Abstract
ObjectivesThe objectives of this study were to (1) validate the Norwegian version of the Compulsive Exercise Test (CET) in adults with longstanding eating disorders, and (2) explore predictors of high CET-score.Methods:Adult inpatients (n = 166) with longstanding DSM-IV Anorexia Nervosa, Bulimia Nervosa (BN) or Eating Disorder not Otherwise Specified (EDNOS) completed the CET instrument, Eating Disorder examination questionnaire (EDE-Q), Beck Depression Inventory-II (BDI-II) and Symptom checklist-90 (SCL-90). A total CET score of 15 or above was defined as high CET-score. ANOVA, Confirmatory factor analysis, Pearson’s correlation, and logistic regression were used to analyze the data.ResultsCronbach’s alpha varied from 0.68 to 0.96 for the CET and its subscales. The confirmatory factor analysis showed adequate fit. Convergent validity of the CET demonstrated correlation between EDE-Q global and subscale scores and CET total score. The same pattern was found for correlation between CET subscales and EDE-Q subscales. EDE-Q global score and frequency of exercise episodes predicted high CET-score, yet 21% of the patients with high CET score had less than one episode of exercise per week.ConclusionThe Norwegian version of CET is valid and useful for assessing compulsive exercise in a sample with longstanding ED. The understanding of compulsive exercise must to a greater extent differ between obsessions and compulsions, as a significant number of patients with high CET score showed no or little exercise behavior.
Highlights
Compulsive exercise has been shown to be one of the core symptoms of eating disorder (ED) in general and anorexia nervosa (AN) in particular, and this symptom is associated with more severe psychopathology, poorer treatment outcome and higher risk of relapse (Strober et al, 1997; Shroff et al, 2006; Meyer et al, 2011)
Convergent Validity Convergent validity of the Compulsive Exercise Test (CET) was assessed by correlation analyses with eating disorder examination-questionnaire (EDE-Q) (Table 3)
The EDE-Q global score was correlated with CET total score, CET Avoidance and rule-driven behavior, CET Weight control, and CET Lack of enjoyment (Table 3)
Summary
Compulsive exercise has been shown to be one of the core symptoms of ED in general and AN in particular, and this symptom is associated with more severe psychopathology, poorer treatment outcome and higher risk of relapse (Strober et al, 1997; Shroff et al, 2006; Meyer et al, 2011). Based on a cognitive behavioral model, Meyer et al (2011) proposed four key constructs underlying compulsive exercising: (1) eating psychopathology; (2) obsessive compulsiveness; (3) mood regulation; and (4) perfectionism. This multidimensional definition of compulsive exercise led to the development of a new self-report instrument, the Compulsive Exercise Test (CET) (Taranis et al, 2011). This instrument examines the emotional, cognitive, and behavioral characteristics of compulsive exercise from a multi-facet perspective. There is still lacking a validation in a transdiagnostic adult sample with longstanding ED, and translations of the instrument need to be validated
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