(PS5-61) Latent Profile Analysis of Excessive and Compulsive Exercise Behavior in Undergraduate Students

Abstract Text: Maladaptive exercise is both a common symptom of eating disorders (EDs) and a standalone health risk behavior. While there remains debate about how best to characterize maladaptive exercise, it is associated with poor ED treatment prognosis (e.g., longer treatment stays, dropout, relapse) and other negative health outcomes (e.g., injury, amenorrhea). Current definitions of maladaptive exercise include frequency, duration, intensity, and/or cognitions about exercise. This study sought to empirically derive a definition of maladaptive exercise in a college sample using latent profile analysis and validate the identified profiles using measures of mental health functioning and disordered eating. We hypothesized four profiles: low compulsive/low excessive (healthy), high excessive/low compulsive (healthy), high compulsive/low excessive (maladaptive), and high excessive/high compulsive (maladaptive). We anticipated maladaptive profiles would be associated with worse mental health functioning.

University students (n = 589; 54% female; 58% Non-Hispanic White, Mage = 20) self-reported exercise cognitions (Eating and Exercise Questionnaire – Compulsive Exercise) and behaviors (Eating Pathology Symptom Index [EPSI] – Excessive Exercise), as well as eating pathology (EPSI subscales), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). Latent profile analysis was conducted in Mplus v8.3 with two continuous indicators (Excessive & Compulsive Exercise subscales). The BCH method and DCATEGORICAL commands tested continuous (e.g., anxiety) and categorical (e.g., purging [binary], gender) correlates, respectively. The Benjamini-Hochberg false discovery rate was applied to account for multiple comparisons.

Partially supporting hypotheses, six profiles were identified: 1) non-exercisers; 2) average exercisers (mean compulsive & excessive); 3) excessive only (+1 SD); 4) compulsive only (+1 SD); 5) compulsive & excessive (both +1 SD); and 6) compulsive & excessive (both +2 SD). Both high compulsive/high excessive exercise profiles were associated with the greatest number and severity of ED symptoms (e.g., restricting, bingeing, purging, body dissatisfaction); high compulsive profiles had the highest depression and anxiety. Excessive exercise was associated with the lowest psychopathology.

The presence of compulsive and excessive exercise features was associated with the most disordered eating, and high compulsive profiles demonstrated the worst mental health. This supports extant theories that posit how people think about exercise distinguishes maladaptive from adaptive. The high excessive profile displayed the least psychopathology; these individuals likely benefit from consistent exercise participation. Future research should replicate these findings and investigate whether the high compulsive/high excessive groups may simply be capturing individuals meeting criteria for an ED.