primary exercise addiction p2

Question 1

comorbidities of primary exercise addiction

Answer 1

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)

Question 2

risk factors for primary exercise addiciton

Answer 2

• Personality
• 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)
• Gender differences?
• Sport type
• Tendencies towards other behavioural addictions
• Strong identification as an exerciser
• Low self-esteem

Question 3

treating primary EA

Answer 3

• 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)

Question 4

10 steps to effective EA

Answer 4

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.

Question 5

presenting symptoms of EA

Answer 5

• 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

Question 6

challenges for the clinician

Answer 6

• 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.
  Important to explore:
   motivations for exercise
   attitudes towards recovery
   prioritisation of exercise above other activities
   perspectives towards being prevented from exercising
   eating attitudes and behaviours