Is exercise addiction in fitness centers a socially accepted behavior?

Background: Fitness exercise is popular and associated with improved health and social status. Taken to extremes, however, exercise can become an addiction. One suggested symptom of exercise addiction is âconflictsâ with family and friends. However, it may be difficult to recognize excessive exercise patterns if they are accepted and encouraged by relatives. The aim of this study was to explore if fitness exercisers with a high risk of addiction experienced the same level of exercise support as exercisers with a low risk of addiction. Furthermore, we wanted to examine if social support affected the subjective reporting of âconflictsâ. Method: A total of 577 fitness exercisers completed the Exercise Addiction Inventory (EAI) and two questions asking about âexercise support from family and friendsâ and âpresent eating disorderâ. Results: Exercisers at high risk of exercise addiction reported the same level of support from relatives as those at low risk. Exercisers with high levels of exercise support reported significantly fewer conflicts, even if they were at high risk of addiction. If an eating disorder was present, the level of exercise support was significantly reduced. Conclusion: Exercise addiction might be difficult to identify with the general behavioral addiction symptom âconflictâ, since exercise is socially accepted even in subjects with high risk of exercise addiction. If an eating disorder is present, the exercise routines seem to be interpreted as socially undesirable. Screening for exercise addiction with the EAI should take into account that fitness exercisers rarely report conflicts, which could result in false negative cases

Cognitive Flexibility in Hospitalized Patients with Severe or Extreme Anorexia Nervosa: A Case-Control Study

Objective: To investigate whether cognitive inflexibility could be identified using the Wisconsin Card Sorting Test (WCST) in patients with severe and extreme anorexia nervosa (AN) compared to healthy control participants (HCs). Method: We used the WCST to assess 34 patients with AN (mean age: 25.9 years, mean body mass index (BMI): 13.2 kg/m2) 3–7 days after admission to a specialized nutrition unit and 34 HCs. The Beck Depression Inventory II and the Eating Disorder Inventory 3 were distributed. Results: The patients displayed more perseveration than HCs controlled for age and years of education, with moderate effect sizes (perseverative responses (%): adjusted difference = −7.74, 95% CI: −14.29–(−1.20), p-value: 0.021; perseverative errors (%): adjusted difference = −6.01, 95% CI: −11.06–(−0.96), p-value: 0.020). There were no significant relationships between perseveration and depression, eating disorder symptoms, illness duration, or BMI. Discussion: Patients with severe and extreme AN demonstrated lower cognitive flexibility compared to HCs. Performance was not related to psychopathology or BMI. Patients with severe and extreme anorexia nervosa may not differ from less severe patients in cognitive flexibility performance. As this study exclusively focused on patients suffering from severe and extreme AN, potential correlations might be masked by a floor effect

Cognitive flexibility in hospitalized patients with severe or extreme Anorexia nervosa : a case-control study

Objective: To investigate whether cognitive inflexibility could be identified using the Wisconsin Card Sorting Test (WCST) in patients with severe and extreme anorexia nervosa (AN) compared to healthy control participants (HCs). Method: We used the WCST to assess 34 patients with AN (mean age: 25.9 years, mean body mass index (BMI): 13.2 kg/m2) 3–7 days after admission to a specialized nutrition unit and 34 HCs. The Beck Depression Inventory II and the Eating Disorder Inventory 3 were distributed. Results: The patients displayed more perseveration than HCs controlled for age and years of education, with moderate effect sizes (perseverative responses (%): adjusted difference = −7.74, 95% CI: −14.29–(−1.20), p-value: 0.021; perseverative errors (%): adjusted difference = −6.01, 95% CI: −11.06–(−0.96), p-value: 0.020). There were no significant relationships between perseveration and depression, eating disorder symptoms, illness duration, or BMI. Discussion: Patients with severe and extreme AN demonstrated lower cognitive flexibility compared to HCs. Performance was not related to psychopathology or BMI. Patients with severe and extreme anorexia nervosa may not differ from less severe patients in cognitive flexibility performance. As this study exclusively focused on patients suffering from severe and extreme AN, potential correlations might be masked by a floor effect

Б1.Б.3 Математические и инструментальные методы поддержки принятия решений. Очное обучение. Магистратура. 2018 года набора

Background: Behavioral addictions often onset in adolescence and increase the risk of psychological and social problems later in life. The core symptoms of addiction are tolerance, withdrawal symptoms, lack of control, and compulsive occupation with the behavior. Psychometrically validated tools are required for detection and early intervention. Adolescent screening instruments exist for several behavioral addictions including gambling and video gaming addiction but not for exercise addiction. Given recent empirical and clinical evidence that a minority of teenagers appear to be experiencing exercise addiction, a psychometrically robust screening instrument is required. Aims: The aim of this study was to develop and test the psychometric properties of a youth version of the Exercise Addiction Inventory (EAI) – a robust screening instrument that has been used across different countries and cultures – and to assess the prevalence of exercise addiction and associated disturbed eating. Methods: A cross-sectional survey was administered to three high-risk samples (n = 471) aged 11–20 years (mean age: 16.3 years): sport school students, fitness center attendees, and patients with eating disorder diagnoses. A youth version of the EAI (EAI-Y) was developed and distributed. Participants were also screened for disordered eating with the SCOFF Questionnaire. Results: Overall, the EAI-Y demonstrated good reliability and construct validity. The prevalence rate of exercise addiction was 4.0% in school athletes, 8.7% in fitness attendees, and 21% in patients with eating disorders. Exercise addiction was associated with feelings of guilt when not exercising, ignoring pain and injury, and higher levels of body dissatisfaction

Case report : cognitive performance in an extreme case of anorexia nervosa with a body mass index of 7.7.

BACKGROUND: Studies show that adult patients with anorexia nervosa display cognitive impairments. These impairments may be caused by illness-related circumstances such as low weight. However, the question is whether there is a cognitive adaptation to enduring undernutrition in anorexia nervosa. To our knowledge, cognitive performance has not been assessed previously in a patient with anorexia nervosa with a body mass index as low as 7.7 kg/m2. CASE PRESENTATION: We present the cognitive profile of a 35-year-old woman with severe and enduring anorexia nervosa who was diagnosed at the age of 10 years. She was assessed with a broad neuropsychological test battery three times during a year. Her body mass index was 8.4, 9.3, and 7.7 kg/m2, respectively. Her general memory performance was above the normal range and she performed well on verbal and design fluency tasks. Her working memory and processing speed were within the normal range. However, her results on cognitive flexibility tasks (set-shifting) were below the normal range. CONCLUSIONS: The case study suggests that it is possible to perform normally cognitively despite extreme and chronic malnutrition though set-shifting ability may be affected. This opens for discussion whether patients with anorexia nervosa can maintain neuropsychological performance in spite of extreme underweight and starvation. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02502617. Registered 20 July 2015

Cognitive performance in hospitalized patients with severe or extreme anorexia nervosa

Purpose: Severe malnourishment may reduce cognitive performance in anorexia nervosa (AN). We studied cognitive functioning during intensive nutritional and medical stabilization in patients with severe or extreme AN and investigated associations between weight gain and cognitive improvement. Methods: A few days after admission to a specialized hospital unit, 33 patients with severe or extreme AN, aged 16–42 years, completed assessments of memory, cognitive flexibility, processing speed, and attention. Mean hospitalization was 6 weeks. Patients completed the same assessments at discharge (n = 22) following somatic stabilization and follow-up up to 6 months after discharge (n = 18). Results: The patients displayed normal cognitive performance at admission compared to normative data. During nutritional stabilization, body weight increased (mean: 11.3%; range 2.6–22.2%) and memory, attention, and processing speed improved (p values: ≤ 0.0002). No relationship between weight gain and cognitive improvement was observed at discharge or follow-up. Conclusions: Cognitive performance at hospital admission was normal in patients with severe or extreme AN and improved during treatment although without association to weight gain. Based on these results, which are in line with previous studies, patients with severe or extreme AN need not be excluded from cognitively demanding tasks, possibly including psychotherapy. As patients may have other symptoms that interfere with psychotherapy, future research could investigate cognitive functioning in everyday life in patients with severe AN. Trial registration number: The study is registered at clinicaltrials.gov (NCT02502617). Level of evidence: Level III, cohort study

Cortisol, Depression, and Anxiety Levels Before and After Short-Term Intensive Nutritional Stabilization in Patients With Severe Anorexia Nervosa

Introduction: Depression and anxiety are well-known comorbid conditions in patients with anorexia nervosa (AN). Hypercortisolemia in patients with AN may be pathogenic and contribute to depression and anxiety symptomatology. Objective: The aim of this study was to investigate short-term changes in cortisol levels and depression and anxiety symptomatology following intensive re-nutrition in patients with severe AN and hospitalized in a specialized unit. Furthermore, we investigated the potential association between cortisol levels and psychometric parameters. Methods: A total of 36 patients with AN were enrolled in the study. Nine dropped out before follow-up. Patients underwent paraclinical and psychometric examinations at admission and discharge. Measurements included plasma cortisol, cortisol binding globulin (CBG), 24-h urine cortisol, and self-report questionnaires regarding eating disorder, depression, anxiety, and stress symptoms. Patients were hospitalized in the unit for somatic stabilization and intensive re-nutrition. Mean admission length was 41 days. The study was registered at ClinicalTrials.gov (NCT02502617). Results: Cortisol levels in blood and urine did not change from admission to discharge in patients with severe AN. Symptoms of depression, anxiety, stress, and eating disorder remained elevated at discharge. There were no associations between changes in cortisol levels and changes in psychometrics. Discussion: Our results suggest that short-term intensive re-nutrition did not alter hypothalamic-pituitary-adrenal axis activity or mental health in patients with severe AN. Long-term stabilization and longer follow-up after hospital discharge may be needed to detect changes in cortisol levels and whether these changes are associated with depression and anxiety symptomatology. Greater knowledge about cortisol levels and mental health in patients with severe AN may help in the development of new treatment choices for the chronically ill patients. Future studies could investigate whether cortisol-lowering drugs have a therapeutic effect on mental health in AN