Psychometric properties of instruments assessing exercise in patients with eating disorders: a systematic review
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REVIEW
Open Access
Psychometric properties of instruments assessing exercise in patients with eating disorders: a systematic review Astrid Harris1, Phillipa Hay2*
and Stephen Touyz3
Abstract Background: Research has identified factors specific to exercise in eating disorder patients such as affect regulation and compulsivity. Existing measures of exercise behaviour which were not originally designed for eating disorder patients may not adequately assess these factors. The aim of this systematic review is to identify and assess the psychometric properties of all self-report measures of exercise designed to be used with eating disorder patients. Method: A systematic review was conducted following the PRISMA guidelines. MedLine, Scopus and PsycINFO were systematically searched. A total of 12 studies examining two measures, the Exercise and Eating Disorders and the Compulsive Exercise Test, met inclusion criteria. Results: Validation studies showed promising results for both tests and established internal consistency, concurrent and convergent validity, and construct validity. The factor structure of the Compulsive Exercise Test was not confirmed in the majority of the studies included in this review, while there are only two studies conducting factor analysis on the Exercise and Eating Disorders. Conclusion: The two measures identified by this systematic review represent the current research on measures of compulsive exercise for eating disorder patients. Further research is needed to confirm a factor structure and validate both the Compulsive Exercise Test and the Exercise and Eating Disorders in more diverse clinical samples. Keywords: Eating disorders, Exercise, Factor analysis, Psychometrics, Validity
Plain English summary Exercise has long been recognised as an important feature of eating disorders. Research has consistently found that many people with eating disorders exercise because they feel a drive to exercise, or in order to regulate their emotions. This type of exercise, called ‘compulsive exercise’ can have a detrimental impact on peoples’ health and well-being. Compulsive exercise in eating disorders has been found to be associated with a range of adverse outcomes such as longer hospitalisation, higher risk of * Correspondence: [email protected] 2 Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, Australia Full list of author information is available at the end of the article
relapse, and higher risk of a chronic outcome. In order to treat exercise as a symptom of eating disorders, clinicians need a way to measure exercise behaviours specific to eating disorders. There are a number of tests that measure exercise behaviours, however most of them were not designed for the needs of eating disorder patients. The current review therefore examines the literature in order to identify and assess measurement tools for patients with eating disorders.
Background Exercise has long been described as an important feature of eating disorders [1, 2]. Despite
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