6,162
Views
4
CrossRef citations to date
0
Altmetric
Review

Exercise addiction: A narrative overview of research issues

ORCID Icon & ORCID Icon
Pages 1-13 | Received 06 Oct 2022, Accepted 29 Dec 2022, Published online: 20 Jan 2023

References

  • Alcaraz-Ibáñez M, Paterna A, Sicilia A, Griffiths MD. 2020. Morbid exercise behaviour and eating disorders: a meta-analysis. J. Behav. Addict. 9(2):206–224.
  • Alcaraz-Ibáñez M, Paterna A, Griffiths MD, Sicilia Á. 2022. An exploratory examination of the relationship between symptoms of depression and ea among undergraduate recreational exercisers. Int J Ment Health Addiction. 20(3):1385–1397.
  • Alcaraz-Ibáñez M, Paterna A, Sicilia Á, Griffiths MD. 2021. A systematic review and meta-analysis on the relationship between body dissatisfaction and morbid exercise behaviour. IJERPH. 18(2):585.
  • Alcaraz-Ibáñez M, Paterna A, Sicilia Á, Griffiths MD. 2022. Examining the reliability of the scores of self-report instruments assessing problematic exercise: a systematic review and meta-analysis. J Behav Addict. 11(2):326-347.
  • American Psychiatric Association. 2013. Diagnostic and statistical manual of mental disorders. 5th ed., text rev. Washington (DC): APA.
  • American Psychiatric Association. 1994. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC) American Psychiatric Publishing, Inc.
  • Beck AT, Steer RA, Brown G. 1996. Beck Depression Inventory–II (BDI-II) [Database record]. APA PsycTests.
  • Bender TW, Gordon KH, Bresin K, Joiner TE. 2011. Impulsivity and suicidality: the mediating role of painful and provocative experiences. J Affect Disord. 129(1–3):301–307.
  • Berczik K, Szabó A, Griffiths MD, Kurimay T, Kun B, Urbán R, Demetrovics Z. 2012. Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Subst Use Misuse. 47(4):403–417.
  • Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, Ruggiero J. 1994. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry. 151(8):1132–1136.
  • Birche J, Griffiths MD, Kasos K, Demetrovics Z, Szabo A. 2017. Eexercis addiction and personality: a two-decade systematic review of the empirical literature (1995–2016). Balt. J Sport Health Sci. 3(106):19–33.
  • Bonfanti RC, Coco GL, Salerno L, Blasi D. 2022. The thin ideal and attitudes towards appearance as correlates of EA among sporty people during the COVID-19 pandemic. Behav Sci. 12(6):187.
  • Bueno-Antequera J, Mayolas-Pi C, Reverter-Masià J, López-Laval I, Oviedo-Caro MÁ, Munguía-Izquierdo D, Ruidíaz-Peña M, Legaz-Arrese A. 2020. EA and its relationship with health outcomes in indoor cycling practitioners in fitness centers. IJERPH. 17(11):4159.
  • Bueno-Antequera J, Oviedo-Caro MAN, Legaz-Arrese A, Paris-Garcia F, Guillén-Correas R, Munguía-Izquierdo D, Mayolas-Pi C. 2022. A 6-month follow-up postcompetition study in amateur endurance cyclists. J Addict Med. 16(3):E140–E149.
  • Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. 1998. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 158(16):1789–1795.
  • Çakın G, Juwono ID, Potenza MN, Szabo A. 2021. Exercise addiction and perfectionism: a systematic review of the literature. Curr Addict Rep. 8(1):144–155.
  • Ceci F, Di Carlo F, Burkauskas J, Salone A, De Luca I, Cicconcelli D, Giorgetti V, La Fratta I, Todaro A, Simonato P, et al. 2022. Physical activity and exercise addiction during the covid-19 pandemic in Italy. Int J Ment Health Addict. doi:10.1007/s11469-022-00815-z
  • Chamberlain SR, Grant JE. 2020. Is problematic exercise really problematic? A dimensional approach. CNS Spectr. 25(1):64–70.
  • Cohen S, Kamarck T, Mermelstein R. 1983. A global measure of perceived stress. J Health Soc Behav. 24(4):385–396.
  • Collado-Boira E, Temprado-Albalat MD, Martínez-Navarro I, Gandhi-Morar K, Hernando-Fuster B, Bernalte-Martí V, Hernando-Domingo C. 2021. Variables related to exercise dependence and quality of life in amateur long-distance runners. Med Sport. 74(2):295–312.
  • Colledge F, Buchner U, Schmidt A, Wiesbeck G, Lang U, Pühse U, Gerber M, Walter M. 2022. Individuals at risk of EA have higher scores for depression, ADHD, and childhood trauma. Fronts Sports Act Living. 3:761844.
  • Cook RH, Griffiths MD, Pontes HM. 2020. Personality factors in exercise addiction: a pilot study exploring the role of narcissism, extraversion, and agreeableness. Int J Ment Health Addiction. 18(1):89–102.
  • Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al. 2003. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sport Exerc. 35(8):1381–1395.
  • de Coverley Veale DM. 1987. Exercise dependence. Br J Addict. 82(7):735–740.
  • Derogatis LR. 2000. Brief Symptom Inventory-18 (BSI-18) [Database record]. APA PsycTests.
  • Di Lodovico L, Poulnais S, Gorwood P. 2019. Which sports are more at risk of physical Exercise Addiction: a systematic review. Addict Behav. 93:257–262.
  • Downs D, Hausenblas H, Nigg C. 2009. Factorial validity and psychometric examination of the exercise dependence scale-revised. Meas Phys Educ Exerc Sci. 8:183–201.
  • Dumitru DC, Dumitru T, Maher AJ. 2018. A systematic review of exercise addiction: examining gender differences. J Phys. Educ. Sport. 18(3):1738–1747.
  • Egorov AY, Szabo A. 2013. The exercise paradox: an interactional model for a clearer conceptualization of exercise addiction. J Behav Addict. 2(4):199–208.
  • First MB, Williams JBW, Benjamin LS, Spitzer RL. 2015. User’s guide for the SCID-5-PD (structured clinical interview for DSM-5 personality disorder). Arlington (VA): American Psychiatric Association.
  • First MB, Williams JBW, Karg RS, Spitzer RL. 2016. Structured clinical interview for DSM-5 disorders, clinician version (SCID-5-CV). Arlington (VA): American Psychiatric Association.
  • Freimuth M, Moniz S, Kim SR. 2011. Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. Int J Environ Res Public Health. 8(10):4069–4081.
  • Ganson KT, Lavender JM, Rodgers RF, Cunningham M, Nagata JM. 2022. Compulsive exercise and vaping among a sample of US College students aged 18–26 years. Eat Weight Disord. 27(3):1153–1161.
  • Garner DM, Garfinkel PE. 1979. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 9(2):273–279.
  • González-Hernández J, Nogueira A, Zangeneh M, López-Mora C. 2022. Exercise addiction and perfectionism, joint in the same path? A systematic review. Int J Ment Health Addiction. 20(3):1733–1756.
  • Gori A, Topino E, Pucci C, Griffiths MD. 2021. The relationship between Alexithymia, dysmorphic concern, and exercise addiction: the moderating effect of self-esteem. JPM. 11(11):1111.
  • Griffiths MD, Szabo A, Terry A. 2005. The exercise addiction inventory: a quick and easy screening tool for health practitioners. Br J Sports Med. 39(6):e30.
  • Griffiths MD. 2005. A ‘components’ model of addiction within a biopsychosocial framework. J Subst Use. 10(4):191–197.
  • Gunnarsson B, Entezarjou A, Fernández-Aranda F, Jiménez-Murcia S, Kenttä G, Håkansson A. 2022. Understanding exercise addiction, psychiatric characteristics and use of anabolic androgenic steroids among recreational athletes – an online survey study. Front Sports Act Living. 4:903777.
  • Habelt L, Kemmler G, Defrancesco M, Spanier B, Henningsen P, Halle M, Sperner-Unterweger B, Hüfner K. 2022. Why do we climb mountains? An exploration of features of behavioural addiction in mountaineering and the association with stress-related psychiatric disorders. Eur Arch Psychiatry Clin Neurosci. doi:10.1007/s00406-022-01476-8
  • Hallward L, Di Marino A, Duncan LR. 2022. A systematic review of treatment approaches for compulsive exercise among individuals with eating disorders. Eat Disord. 30(4):411–436.
  • Hausenblas HA, Downs D. 2002. Exercise dependence: a systematic review. Psychol Sport Exerc. 3(2):89–123.
  • Ji N, Li YS. Preparation of subjective well-being scale of college students. Stud Psychol Behav. 2006;4:59.
  • Johnston O, Reilly J, Kremer J. 2011. Excessive exercise: from quantitative categorisation to a qualitative continuum approach. Eur Eat Disord Rev. 19(3):237.
  • Juwono ID, Szabo A. 2021. 100 Cases of exercise addiction: more evidence for a widely researched but rarely identified dysfunction. Int J Ment Health Addiction. 19(5):1799–1811.
  • Kotbagi G, Morvan Y, Romo L, Kern L. 2017. Which dimensions of impulsivity are related to problematic practice of physical exercise? J Behav Addict. 6(2):221–228.
  • Kovacsik R, Griffiths MD, Pontes HM, Soós I, de la Vega R, Ruíz-Barquín R, Demetrovics Z, Szabo A. 2019. The role of passion in exercise addiction, exercise volume, and exercise intensity in long-term exercisers. Int J Ment Health Addiction. 17(6):1389–1400.
  • Kovacsik R, Soós I, de la Vega R, Ruíz-Barquín R, Szabo A. 2020. Passion and exercise addiction: healthier profiles in team than in individual sports. Int. J Sport Exercise Psychol. 18(2):176–186.
  • Kovácsik R, Tóth-Király I, Egorov A, Szabo A. 2021. A longitudinal study of exercise addiction and passion in new sport activities: the impact of motivational factors. Int J Ment Health Addiction. 19(5):1511–1526.
  • Krivoschekov SG, Lushnikov ON. 2011. Psychophysiology of sports addictions (exercise addiction). Hum Physiol. 37(4):509–513.
  • Kwon M, Kim Y, Kim H, Kim J. 2018. Does sport addiction enhance frontal executive function? The case of badminton. Neuroquantology. 16(6):13–21.
  • Lassner A, Papazova I, Pross B, Scherr J, Schoenfeld J, Halle M, Haller B, Falkai P, Hasan A, Roeh A. 2022. EA measured at a naturalistic marathon-event–associations of the EAI with the general level of functioning, affect and performance parameters. Int J Sport Exercise Psychol. doi:10.1080/1612197X.2022.2098357
  • Levis B, Benedetti A, Thombs BD. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:1476.
  • Levit M, Weinstein A, Weinstein Y, Tzur-Bitan D, Weinstein A. 2018. A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel. J Behav Addict. 7(3):800–805.
  • Lewinsohn PM, Seeley JR, Roberts RE, Allen NB. 1997. Centre for Epidemiological Studies-Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychol Ageing. 12:277–287.
  • Li M, Nie J, Ren Y. 2015. Effects of exercise dependence on psychological health of Chinese college students. Psychiatr Danub. 27(4):413–419.
  • Li M. 2018. The influence of psychological needs and exercise motivation on exercise dependence among Chinese college students. Psychiatr Q. 89(4):983–990.
  • Lichtenstein MB, Andries A, Hansen S, Frystyk J, Stoving RK. 2015. EA in men is associated with lower fat-adjusted leptin levels. Clin J Sport Med. 25(2):138–143.
  • Lichtenstein MB, Jensen TT. 2016. EA in CrossFit: prevalence and psychometric properties of the EA Inventory. Addict Behav Rep. 3:33–37.
  • Lichtenstein MB, Melin AK, Szabo A, Holm L. 2021. The prevalence of EA symptoms in a sample of national level elite athletes. Front Sports Act Living. 3:635418.
  • Lichtenstein MB, Nielsen RO, Gudex C, Hinze CJ, Jørgensen U. 2018. EA is associated with emotional distress in injured and non-injured regular exercisers. Addict Behav Rep. 8:33–39.
  • Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, Schneider A, Brähler E. 2010. A 4-item measure of depression and anxiety: validation and standardisation of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 122(1–2):86–95. Epub 2009 Jul 17. PMID: 19616305.
  • Lyvers M, Sweetnam T, Thorberg FA. 2021. Alexithymia, rash impulsiveness, and reward sensitivity in relation to symptoms of exercise dependence in physically active young adults. Aust. J Psychol. 73(4):475–485.
  • Lyvers M, Truncali J, Stapleton P, Thorberg FA. 2022. Alexithymia, reward sensitivity and excessive exercise in non-binge-eaters versus severe binge eaters: implications for primary and secondary exercise dependence. Curr Psychol. doi:10.1007/s12144-022-03511-2
  • Martenstyn JA, Touyz S, Maguire S. 2021. Treatment of compulsive exercise in eating disorders and muscle dysmorphia: protocol for a systematic review. J Eat Disord. 9(1):19.
  • Meyer M, Sattler I, Schilling H, Lang UE, Schmidt A, Colledge F, Walter M. 2021. Mental disorders in individuals with exercise addiction—a cross-sectional study. Front Psychiatr. 12:751550.
  • Miller KJ, Mesagno C. 2014. Personality traits and exercise dependence: exploring the role of narcissism and perfectionism. Int. J of Sport Exercise Psychol. 12(4):368–381.
  • Modolo VB, Antunes HKM, Borba de Gimenez PR, De Mello Santiago ML, Tufik S, de Mello MT. 2011. Negative addiction to exercise: are there differences between genders? Clinics (Sao Paulo). 66(2):255–260.
  • Morgan JF, Reid F, Lacey JH. 1999. The SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ. 319(7223):1467–1468.
  • Müller A, Cook B, Zander H, Herberg A, Müller V, de Zwaan M. 2014. Does the German version of the Exercise Dependence Scale measure exercise dependence? Psychol. Sport Exerc. 15(3):288–292.
  • Nogueira A, Tovar-Gálvez M, González-Hernández J. 2019. Do It, Don’t Feel It, and Be Invincible: a Prolog of exercise addiction in Endurance Sports. Front Psychol. 10:2692.
  • Olave L, Estévez A, Momeñe J, Muñoz-Navarro R, Gómez-Romero MJ, Boticario MJ, Iruarrizaga I. 2021. Exercise addictionand muscle dysmorphia: the role of emotional dependence and attachment. Front. Psychol. 12:681808.
  • Outar L, Turner MJ, Wood AG, Lowry R. 2018. I need to go to the gym”: exploring the use of rational emotive behaviour therapy upon exercise addiction, irrational and rational beliefs. Perform. Enhanc Health. 6(2):82–93.
  • Pálfi V, Kovacsik R, Szabo A. 2021. Symptoms of exercise addiction in aerobic and anaerobic exercises: beyond the components model of addiction. Addict Behav Rep. 14:100369.
  • Pinto A, Griffiths MD, Weinstein A, Demetrovics Z, Szabo A. 2019. Perceived stress, exercise habits, and exercise addiction in Israeli army reserves: a pilot study. Mil Psychol. 31(5):355–362.
  • Rogers ML, Duffy ME, Buchman-Schmitt JM, Datoc AE, Joiner TE. 2019. Exercise dependence: associations with capability for suicide and past suicidal behavior. J Clin Psychol. 75(1):165–177.
  • Ruiz‐Turrero J, Massar K, Kwasnicka D, Hoor GAT. 2022. The relationship between compulsive exercise, self‐esteem, body image and body satisfaction in women: a cross‐sectional study. IJERPH. 19(3):1857.
  • Ryu K, Kim Y, Kwon M, Kim H, Kim J. 2016. The frontal executive function in exercise addicts, moderate exercisers, and exercise avoiders. Am J Addict. 25(6):466–471.
  • Schmidt S, Petermann F. 2018. Testbesprechung: Homburger ADHS-Skalen für Erwachsene (HASE). Z Psychiatr Psychol Psychother. 56:155–159.
  • Sicilia A, Alcaraz-Ibáñez M, Dumitru DC, Paterna A, Griffiths MD. 2020. Fitness-related self-conscious emotions and risk for exercise addiction: examining the mediating role of passion. J Sport Exercise Psychol. 42(3):240–248.
  • Sicilia Á, Paterna A, Alcaraz-Ibáñez M, Griffiths MD. 2021. Theoretical conceptualisations of problematic exercise in psychometric assessment instruments: a systematic review. J Behav Addict. 10(1):4–20.
  • Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. 1983. Manual for the state-trait anxiety inventory. Manual for the state-trait anxiety inventory. Palo Alto (CA): Consulting Psychologists Press.
  • Start-up M, Jackson MC, Bendix S. 2002. The concurrent validity of the Global Assessment of Functioning (GAF). Br J Clin Psychol. 41:417–422.
  • Sussman S, Lisha N, Griffiths MD. 2011. Prevalence of the addictions: a problem of the majority or the minority? Eval Health Prof. 34(1):3–56.
  • Szabo A, de la Vega R, Kovácsik R, Almendros Ruíz-Barquín JL, Demetrovics R, Boros Z, Köteles S. 2022. Dimensions of passion and their relationship to the risk of exercise addiction: cultural and gender differences. Addict Behav Rep. 16:100451.
  • Szabo A, Demetrovics Z. 2022. Passion and addiction in sports and exercise. Ney York (NY): Routledge. Available from:
  • Szabo A, Griffiths MD, Høglid RA, Demetrovics Z. 2018. Drug, nicotine, and alcohol use among exercisers: does substance addiction co-occur with exercise addiction? Addict Behav Rep. 7:26–31.
  • Szabo A. 2010. Exercise addiction: a symptom or a disorder? New York: Nova Science Publishers Inc.
  • Torstveit MK, Fahrenholtz IL, Lichtenstein MB, Stenqvist TB, Melin AK. 2019. Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes. BMJ Open Sport Exerc Med. 5(1):e000439. eCollection 2019.
  • Trott M, Jackson SE, Firth J, Fisher A, Johnstone J, Mistry A, Stubbs B, Smith L. 2020. Exercise addiction prevalence and correlates in the absence of eating disorder symptomology: a systematic review and meta-analysis. J Addict Med. 14(6):e321–e329.
  • Trott M, Jackson SE, Firth J, Jacob L, Grabovac I, Mistry A, Stubbs B, Smith L. 2021. A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders. Eat Weight Disord. 26(1):37–46.
  • Tuttle LW. 1992. Compulsive exercise: the symptomatology, associated psychopathology, and diagnostic validity of a compulsive exercise syndrome; (Order No. 9325819). Available from ProQuest Dissertations & Theses Global (303998529). https://www.proquest.com/dissertations-theses/compulsive-exercise-symptomatology-associated/docview/303998529/se-2
  • Watson D, Clark LA, Tellegen A. 1998. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 54(6):1063.
  • Weinstein A, Gavriel M, Weinstein Y. 2015. A study on the relationship between compulsive exercise, depression and anxiety among professional sportsmen, people who regularly exercise sports and non-exercising control subjects. J Behav Addict. 4(4):320–323.
  • Weinstein AM, Weinstein I. 2014. Exercise addiction - diagnosis, bio-psychological mechanisms and treatment issues. Curr Pharm Des. 20(25):4062–4069.
  • Zandonai T, Manresa-Rocamora A, Monese L, Moya-Ramón M, Schena F, Chiamulera C. 2021. A descriptive study of exercise dependence: a short report among Italian and Japanese runners. J Addict Dis. 39(1):133–137.
  • Zeigler-Hill V, Besser A, Gabay M, Young G. 2021. Narcissism and exercise addiction: the mediating roles of exercise-related motives. IJERPH. 18(8):4243.
  • Zhang F, Wang S, Feng Y, Qin K, Li H, Wu B, Jia Z, Gong Q. 2021. Regional gray matter volume associated with exercise dependence: a voxel-based morphometry study. Hum Brain Mapp. 42(15):4857–4868.
  • Zimanyi Z, Wolff W, Schüler J. 2021. Too much of a good thing? Exercise dependence in endurance athletes: relationships with personal and social resources. IJERPH. 18(6):2966.
  • Zou L, Yang P, Herold F, Liu W, Szabo A, Taylor A, Sun J, Ji L. 2022. The contribution of BMI, body image inflexibility, and generalized anxiety to symptoms of eating disorders and exercise dependence in exercisers. Int J Ment Health Promot. 24(6):811–823.