Carolyn R. Plateau

Use of the Compulsive Exercise Test With Athletes: Norms and Links With Eating Psychopathology

This study assessed the 5-factor structure of the Compulsive Exercise Test (CET) and explored the relationship between compulsive exercise and eating psychopathology in athletes. Confirmatory and exploratory factor analyses of the CET were conducted with 689 competitive athletes (18–35 years of age). Convergent validity with the Eating Disorders Examination Questionnaire (EDE-Q) was explored. The 5-factor structure showed a poor fit; an alternative 3-factor structure is proposed. Exercising for weight control and exercising to avoid a negative mood were strongly associated with eating psychopathology. Implications for using the CET with athletes are discussed.

The Compulsive Exercise Test: confirmatory factor analysis and links with eating psychopathology among women with clinical eating disorders

BackgroundThis study aimed to determine the psychometric properties of the Compulsive Exercise Test (CET) among an adult sample of patients with eating disorders.MethodThree hundred and fifty six patients and 360 non-clinical control women completed the CET and the Eating Disorders Examination questionnaire (EDE-Q).ResultsA confirmatory factor analysis revealed that the clinical data showed a moderate fit to the previously published five factor model derived from a community sample (Taranis L, Touyz S, Meyer C, Eur Eat Disord Rev 19:256-268, 2011). The clinical group scored significantly higher than the non-clinical group on four of the five CET subscales, and logistic regression analysis revealed that the CET could successfully discriminate between the two groups. A Receiver Operating Curve analysis revealed that a cut-off score of 15 on the CET resulted in acceptable values of both sensitivity and specificity.ConclusionsThe CET appears to have a factor structure that is acceptable for use with an adult sample of patients with eating disorders. It can identify compulsive exercise among patients with eating disorders and a cut-off score of 15 is acceptable as indicating an appropriate cut-off point.

Female athlete experiences of seeking and receiving treatment for an eating disorder

Abstract Clinical eating disorders are common among athletes; however research has yet to explore the process of seeking and receiving treatment for an eating disorder in this population. Semi-structured interviews were conducted with 13 female athletes currently receiving treatment for an eating disorder. A total of three themes emerged: challenges to treatment seeking, feeling out of place, and coping with exercise transitions. Athletes reported low levels of eating disorder literacy and lacked motivation to engage with therapy due to a lack of perceived relevance. Athletes found it challenging to relinquish exercise behaviours in treatment and expressed concerns around managing a return to sport. It may be necessary to provide additional support to athletes when embarking on and leaving treatment programs, particularly with regards to managing expectations about exercise.

Evaluation of a Motivation and Psycho-Educational Guided Self-Help Intervention for People with Eating Disorders (MOPED).

High dropout rates and poor levels of engagement are well documented for patients with eating disorders. Utilising motivational techniques and providing psycho-education have been suggested as ways to reduce treatment disengagement. This study aimed to evaluate the effect of a newly developed motivational and psycho-educational (MOPED) guided self-help intervention for people with eating disorders on engagement and retention in therapy. Patients who received MOPED pre-treatment (n = 79) were compared with a diagnosis-matched group of patients receiving treatment as usual (TAU; n = 79). The study found that patients receiving MOPED had a higher engagement rate than those within the TAU group. Specifically, patients in the anorexic spectrum were found to present with both higher rates of engagement and completion of therapy when issued with MOPED in comparison with TAU. Self-help packages using motivational style could be a valuable and cost-effective intervention for patients with eating disorders.

Responses of track and field coaches to athletes with eating problems

This study aimed to explore how track and field coaches respond to athletes with eating problems. Eleven experienced coaches participated in semi‐structured interviews exploring their responses to, and challenges faced when, working with athletes with eating problems. The analysis revealed three themes relating to the strategies employed by coaches. The first theme indicated a supportive approach, where coaches were proactive in seeking support and in reducing training at the early stages of an eating problem. The second theme outlined an avoidant approach, characterized by coach reluctance to be involved in managing eating problems, and a lack of confidence in their knowledge of eating disorders. The third theme involved a confrontational approach, where coaches employed strict rules and engaged in coercion to persuade athletes to seek treatment. All of the coaches reported facing challenges in persuading athletes to seek treatment and were frustrated by the lack of available support. The study highlights the importance of providing resources and support services where coaches can seek advice. Coach‐education packages can utilize the findings to highlight the strengths and limitations of different coach strategies, and to reinforce the importance of their role in identification and intervention when eating problems in athletes are suspected.

Exercise attitudes and behaviours among retired female collegiate athletes

Objectives: The present study explored exercise attitudes and behaviours among retired female collegiate athletes. Design: A survey design incorporating both closed and open‐ended questions was adopted. Method: A total of 218 former NCAA Division I female athletes (n = 144 gymnastics; n = 74 swimming/diving) provided details on their current exercise behaviours and their thoughts regarding exercise since retiring from collegiate sport. Results: No relations were found between years since retirement and athletes’ current exercise frequency, types of exercise activities, and reasons for exercising. Despite reporting activity levels consistent with recommendations (5 days/week, 1 h per session), retired athletes remained dissatisfied with their activity levels and struggled to integrate exercise alongside occupational, academic and social demands. Conclusions: Athletes may require support in adapting to an independent and less intense exercise regime on retirement. Future research may look to explore exercise attitudes and behaviours among retired athletes from a longitudinal perspective. HighlightsExercise motives and behaviours were not related to length of time since retirement.Retired female athletes reported exercising in line with physical activity guidelines.Athletes reported lacking intrinsic motivation to exercise in retirement.Athletes remained dissatisfied with their activity levels, body shape and weight.Athletes may require support in accepting and adapting their exercise on retirement.

Identifying and preventing disordered eating among athletes. What can we learn from coaches

This study aimed to identify those factors affecting coach identification of disordered eating (DE) among athletes. Semi-structured interviews were undertaken with eleven athletic coaches, with experience of coaching at national and international level. The interviews were recorded, transcribed verbatim and later analysed using thematic analysis as described by Braun and Clarke (2006). Coaches reported using physical, social and performance indicators to identify a potential eating problem. In addition, they reported monitoring eating attitudes and eating behaviours among their athletes. Weight-loss (both observed and objectively monitored) was considered to be a key indicator of eating problems. Very few coaches referred to changes in mood and anxiety as potential co-morbid indicators of an eating problem. Previous experiences and a close coach/athlete relationship facilitated the identification of an eating problem. However, athlete secrecy and masking behaviours, difficulties with communication and coaches’ stereotypical beliefs were factors that complicated the identification process. This study highlights the need for additional information, advice and guidance for coaches to improve their knowledge and confidence in identifying eating problems among their athletes.

Changes in body image perceptions upon leaving elite sport: The retired female athlete paradox

Little is known about the evolution of female athlete body image into retirement. In this study, 218 retired athletes from aesthetic sports answered a series of closed- and open-ended questions regarding bodily changes since retirement. Years since retirement were unrelated to current weight status (e.g., underweight and normal weight), what they were doing about their current weight (e.g., lose weight), and satisfaction with current weight (all ps > .69). Overall, 74.3% thought they were normal weight, yet 55% were dissatisfied with their weight, and 59.6% were trying to lose weight. A rigorous thematic analysis of the qualitative data yielded 4 core themes that characterized participants’ experiences: (a) a move toward the feminine ideal; (b) feeling fat, flabby, and ashamed; (c) a continued commitment to a former self; and (d) conflicting ideals: the retired female athlete paradox. Perceived muscle loss was considered indicative of either increased fat (dissatisfaction) or increased femininity (satisfaction). For some retired athletes, the satisfaction brought on by newfound femininity was complicated by a coinciding and conflicting commitment to a muscular athletic physique. Practical applications include strategies for sport psychologists to better support athletes in coping with the body changes that occur on retirement from elite sport.

Detecting eating psychopathology in female athletes by asking about exercise: use of the Compulsive Exercise Test

The present study assessed the suitability of the Compulsive Exercise Test (athlete version; CET-A) for identifying female athletes with clinically significant features related to or comparable with eating psychopathology. Three hundred and sixty-one female athletes (including 12 with a clinically diagnosed eating disorder) completed the Eating Disorders Examination Questionnaire and the CET-A. Receiver operating curve analysis was employed to identify a cut-off value on the CET-A, which could indicate clinically significant features related to or comparable with eating psychopathology among female athletes. The analysis demonstrated that a CET-A score of 10 successfully discriminated female athletes with a current eating disorder. The results suggest that the CET-A may be a suitable tool for detecting eating psychopathology in female athletes. Additional longitudinal research is needed to evaluate the predictive value of the CET-A. Copyright

Learning to eat again: Intuitive eating practices among retired female collegiate athletes

ABSTRACT The present study used an open-ended survey to collect information about current eating practices and coping strategies among 218 retired female athletes. An inductive and deductive thematic analysis revealed three themes relevant to the intuitive eating framework—permission to eat; recognizing internal hunger and satiety cues; and eating to meet physical and nutritional needs. Athletes described feeling liberated with regards to their eating following retirement from sport, and for some this included an alleviation of disordered eating practices. These changes, however, required an effortful process of recalibration, during which athletes had to relearn and reinterpret their body’s physiological signals of hunger and satiety. Additional research is needed to understand just how this process unfolds and how retired athletes can be supported in developing a healthier and more adaptive approach to eating.