Schlegl Sandra, Dittmer Nina, Hoffmann Svenja, Voderholzer Ulrich
1Department of Psychiatry and Psychotherapy, University Hospital of Munich (LMU), Nußbaumstraße 7, 80336 Munich, Germany.
Schoen Clinic Roseneck, Prien am Chiemsee, Germany.
J Eat Disord. 2018 Jul 1;6:17. doi: 10.1186/s40337-018-0202-6. eCollection 2018.
Compulsive exercise (CE) is a frequent symptom in patients with eating disorders (EDs). It includes, in addition to quantitatively excessive exercise behaviour, a driven aspect and specific motives of exercise. CE is generally associated with worse therapy outcomes. The aims of the study were to compare self-reported quantity of exercise, compulsiveness of exercise as well as motives for exercise between patients with anorexia nervosa (AN), bulimia nervosa (BN) and healthy controls (HC). Additionally, we wanted to explore predictors of compulsive exercise (CE) in each group.
We investigated 335 female participants ( = 226 inpatients, = 109 HC) and assessed self-reported quantity of exercise, compulsiveness of exercise (Compulsive Exercise Test), motives for exercise (Exercise Motivations Inventory-2), ED symptoms (Eating Disorder Inventory-2), obsessive-compulsiveness (Obsessive-Compulsive Inventory-Revised), general psychopathology (Brief Symptom Inventory-18) and depression (Beck Depression Inventory-2).
Both patients with AN and BN exercised significantly more hours per week and showed significantly higher CE than HC; no differences were found between patients with AN and BN. Patients with EDs and HC also partly varied in motives for exercise. Specific motives were enjoyment, challenge, recognition and weight management in patients with EDs in contrast to ill-health avoidance and affiliation in HC. Patients with AN and BN only differed in regard to exercise for appearance reasons in which patients with BN scored higher. The most relevant predictor of CE across groups was exercise for weight and shape reasons.
Exercise behaviours and motives differ between patients with EDs and HC. CE was pronounced in both patients with AN and BN. Therefore, future research should focus not only on CE in patients with AN, but also on CE in patients with BN. Similarities in CE in patients with AN and BN support a transdiagnostic approach during the development of interventions specifically targeting CE in patients with EDs.
强迫性运动（CE）是饮食失调（EDs）患者的常见症状。除了运动量过大的运动行为外，它还包括运动的强迫性方面和特定动机。CE通常与较差的治疗结果相关。本研究的目的是比较神经性厌食症（AN）、神经性贪食症（BN）患者与健康对照者（HC）自我报告的运动量、运动强迫性以及运动动机。此外，我们想探索每组中强迫性运动（CE）的预测因素。
我们调查了335名女性参与者（226名住院患者，109名HC），并评估了自我报告的运动量、运动强迫性（强迫性运动测试）、运动动机（运动动机量表-2）、ED症状（饮食失调量表-2）、强迫观念-强迫行为（修订版强迫观念-强迫行为量表）、一般精神病理学（简明症状量表-18）和抑郁（贝克抑郁量表-2）。
AN和BN患者每周运动的时间均显著多于HC，且CE显著高于HC；AN和BN患者之间未发现差异。ED患者和HC在运动动机方面也存在部分差异。ED患者的特定动机是享受、挑战、认可和体重管理，而HC的动机是避免健康问题和社交。AN和BN患者仅在出于外表原因的运动方面存在差异，其中BN患者得分更高。各组中CE最相关的预测因素是出于体重和体型原因的运动。
ED患者和HC的运动行为及动机存在差异。AN和BN患者均存在明显的CE。因此，未来研究不仅应关注AN患者的CE，还应关注BN患者的CE。AN和BN患者CE的相似性支持在开发专门针对ED患者CE的干预措施时采用跨诊断方法。
