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Exercise Dependence

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.

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Exercise Dependence

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  1. Exercise Dependence EPHE 348

  2. Addiction to Something Good? • Benefits are well-established about physical activity • Adherence is a problem for most • Some – too much of a good thing?

  3. 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

  4. 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

  5. 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

  6. 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

  7. Obsessive Compulsive Disorder • Recurrent, persistent thoughts, impulses ….that cause 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

  8. Current Research • Three main areas: • Comparing to eating disorder patients • Comparing to less excessive regular exercisers • Comparing exercisers and nonexercisers

  9. 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)

  10. 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

  11. Hausenblas & Symons Downs (2003) • 2300 exercisers surveyed • Prevalence of 9% found (perhaps 3-4% of populace) • 40% had some symptoms

  12. 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

  13. 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

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