primary exercise addiciton Flashcards
exercise on the mind
“Runners high”
* Opioid theory – activation of the mesolimbic dopaminergic pathway
* Evidence of increased endorphins in blood and in brain following exercise (Boecker et
al., 2008)
* Positive and negative reward mechanisms (stress versus euphoria)
Virtually all exercisers can vouch for the fact that exercise has mind-altering
properties, a sort of meditation in motion…the experience has been described as a
glow, a feeling of unity with yourself or nature, a sense of calm, timelessness, and
boundless energy…’ (Dietrich, 2007, p. 275)
definition of exercise addiciton
“…a rigid and highly driven urge to be active, in association with a perceived
inability to stop, despite being aware of the possible negative consequences…”
(Meyer & Plateau, 2017)
* Lots of different terms
* Exercise addiction, exercise dependence, obligatory exercise, excessive
exercise, compensatory exercise, compulsive exercise…
* Not always referring to the same thing.
what is primary exercise addiction?
- Exercise is the primary issue, rather than a symptom of another disorder.
- Individuals exercise for intrinsic rewards and experience withdrawal when unable to exercise (Sachs, 1981).
- Debate exists about its prevalence—some argue it may not exist or is rare (Landolfi, 2012).
Addiction framework
* Exercise addiction, excessive exercise, exercise
dependence, obligatory exercise.
* Quantitative approach to exercise
* Exercise becomes an obligation and excessive.
* Similar negative effects on emotional and social
health as other addictions.
* Loss of control over exercise activity
Reardon et al., 2019- highlgihts tolerance and withdrawl. an inibility to stop due to injury/ eliminatin to do other activities such as socialisation!
criteria-
Exercise dependence criteria
Hausenblas & Symons Downs (2002)
1. Tolerance - need for increasing amounts of exercise to achieve desired effects
2. Withdrawal symptoms
3. Intention effects – exercising for longer or doing more than was initially intended
4. Lack of control – desire to cut down, or difficulty doing so
5. Time
6. Reduction in other activities
7. Continuance – exercising despite knowing that it exacerbates/causes a physical or psychological
issue
One limitation of this scale is that it does not distinguish between primary and secondary exercise dependence Hausenblas and Downs (2002b)
Exercise dependence scale (revised)
* Based on exercise dependence criteria; 21 item questionnaire
Example items
*“I exercise to avoid feeling anxious”
*“I exercise longer than I intend”
*“I spend most of my free time exercising”
*“I would rather exercise than spend time with family and friends”
*Correlates with exercise frequency
prevalance of PA
Prevalence
* Estimating prevalence without specific, agreed classification criteria is tricky.
* Differences in definitions, measures and thresholds for cut off leads to considerable
variability within the field.
* General population prevalence – varies from 0.5% to ~ 8%
* Elevated in athletic populations – 5-14% (Trott et al., 2020; Di Lodovico et al., 2019).
* Differences by sport
* Are we measuring exercise addiction, or just high(er) levels of normative exercise
behaviour?
* Other ‘at risk’ groups – e.g., students (5.5%, Trott et al., 2020).
* Failure to measure/assess for secondary EA in prevalence studies.
assessment tools
Exercise addiction inventory (Griffiths, Szabo & Terry, 2005).
Correlations between exercise frequency and EAI scores
Concurrent validity with other, similar measures (e.g., Obligatory Exercise Questionnaire; Pasman & Thompson,
1988; Exercise Dependence Scale; Hausenblas & Symons Downs, 2001).
comorbidities of PA
Evidence for:
* Lower wellbeing
* Higher levels of anxiety and depression
* Increased exercise behaviour
* Increased personality disorders
* Increased obsessive-compulsive disorders
* Increased disordered eating
* Some physiological changes (e.g., increased cortisol) but poorly conceptualised and studied.
(Trott, 2020; Symons Downs, 2004; Cunningham et al., 2016)
- Physical: Overuse injuries, chronic fatigue, and stress fractures (Landolfi, 2012).
- Psychological: Depression, anxiety, and distress when unable to exercise (Landolfi, 2012).
- Social: Strained relationships due to excessive exercise prioritization.
Sachs (1981) differentiates committed exercisers (who enjoy exercise but do not suffer withdrawal) from addicted exercisers (who experience disturbing deprivation sensations without exercise).
risk factors
- People prone to other behavioral addictions (gambling, substance abuse) may also develop exercise addiction due to shared neurobiological mechanisms (Cunningham et al., 2016).
- Athletes, particularly in endurance sports like running or bodybuilding, are at higher risk due to training demands and extreme discipline (Di Lodovico et al., 2019).
- Perfectionism and obsessive-compulsive tendencies increase risk (Stollarrf, 2003; Berczik et al.).
- Many rely on excessive exercise to cope with poor self-concept and depression (Katz, 2003).
Links between narcissism and EA (Birche et al., 2017, systematic review of 22 studies)
* Links with elements of perfectionism (Cakin et al., 2021; systematic review of 22 studies)
* Elevated levels of impulsivity and emotion dysregulation (e.g., Chamberlain & Grant, 2020)
* Alexithymia (e.g., Lyvers et al., 2021)
* Emotions- shame, guilt, pride (Sicilia, et al., 2020
treatment
No specified or validated treatment approaches to date
* CBT, REBT likely suitable for restructuring thoughts and modifying behaviours.
* Hausenblas et al., (2017)
* Use of SMART goals for exercise; involvement of fitness professionals to develop a manageable
training plan.
* Management of injuries, physical health and psychological wellbeing.
*10 key steps to treating EA (Szabo & Demetrovics, 2022)
Szabo & Demetrovics (2022)
1) Recognition and admission of problematic symptoms
2) Identify stage and severity of the problem
3) Teach the individual about value of exercise and the risks of over exercising
4) Identify complementary exercise alternatives
5) Reinforce and teach the value of exercise alternatives
6) Adopt a balance sheet of gains/losses as a consequence of exercise alternatives
7) Focus on the gains; use goal setting to amplify these
8) Evaluate goals
9) Adjust therapy as needed
10) Generate social support for the new adaptive behaviours.
presenting
Overuse injuries (e.g., stress fractures)
* Indicators of overtraining (e.g., unexplained decreases in performance, persistent fatigue, sleep
disturbances)
* Symptoms of endocrine, metabolic or immune dysfunction; anaemia and amenorrhea
* Persisting with exercise despite negative consequences
* Neglecting social, occupational and/or family in order to exercise
* Disregarding training schedule or guidance provided by a coach or fitness professional
* Withdrawal effects when exercise is prevented or stopped (which proves difficult to manage).
Hausenblas et al., 2017
issues for clincian
Absence of specific criteria to ascertain a diagnosis – creates a grey area.
* Athletes may need to be considered differently due to demands of sport.
* No validated treatment approaches
* Presentation to services and help seeking behaviours in this group are unknown.
* However, diagnosing exercise addiction is difficult due to lack of clinical recognition and inconsistent prevalence rates (ranging from 0.3% to 51.4%) (De Moor, 2006).
