ASSESSMENT

Assessing the quantity of exercise alone is not indicative of the level of dysfunctional exercise, as it does not account for the thought patterns and compulsions driving the behaviour(1). To assess and monitor these, there are a range of questionnaires that can be beneficial. A few key questionnaires are:  

Exercise dependence scale

Contains 21 statements which are rated on a scale of 1-6, from never to always, and takes approximately 5 minutes to complete(2)

Is based on the criteria for addiction which include the following factors(2):

• Tolerance - a need for increased amounts of exercise or a diminished effect of the exercise over time

• Withdrawal - presence of withdrawal effects when unable to exercise

• Intention effect - engagement in a larger quantity or intensity than intended

• Lack of control - difficulties cutting down or controlling exercise

• Time - excessive time spent exercising

• Reductions in other activities - decreased social, work or recreational activities due to exercise

• Continuance - exercise is continued despite causing or exacerbating physical or psychological problems (e.g. running despite injury)

Compulsive exercise test (CET)

Specifically designed for use within the eating disorders domain(3)

Addresses 5 factors that maintain compulsive exercise(3):

• Avoidance and rule-driven behaviour e.g. withdrawal effects of not exercising, compulsivity, exercising despite injury and illness

• Weight control e.g. exercising to improve appearance, exercise to compensate for food intake

• Mood improvement e.g. exercise to decrease anxiety and stress

• Lack of exercise enjoyment e.g. finding exercise a chore, not enjoying exercise

• Exercise rigidity e.g. set routine, organised and structured exercise

Exercise dependence questionnaire

Consists of 29 items(4)

Addresses the following 8 factors(4):

• Interference with social / family / work life

• Positive reward following exercise

• Withdrawal symptoms

• Exercise for weight control

• Insight into problem

• Exercise for social reasons

• Exercise for health reasons

• Stereotyped behaviour

Intuitive exercise scale

A 14-item questionnaire, based on 4 factors(5):

• Emotional exercise - measures the use of exercise to manage unpleasant emotions

• Body trust - assesses reliance on internal bodily cues to guide exercise type, intensity and frequency

• Exercise rigidity - measure exercise variety

• Mindful exercise - measures awareness of bodily cues and ability to discontinue exercise based on these 

References