, 369382. doi: 10.1111/j.2044-8287.2012.02091Google Scholar
O’Connor, R. C. (2007). The relations between perfectionism and suicidality: A systematic reviewSuicide and Life-Threatening Behavior37, 698714. doi:10.1521/suli.2007.37.6.698Google Scholar
O’Connor, P. J. & Smith, J. C. (1999). Physical activity and eating disorders. In Rippe, J. M. (Ed.), Lifestyle Medicine. Cambridge, MA: Blackwell Science, pp. 10051015.Google Scholar
Oliva, P., Costa, S. & Rosalba, L. (2013). Physical self-concept and its relationship to exercise dependence symptoms in young regular physical exercisers. American Journal of Sports Science and Medicine, 1, 16.Google Scholar
Rudy, E. B. & Estok, P. J. (1989). Measurement and significance of negative addiction in runnersWestern Journal of Nursing Research11, 548558. doi:10.1177/019394598901100504CrossRefGoogle ScholarPubMed
Sherry, S. B., Hewitt, P. L., Flett, G. L. & Harvey, M. (2003). Perfectionism dimensions, perfectionistic attitudes, dependent attitudes, and depression in psychiatric patients and university studentsJournal of Counseling Psychology50, 373386. doi:10.1037/0022-0167.50.3.373Google Scholar
Smith, D., Hale, B. D. & Collins, D. J. (1998). Measurement of exercise dependence in bodybuilders. Journal of Sports Medicine and Physical Fitness, 8, 19.Google Scholar
Spano, L. (2001). The relationship between exercise and anxiety, obsessive-compulsiveness, and narcissismPersonality and Individual Differences30, 8793. doi:10.1016/s0191-8869(00)00012-xGoogle Scholar
Stets, J. E. & Burke, P. J. (2000). Identity theory and social identity theorySocial Psychology Quarterly63, 224. doi:10.2307/2695870Google Scholar
Stice, E., Presnell, K. & Spangler, D. (2002). Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigationHealth Psychology21, 131138. doi:10.1037//0278-6133.21.2.131Google Scholar
Symons Downs, D., Hausenblas, H. A. & Nigg, C. R. (2004). Factorial validity and psychometric examination of the exercise dependence scale-revised. Measurement in Physical Education and Exercise Science, 8(4), 183201. doi: 10.1207/s15327841mpee0804_1Google Scholar
Szabo, A., Griffiths, M. D., de la Vega Marcos, R., Mervó, B. & Demetrovics, Z. (2015). Methodological and conceptual limitations in exercise addiction research. Yale Journal of Biology and Medicine, 88, 303308.Google ScholarPubMed
Szabo, A., Griffiths, M. D., Høglid, R. A. & Demetrovics, Z. (2018). Drug, nicotine, and alcohol use among exercisers: Does substance addiction co-occur with exercise addiction? Addictive Behaviors Reports7, 2631. doi:10.1016/j.abrep.2017.12.001Google Scholar
Terry, A., Szabo, A. & Griffiths, M. (2004). The exercise addiction inventory: A new brief screening tool. Addiction Research and Theory, 12, 489499. doi:10.1080/16066350310001637363CrossRefGoogle Scholar
Thornton, E. W. & Scott, S. E. (1995). Motivation in the committed runner: Correlations between self-report scales and behaviour. Health Promotion International, 10, 177184.Google Scholar
Veale, D. (1987). Exercise dependence. British Journal of Addiction, 82, 735740. doi:10.1111/j.1360-0443.1987.tb01539.xGoogle Scholar
Veale, D. (1995). Does primary exercise dependence really exist? In Annett, J., Cripps, B. & Steinberg, H. (Eds.), Exercise Addiction: Motivation for Participation in Sport and Exercise. Leicester, UK: British Psychological Society, pp. 15.Google Scholar
Villella, C., et al. (2010). Behavioural addictions in adolescents and young adults: Results from a prevalence study. Journal of Gambling Studies, 27, 203214. doi: 10.1007/s10899-010-9206-0Google Scholar

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