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Chapter 3 - The COVID-19 Pandemic

A Novel Risk Factor for Exercise Addiction and Related Disorders

from Section 1 - From Exercise to Addiction: An Introduction to the Phenomenon

Published online by Cambridge University Press:  30 March 2023

Ornella Corazza
Affiliation:
University of Hertfordshire and University of Trento, Italy
Artemisa Rocha Dores
Affiliation:
Polytechnic Institute of Porto and University of Porto, Portugal
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Summary

Exercise addiction (AE), which can be defined as engaging in excessive and problematic physical exercise, is still not officially included in the psychiatric nosography, although this disorder can be identified as linked to addictive behaviours. Many different etiopathogenetic hypotheses have been proposed to account for the epidemiological distribution of EA in the general population. However, a clear phenomenological concept of the disorder and shared diagnostic tools are still lacking. It is frequently comorbid with eating disorders and body dysmorphic disorder, which can both trigger EA and develop secondary to it. In recent times it has been proposed that the lockdowns and other restrictions which were imposed during the COVID-19 pandemic could have been possible risk factors for the development or worsening of EA, as physical exercise was widely recommended as a strategy for coping with these restrictions. The initial evidence about the emergence of EA during the COVID-19 pandemic is presented.

Type
Chapter
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The Body in the Mind
Exercise Addiction, Body Image and the Use of Enhancement Drugs
, pp. 49 - 66
Publisher: Cambridge University Press
Print publication year: 2023

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References

Waddington, I. Sport, Health and Drugs: A Critical Sociological Perspective. Spoon Press, 2000.Google Scholar
Peluso, MAM, Guerra de Andrade, LHS. Physical activity and mental health: the association between exercise and mood. Clinics 2005; 60: 6170.Google Scholar
Biddle, SJH, Asare, M. Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med 2011; 45: 886–95.CrossRefGoogle ScholarPubMed
Morgan, WP. Negative addiction in runners. Phys Sportsmed 1979; 7: 5670.CrossRefGoogle ScholarPubMed
Griffiths, M. Behavioural addiction: an issue for everybody? Empl Couns Today 1996; 8: 1925.Google Scholar
Szabo, A. Addiction to Exercise: A Symptom or a Disorder? Nova Science Publishers, 2010.Google Scholar
Thaxton, L. Physiological and psychological effects of short-term addiction on habitual runners. J Sport Psychol 1982; 4: 7380.CrossRefGoogle Scholar
Hausenblas, HA, Symons Downs, D. How much is too much? The development and validation of the Exercise Addiction Scale. Psychol Heal 2002; 17: 387404.Google Scholar
Symons Downs, D, Hausenblas, HA, Nigg, CR. Factorial validity and psychometric examination of the Exercise Dependence Scale-Revised. Meas Phys Educ Exerc Sci 2004; 8: 183201.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. American Psychiatric Association, 2000.Google Scholar
Albrecht, U, Kirschner, NE, Grüsser, SM. Diagnostic instruments for behavioural addiction: an overview. Psychosoc Med 2007; 4: 111.Google ScholarPubMed
Di Forti, M, Marconi, A, Carra, E et al. Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. Lancet Psychiatry 2015; 2: 233–8.CrossRefGoogle ScholarPubMed
Grant, JE, Potenza, MN, Weinstein, A, Gorelick, DA. Introduction to behavioral addictions. Am J Drug Alcohol Abuse 2010; 36: 233–41.Google Scholar
Bamber, D, Carroll, D, Cockerill, IM, Rodgers, S. “It’s exercise or nothing”: a qualitative analysis of exercise dependence. Br J Sports Med 2000; 34: 423–30.Google Scholar
Blaydon, MJ, Lindner, KJ. Eating disorders and exercise dependence in triathletes. Eat Disord 2002; 10: 4960.Google Scholar
De Coverley Veale, DMW. Exercise dependence. Br J Addict 1987; 82: 735–40.CrossRefGoogle ScholarPubMed
Berczik, K, Szabó, A, Griffiths, MD et al. Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Subst Use Misuse 2012; 47: 403–17.CrossRefGoogle ScholarPubMed
Slay, HA, Hayaki, J, Napolitano, MA, Brownell, KD. Motivations for running and eating attitudes in obligatory versus nonobligatory runners. Int J Eat Disord 1998; 23: 267–75.Google Scholar
Lejoyeux, M, Avril, M, Richoux, C, Embouazza, H, Nivoli, F. Prevalence of exercise dependence and other behavioral addictions among clients of a Parisian fitness room. Compr Psychiatry 2008; 49: 353–8.Google Scholar
Allegre, B, Therme, P, Griffiths, M. Individual factors and the context of physical activity in exercise dependence: a prospective study of “ultra-marathoners.” Int J Ment Health Addict 2007; 5: 233–43.Google Scholar
Schipfer, M, Stoll, O. OR-77: Exercise-Addiction/Exercise-Commitment-Model (EACOM). J Behav Addict 2015; 4: 35–7.Google Scholar
Terry, A, Szabo, A, Griffiths, M. The Exercise Addiction Inventory: a new brief screening tool. Addict Res Theory 2004; 12: 489–99.CrossRefGoogle Scholar
Hausenblas, HA, Fallon, EA. Relationship among body image, exercise behavior, and exercise dependence symptoms. Int J Eat Disord 2002; 32: 179–85.Google Scholar
Griffiths, M. A “components” model of addiction within a biopsychosocial framework. J Subst Use 2005; 10: 191–7.CrossRefGoogle Scholar
Szabo, A, Griffiths, MD. Exercise addiction in British sport science students. Int J Ment Health Addict 2007; 5: 25–8.CrossRefGoogle Scholar
Mónok, K, Berczik, K, Urbán, R et al. Psychometric properties and concurrent validity of two exercise addiction measures: a population wide study. Psychol Sport Exerc 2012; 13: 739–46.Google Scholar
Griffiths, MD, Urbán, R, Demetrovics, Z et al. A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sport Med Open 2015; 1: 17.Google Scholar
Goldberg, A. The Sports Mind: A Workbook of Mental Skills for Athletes. Competitive Advantage, 1988.Google Scholar
Farrell, PA, Gates, WK, Maksud, MG, Morgan, WP. Increases in plasma β-endorphin/β-lipotropin immunoreactivity after treadmill running in humans. J Appl Physiol Respir Environ Exerc Physiol 1982; 52: 1245–9.Google Scholar
Thompson, JK, Blanton, P. Energy conservation and exercise dependence: a sympathetic arousal hypothesis. Med Sci Sports Exerc 1987; 19: 91–9.CrossRefGoogle ScholarPubMed
DeVries, HA. Tranquilizer effect of exercise: a critical review. Phys Sportsmed 1981; 9: 4755.Google Scholar
Morgan, WP, O’Connor, PJ. Exercise and mental health. In: Dishman, RK, ed. Exercise Adherence: Its Impact on Public Health. Human Kinetics, 1988: 91121.Google Scholar
Cousineau, D, Ferguson, RJ, de Champlain, J et al. Catecholamines in coronary sinus during exercise in man before and after training. J Appl Physiol Respir Environ Exerc Physiol 1977; 43: 801–6.Google Scholar
Szabo, A. The impact of exercise deprivation on well-being of habitual exercises. Aust J Sci Med Sport 1995; 27: 6875.Google ScholarPubMed
Hamer, M, Karageorghis, CI. Psychobiological mechanisms of exercise dependence. Sports Med 2007; 37: 477–84.Google Scholar
Freimuth, M, Moniz, S, Kim, SR. Clarifying exercise addiction: differential diagnosis, co-occurring disorders, and phases of addiction. Int J Environ Res Public Health 2011; 8: 4069–81.Google Scholar
Huang, QIN, Huang, J, Chen, Y et al. Overactivation of the reward system and deficient inhibition in exercise addiction. Med Sci Sports Exerc 2019; 51: 1918–27.Google Scholar
Sussman, S, Lisha, N, Griffiths, M. Prevalence of the addictions: a problem of the majority or the minority? Eval Heal Prof 2011; 34: 356.CrossRefGoogle ScholarPubMed
Aidman, EV, Woollard, S. The influence of self-reported exercise addiction on acute emotional and physiological responses to brief exercise deprivation. Psychol Sport Exerc 2003; 4: 225–36.Google Scholar
Allegre, B, Souville, M, Therme, P, Griffiths, M. Definitions and measures of exercise dependence. Addict Res Theory 2006; 14: 631–46.CrossRefGoogle Scholar
Di Nicola, M, Tedeschi, D, De Risio, L et al. Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving. Drug Alcohol Depend 2015; 148: 118–25.Google Scholar
Müller, A, Loeber, S, Söchtig, J, Te Wildt, B, De Zwaan, M. Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers. J Behav Addict 2015; 4: 273–80.CrossRefGoogle ScholarPubMed
Carnes, PJ, Murray, RE, Charpentier, L. Bargains with chaos: sex addicts and addiction interaction disorder. Sex Addict Compulsivity 2005; 12: 79120.CrossRefGoogle Scholar
Klein, DA, Bennett, AS, Schebendach, J et al. Exercise “addiction” in anorexia nervosa: model development and pilot data. CNS Spectr 2004; 9: 531–7.CrossRefGoogle ScholarPubMed
Lyons, HA, Cromey, R. Compulsive jogging: exercise dependence and associated disorder of eating. Ulster Med J 1989; 58: 100–2.Google Scholar
Sundgot-Borgen, J. Eating disorders in female athletes. Sports Med 1994; 17: 176–88.Google Scholar
Bamber, DJ, Cockerill, IM, Rodgers, S, Carroll, D. Diagnostic criteria for exercise dependence in women. Br J Sports Med 2003; 37: 393400.CrossRefGoogle ScholarPubMed
Bruno, A, Quattrone, D, Scimeca, G et al. Unraveling exercise addiction: the role of narcissism and self-esteem. J Addict 2014; 2014: 16.Google Scholar
Hausenblas, HA, Giacobbi, PR. Relationship between exercise dependence symptoms and personality. Pers Individ Dif 2004; 36: 1265–73.Google Scholar
Cunningham, HE, Pearman, S, Brewerton, TD. Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise. Int J Eat Disord 2016; 49: 778–92.CrossRefGoogle ScholarPubMed
Mooney, R, Simonato, P, Ruparelia, R et al. The use of supplements and performance and image enhancing drugs in fitness settings: an exploratory cross-sectional investigation in the United Kingdom. Hum Psychopharmacol 2017; 32: e2619.Google Scholar
Al-Sarraf, A, Khatib, Y, Corazza, O. The interaction between skin and mind: the case of body dysmorphic disorder. Res Adv Psychiatry 2018; 5: 3842.Google Scholar
Buhlmann, U, Glaesmer, H, Mewes, R et al. Updates on the prevalence of body dysmorphic disorder: a population-based survey. Psychiatry Res 2010; 178: 171–5.CrossRefGoogle ScholarPubMed
Sandgren, SS, Lavallee, D. Muscle dysmorphia research neglects DSM-5 diagnostic criteria. J Loss Trauma 2018; 23: 211–43.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. American Psychiatric Association, 2013.Google Scholar
Altamura, C, Paluello, MM, Mundo, E, Medda, S, Mannu, P. Clinical and subclinical body dysmorphic disorder. Eur Arch Psychiatry Clin Neurosci 2001; 251: 105–8.CrossRefGoogle ScholarPubMed
Beucke, JC, Sepulcre, J, Buhlmann, U et al. Degree connectivity in body dysmorphic disorder and relationships with obsessive and compulsive symptoms. Eur Neuropsychopharmacol 2016; 26: 1657–66.CrossRefGoogle ScholarPubMed
Leone, JE, Sedory, EJ, Gray, KA. Recognition and treatment of muscle dysmorphia and related body image disorders. J Athl Train 2005; 40: 352–9.Google ScholarPubMed
Murray, SB, Rieger, E, Hildebrandt, T et al. A comparison of eating, exercise, shape, and weight related symptomatology in males with muscle dysmorphia and anorexia nervosa. Body Image 2012; 9: 193200.CrossRefGoogle ScholarPubMed
Corazza, O, Simonato, P, Demetrovics, Z et al. The emergence of exercise addiction, body dysmorphic disorder, and other image-related psychopathological correlates in fitness settings: a cross sectional study. PLoS ONE 2019; 14: e0213060.CrossRefGoogle ScholarPubMed
Silver, J, Farrants, J. ‘I once stared at myself in the mirror for eleven hours.’ Exploring mirror gazing in participants with body dysmorphic disorder. J Health Psychol 2016; 21: 2647–57.Google Scholar
Bewley, A. The neglected psychological aspects of skin disease. BMJ 2017; 6: j3208.Google Scholar
Veale, D, Riley, S. Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder. Behav Res Ther 2001; 39: 1381–93.CrossRefGoogle ScholarPubMed
Soler, PT, Ferreira, CMH, Novaes, J da S, Fernandes, HM. Body dysmorphic disorder: characteristics, psychopathology, clinical associations, and influencing factors. In: Gaze, DC, ed. Pathophysiology: Altered Physiological States. IntechOpen, 2018: 322.Google Scholar
Veale, D, Bewley, A. Body dysmorphic disorder. BMJ 2015; 350: h2278.Google Scholar
Corazza, O, Roman-Urrestarazu, A. Novel Psychoactive Substances: Policy, Economics and Drug. Regulation. Springer, 2017.CrossRefGoogle Scholar
Reuter, P, Pardo, B. Can new psychoactive substances be regulated effectively? An assessment of the British Psychoactive Substances Bill. Addiction 2017; 112: 2531.Google Scholar
Heinrich, J. Dietary Supplements For Weight Loss: Limited Federal Oversight Has Focused More on Marketing than on Safety. GAO-02-985T, 2002. www.gao.gov/products/GAO-02-985TGoogle Scholar
Graham, MR, Ryan, P, Baker, JS et al. Counterfeiting in performance- and image-enhancing drugs. Drug Test Anal 2009; 1: 135–42.Google Scholar
Thevis, M, Schrader, Y, Thomas, A et al. Analysis of confiscated black market drugs using chromatographic and mass spectrometric approaches. J Anal Toxicol 2008; 32: 232–40.Google Scholar
Van de Ven, K, Maher, L, Wand, H et al. Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in Australia. Drug Alcohol Rev 2018; 37: 837–46.Google Scholar
Barry, CT, Doucette, H, Loflin, DC, Rivera-Hudson, N, Herrington, LL. “Let me take a selfie”: associations between self-photography, narcissism, and self-esteem. Psychol Pop Media Cult 2017; 6: 4860.Google Scholar
Mabe, AG, Forney, KJ, Keel, PK. Do you “like” my photo? Facebook use maintains eating disorder risk. Int J Eat Disord 2014; 47: 516–23.Google Scholar
Meier, EP, Gray, J. Facebook photo activity associated with body image disturbance in adolescent girls. Cyberpsychol Behav Soc Netw 2014; 17: 199206.CrossRefGoogle ScholarPubMed
Simpson, CC, Mazzeo, SE. Skinny is not enough: a content analysis of fitspiration on Pinterest. Health Commun 2017; 32: 560–7.CrossRefGoogle Scholar
Dores, AR, Carvalho, IP, Burkauskas, J et al. Exercise and use of enhancement drugs at the time of the COVID-19 pandemic: a multicultural study on coping strategies during self-isolation and related risks. Front Psychiatry 2021; 12: 648501.Google Scholar
World Health Organization (WHO). Archived: WHO Timeline - COVID-19. World Health Organization, 2020. www.who.int/news/item/27-04-2020-who-timeline---covid-19Google Scholar
Xu, Z, Li, S, Tian, S, Li, H, Kong, LQ. Full spectrum of COVID-19 severity still being depicted. Lancet 2020; 395: 947–8.CrossRefGoogle ScholarPubMed
Cothran, TP, Kellman, S, Singh, S et al. A brewing storm: the neuropsychological sequelae of hyperinflammation due to COVID-19. Brain Behav Immun 2020; 88: 957-8.Google Scholar
Ellul, MA, Benjamin, L, Singh, B et al. Neurological associations of COVID-19. Lancet Neurol 2020; 19: 767–83.Google Scholar
Ferguson, NM, Laydon, D, Nedjati-Gilani, G et al. Impact of Non-Pharmaceutical Interventions (NPIs) to Reduce COVID-19 Mortality and Healthcare Demand. Imperial College London, 2020. www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-9-impact-of-npis-on-covid-19/Google Scholar
Mendes-Santos, C, Andersson, G, Weiderpass, E, Santana, R. Mitigating COVID-19 impact on the Portuguese population mental health: the opportunity that lies in digital mental health. Front Public Heal 2020; 8: 553345.Google Scholar
Wise, T, Zbozinek, TD, Michelini, G, Hagan, CC, Mobbs, D. Changes in risk perception and self-reported protective behaviour during the first week of the COVID-19 pandemic in the United States. R Soc Open Sci 2020; 7: 200742.Google Scholar
Santana, R, Rocha, J, Soares, P, Sousa, J. Os Momentos das Políticas de Saúde no Combate ao COVID-19. Escola Nacional de Saúde Publica (ENSP), 2020. https://barometro-covid-19.ensp.unl.pt/wp-content/uploads/2020/04/osmomentosdaspoliticasdesaudenocombateaocovid19–26.03.2020.pdfGoogle Scholar
Ammar, A, Trabelsi, K, Brach, M et al. Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study. Biol Sport 2021; 38: 921.Google Scholar
Dores, AR, Geraldo, A, Carvalho, IP, Barbosa, F. The use of new digital information and communication technologies in psychological counseling during the COVID-19 pandemic. Int J Environ Res Public Health 2020; 17: 7663.Google Scholar
Prime, H, Wade, M, Browne, DT. Risk and resilience in family well-being during the COVID-19 pandemic. Am Psychol 2020; 75: 631–43.Google Scholar
Bluedorn, J, Gopinath, GSD. An early view of the economic impact of the pandemic in 5 charts. IMFBlog, International Monetary Fund, 2020. https://blogs.imf.org/2020/04/06/an-early-view-of-the-economic-impact-of-the-pandemic-in-5-charts/Google Scholar
Maital, S, Barzani, E. The Global Economic Impact of COVID-19: A Summary of Research. Samuel Neaman Institute, 2020. www.neaman.org.il/EN/The-Global-Economic-Impact-of-COVID-19-A-Summary-of-ResearchGoogle Scholar
Stiglitz, JE, Shiller, RJ, Gopinath, G et al. How the Economy Will Look After the Coronavirus Pandemic. Foreign Policy, 2020. https://foreignpolicy.com/2020/04/15/how-the-economy-will-look-after-the-coronavirus-pandemicGoogle Scholar
Alzueta, E, Perrin, P, Baker, FC et al. How the COVID-19 pandemic has changed our lives: a study of psychological correlates across 59 countries. J Clin Psychol 2021; 77: 556–70.CrossRefGoogle ScholarPubMed
Jeong, H, Yim, HW, Song, YJ et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health 2016; 38: e2016048.Google Scholar
Brooks, SK, Webster, RK, Smith, LE et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020; 345: 912–20.Google Scholar
Horesh, D, Brown, AD. Traumatic stress in the age of COVID-19: a call to close critical gaps and adapt to new realities. Psychol Trauma 2020; 12: 331–5.Google Scholar
Holmes, EA, O’Connor, RC, Perry, VH et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry 2020; 7: 547–60.Google Scholar
Ammar, A, Brach, M, Trabelsi, K et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 international online survey. Nutrients 2020; 12: 1583.Google Scholar
Pfund, GN, Hill, PL, Harriger, J. Video chatting and appearance satisfaction during COVID-19: appearance comparisons and self-objectification as moderators. Int J Eat Disord 2020; 53: 2038–43.Google Scholar
Zamboni, L, Carli, S, Marika, B et al. COVID-19 lockdown: impact on online gambling, online shopping, web navigation and online pornography. J Public Health Res 2021; 10: 97102.Google Scholar
Czeisler, , Ma, RIL, Petrosky, E et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24–30, 2020. Morb Mortal Wkly Rep 2020; 69: 1049–57.Google Scholar
Martinotti, G, Alessi, MC, Di Natale, C et al. Psychopathological burden and quality of life in substance users during the COVID-19 lockdown period in Italy. Front Psychiatry 2020; 11:18.CrossRefGoogle ScholarPubMed
De la Vega, R, Almendros, LJ, Barquín, RR et al. Exercise addiction during the COVID-19 pandemic: an international study confirming the need for considering passion and perfectionism. Int J Ment Health Addict 2022; 20: 1159–70.Google Scholar
Szabo, A, Kovacsik, R. When passion appears, exercise addiction disappears: should hundreds of studies not considering passion be revisited? Swiss J Psychol 2019; 78: 137–42.Google Scholar
Egorov, AY, Szabo, A. The exercise paradox: an interactional model for a clearer conceptualization of exercise addiction. J Behav Addict 2013; 2: 199208.Google Scholar
Campbell, JP, Turner, JE. Debunking the myth of exercise-induced immune suppression: redefining the impact of exercise on immunological health across the lifespan. Front Immunology 2018; 9: 648.CrossRefGoogle ScholarPubMed
Chamorro-Viña, C, Fernandez-Del-Valle, M, Tacón, AM. Excessive exercise and immunity: the J-shaped curve. In: McComb, JJ, Norman, R, Zumwalt, M, eds. The Active Female: Health Issues Throughout the Lifespan, 2nd ed. Springer, 2014: 357–72.Google Scholar
Lim, MA. Exercise addiction and COVID-19-associated restrictions. J Ment Health 2021; 30: 135-7.Google Scholar
Molinero, O, Marquez, S. Use of nutritional supplements in sports: risks, knowledge, and behavioural-related factors. Nutr Hosp 2009; 24: 128–34.Google Scholar
Müller, RK. History of doping and doping control. In: Thieme, D, Hemmersbach, P, eds. Doping in Sports: Biochemical Principles, Effects and Analysis. Springer, 2010: 123.Google Scholar
Kamber, M, Mullis, PE. The worldwide fight against doping: from the beginning to the world anti-doping agency. Endocrinol Metab Clin North Am 2010; 39: 19.Google Scholar
Scharmer, C, Martinez, K, Gorrell, S et al. Eating disorder pathology and compulsive exercise during the COVID-19 public health emergency: examining risk associated with COVID-19 anxiety and intolerance of uncertainty. Int J Eat Disord 2020; 53: 2049–54.CrossRefGoogle ScholarPubMed
Mahoney, AEJ, McEvoy, PM. Trait versus situation-specific intolerance of uncertainty in a clinical sample with anxiety and depressive disorders. Cogn Behav Ther 2012; 41: 2639.Google Scholar
Boswell, JF, Thompson-Hollands, J, Farchione, TJ, Barlow, DH. Intolerance of uncertainty: a common factor in the treatment of emotional disorders. J Clin Psychol 2013; 69: 630–45.Google Scholar
Holaway, RM, Heimberg, RG, Coles, ME. A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. J Anxiety Disord 2006; 20: 158–74.Google Scholar
Brown, M, Robinson, L, Campione, GC et al. Intolerance of uncertainty in eating disorders: a systematic review and meta-analysis. Eur Eat Disord Rev 2017; 25: 329–43.Google Scholar
Kesby, A, Maguire, S, Brownlow, R, Grisham, JR. Intolerance of uncertainty in eating disorders: an update on the field. Clin Psychol Rev 2017; 56: 94105.Google Scholar
Scharmer, C, Reilly, EE, Gorrell, S, Anderson, DA. Establishing a link between compulsive exercise and intolerance of uncertainty to inform intervention development. Paper presented at the University of California San Diego 4th Annual Eating Disorders Conference, 27–28 February 2020, San Diego.Google Scholar
Juwono, ID, Szabo, A. 100 cases of exercise addiction: more evidence for a widely researched but rarely identified dysfunction. Int J Ment Health Addict 2021; 19: 1799–811.Google Scholar
Marsh, HW, Vallerand, RJ, Lafreniére, MAK et al. Passion: does one scale fit all? Construct validity of two-factor passion scale and psychometric invariance over different activities and languages. Psychol Assess 2013; 25: 796809.Google Scholar
Frost, RO, Marten, PA. Perfectionism and evaluative threat. Cogn Ther Res 1990; 14: 559–72.Google Scholar
Rosenstock, IM. Historical origins of the health belief model. Health Educ Behav 1974; 2: 328–35.Google Scholar
Kovacsik, R, Griffiths, MD, Pontes, HM et al. The role of passion in exercise addiction, exercise volume, and exercise intensity in long-term exercisers. Int J Ment Health Addict 2019; 17: 1389–400.Google Scholar
Kovacsik, R, Soós, I, De la Vega, R, Ruíz-Barquín, R, Szabo, A. Passion and exercise addiction: healthier profiles in team than in individual sports. Int J Sport Exerc Psychol 2020; 18: 176–86.Google Scholar
Birche, J, Griffiths, MD, Kasos, K, Demetrovics, Z, Szabo, A. Exercise addiction and personality: a two-decade systematic review of the empirical literature (1995–2016). Balt J Sport Heal Sci 2017; 3: 1933.Google Scholar
Curran, T, Hill, AP, Jowett, GE, Mallinson, SH. The relationship between multidimensional perfectionism and passion in junior athletes. Int J Sport Psychol 2014; 45: 369–84.Google Scholar
Veale, D, Eshkevari, E, Kanakam, N et al. The Appearance Anxiety Inventory: validation of a process measure in the treatment of body dysmorphic disorder. Behav Cogn Psychother 2014; 42: 605–16.Google Scholar
Neff, KD. The development and validation of a scale to measure self-compassion. Neuropsychopharmacology 2003; 2: 223–50.Google Scholar
Castilho, P, Gouveia, JP. Auto-Compaixão: estudo da validação da versão portuguesa da Escala da Auto-Compaixão e da sua relação com as experiências adversas na infância, a comparação social e a psicopatologia [Self-Compassion: study of the validation of the Portuguese version of the Self-Compassion Scale and its relationship with adverse childhood experiences, social comparison and psychopathology]. Psychologica 2011; 54: 203–30.Google Scholar
Ceci, F, Di Carlo, F, Burkauskas, J et al. Physical activity and exercise addiction during the Covid-19 pandemic in Italy. Int J Ment Health Addict 2022. DOI: https://doi.org/10.1007/s11469-022-00815-zGoogle Scholar

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