Huw Goodwin

Compulsive exercise and eating disorders.

The aim of this review was to develop an empirically supported cognitive behavioural model of compulsive exercise within the context of the eating disorders. A systematic review of the correlates and predictors of compulsive exercise among eating disordered patients identified four key correlates. These were subsequently validated by a second review, incorporating both the clinical and non-clinical as well as the exercise science literatures. A proposed model is presented which is both evidence-based and testable.

Eating disorder examination questionnaire: Factor structure for adolescent girls and boys

OBJECTIVE To examine the factor structure of the EDE-Q among a sample of adolescents. METHOD A community-based sample of 917 adolescents (522 girls and 395 boys) aged 14-18 years completed the EDE-Q version 6.0 as part of a larger study. Participants were randomly assigned to one of two subsamples to enable separate analyses. RESULTS A confirmatory factor analysis on the original four factor model of the EDE-Q produced an inadmissible model with a poor fit. Exploratory factor analysis using principal axis factoring produced an alternative three factor model of the EDE-Q among adolescents. The Shape and Weight Concerns, Restriction and Preoccupation and Eating Concern subscales accounted for 65% of the total variance. Subscale and global scores were significantly higher for girls than for boys. A high proportion of both girls (53.6%) and boys (30.5%) reported participating in at least one key eating disordered behaviour during the previous 28 days. DISCUSSION The results of this study present three new subscales (Shape and Weight Concerns, Restriction and Preoccupation and Eating Concern) which are suggested for use in future research which uses the EDE-Q with community samples of adolescents.

Compulsive exercise: The role of personality, psychological morbidity, and disordered eating

OBJECTIVE Compulsive exercise has been closely linked with eating disorders, and has been widely reported in both clinical and nonclinical settings. It has been shown to have a negative impact on eating disorder treatment and outcome. However, the risk factors for compulsive exercise have not been examined. This study aimed to provide a first step in identifying potential cross-sectional predictors of compulsive exercise. METHOD The sample consisted of 1,488 male and female adolescents, aged 12-14 years old, recruited from schools in the United Kingdom. Participants completed measures of compulsive exercise, personality, psychological morbidity, and disordered eating attitudes during a school class period. RESULTS Multiple stepwise regressions showed that the strongest cross-sectional predictors of compulsive exercise were a drive for thinness, perfectionism, and obsessive-compulsiveness. DISCUSSION These results are discussed in terms of the role that personal factors may play in the development of compulsive exercise.

Psychometric evaluation of the compulsive exercise test (CET) in an adolescent population: Links with eating psychopathology

OBJECTIVE Compulsive exercise describes a rigid, driven urge to exercise that has been reported in different populations, including eating disorder patients. This compulsion can develop at an early age and yet the measurement of compulsive exercise in adolescents is limited by inappropriate assessment techniques. This study aimed to psychometrically evaluate the Compulsive Exercise Test (CET) in a sample of adolescents. METHODS The sample consisted of 1012 adolescents aged 12-14 years old, who completed the CET, the Commitment to Exercise Scale (CES), and selected subscales from the Eating Disorder Inventory-2 (EDI-2). RESULTS Results confirmed the original five-factor solution of the CET. The CETs concurrent validity with the CES, as well as the convergent validity with the EDI-2, was established. The CET was not strongly related to exercise frequency. CONCLUSION The CET appears to be valid and reliable for use with adolescents. Replication with an adolescent clinical eating disorder sample is now required.

Muscle Dysmorphia: Methodological Issues, Implications for Research

Muscle dysmorphia is a male-dominated, body image-related psychological condition. Despite continued investigation, contention surrounds the nosological status of this disorder. The aim of this article was to review the literature on muscle dysmorphia to provide a qualitative account of methodological issues that may inhibit our understanding. Key areas relating to non-standardized participant groups, measuring instruments, and terminology were identified as potentially inhibiting symptom coherence and diagnostic reliability. New measuring instruments validated with clinical samples and carefully described participant groups, standardized terminology, and a greater emphasis on prospective longitudinal research with specific sub groups of the weight training community would be of interest to the field.

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.

Perfectionism and Eating Psychopathology Among Dancers: The Role of High Standards and Self-criticism

This study examined the associations between conscientious perfectionism (high standards), self-evaluative perfectionism (self-criticism) and eating psychopathology among dancers. A sample of 244 female dancers, with a mean age of 20.11 years (standard deviation=1.97) completed the Perfectionism Inventory and Eating Disorder Examination Questionnaire. Self-evaluative perfectionism predicted eating psychopathology (eating restraint, eating concern, weight concern and shape concern). This relationship was not moderated by conscientious perfectionism. The mediation analyses showed that although conscientious perfectionism predicted eating psychopathology, this relationship was fully mediated by self-evaluative perfectionism. These findings demonstrate the greater influence of self-evaluative perfectionism, rather than conscientious perfectionism, on eating psychopathology in dancers.

Sociocultural Risk Factors for Compulsive Exercise: A Prospective Study of Adolescents

The risk factors for compulsive exercise are unknown. This study aims to explore longitudinal sociocultural risk factors for compulsive exercise, using a 12-month prospective design. A sample of 332 male and female adolescents (aged 13-15 years at baseline) completed self-report measures of sociocultural risk factors and compulsive exercise at baseline and eating disorder psychopathology and compulsive exercise at 12-month follow-up assessment. Hierarchical regressions found that family and peer messages to become more muscular predicted compulsive exercise in boys, whereas feeling pressure from the media to be thin was a significant predictor of compulsive exercise in girls. These relationships remained significant when controlling for eating disorder psychopathology but became nonsignificant when initial levels of compulsive exercise were entered into the model. The findings suggest that sociocultural risk factors may contribute to the development of compulsive exercise but future research should utilise a younger sample and employ a longer follow-up period to identify true longitudinal effects.

Critical comments concerning shape and weight: associations with eating psychopathology among full-time dance students.

Both eating psychopathology and body dissatisfaction are more prevalent among dancers than among non-dancing controls [1]. This increased prevalence can be explained by individual risk factors, including characteristic low selfesteem [2], and specific environmental factors, including critical appearance comments which are relatively common in the dance community [3]. Indeed, in a recent qualitative study of ballet students, it was found that the desire for thinness is both an implicit desire of the dance environment, as well as an explicit target being reinforced by critical comments by teachers and peers about eating, weight and shape [4]. To date, the mechanisms via which critical comments are related to eating psychopathology among dancers remain unclear. One potentially important factor is selfesteem, which has been associated with levels of eating psychopathology [1] and has also been linked to body image among ballet dancers [2]. Self-esteem was also found to partially mediate the relationship between a pressure to be thin and disordered eating among ballet dancers [5]. Importantly, though, high self-esteem has also been shown to be protective against disordered eating [6]. Therefore, the relationship between self-esteem and eating psychopathology warrants further investigation. This study has two aims: First, to determine as to what extent experiencing critical comments is associated with increased eating psychopathology among full-time dance students. Second, to determine whether this relationship is mediated by self-esteem. It is hypothesised that those dancers who recall receiving a critical comment about their body weight or shape will report significantly greater levels of eating psychopathology and lower self-esteem than those who have not received such a comment. In addition, it is hypothesised that self-esteem will be a significant mediator in the relationship between critical comments and eating psychopathology, with more severe critical comments being associated with higher eating psychopathology through lowered self-esteem.

Disordered Eating, Compulsive Exercise, and Sport Participation in a UK Adolescent Sample.

The sport literature has produced equivocal results as to whether sport participation is a protective or risk factor for disordered eating. One mechanism by which it could be a risk factor is the increased drive or compulsion to exercise. This study compared the levels of disordered eating and compulsive exercise between adolescent sport and non-sport participants. A sample of 417 male and female adolescents, aged 14-16 years old, was recruited from UK secondary schools. Participants completed questionnaire packs that included: the Eating Disorder Inventory; a measure of exercise behaviour; and the Compulsive Exercise Test (CET). Non-sport participants reported significantly greater body dissatisfaction than sport participants, and this was true for boys and girls. Significant group differences were also reported for many of the CET scales, with sport participants generally reporting greater levels of compulsive exercise than non-sport participants. Implications of these results are discussed. Copyright