Harris Astrid, Aouad Phillip, Noetel Melissa, Hay Phillipa, Touyz Stephen
The University of Sydney, Sydney, Australia.
Western Sydney University, Sydney, Australia.
J Eat Disord. 2022 Sep 12;10(1):139. doi: 10.1186/s40337-022-00641-7.
Exercise is a prominent feature of most eating disorders, and has been shown to have a number of detrimental effects on treatment outcome. There is some disagreement in the literature regarding the construct of compulsive exercise, and assessment and treatment varies significantly. This study therefore aimed to aggregate expert clinicians' and researchers' views on how to define and measure compulsive exercise in eating disorder patients. The expert panel was also asked about questionnaire design, and possible problems when measuring compulsive exercise.
This study used the Delphi method to establish consensus amongst an expert panel. Three successive rounds of questionnaires were distributed to the panel over a period of six months. The first round consisted of four open-ended questions regarding the definition and measurement of compulsive exercise in eating disorder patients. For Round 2, 70 statements were derived from the answers, and panelists were asked to rate each item on a Likert-based scale. An 85% consensus level was chosen. In Round 3, 44 statements were re-rated by the panel.
Seventeen of 24 participants completed all three rounds of the study. Consensus was achieved for 63% of the items, while 18.5% reached near consensus, and 18.5% did not reach consensus after Round 3. The panel agreed on a number of important aspects of compulsive exercise. Several suggestions regarding the format of a questionnaire assessing this behavior were also endorsed. The panel further identified common difficulties when assessing compulsive exercise in eating disorder patients, notably a lack of consensus still apparent in the literature.
The current findings constitute a further step towards a unified definition of compulsive exercise, and contribute important suggestions to the measurement of this behavior.
运动是大多数饮食失调症的一个显著特征，并且已被证明对治疗结果有许多不利影响。关于强迫性运动的概念，文献中存在一些分歧，评估和治疗方法也有很大差异。因此，本研究旨在汇总专家临床医生和研究人员对于如何定义和测量饮食失调症患者的强迫性运动的观点。专家小组还被问及问卷设计以及测量强迫性运动时可能出现的问题。
本研究采用德尔菲法在专家小组中达成共识。在六个月的时间里，向该小组连续分发三轮问卷。第一轮包括四个关于饮食失调症患者强迫性运动的定义和测量的开放式问题。在第二轮中，从答案中提炼出70条陈述，并要求小组成员基于李克特量表对每个项目进行评分。选择了85%的共识水平。在第三轮中，小组成员对44条陈述重新进行评分。
24名参与者中有17名完成了所有三轮研究。63%的项目达成了共识，18.5%接近达成共识，18.5%在第三轮后未达成共识。该小组就强迫性运动的一些重要方面达成了一致。还认可了一些关于评估这种行为的问卷形式的建议。该小组进一步确定了在评估饮食失调症患者的强迫性运动时常见的困难，尤其是文献中仍然明显缺乏共识。
目前的研究结果朝着强迫性运动的统一定义又迈进了一步，并为这种行为的测量提供了重要建议。
