Emotion Dysregulation as a Mediator of the Relationship between Anxiety, Compulsive Exercise and Eating Disorder Symptoms in Adolescents.

Cristina Cuesta-Zamora,Laura Ros,Carolyn R Plateau,Luis Miguel García-López,Jorge Javier Ricarte,Irene González-Martí

doi:10.3390/children8121088

Cristina Cuesta-Zamora, Laura Ros + Show 4 more

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https://doi.org/10.3390/children8121088

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Abstract

Anxiety has been suggested to be a key contributing factor for compulsive exercise, however, existing literature has demonstrated contradictory relationships between anxiety and compulsive exercise among adolescents. According to the Emotional Cascade Model (ECM), factors such as rumination and emotional suppression may mediate the association between affect and exercise. The current study therefore aimed to investigate whether rumination and emotional suppression mediate the relationship between anxiety and compulsive exercise in predicting ED symptoms in adolescents. Questionnaires assessing compulsive exercise, anxiety, depressive rumination, emotional suppression, and ED symptoms were completed by 212 adolescent males (Mage = 13.39, SD = 1.22) and 189 adolescent females (Mage = 13.64, SD = 1.29). The structural equation model showed indirect effects between anxiety and compulsive exercise through rumination and emotional suppression in males but not in females. Moreover, anxiety had an indirect effect on eating disorder symptoms through rumination, emotional suppression and compulsive exercise in both males and females. In line with ECM, the results suggest that rumination and emotional suppression may have a key role in the association between anxiety, compulsive exercise and eating disorder symptoms in adolescents. These findings suggest that compulsive exercise may be used as a dysfunctional coping mechanism to escape from a negative emotional cascade generated by the interaction of anxiety, rumination and emotional suppression. Future longitudinal studies to test the role of compulsive exercise as a dysfunctional behaviour in the ECM are needed.

Highlights

The results from this study suggest that the inclusion of strategies to reduce rumination in preventative programmes could help to reduce the risk of some dysfunctional behaviours [81], compulsive exercise in males and eating disorder symptoms in both males and females
Further explorations of the role of compulsive exercise for predicting specific eating disorder (ED) symptoms, beyond the overall ED symptoms that were considered in this study. These preliminary results suggest that rumination may mediate the relationship between anxiety and compulsive exercise among male adolescents
These results are in line with the Emotional Cascade Model (ECM), and suggest that harmful attitudes and behaviours may be used to cope with anxiety and rumination

Summary

Introduction

Compulsive exercise is a multidimensional construct, whereby exercise attitudes and behaviours are characterised by weight and shape concerns, and persistent continuation of exercise in order to mitigate the experience of extreme guilt and/or negative affect when unable to exercise, and to avoid the perceived negative consequences of stopping [1]. Despite the clinical significance of compulsive exercise, it remains understudied compared to other psychopathological aspects of EDs [10]. The compulsive exercise model [1] proposes that exercise could be maintained via positive reinforcement mechanisms (due to the mood enhancing effects of exercise) and via a negative reinforcement mechanism (i.e., where exercise is conducted to avoid or mitigate the experience of guilt and/or negative affect)

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