The Role of Ego Networks in Compulsive Exercise Behavior Among a Sample of College Sorority Women

in Journal of Physical Activity and Health
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Background: Compulsive exercise (CE) is a harmful form of exercise that elevates the risk of developing/sustaining clinical eating disorders. College-aged sorority women are especially prone to CE. Due to the pronounced impact social relationships have on college students’ behavior, this study aims to examine personal networks and CE among a sample of sorority women through an egocentric network analysis. Methods: A total of 204 women in a sorority from a large, private university in the southeastern United States completed a cross-sectional survey in spring 2015. Descriptive and regression analyses were conducted on demographic, attribute, and ego network data. Results: Relationships with siblings, significant others, and roommates were protective against CE in this sample. Conversely, body dissatisfaction and exercise frequency predicted CE. Conclusions: Findings suggest that social relationships can impact CE behaviors in this sample. Along with promoting body satisfaction and healthy exercise, public health efforts should focus on facilitating close interpersonal relationships, especially between sorority women and siblings, significant others, and roommates.

Patterson and Goodson are with Texas A&M University, College Station, TX.

Patterson (meganstiefelpatterson@gmail.com) is corresponding author.
  • 1.

    Meyer C, Taranis L, Goodwin H, Haycraft E. Compulsive exercise and eating disorders. Eur Eat Disord Rev. 2011;19(3):174–189. PubMed ID: 21584911 doi:10.1002/erv.1122

  • 2.

    Taranis L, Touyz S, Meyer C. Disordered eating and exercise: development and preliminary validation of the compulsive exercise test (CET). Eur Eat Disord Rev. 2011;19(3):256–268. PubMed ID: 21584918 doi:10.1002/erv.1108

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Dalle Grave R. Features and management of compulsive exercising in eating disorders. Phys Sportsmed. 2009;37(3):20–28. doi:10.3810/psm.2009.10.1725

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Polivy J, Herman CP. Causes of eating disorders. Annu Rev Psychol. 2002;53:187–213. PubMed ID: 11752484 doi:10.1146/annurev.psych.53.100901.135103

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Hudson JL, Hiripi E, Pope HG, Kessler RG. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61:348–358. PubMed ID: 16815322 doi:10.1016/j.biopsych.2006.03.040

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    National Eating Disorder Association. NEDA: Feeding hope. What are eating disorders. 2018. www.nationaleatingdisorders.org/what-are-eating-disorders. Accessed June 28, 2018.

    • Search Google Scholar
    • Export Citation
  • 7.

    Wade TD, Keski-Rahkonen A, Hudson JL. Epidemiology of eating disorders. In: Tsuang M, Tohen M, eds. Textbook in Psychiatric Epidemiology. 3rd ed. New York, NY: Wiley; 2011:343–360.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Angold A, Costello EJ, Farmer EMZ, Burns BJ, Erkanli A. Impaired but undiagnosed. J Am Acad Child Adolesc Psychiatry. 1999;38(2):129–137. PubMed ID: 9951211 doi:10.1097/00004583-199902000-00011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Ressler A. “A body to die for”: eating disorders and body-image distortion in women. Int J Fertil Womens Med. 1998;43(3):133–138. PubMed ID: 9692535

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Fairburn CG, Harrison PJ. Eating disorders. Lancet. 2003;361(9355):407–416. doi:10.1016/S0140-6736(03)12378-1

  • 11.

    Donatelle RJ. Access to Health. 13th ed. Boston, MA: Benjamin Cummings; 2013.

  • 12.

    Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011;68(7):724–731. PubMed ID: 21727255 doi:10.1001/archgenpsychiatry.2011.74

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014;13(2):153–160. PubMed ID: 24890068 doi:10.1002/wps.20128

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Walter K. Mortality and eating disorders. UCSD eating disorders research and treatment program. 2013. https://www.nationaleatingdisorders.org. Accessed June 28, 2018.

    • Export Citation
  • 15.

    Walsh BT. Recovery from eating disorders. Aust N Z J Psychiatry. 2008;42(2):95–96. PubMed ID: 18197503 doi:10.1080/00048670701793402

  • 16.

    Dittmar H, Howard S. Thin-ideal internalization and social comparison tendency as moderators of media models’ impact on women’s body-focused anxiety. J Soc Clin Psychol. 2004;23(6):768–791. doi:10.1521/jscp.23.6.768.54799

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Vartanian LR, Smyth JM, Zawadzki MJ, Heron KE, Sulamunn RM, Coleman BA. Early adversity, personal resources, body dissatisfaction, and disordered eating. Int J Eat Disord. 2014;47(6):620–629. doi:10.1002/eat.22313

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Cash TF, Smolak L. Body Image, Second Edition: A Handbook of Science, Practice, and Prevention. New York, NY: Guilford Press; 2011.

  • 19.

    Smolak L. Body image in children and adolescents: where do we go from here? Body Image. 2004;1:15–28. PubMed ID: 18089138 doi:10.1016/S1740-1445(03)00008-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Grogan S. Body Image: Understanding Body Dissatisfaction in Men, Women and Children. New York, NY: Routledge; 2007.

  • 21.

    Beren SE, Hayden HA, Wilfley DE, Grilo CM. The influence of sexual orientation on body dissatisfaction in adult men and women. Int J Eat Disord. 1996;20(2):135–141. PubMed ID: 8863065 doi:10.1002/(SICI)1098-108X(199609)20:2<135::AID-EAT3>3.0.CO;2-H

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Stice E, Whitenton K. Risk factors for body dissatisfaction in adolescent girls: a longitudinal investigation. Dev Psychol. 2002;38(5):669–678. PubMed ID: 12220046 doi:10.1037/0012-1649.38.5.669

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Stice E, Shaw HE. Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosom Res. 2002;53(5):985–993. PubMed ID: 12445588 doi:10.1016/S0022-3999(02)00488-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Gulker MG, Laskis TA, Kuba SA. Do excessive exercisers have a higher rate of obsessive–compulsive symptomatology? Psychol Health Med. 2001;6(4):387–398. doi:10.1080/13548500126535

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Eisenberg D, Nicklett EJ, Roeder K, Kirz NE. Eating disorder symptoms among college students: prevalence, persistence, correlates, and treatment-seeking. J Am Coll Health. 2011;59(8):700–707. doi:10.1080/07448481.2010.546461

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Striegel-Moore R, Franko DL. Epidemiology of binge eating disorder. Int J Eat Disord. 2003;34:19–29. PubMed ID: 12900983 doi:10.1002/eat.10202

  • 27.

    Dalle Grave R, Calugi S, Machesini G. Compulsive exercise to control shape or weight in eating disorders: prevalence, associated features, and treatment outcome. Compr Psychiatry. 2008;49(4):346–352. PubMed ID: 18555054 doi:10.1016/j.comppsych.2007.12.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Garman JF, Hayduk DM, Crider DA, Hodel MM. Occurrence of exercise dependence in a college-aged population. J Am Coll Health. 2004;52(5):221–228. PubMed ID: 15029944 doi:10.3200/JACH.52.5.221-228

    • Search Google Scholar
    • Export Citation
  • 29.

    Sussman S, Lisha N, Griffiths M. Prevalence of the addictions: a problem of the majority or the minority? Eval Health Prof. 2011;34(1):3–56. PubMed ID: 20876085 doi:10.1177/0163278710380124

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Kobus K. Peers and adolescent smoking. Addiction. 2003;98:37–55. PubMed ID: 12752361 doi:10.1046/j.1360-0443.98.s1.4.x

  • 31.

    Simons-Morton BG, Farhat T. Recent findings on peer group influences on adolescent smoking. J Prim Prev. 2010;31(4):191–208. PubMed ID: 20614184 doi:10.1007/s10935-010-0220-x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Huang GC, Unger JB, Soto DW, et al. Peer influences: the impact of online and offline friendship networks on adolescent smoking and alcohol use. J Adolesc Health. 2014;54(5):508–514. PubMed ID: 24012065 doi:10.1016/j.jadohealth.2013.07.001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Paxton SJ, Schutz HK, Wertheim EH, Muir SL. Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight loss behaviors, and binge eating in adolescent girls. J Abnorm Psychol. 1999;108:255–266. PubMed ID: 10369035 doi:10.1037/0021-843X.108.2.255

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Thompson JK, Heinberg LJ, Altabe M, Tantlett-Dunn S. Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance. Washington, DC: American Psychological Association; 1999.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Shroff H, Thompson KJ. The tripartite influence model of body image and eating disturbance: a replication with adolescent girls. Body Image. 2006;3:17–23. PubMed ID: 18089205 doi:10.1016/j.bodyim.2005.10.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Rodgers R, Chabrol H, Paxton SJ. An exploration of the tripartite influence model of body dissatisfaction and disordered eating among Australian and French college women. Body Image. 2011;8(3):208–215. PubMed ID: 21664887 doi:10.1016/j.bodyim.2011.04.009

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    van den Berg P, Thompson KJ, Obremski-Brandon K, Cooverty M. The tripartite influence model of body image and eating disturbance: a covariance structure modeling investigation testing the mediational role of appearance comparison. J Psychosom Res. 2002;53:1007–1020. PubMed ID: 12445590 doi:10.1016/S0022-3999(02)00499-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Haworth-Hoeppner S. The critical shapes of body image: the role of culture and family in the production of eating disorders. J Marriage Fam. 2000;62(1):212–227. doi:10.1111/j.1741-3737.2000.00212.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Kluck AS. Family influence on disordered eating: the role of body image dissatisfaction. Body Image. 2010;7(1):8–14. PubMed ID: 19945366 doi:10.1016/j.bodyim.2009.09.009

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Phares V, Steinberg AR, Thompson JK. Gender differences in peer and parental influences: body image disturbance, self-worth, and psychological functioning in preadolescent children. J Youth Adolesc. 2004;33(5):421–429. doi:10.1023/B:JOYO.0000037634.18749.20

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Shroff H, Thompson JK. Peer influences, body-image dissatisfaction, eating dysfunction and self-esteem in adolescent girls. J Health Psychol. 2006;11(4):533–551. PubMed ID: 16769734 doi:10.1177/1359105306065015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Gibbs M. Media influence on body image dissatisfaction. ETD Collection for Tennessee State University. January 2010:1–69. https://digitalscholarship.tnstate.edu/dissertations/AAI1476479/. Accessed June 28, 2018

    • Search Google Scholar
    • Export Citation
  • 43.

    Thompson JK, Heinberg LJ. The media’s influence on body image disturbance and eating disorders: we’ve reviled them, now can we rehabilitate them? J Soc Issues. 1999;55(2):339–353. doi:10.1111/0022-4537.00119

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44.

    Arbour KP, Martin Ginis KA. Effects of exposure to muscular and hypermuscular media images on young men’s muscularity dissatisfaction and body dissatisfaction. Body Image. 2006;3(2):153–161. PubMed ID: 18089218 doi:10.1016/j.bodyim.2006.03.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Field AE, Cheung L, Wolf AM, Hreczog DB, Gortmaker SL, Colditz GA. Exposure to the mass media and weight concerns among girls. Pediatrics. 1999;103:E36. PubMed ID: 10049992 doi:10.1542/peds.103.3.e36

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Hargreaves DA, Tiggemann M. Idealized media images and adolescent body image: “comparing” boys and girls. Body Image. 2004;1(4):351–361. PubMed ID: 18089166 doi:10.1016/j.bodyim.2004.10.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 47.

    Homan KJ. Athletic-ideal and thin-ideal internalization as prospective predictors of body dissatisfaction, dieting, and compulsive exercise. Body Image. 2010;7:240–245. PubMed ID: 20226748 doi:10.1016/j.bodyim.2010.02.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Thompson JK, Stice E. Thin-ideal internalization: mounting evidence for a new risk factor for body-image disturbance and eating pathology. Curr Dir Psychol Sci. 2001;10(5):181–183. doi:10.1111/1467-8721.00144

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 49.

    Hardit SK, Hannum JW. Attachment, the tripartite influence model, and the development of body dissatisfaction. Body Image. 2012;9(4):469–475. PubMed ID: 22795652 doi:10.1016/j.bodyim.2012.06.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Dumas TM, Wells S, Flynn A, Lange JE, Graham K. The influence of status on group drinking by young adults: a survey of natural drinking groups on their way to and from bars. Alcohol Clin Exp Res. 2014;38(4):1100–1107. doi:10.1111/acer.12314

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51.

    Dumas TM, Graham K, Bernards S, Wells S. Drinking to reach the top: young adults’ drinking patterns as a predictor of status within natural drinking groups. Addict Behav. 2014;39:1510–1515. PubMed ID: 24968362 doi:10.1016/j.addbeh.2014.05.019

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Hendrickson B, Rosen D, Kelly Aune R. An analysis of friendship networks, social connectedness, homesickness, and satisfaction levels of international students. Int J Intercult Relat. 2011;35(3):281–295. doi:10.1016/j.ijintrel.2010.08.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 53.

    Swartout KM. The company they keep: how peer networks influence male sexual aggression. Psychol Violence. 2013;3(2):157–171. doi:10.1037/a0029997

  • 54.

    Lamkin J, Campbell WK, van Dellen MR, Miller JD. An exploration of the correlates of grandiose and vulnerable narcissism in romantic relationships: homophily, partner characteristics, and dyadic adjustment. Pers Individ Dif. 2015;79:166–171. doi:10.1016/j.paid.2015.01.029

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 55.

    Hutchinson DM, Rapee RM. Do friends share similar body image and eating problems? The role of social networks and peer influences in early adolescence. Behav Res Ther. 2007;45(7):1557–1577. PubMed ID: 17258173 doi:10.1016/j.brat.2006.11.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Rayner KE, Schniering CA, Rapee RM, Taylor A, Hutchinson DM. Adolescent girls’ friendship networks, body dissatisfaction, and disordered eating: examining selection and socialization processes. J Abnorm Psychol. 2013;122(1):93–104. PubMed ID: 22867115 doi:10.1037/a0029304

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Feld S. The focused organization of social ties. Am J Sociol. 1981;86(5):1015–1035. doi:10.1086/227352

  • 58.

    Perry BL. Coming untied? Narrative accounts of social network dynamics from first-time mental health clients. Sociol Health Illn. 2012;34:1125–1139. PubMed ID: 22332876 doi:10.1111/j.1467-9566.2012.01459.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 59.

    Borgatti SP, Everett MG, Johnson JC. Analyzing Social Networks. London, UK: Sage Publications; 2013.

  • 60.

    McCallister L, Fisher CS. A procedure for surveying personal networks. Sociol Methods Res. 1978;7(2):131–148. doi:10.1177/004912417800700202

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 61.

    Valente TW. Social Networks and Health: Models, Methods, and Applications. New York, NY: Oxford University Press; 2010.

  • 62.

    Marsden PV. Network data and measurement. Annu Rev Sociol. 1990;16:435–463. doi:10.1146/annurev.so.16.080190.002251

  • 63.

    Wasserman S, Faust K. Social Network Analysis: Methods and Applications (Structural Analysis in the Social Sciences). Cambridge, UK: Cambridge University Press; 1994.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 64.

    Marsella AJ, Snyder KK. Stress, social supports, and schizophrenic disorders: toward an interactional model. Schizophr Bull. 1981;7:152–163. doi:10.1093/schbul/7.1.152

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 65.

    McCarty C. Structure in personal networks. J Soc Struct. 2002;3:1.

  • 66.

    Min MO, Tracy EM, Kim H, et al. Changes in personal networks of women in residential and outpatient substance abuse treatment. J Subst Abuse Treat. 2013;45:325–334. PubMed ID: 23755971 doi:10.1016/j.jsat.2013.04.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 67.

    Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10:141–146. PubMed ID: 4053261

  • 68.

    Godin G. Commentary: the Godin-Shephard leisure-time physical activity questionnaire. Health Fit J Can. 2011;4(1):18–22.

  • 69.

    Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc. 1993;25(1):81–91. PubMed ID: 8423759 doi:10.1249/00005768-199301000-00012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 70.

    Joseph RP, Royse KE, Benitez TJ, Pekmezi DW. Physical activity and quality of life among university students: exploring self-efficacy, self-esteem, and affect as potential mediators. Qual Life Res. 2014;23(2):659–667. doi:10.1007/s11136-013-0492-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 71.

    Goodwin H, Haycraft E, Taranis L, Meyer C. Psychometric evaluation of the compulsive exercise test (CET) in an adolescent population: links with eating psychopathology. Eur Eat Disord Rev. 2011;19(3):269–279. PubMed ID: 21584919 doi:10.1002/erv.1109

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 72.

    Evans C, Dolan B. Body Shape Questionnaire: derivation of shortened “alternate forms”. Int J Eat Disord. 1993;13(3):315–321. PubMed ID: 8477304 doi:10.1002/1098-108X(199304)13:3<315::AID-EAT2260130310>3.0.CO;2-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 73.

    Pook M, Tuschen-Caffier B, Brähler E. Evaluation and comparison of different versions of the Body Shape Questionnaire. Psychiatry Res. 2008;158(1):67–73. PubMed ID: 18037499 doi:10.1016/j.psychres.2006.08.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 74.

    Rosen JC, Jones A, Ramirez E, Waxman S. Body shape questionnaire: studies of validity and reliability. Int J Eat Disord. 1996;20(3):315–319. PubMed ID: 8912044 doi:10.1002/(SICI)1098-108X(199611)20:3<315::AID-EAT11>3.0.CO;2-Z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 75.

    Borgatti SP. E-Net Software for the Analysis of Ego-Network Data. Needham, MA: Analytic Technologies; 2006.

  • 76.

    Halgin DS, Borgatti SP. An introduction to personal network analysis with E-Net. Connections. 2012;31(1):37–48.

  • 77.

    Tabachnick BG, Fidell LS. Using Multivariate Statistics. 6th ed. New York, NY: Pearson; 2013.

  • 78.

    Guidi J, Pender M, Hollon SD, et al. The prevalence of compulsive eating and exercise among college students: an exploratory study. Psychiatry Res. 2009;165(1):154–162. doi:10.1016/j.psychres.2007.10.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 79.

    Taranis L, Meyer C. Perfectionism and compulsive exercise among female exercisers: high personal standards or self-criticism? Pers Individ Dif. 2010;49:3–7. doi:10.1016/j.paid.2010.02.024

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 80.

    Taranis L, Meyer C. Associations between specific components of compulsive exercise and eating-disordered cognitions and behaviors among young women. Int J Eat Disord. 2011;44(5):452–458. doi:10.1002/eat.20838

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 81.

    Duckham RL, Peirce N, Meyer C, Summers GD, Cameron N, Brooke-Wavell K. Risk factors for stress fracture in female endurance athletes: a cross-sectional study. BMJ Open. 2012. http://bmjopen.bmj.com. Accessed September 14, 2015.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 82.

    Yates A. Compulsive Exercise and the Eating Disorders: Toward an Integrated Theory of Activity. New York, NY: Routledge; 2013.

  • 83.

    Costa S, Hausenblas HA, Oliva P, Cuzzocrea F, Larcan R. The role of age, gender, mood states and exercise frequency on exercise dependence. J Behav Addict. 2013;2(4):216–223. PubMed ID: 25215203 doi:10.1556/JBA.2.2013.014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 84.

    Davis C, Kennedy SH, Ralevski E, Dionne M. The role of physical activity in the development and maintenance of eating disorders. Psychol Med. 1994;24(4):957–967. PubMed ID: 7892363 doi:10.1017/S0033291700029044

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 85.

    Szabo A, de La Vega R, Ruiz-Barquin R, Rivera O. Exercise addiction in Spanish athletes: investigation of the roles of gender, social context and level of involvement. J Behav Addict. 2013;2(4):249–252. PubMed ID: 25215208 doi:10.1556/JBA.2.2013.4.9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 86.

    Bradbury TN, Fincham FD, Beach SRH. Research on the nature and determinants of marital satisfaction: a decade in review. J Marriage Fam. 2000;62(4):964–980. doi:10.1111/j.1741-3737.2000.00964.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 87.

    Braithwaite SR, Delevi R, Fincham FD. Romantic relationships and the physical and mental health of college students. Pers Relatsh. 2010;17(1):1–12. doi:10.1111/j.1475-6811.2010.01248.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 88.

    Berge JM, MacLehose R, Eisenberg ME, Laska MN, Neumark-Sztainer D. How significant is the ‘significant other’? Associations between significant others’ health behaviors and attitudes and young adults’ health outcomes. Int J Behav Nutr Phys Act. 2012;9(1):35. doi:10.1186/1479-5868-9-35

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 89.

    Eisenberg D, Golberstein E, Whitlock JL, Downs MF. Social contagion of mental health: evidence from college roommates. Health Econ. 2013;22(8):965–986. PubMed ID: 23055446 doi:10.1002/hec.2873

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 90.

    Eisenberg D, Golberstein E, Whitlock JL. Peer effects on risky behaviors: new evidence from college roommate assignments. J Health Econ. 2014;33:126–138. PubMed ID: 24316458 doi:10.1016/j.jhealeco.2013.11.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 91.

    Lampis J, Agus M, Cacciarru B. Quality of family relationships as protective factors of eating disorders: an investigation amongst Italian teenagers. Appl Res Qual Life. 2013;9(2):309–324. doi:10.1007/s11482-013-9234-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 92.

    Latzer Y, Hochdorf Z, Bachar E, Canetti L. Attachment style and family functioning as discriminating factors in eating disorders. Contemp Fam Ther. 2002;24(4):581–599. doi:10.1023/A:1021273129664

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 93.

    Onnis L, Barbara E, Bernardini M, et al. Family relations and eating disorders. The effectiveness of an integrated approach in the treatment of anorexia and bulimia in teenagers: results of a case-control systemic research. Eat Weight Disord. 2012;17(1):e36–e48. PubMed ID: 22751270 doi:10.1007/BF03325326

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 94.

    Granovetter MS. The strength of weak ties. Am J Sociol. 1973;78(6):1360–1380. doi:10.1086/225469

  • 95.

    Merluzzi J, Burt RS. How many names are enough? Identifying network effects with the least set of listed contacts. Soc Netw. 2013;35(3):331–337. doi:10.1016/j.socnet.2013.03.004

    • Crossref
    • Search Google Scholar
    • Export Citation
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