Transcript Exercise Dependence

EPHE 348
Addiction to Something Good?
 Benefits are well-established about physical activity
 Adherence is a problem for most
 Some – too much of a good thing?
Exercise Dependence
 Craving for leisure-time physical activity, resulting in
uncontrollable excessive exercise behaviour, that
manifests in physiological (withdrawl) and/or
psychological (anxiety, depression) symptoms
History
 First considered in 1970 by Baekeland via a study
designed to examine sleep and a month of exercise
deprivation – couldn’t find any subjects in the 6+
frequency category even with pay!
 Had to use 3-4 per week participants
 During the month, participants experienced anxiety,
sexual tension, nocturnal awakening
Properties
Downs & Hausenblas (2002) suggest three of :
-Tolerance (need for increases with diminished effect)
-Withdrawal (symptoms of mood/anxiety)
-Intention discrepancy (exercise is more than intended)
-Loss of Control (failure to cut down)
-Time (consumes/controls a great deal time)
-Conflict (other activities are give-up or reduced)
-Continuance (continued despite adverse events)
Mimics substance dependence
DSM-IV-TR Eating Disorders
 DeCoverley Veale (1995) has suggested that exercise
dependence not be assessed until eating disorders
have been ruled out:
 Refusal to maintain body weight
 Intense fear of gaining weight
 Disturbance in how one’s body is viewed in self-
evaluation; denial of seriousness of body weight
Obsessive Compulsive Disorder
 Recurrent, persistent thoughts, impulses ….that cause
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anxiety or distress
The behaviours are performed to reduce distress but are
clearly not aligned with the intended outcome (i.e., clearly
excessive)
Person recognizes that the impulses are a product of his or
her own mind
Behaviour is repetitive and must be applied rigidly
Behaviours are time consuming and interfere with other
activities
Disturbance is not the direct effect of substance or medical
condition
Current Research
 Three main areas:
 Comparing to eating disorder patients
 Comparing to less excessive regular exercisers
 Comparing exercisers and nonexercisers
Hausenblas & Symons Downs 2002
Review
 77 studies
 Exercise deprivation Research (11 studies)
 Adverse effects on well-being
 The effect is partially independent of dependence
 Feelings of guilt, depression, irritability, stress/anxiety,
sluggishness
 Limits to research because most research is with
involuntary deprivation (dependents do not enter
research of this kind)
Continued
 Measurement
 Mixed measures across studies from questionnaires to
case studies
 Exercise itself is not a good measure
 Lack of cohesive measures makes it difficult to estimate
prevalence
 Not a formal clinical condition
Hausenblas & Symons Downs
(2003)
 2300 exercisers surveyed
 Prevalence of 9% found (perhaps 3-4% of populace)
 40% had some symptoms
Why Dependence?
 Psychological
 Personality (perfectionism, OC, neuroticism)
 Anorexia-analogue hypothesis (personality-based,
attempts to establish an identity)
 Affect regulation – reverse of benefits; used to keep
affect positive
 Physiological
 Beta-endorphin – dependency on this process
 Sympathetic arousal – efficiency of exercise widens the
gap between systems
Treatment
 Single study of physiotherapy clinicians (Adams &
Kirby, 1997)
 Education of overuse outcomes
 Prescribing reduced or alternative activities
 Referral to other health professionals
 Behaviour modification
 Results suggested that the clinicians were not very
effective