Classifying excessive exercise : examining the relationship between compulsive exercise with obsessive-compulsive disorder symptoms and disordered eating symptoms
- Cosh, Suzanne, Eshkevari, Ertimiss, McNeil, Dominic, Tully, Phillip
- Authors: Cosh, Suzanne , Eshkevari, Ertimiss , McNeil, Dominic , Tully, Phillip
- Date: 2023
- Type: Text , Journal article
- Relation: European Eating Disorders Review Vol. 31, no. 6 (2023), p. 769-780
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- Description: Objective: There remains a lack of consensus around nosology for compulsive exercise (CE). Although widely observed in eating disorders (ED), CE shares theoretical overlap with obsessive-compulsive disorder (OCD), where exercise compulsions occur in response to obsessions. Yet, there is limited and mixed evidence of a relationship between CE with OCD. This study aims to explore the appropriate diagnostic classification of CE through examination of CE in relation to OCD, obsessional thinking, and ED symptoms. Method: Two hundred and eighty one adults with mental health symptoms, dieting, and exercise behaviour completed measures of OCD, CE, and disordered eating symptoms. Regression and Receiver Operating Characteristic analyses examined relationships between dimensions of CE with OCD and ED symptoms, and the predictive ability of CE assessment for detecting threshold OCD and ED symptoms. Results: CE assessment was poor at predicting threshold OCD symptoms, probable Anorexia Nervosa, and Binge Eating Disorder and moderate at detecting probable disordered eating and Bulimia Nervosa. Associations between CE and OCD symptoms were not significant after adjustment for ED symptoms. Obsessional thinking was associated only with lack of exercise enjoyment. Conclusions: Results indicate that excessive exercise might represent a distinct disorder, with some shared traits across CE, OCD and ED symptoms. Findings question the utility of adaptation of OCD diagnostic criteria for CE. Assessment and treatment implications are considered. © 2023 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.
- Authors: Cosh, Suzanne , Eshkevari, Ertimiss , McNeil, Dominic , Tully, Phillip
- Date: 2023
- Type: Text , Journal article
- Relation: European Eating Disorders Review Vol. 31, no. 6 (2023), p. 769-780
- Full Text:
- Reviewed:
- Description: Objective: There remains a lack of consensus around nosology for compulsive exercise (CE). Although widely observed in eating disorders (ED), CE shares theoretical overlap with obsessive-compulsive disorder (OCD), where exercise compulsions occur in response to obsessions. Yet, there is limited and mixed evidence of a relationship between CE with OCD. This study aims to explore the appropriate diagnostic classification of CE through examination of CE in relation to OCD, obsessional thinking, and ED symptoms. Method: Two hundred and eighty one adults with mental health symptoms, dieting, and exercise behaviour completed measures of OCD, CE, and disordered eating symptoms. Regression and Receiver Operating Characteristic analyses examined relationships between dimensions of CE with OCD and ED symptoms, and the predictive ability of CE assessment for detecting threshold OCD and ED symptoms. Results: CE assessment was poor at predicting threshold OCD symptoms, probable Anorexia Nervosa, and Binge Eating Disorder and moderate at detecting probable disordered eating and Bulimia Nervosa. Associations between CE and OCD symptoms were not significant after adjustment for ED symptoms. Obsessional thinking was associated only with lack of exercise enjoyment. Conclusions: Results indicate that excessive exercise might represent a distinct disorder, with some shared traits across CE, OCD and ED symptoms. Findings question the utility of adaptation of OCD diagnostic criteria for CE. Assessment and treatment implications are considered. © 2023 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.
Compulsive exercise and its relationship with mental health and psychosocial wellbeing in recreational exercisers and athletes
- Cosh, Suzanne, McNeil, Dominic, Tully, Phillip
- Authors: Cosh, Suzanne , McNeil, Dominic , Tully, Phillip
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 26, no. 7 (2023), p. 338-344
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- Description: Objectives: Better understanding of compulsive exercise is needed in sports medicine. Whilst compulsive exercise may impact mental health, the limited research exploring the relationship between compulsive exercise and psychosocial outcomes is equivocal. The majority of studies have examined eating disorder populations where the eating disorder pathology might account for distress. This study explores relationships between compulsive exercise and mental health. Design: Cross-sectional observational study. Methods: Australian recreational exercisers and athletes (N = 1157; Mage 36.4, standard deviation = 12.9, 77 % female) recruited through sporting organisations, clubs, and gyms, completed measures of compulsive exercise, depression, anxiety, stress, life satisfaction, social physique anxiety, and self-esteem. Regression analyses examined relationships between dimensions of compulsive exercise and wellbeing. Results: After adjustment for eating disorder symptoms and sporting level, compulsive exercise was associated with increased risk of clinically-significant anxiety, depression, and stress symptoms. Compulsive exercise was also associated with lower life satisfaction and self-esteem, and higher social physique anxiety. Notably, different dimensions of compulsive exercise had varying relationships with outcomes, and avoidance and rule-driven behaviour and lack of exercise enjoyment were associated with poorer mental health and wellbeing. Conclusions: Results suggest that compulsive exercise is uniquely associated with a range of psychosocial and mental health outcomes. Results support the need to improve identification and treatment of compulsive exercise in sport and exercise settings. Results highlight that mental health intervention is an important component of treatment, and treatments targeting symptoms related to avoidance and rule-driven behaviour, and anhedonia may be valuable treatment components for those with compulsive exercise. © 2023 The Author(s)
- Authors: Cosh, Suzanne , McNeil, Dominic , Tully, Phillip
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 26, no. 7 (2023), p. 338-344
- Full Text:
- Reviewed:
- Description: Objectives: Better understanding of compulsive exercise is needed in sports medicine. Whilst compulsive exercise may impact mental health, the limited research exploring the relationship between compulsive exercise and psychosocial outcomes is equivocal. The majority of studies have examined eating disorder populations where the eating disorder pathology might account for distress. This study explores relationships between compulsive exercise and mental health. Design: Cross-sectional observational study. Methods: Australian recreational exercisers and athletes (N = 1157; Mage 36.4, standard deviation = 12.9, 77 % female) recruited through sporting organisations, clubs, and gyms, completed measures of compulsive exercise, depression, anxiety, stress, life satisfaction, social physique anxiety, and self-esteem. Regression analyses examined relationships between dimensions of compulsive exercise and wellbeing. Results: After adjustment for eating disorder symptoms and sporting level, compulsive exercise was associated with increased risk of clinically-significant anxiety, depression, and stress symptoms. Compulsive exercise was also associated with lower life satisfaction and self-esteem, and higher social physique anxiety. Notably, different dimensions of compulsive exercise had varying relationships with outcomes, and avoidance and rule-driven behaviour and lack of exercise enjoyment were associated with poorer mental health and wellbeing. Conclusions: Results suggest that compulsive exercise is uniquely associated with a range of psychosocial and mental health outcomes. Results support the need to improve identification and treatment of compulsive exercise in sport and exercise settings. Results highlight that mental health intervention is an important component of treatment, and treatments targeting symptoms related to avoidance and rule-driven behaviour, and anhedonia may be valuable treatment components for those with compulsive exercise. © 2023 The Author(s)
Conceptualising social media addiction: a longitudinal network analysis of social media addiction symptoms and their relationships with psychological distress in a community sample of adults
- Tullett-Prado, Deon, Doley, Jo, Zarate, Daniel, Gomez, Rapson, Stavropoulos, Vasileios
- Authors: Tullett-Prado, Deon , Doley, Jo , Zarate, Daniel , Gomez, Rapson , Stavropoulos, Vasileios
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 23, no. 1 (2023), p.
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- Description: Background: Problematic social media use has been identified as negatively impacting psychological and everyday functioning and has been identified as a possible behavioural addiction (social media addiction; SMA). Whether SMA can be classified as a distinct behavioural addiction has been debated within the literature, with some regarding SMA as a premature pathologisation of ordinary social media use behaviour and suggesting there is little evidence for its use as a category of clinical concern. This study aimed to understand the relationship between proposed symptoms of SMA and psychological distress and examine these over time in a longitudinal network analysis, in order better understand whether SMA warrants classification as a unique pathology unique from general distress. Method: N = 462 adults (M age = 30.8, SD age = 9.23, 69.3% males, 29% females, 1.9% other sex or gender) completed measures of social media addiction (Bergen Social Media Addiction Scale), and psychological distress (DASS-21) at two time points, twelve months apart. Data were analysed using network analysis (NA) to explore SMA symptoms and psychological distress. Specifically, NA allows to assess the ‘influence’ and pathways of influence of each symptom in the network both cross-sectionally at each time point, as well as over time. Results: SMA symptoms were found to be stable cross-sectionally over time, and were associated with, yet distinct, from, depression, anxiety and stress. The most central symptoms within the network were tolerance and mood-modification in terms of expected influence and closeness respectively. Depression symptoms appeared to have less of a formative effect on SMA symptoms than anxiety and stress. Conclusions: Our findings support the conceptualisation of SMA as a distinct construct occurring based on an underpinning network cluster of behaviours and a distinct association between SMA symptoms and distress. Further replications of these findings, however, are needed to strengthen the evidence for SMA as a unique behavioural addiction. © 2023, The Author(s).
- Authors: Tullett-Prado, Deon , Doley, Jo , Zarate, Daniel , Gomez, Rapson , Stavropoulos, Vasileios
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Problematic social media use has been identified as negatively impacting psychological and everyday functioning and has been identified as a possible behavioural addiction (social media addiction; SMA). Whether SMA can be classified as a distinct behavioural addiction has been debated within the literature, with some regarding SMA as a premature pathologisation of ordinary social media use behaviour and suggesting there is little evidence for its use as a category of clinical concern. This study aimed to understand the relationship between proposed symptoms of SMA and psychological distress and examine these over time in a longitudinal network analysis, in order better understand whether SMA warrants classification as a unique pathology unique from general distress. Method: N = 462 adults (M age = 30.8, SD age = 9.23, 69.3% males, 29% females, 1.9% other sex or gender) completed measures of social media addiction (Bergen Social Media Addiction Scale), and psychological distress (DASS-21) at two time points, twelve months apart. Data were analysed using network analysis (NA) to explore SMA symptoms and psychological distress. Specifically, NA allows to assess the ‘influence’ and pathways of influence of each symptom in the network both cross-sectionally at each time point, as well as over time. Results: SMA symptoms were found to be stable cross-sectionally over time, and were associated with, yet distinct, from, depression, anxiety and stress. The most central symptoms within the network were tolerance and mood-modification in terms of expected influence and closeness respectively. Depression symptoms appeared to have less of a formative effect on SMA symptoms than anxiety and stress. Conclusions: Our findings support the conceptualisation of SMA as a distinct construct occurring based on an underpinning network cluster of behaviours and a distinct association between SMA symptoms and distress. Further replications of these findings, however, are needed to strengthen the evidence for SMA as a unique behavioural addiction. © 2023, The Author(s).
Coping strategies to overcome psychological distress and fear during COVID-19 pandemic in Kuwait
- Elaidy, Asmaa, Hammoud, Majeda, N. Albatineh, Ahmed, Ridha, Fatma, Hammoud, Sabri, Elsadek, Hala, Rahman, Muhammad Aziz
- Authors: Elaidy, Asmaa , Hammoud, Majeda , N. Albatineh, Ahmed , Ridha, Fatma , Hammoud, Sabri , Elsadek, Hala , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: Middle East Current Psychiatry Vol. 30, no. 1 (2023), p.
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- Description: Background: The COVID-19 pandemic has detrimental effects on both physical and psychological well-being of community people worldwide. The purpose of this research was to determine coping strategies and the factors associated with psychological distress and fear among adults in Kuwait during the COVID-19 pandemic. Results: Participants with good-excellent mental health perception had significantly lower prevalence of reporting high psychological distress, while those identified as patients as used health services in the past 4 weeks had significantly higher prevalence of reporting high psychological distress. On the other hand, individuals born in the same country of residence, whose financial situation was impacted by COVID-19 had significantly lower prevalence of reporting high levels of fear from COVID-19. Those with an income source, with co-morbidities, tested negative to COVID-19, being frontline or essential worker, reported medium to high psychological distress and had significantly higher prevalence of high levels of fear of COVID-19. Conclusions: Mental health services should be provided in addition to the existing services in primary healthcare settings, so that the impact of ongoing pandemic on psychological wellbeing of people in Kuwait can be addressed. © 2023, The Author(s).
- Authors: Elaidy, Asmaa , Hammoud, Majeda , N. Albatineh, Ahmed , Ridha, Fatma , Hammoud, Sabri , Elsadek, Hala , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: Middle East Current Psychiatry Vol. 30, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: The COVID-19 pandemic has detrimental effects on both physical and psychological well-being of community people worldwide. The purpose of this research was to determine coping strategies and the factors associated with psychological distress and fear among adults in Kuwait during the COVID-19 pandemic. Results: Participants with good-excellent mental health perception had significantly lower prevalence of reporting high psychological distress, while those identified as patients as used health services in the past 4 weeks had significantly higher prevalence of reporting high psychological distress. On the other hand, individuals born in the same country of residence, whose financial situation was impacted by COVID-19 had significantly lower prevalence of reporting high levels of fear from COVID-19. Those with an income source, with co-morbidities, tested negative to COVID-19, being frontline or essential worker, reported medium to high psychological distress and had significantly higher prevalence of high levels of fear of COVID-19. Conclusions: Mental health services should be provided in addition to the existing services in primary healthcare settings, so that the impact of ongoing pandemic on psychological wellbeing of people in Kuwait can be addressed. © 2023, The Author(s).
Psychological distress, fear and coping strategies during the second and third waves of the COVID-19 pandemic in Southern Germany
- Elsayed, Mohamed, Schönfeldt-Lecuona, Carlos, Welte, Xenia, Dardeer, Khaled, Kamal, Manar, Abdelnaby, Ramy, Rudek, Markus, Riedel, Evelyne, Denkinger, Michael, Gahr, Maximilian, Connemann, Bernhard, Alif, Sheikh, Banik, Biswajit, Cross, Wendy, Rahman, Muhammad Aziz
- Authors: Elsayed, Mohamed , Schönfeldt-Lecuona, Carlos , Welte, Xenia , Dardeer, Khaled , Kamal, Manar , Abdelnaby, Ramy , Rudek, Markus , Riedel, Evelyne , Denkinger, Michael , Gahr, Maximilian , Connemann, Bernhard , Alif, Sheikh , Banik, Biswajit , Cross, Wendy , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
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- Description: Background: The COVID-19 pandemic has imposed enormous psychological discomfort and fear across the globe, including Germany. Objectives: To assess the levels of COVID-19 associated psychological distress and fear amongst Southern German population, and to identify their coping strategies. Methods: A cross-sectional survey using an online questionnaire was conducted in healthcare and community settings in the region of Ulm, Southern Germany. Assessment inventories were the Kessler Psychological Distress Scale (K-10), the Brief Resilient Coping Scale (BRCS), and the Fear of COVID-19 Scale (FCV-19S), which were valid and reliable tools. Results: A total of 474 Individuals participated in the study. The mean age was 33.6 years, and 327 (69%) were females. Most participants (n = 381, 80.4%) had high levels of psychological distress, whereas only 5.1% had high levels of fear, and two-thirds of participants showed higher levels of coping. Moderate to very high levels of psychological distress were associated with being female, living alone, distress due to employment changes, experiencing financial impact, having multiple co-morbidities, being a smoker, increased alcohol use over the previous 6 months, contact with COVID-19 cases and healthcare providers for COVID-19-related stress. Individuals who were
- Authors: Elsayed, Mohamed , Schönfeldt-Lecuona, Carlos , Welte, Xenia , Dardeer, Khaled , Kamal, Manar , Abdelnaby, Ramy , Rudek, Markus , Riedel, Evelyne , Denkinger, Michael , Gahr, Maximilian , Connemann, Bernhard , Alif, Sheikh , Banik, Biswajit , Cross, Wendy , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Background: The COVID-19 pandemic has imposed enormous psychological discomfort and fear across the globe, including Germany. Objectives: To assess the levels of COVID-19 associated psychological distress and fear amongst Southern German population, and to identify their coping strategies. Methods: A cross-sectional survey using an online questionnaire was conducted in healthcare and community settings in the region of Ulm, Southern Germany. Assessment inventories were the Kessler Psychological Distress Scale (K-10), the Brief Resilient Coping Scale (BRCS), and the Fear of COVID-19 Scale (FCV-19S), which were valid and reliable tools. Results: A total of 474 Individuals participated in the study. The mean age was 33.6 years, and 327 (69%) were females. Most participants (n = 381, 80.4%) had high levels of psychological distress, whereas only 5.1% had high levels of fear, and two-thirds of participants showed higher levels of coping. Moderate to very high levels of psychological distress were associated with being female, living alone, distress due to employment changes, experiencing financial impact, having multiple co-morbidities, being a smoker, increased alcohol use over the previous 6 months, contact with COVID-19 cases and healthcare providers for COVID-19-related stress. Individuals who were
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