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Accuracy of self-reported physical activity in patients with anorexia nervosa: links with clinical features

Bezzina, Louise; Touyz, Stephen; Young, Sarah; Foroughi, Nasim; Clemes, Stacy; Meyer, Caroline; Arcelus, Jon; Madden, Sloane; Attia, Evelyn; Pike, Kathleen M.; Hay, Phillipa

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Authors

Louise Bezzina

Stephen Touyz

Sarah Young

Nasim Foroughi

Stacy Clemes

Caroline Meyer

Jon Arcelus

Sloane Madden

Evelyn Attia

Kathleen M. Pike

Phillipa Hay



Abstract

Background
High levels of physical activity (PA) have long been described in patients with Anorexia Nervosa (AN). Despite the importance of measuring PA in this population, there are two important factors that remain unknown. First, it is not clear how accurate self-report measures of PA are among patients. Second, little is known about how clinical characteristics are associated with the accuracy of self-reported PA. Therefore, this study aimed to examine the accuracy of self-reported PA compared to an objective measure of PA in patients with AN. It also investigated whether levels of accuracy/inaccuracy were associated with compulsive exercise, motivation to change, and psychological distress.

Method
Data were analysed from 34 adult outpatients with AN. Patients wore an accelerometer device (ActiGraph) for 4 days and completed a retrospective self-report measure of exercise (Exercise Participation Screening Questionnaire). They also completed measures of compulsive exercise (Compulsive Exercise Test), motivation to change (The Anorexia Nervosa Stages of Change Questionnaire), and psychological distress (Kessler-10).

Results
On the self-report measure, patients accurately reported their time spent in moderate and vigorous intensity PA, however, they significantly under-reported their light physical activity (compared to the accelerometer data). Accurate reporting of total PA was positively associated with higher levels of compulsive exercise. There was evidence to suggest that clinical features, such as motivation to change and psychological distress, may be associated with inaccurate reporting at some levels of PA intensity and not others.

Conclusions
Results indicate that patients with AN are likely to under-report their light intensity PA. We also found preliminary evidence for how compulsive exercise, motivation to change, and distress are associated with self-reported PA accuracy. Clinical implications and directions for future research are considered.

Citation

Bezzina, L., Touyz, S., Young, S., Foroughi, N., Clemes, S., Meyer, C., …Hay, P. (2019). Accuracy of self-reported physical activity in patients with anorexia nervosa: links with clinical features. Journal of Eating Disorders, 7, Article 28. https://doi.org/10.1186/s40337-019-0258-y

Journal Article Type Article
Acceptance Date Aug 1, 2019
Online Publication Date Aug 23, 2019
Publication Date Aug 23, 2019
Deposit Date Jul 16, 2020
Publicly Available Date Mar 29, 2024
Journal Journal of Eating Disorders
Electronic ISSN 2050-2974
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 7
Article Number 28
DOI https://doi.org/10.1186/s40337-019-0258-y
Keywords Nutrition and Dietetics; Behavioral Neuroscience; Psychiatry and Mental health
Public URL https://nottingham-repository.worktribe.com/output/4769826
Publisher URL https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-019-0258-y
Additional Information Received: 27 February 2019; Accepted: 1 August 2019; First Online: 23 August 2019; : Ethics approval was granted at the Western Sydney University Human Research Ethics Committee in Australia and the National Health Service Research Ethics Committee in the UK, as part of the Health Research Authority.; : All participants provided written informed consent for publication of grouped (not individual or identifying) data.; : ST and PH receive royalties from Routledge, Hogrefe, and Huber and McGraw-Hill publishers for printed contributions on eating disorders. SM received, and PH and ST receive honoraria from Shire Pharmaceuticals. PH received royalties from Oxford University Press and receives sessional fees and lecture fees from the Australian Medical Council, Therapeutic Guidelines publication, and New South Wales Institute of Psychiatry. PH and ST are Editors-in-Chief of this journal, and CM, JA, SM, KP, and SY are on the editorial board.All authors have other published papers cited in this manuscript.

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