Validation française du questionnaire de dépendance de l’exercice physique (Exercise Dependence Questionnaire)

IntroductionThe Exercise Dependence Questionnaire (EDQ) conceptualises exercise dependence (ED) within both traditional biomedical and psychosocial perspectives. This tool is a valid and reliable multidimensional measure of ED.ObjectiveThe aim of the present study was to examine the internal consistency, test-retest reliability and factorial validity of the EDQ, in a French language version. In comparison to other existing scales like the EDS (Exercise Dependance Scale), the EDQ emphases not only the symptoms of addiction but also the motivations to exercise.MethodThe French language version of the EDQ was completed by 160 participants (60% male, students and practitioners leisures of sports activities). Participants completed the EDS and measures of exercise behavior.ResultsAdequate internal consistency and test-retest reliability for the scale were obtained. Confirmatory analysis (SPSS 16) supported a correlated eight-factor model, as suggested by Ogden, Veale and Summers (1997). The model fit indices were satisfying, RMSEA = 0.048; CFI = 0.90; IFI = 0.91; Chi²/dll = 1.38. This study provides evidence for the reliability and validity of the French language version of the EDQ. The convergent validity of this scale with the Exercise Dependence Scale was r = 0.52. These two scales appear more complementary than redundant. The EDS focuses more on the strict definition of the dependence whereas the EDQ adds a motivational perspective often link to eating disorders.ConclusionThe EDQ can be thus used in the clinical and studies framework on the exercise dependence.     

Compulsive exercise or exercise dependence? Clarifying conceptualizations of exercise in the context of eating disorder pathology

ObjectiveMaladaptive exercise relates to eating disorder (ED) pathology and impairment in clinical and non-clinical populations. At present, two different conceptualizations of maladaptive exercise are often studied in relation to ED pathology: compulsive exercise and exercise dependence. Compulsive exercise functions to avoid negative affect (e.g., guilt and anxiety) associated with not exercising, whereas exercise dependence is associated with tolerance to exercise benefits and avoidance of exercise withdrawal. At present, clinicians and researchers struggle to determine the most appropriate term for describing problematic exercise in individuals with ED pathology. This study aimed to directly compare these conceptualizations of maladaptive exercise in relation to severity of ED pathology.DesignThis study examined cross-sectional data.MethodUndergraduate participants (N = 235, 78% female) with elevated ED pathology completed the Eating Disorder Examination Questionnaire (EDE-Q), Compulsive Exercise Test (CET), and Exercise Dependence Scale (EDS). Multiple linear regression analyses evaluated associations between EDE-Q and CET and EDS scores and dominance analysis determined which qualities of exercise were uniquely associated with EDE-Q scores.ResultsResults suggest that compulsive qualities of exercise, including exercise to control shape and weight and to avoid negative affect are more strongly associated with severity of ED pathology than qualities of exercise dependence.ConclusionsClinicians and researchers working with ED populations can benefit from prioritizing assessments that capture compulsive qualities of exercise. Additionally, these results suggest that interventions that effectively target other compulsive behaviors (e.g., exposure and response prevention) may be promising treatment options for problematic exercise in the context of EDs.     

The mediating influence of unconditional self-acceptance and labile self-esteem on the relationship between multidimensional perfectionism and exercise dependence

ObjectivesPrevious research has indicated that perfectionism may be an important antecedent of exercise dependence (Hagan, A. L., & Hausenblas, H. A. (2003). The relationship between exercise dependence and perfectionism. American Journal of Health Studies, 18, 133–137; Hausenblas, H. A., & Symons Downs, D. (2002a). Exercise dependence: a systematic review. Psychology of Sport and Exercise, 3, 89–123, Hausenblas, H.A., & Symons Downs, D. (2002b). How much is too much? The development and validation of the exsrcise dependence scale. Psychology and Health, 17, 387–404). To date, however, few studies have sought to examine the psychological processes that underpin this relationship. The purpose of the present investigation was to determine the degree to which self-oriented and socially prescribed perfectionism were associated with exercise dependence, and to ascertain whether the relationships were mediated by unconditional self-acceptance and labile self-esteem.MethodThree hundred and seven middle-distance runners completed a multi-section inventory that included Hewitt, P. L., & Flett, G. L. [(1991). Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470] Multidimensional Perfectionism Scale, Chamberlain, J. M., & Haaga, D. A. F. [(2001). Unconditional self-acceptance and psychological health. Journal of Rational Emotive and Cognitive Behavior Therapy, 19, 163–176] Unconditional Self-acceptance Scale, Dykman, B. M. [(1998). Integrating cognitive and motivational factors in depression: initial tests of a goal orientation approach. Journal of Personality and Social Psychology, 74, 139–158] Labile Self-Esteem Scale, and Ogden, J., Veale, D., & Summers, Z. [(1997). The development and validation of the Exercise Dependence Questionnaire. Addiction Research, 5, 343–356] Exercise Dependence Questionnaire.ResultsStructural Equation Modeling provided support for three hypotheses. First, that self-oriented perfectionism had a direct positive effect on exercise dependence. Second, that unconditional self-acceptance fully mediated the relationship between socially prescribed perfectionism and exercise dependence. Third, that labile self-esteem mediated the relationship between unconditional self-acceptance and exercise dependence. Multi-group invariance analysis further indicated that there were subtle variations in the nature of these relationships for male and female samples.ConclusionsThe findings from the present study indicate that both self-oriented and socially prescribed perfectionism may be critical antecedents of exercise dependence, but that the psychological mechanisms underpinning their association with exercise dependence may differ.     

Too much of a good thing? Examining the relationship between passion for exercise and exercise dependence

ObjectivesTo examine the relationship between passion (i.e., love for an activity that is valued for which and a great deal of time is invested) for exercise and exercise dependence symptoms.DesignA cross-sectional correlational survey design was utilised.MethodA total of 480 participants (n = 275 females, n = 205 males; M_age = 18.58, SD = 1.66) completed the Leisure Time Exercise Questionnaire (Godin, Jobin, & Bouillon, 1986), the Passion Scale (Vallerand et al., 2003), and the Exercise Dependence Scale-Revised (Hausenblas, Symons-Downs, & Nigg, 2004). Path analysis using structural equation modelling was used to assess the relationships between passion and exercise dependence.ResultsPath analysis using structural equation modelling via AMOS 20.0 (Arbuckle, 2011) revealed that harmonious passion (i.e., being in control of the activity and deciding when and when not to engage in it) was positively related to the exercise dependence dimensions of time and tolerance. On the other hand, obsessive passion (i.e., an internal compulsion to engage in the activity even when not appropriate to do so) was positively related to all seven exercise dependence dimensions: time, tolerance, withdrawal, continuance, intention effects, lack of control, and reduction in other activities (CFI = .91, RMSEA = .05, SRMR = .06).ConclusionAn empirical relationship has been established to support the proposed theoretical link between passion (harmonious and obsessive) for exercise and exercise dependence dimensions.     

Does the German version of the Exercise Dependence Scale measure exercise dependence?

ObjectiveTo examine the concordance of a questionnaire-based categorization as ‘at-risk for exercise dependence’ and an interview-based diagnosis of exercise dependence.DesignOne hundred thirty four subjects answered the German version of the Exercise Dependence Scale-21 (EDS-G). They were also assessed with a structured clinical interview for exercise dependence.MethodThe congruence between the questionnaire-based categorizations of ‘at-risk for exercise dependence’ and the diagnosis of exercise dependence based on the interview was examined using κ-coefficients.ResultThe agreement between questionnaire-based and interview-based diagnoses was fair to moderate with more false positive categorization based on the EDS-G.ConclusionAssuming that a structured clinical interview allows a more accurate diagnostic categorization, the EDS-G might overestimate the prevalence of exercise dependence.     

Using implicit attitudes of exercise importance to predict explicit exercise dependence symptoms and exercise behaviors

Objectives“Fast” (i.e., implicit) processing is relatively automatic; “slow” (i.e., explicit) processing is relatively controlled and can override automatic processing. These different processing types often produce different responses that uniquely predict behaviors. In the present study, we tested if explicit, self-reported symptoms of exercise dependence and an implicit association of exercise as important predicted exercise behaviors and change in problematic exercise attitudes.DesignWe assessed implicit attitudes of exercise importance and self-reported symptoms of exercise dependence at Time 1. Participants reported daily exercise behaviors for approximately one month, and then completed a Time 2 assessment of self-reported exercise dependence symptoms.MethodUndergraduate males and females (Time 1, N = 93; Time 2, N = 74) tracked daily exercise behaviors for one month and completed an Implicit Association Test assessing implicit exercise importance and subscales of the Exercise Dependence Questionnaire (EDQ) assessing exercise dependence symptoms.ResultsImplicit attitudes of exercise importance and Time 1 EDQ scores predicted Time 2 EDQ scores. Further, implicit exercise importance and Time 1 EDQ scores predicted daily exercise intensity while Time 1 EDQ scores predicted the amount of days exercised.ConclusionImplicit and explicit processing appear to uniquely predict exercise behaviors and attitudes. Given that different implicit and explicit processes may drive certain exercise factors (e.g., intensity and frequency, respectively), these behaviors may contribute to different aspects of exercise dependence.     

Gender-related differences in self-reported problematic exercise symptoms: A systematic review and meta-analysis

AimsTo provide quantitative summarized evidence on gender-related differences in self-reported problematic exercise (PE) symptoms.MethodsEligible studies were searched up to December 31, 2021 in the databases MEDLINE, Current Contents Connect, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global. Studies were considered eligible if they included information that allowed the calculation of the differences of interest as expressed by either the aggregate or subscales scores of the main self-reported instruments of PE identified by previous research (i.e., Commitment to Exercise Scale, Compulsive Exercise Test, Exercise Addiction Inventory, Exercise Dependence Questionnaire, Exercise Dependence Scale-Revised, and Obligatory Exercise Questionnaire). Data were analysed using three-level meta-analytic models. Potential moderator variables were examined using meta-regressions.ResultsA total of 168 effect-sizes from 117 studies (N = 65,718) were retrieved. Results showed (i) small overall differences favouring males for the aggregate scores of the instruments (g = 0.105), (ii) small-to-moderate differences favouring females for symptoms involving withdrawal (g = 0.169 and 0.118), lack of exercise enjoyment (g = 0.226), and the employment of exercise as a means to ends such as health improvement (g = 0.222), mood management (g = 0.158 and 0.226), and body weight control (g = 0.453 and 0.465); and (iii) small differences favouring males for symptoms involving spending considerable amount of time in the activity (g = 0.250), exercising with greater volume/intensity than planned (g = 0.254), a need for increased amounts of exercise to achieve the desired effect (g = 0.291), loss of control over the behaviour (g = 0.101), reduction or cessation of other activities because of exercise (g = 0.323), and continue to exercise despite physical and/or psychological issues being caused or exacerbated by this behaviour (g = 0.243).ConclusionsAdopting a gender-informed perspective may be needed both in the professional praxis of exercise and health practitioners prescribing and guiding exercise practice and in the design of prevention and treatment efforts aimed at avoiding the occurrence of PE.     

The interplay between emotion dysregulation,psychological distress,emotional eating,and weight status: A path model

Background/objectiveThe aim of the current cross-sectional study is to assess the relations between emotion dysregulation, psychological distress, emotional eating, and BMI in a sample of Italian young adults (20-35).MethodsA total sample of 600 participants frm the general population, were asked to fill in demographical and physical data, the Difficulties in Emotion Regulation Scale, the Depression Anxiety and Stress Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire via an online anonymous survey. Relations between variables have been inspected using a path model.ResultsResults showed that emotion dysregulation was a contributor to higher levels of psychological distress [b= 0.348; SE: 0.020; p=<0.001; 95% BC-CI (0.306–0.387)] and emotional eating [b= 0.010; SE: 0.002; p=<0.001; 95% BC-CI (0.006–0.014)] which in turn, was related to higher Body Mass Index [b= 0.0574; SE: 0.145; p=<0.001; 95% BC-CI (0.286–0.863)].ConclusionsBy providing additional evidence concerning the role of emotion dysregulation for physical and psychological outcomes, the current study could inform for improving psychological interventions aimed to promote emotion regulation strategies aimed at fostering physical and psychological well-being.     

Exercise dependence and the drive for muscularity in male bodybuilders,power lifters,and fitness lifters

Researchers have hypothesized differences in exercise dependence and drive for muscularity between bodybuilders and power lifters, while others have not found the predicted differences. This study assessed 146 weight lifters (bodybuilders, n = 59; power lifters, n = 47; fitness lifters, n = 40) on the Exercise Dependence Scale, Bodybuilding Dependence Scale, and the Drive for Muscularity Scale. Results showed that bodybuilders and power lifters were significantly higher than fitness lifters on EDS Total, 7 EDS scales, and the 3 BDS scales. In contrast, power lifters were found to be significantly higher on DMS Total and DMS Behavior scales than bodybuilders. The regression results suggest that exercise dependence may be directly related to the drive for muscularity.     

Defining features of unhealthy exercise associated with disordered eating and eating disorder diagnoses

ObjectivesThe current study sought to compare different features of unhealthy exercise on associations with disordered eating and their ability to identify individuals with eating disorders. A secondary aim of the study was to compare prevalence and overlap of different aspects of unhealthy exercise and potential differences in their gender distribution.DesignCross-sectional epidemiological study.MethodsA community-based sample of men (n = 592) and women (n = 1468) completed surveys of health and eating patterns, including questions regarding exercise habits and eating disorder symptoms.ResultsCompulsive and compensatory features of exercise were the best predictors of disordered eating and eating disorder diagnoses compared to exercise that was excessive in quantity. Further, compulsive and compensatory aspects of unhealthy exercise represented overlapping, yet distinct qualities in both men and women.ConclusionsIncluding the compulsive quality among the defining features of unhealthy exercise may improve identification of eating disorders, particularly in men. Results suggest that the compensatory aspect of unhealthy exercise is not adequately captured by the compulsive aspect of unhealthy exercise. Thus, interventions that target unhealthy exercise behaviors among high-risk individuals, such as athletes, may benefit from addressing both the compulsive and compensatory aspects of unhealthy exercise. Future prospective longitudinal studies will aid in determining the direction of the association between these features of unhealthy exercise and the onset of eating pathology.     

Exercise behavior and gender-related differences in posttraumatic stress disorder symptoms

ObjectivesExercise has been proposed as a potential treatment for posttraumatic stress disorder (PTSD). However, the relationship between exercise, gender, and PTSD symptoms is unknown.DesignThis study examined the cross-sectional relationship among these variables in a national sample of 165 men and women who screened positive for PTSD.MethodParticipants completed an online survey consisting of the Godin Leisure-Time Exercise Questionnaire and the PTSD Checklist-Civilian.ResultsActive participants had significantly lower PTSD symptoms than insufficiently active participants. Significant interactions between gender and exercise for PTSD symptoms were found, such that active men had significantly lower PTSD symptoms than active women, and insufficiently active men and women. Additionally, strenuously active men reported significantly lower hyperarousal symptoms than strenuously active women, and insufficiently active men and women.ConclusionFindings suggest that the relationship between PTSD and exercise may differ for specific sub-populations of individuals with PTSD, such as men and women.     

Cross-cultural invariance of the basic psychological needs in exercise scale and need satisfaction latent mean differences among Greek,Spanish, Portuguese and Turkish samples

ObjectivesThe present study examined the extent to which scores from the Basic Psychological Needs in Exercise Scale are measurement invariant across Greek, Spanish, Portuguese, and Turkish samples of exercise participants.DesignA cross-sectional design wherein responses were analyzed from 504 Greek participants, 518 Spanish participants, 989 Portuguese participants, and 686 Turkish participants.MethodsData on exercise participants' need satisfaction were collected using the Basic Psychological Needs in Exercise Scale (Vlachopoulos & Michailidou, 2006) after back translation for the languages involved in the study.ResultsMulti-sample confirmatory factor analyses showed that BPNES scores were largely invariant at the configural, metric, and strong invariance levels, but not at the strict invariance level for Spanish, Portuguese, and Turkish samples compared to the Greek sample. Portuguese participants reported higher levels of satisfaction for all three needs compared to Greek participants, while for Spanish participants this was the case only for competence and relatedness. Turkish participants did not differ from Greek participants.ConclusionsThe present findings support valid cross-cultural comparisons at the latent variance/covariance level and the latent/observed mean level of the constructs of autonomy, competence, and relatedness using the BPNES.     

Current issues and new directions in psychology and health: Culture and health psychology. Why health psychologists should care about culture

This paper presents five studies with 2,420 total participants on the development and validation of the Exercise Dependence Scale (EDS), which is conceptualized based on the Diagnostic and Statistical Manual-IV (APA, 1994) criteria for substance dependence, and differentiates among at-risk, nondependent-symptomatic, and nondependent-asymptomatic exercisers. Results of the studies revealed evidence for the a priori hypothesized components, acceptable test-retest and internal consistency reliability, and content and concurrent validity of the EDS. Individuals at-risk for exercise dependence reported more strenuous exercise, perfectionism, and self-efficacy compared to the nondependent groups. The findings provide initial support for the EDS and indicate the need for a multifaceted approach to its conceptualization and measurement.     

Mindfulness Moderates the Relationship Between Disordered Eating Cognitions and Disordered Eating Behaviors in a Non-Clinical College Sample

Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based survey. Of 278 participants (nfemale = 208; nmale = 70) aged 18–24 years old, disordered eating cognitions, mindfulness, and psychological flexibility were related to psychological distress after controlling for gender, ethnicity, and body mass index. Disordered eating cognitions and mindfulness accounted for unique variance in disordered eating behaviors. Finally, mindfulness was found to moderate the association between disordered eating cognitions and disordered eating behaviors.     

Self-compassion,social rank,and psychological distress in athletes of varying competitive levels

BackgroundSelf-Compassion may be seen as a concept contrary to the aims of athletes engaged in competitive sport. This could be accentuated at more elite levels, where athletes may view concepts like self-criticism and self-judgement as more important for improvement.ObjectivesThe current study aimed to better understand how athletes of different competitive levels (from social to international) relate to concepts of self-compassion. Further, we aimed to explore how factors relating to social rank and self-compassion contribute to psychological distress.DesignCross-sectional online survey.MethodAn online survey was distributed, including the following validated questionnaires: Depression Anxiety and Stress Scales, the Self-Compassion Scale, Fears of Compassion Scales, Social Comparison Scale, Forms of Self-Criticising/Attacking & Self-Reassuring Scale, and the Striving to Avoid Inferiority Scale.ResultsTwo hundred and fifty-three participants responded to the survey, including 115 recreational and 79 competitive athletes. There were no differences between groups on any measure of compassion or social rank. In a multiple linear regression model, lower self-compassion, higher fears of compassion (for self), and higher feelings of inadequacy predicted more pronounced psychological distress in athletes.ConclusionsContrary to expectation, the results suggest that even highly elite athletes may be open to using self-compassion. Given that reduced self-compassion and sense of social rank contributed to psychological distress in athletes, the results suggest that compassion-based approaches to treating psychological distress in this population may be valid.     

The role of state mindfulness during yoga in predicting self-objectification and reasons for exercise

ObjectivesObjectification theory is a useful framework for understanding how individuals internalize the sexual objectification of male and female bodies. This internalization, called self-objectification, can result in negative psychological and behavioral outcomes (e.g., body shame, disordered eating). Exercise that uses mindfulness to draw attention to the body's function and sensations rather than appearance may be one way to minimize self-objectification and improve associated outcomes. Therefore, the objective of this study was to explore how state mindfulness during exercise may associate with change in self-objectification, body image variables, and reasons for exercise.DesignThis study prospectively followed participants (N = 148, 80% female) from six yoga classes that met 2–3 times a week across an 8-week period.MethodRepeated measures MANOVAs were used to examine change over time in state mindfulness, self-objectification, physical self-concept, and reasons for exercise. Regression analysis was used to examine how state mindfulness predicted change in outcome variables.ResultsMANOVAs revealed significant decreases in self-objectification and increases in physical self-concept, health/fitness-related reasons for exercise, and state mindfulness. Further, results indicated that mindfulness during exercise was linked with decreases in self-objectification and increases in more internal reasons for exercise over time.ConclusionsState mindfulness plays a role in predicting change in self-objectification and reasons for exercise during yoga practice.     

Prediction of end-of-life fears in COPD – hoping for the best but preparing for the worst

Objective: The diagnosis of a life-threatening illness can trigger end-of-life fears. Early studies show that end-of-life fears play an important role in chronic obstructive pulmonary disease (COPD). However, predictors of these fears have not yet been identified. This study investigated the relevance of socio-demographic variables, illness severity, psychological distress and disease-specific anxieties as predictors of end-of-life fears in COPD.

Design: A total of 131 COPD patients participated at two time points. Regression and mediation analyses, as well as cross-lagged panel analyses were conducted.

Main outcome measures: The participants completed questionnaires assessing end-of-life fears (Multidimensional Orientation toward Dying and Death Inventory), psychological distress (Hospital Anxiety and Depression Scale), and disease-specific anxieties (COPD Anxiety Questionnaire). Pulmonary function and a 6-min walk test served as measures of illness severity.

Results: Illness severity was not predictive of end-of-life fears. However, gender and psychological distress explained incremental variance. When disease-specific anxieties were included as additional predictors, psychological distress was no longer significant. Cross-lagged panel analyses mostly supported these results. Moreover, disease-specific anxieties mediated the association between psychological distress and end-of-life fears.

Conclusion: Administration and intensity of end-of-life care (especially concerning end-of-life fears) in COPD patients should be based not only on illness severity, but rather on psychological distress and disease-specific anxieties.     

Psychometric properties and concurrent validity of two exercise addiction measures: A population wide study

ObjectivesThe existence of exercise addiction has been examined in numerous studies. However, none of the measures developed for exercise addiction assessment have been validated on representative samples. Furthermore, estimates of exercise addiction prevalence in the general population are not available. The objective of the present study was to validate the Exercise Addiction Inventory (EAI; Terry, Szabo, & Griffiths, 2004), and the Exercise Dependence Scale (EDS; Hausenblas & Downs, 2002b), and to estimate the prevalence of exercise addiction in general population.DesignExercise addiction was assessed within the framework of the National Survey on Addiction Problems in Hungary (NSAPH), a national representative study for the population aged 18–64 years (N = 2710).Method474 people in the sample (57% males; mean age 33.2 years) who reported to exercise at least once a week were asked to complete the two questionnaires (EAI, EDS).ResultsConfirmatory Factor Analysis (CFA) indicated good fit both in the case of EAI (CFI = 0.971; TLI = 0.952; RMSEA = 0.052) and EDS (CFI = 0.938; TLI = 0.922; RMSEA = 0.049); and confirmed the factor structure of the two scales. The correlation between the two measures was high (r = 0.79). Results showed that 6.2% (EDS) and 10.1% (EAI) of the population were characterized as nondependent-symptomatic exercisers, while the proportion of the at-risk exercisers were 0.3% and 0.5%, respectively.ConclusionsBoth EAI and EDS proved to be a reliable assessment tool for exercise addiction, a phenomenon that is present in the 0.3–0.5% of the adult general population.     

Personality factors associated with psychological distress in testicular cancer survivors

The aim of this study was to investigate symptoms of anxiety and depression in testicular cancer survivors (TCSs) and to identify personality traits associated with psychological distress in these patients by means of the MMPI (Hathaway & McKinley, 1943). A total of 50 TCSs and 50 age-adjusted healthy men participated in the study, and we used the following self-report instruments: Montgomery-Asberg Depression Rating Scale (Montgomery & Asberg, 1979), Hamilton Anxiety Rating Scale (Hamilton, 1959, 1969), Spielberger's State-Trait Anxiety Inventory (Spielberger, 1970, 2005), and the MMPI. TCSs displayed higher rates on all psychopathology scales studied compared to controls, but the majority of the patients' scores were within the "normal range," indicating rather mild psychological distress. TCSs' MMPI profiles showed higher rates on Scales 1, 3, 6, and 9 compared to controls; and within the TCSs sample, symptoms of depression were most closely associated with Scales 3 and 5. Similarly, anxiety symptoms were mainly associated with Scale 3. These findings indicate that TCSs present mild symptoms of psychological distress, mainly anxiety and depressive symptoms, suggesting that careful assessment and consultation in TC patients is essential to help them deal with distress after treatment and to minimize possible risk factors.