title: The reinforcing effect of exercise in anorexia nervosa: Clinical correlates and relationship to outcome.
abstract: The purpose of the current study was to examine the relative reinforcing effect of exercise compared to a non-monetary alternative reinforcer (leisure activity), and to money, before and after weight restoration in an inpatient population with anorexia nervosa (AN). Sixty-two inpatients with AN completed a progressive ratio (PR) task to earn exercise, leisure activities, or cash at low weight and after weight restoration. Measures of pathology and motivation to exercise were completed and post-treatment discharge weights were collected. Patients worked harder for exercise at low weight than after weight restoration (df = 46, t = 5.50, p < .001). PR task performance was weakly associated with a measure of commitment to exercise (low weight: r = 0.31, weight restored: r = 0.36, p < .05), but not with other clinical measures or follow-up weights. Contrary to prior suggestions, measurement of the reinforcing value of exercise among individuals with AN via a PR task does not appear valuable in assessing clinical severity or outcome. Other, simpler, self-report measures of commitment to exercise may have greater value in assessing these outcomes.
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: Loren M
authors.initials: LM
authors.lastname: Gianini
authors.affiliation: b Department of Psychiatry , New York University Langone Medical Center , New York , New York , USA.
authors.forename: Diane A
authors.initials: DA
authors.lastname: Klein
authors.affiliation: c Department of Psychology , Drexel University , Philadelphia , Pennsylvania , USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Call
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: Laurel
authors.initials: L
authors.lastname: Mayer
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Foltin
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: B Timothy
authors.initials: BT
authors.lastname: Walsh
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: Yuanjia
authors.initials: Y
authors.lastname: Wang
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: Peng
authors.initials: P
authors.lastname: Wu
authors.affiliation: a Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , New York , USA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Attia
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D009042:Motivation; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology*; D012054:Reinforcement, Psychology; D055815:Young Adult