Kolar David R, Haynos Ann F, Wang Shirley B, Lask Theresa, Murray Stuart B, Voderholzer Ulrich, Gorrell Sasha
Department of Psychology, University of Regensburg, Regensburg, Germany.
Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
Clin Psychol Sci. 2025 May;13(3):582-597. doi: 10.1177/21677026241290455. Epub 2024 Dec 14.
Driven exercise is a transdiagnostic maladaptive behavior, especially common in eating disorders (ED); however, its maintenance mechanisms remain poorly understood. To address this gap, we examined the applicability of previously empirically-derived and validated reinforcement function models in explaining driven exercise maintenance in studies varying across developmental stages and clinical presentations (Study 1: =279 adolescents/adults oversampled for EDs; Study 2: =118 adolescent/adult inpatients with severe EDs; Study 3: =52 adults oversampled for athletes and/or EDs). Results supported the utility of a four-function model (automatic positive/negative reinforcement [APR/ANR; increase/decrease negative affect], social positive/negative reinforcement [SPR/SNR; engage in/avoid interpersonal situations]) in explaining driven exercise. APR was most frequently endorsed, followed by ANR, SNR, and SPR in all studies. APR correlated with last-month driven exercise episodes across studies; associations between other functions and ED psychopathology varied between studies. Further, results suggested a separate control function could be considered in samples with more severe EDs.
强迫性运动是一种跨诊断的适应不良行为，在饮食失调（ED）中尤为常见；然而，其维持机制仍知之甚少。为了填补这一空白，我们在不同发育阶段和临床表现的研究中，检验了先前通过实证得出并经过验证的强化功能模型在解释强迫性运动维持方面的适用性（研究1：n = 279名因饮食失调而过度抽样的青少年/成年人；研究2：n = 118名患有严重饮食失调的青少年/成人住院患者；研究3：n = 52名因运动员和/或饮食失调而过度抽样的成年人）。结果支持了一个四功能模型（自动正性/负性强化[APR/ANR；增加/减少负面影响]、社交正性/负性强化[SPR/SNR；参与/避免人际情境]）在解释强迫性运动方面的效用。在所有研究中，APR最常被认可，其次是ANR、SNR和SPR。在各项研究中，APR与上个月的强迫性运动发作相关；其他功能与饮食失调精神病理学之间的关联在不同研究中有所不同。此外，结果表明，在患有更严重饮食失调的样本中，可以考虑一个单独的控制功能。
