本研究目的在調查臺灣成年習慣性運動者罹患初級運動成癮的風險，與探索自尊、身體意象、心理困擾與初級運動成癮風險的關係。此為斷代研究（cross-sectional study）並使用線上問卷收案，包括：基本資料、修訂版健身運動依賴量表、Rosenberg 自尊量表中文版、身體意象關注問卷、心理困擾量表（Kessler 10）。研究共收到229 個有效樣本（126 位女性，平均年齡30.08，標準差9.51；102位男性，平均年齡30.55，標準差8.94；1 位跨性別男性），百分之六點六的受測者在運動成癮的部分達到「有風險」的等級。相關性分析指出運動成癮症狀與自尊、自尊與身體意象困擾、自尊與心理困擾皆呈顯著負相關，而運動成癮症狀與心理困擾、身體意象困擾與心理困擾呈顯著正相關。徑路分析在全體受測者指出低自尊與身體意象困擾不僅分別導致心理困擾，也透過心理困擾的中介作用導致運動成癮症狀的發生。在男性受測者中，身體意象困擾透過自尊導致心理困擾，而心理困擾進一步造成運動成癮症狀。而對女性受測者來說，低自尊、身體意象困擾、心理困擾的互動並沒有導致運動成癮症狀。研究結果建議自尊為初級運動成癮症狀發展過程中重要的保護性與貢獻性因素。未來研究建議納入受測者之應對壓力的資源（coping resources）進行分析。

The study aims to surveys the percentage of primary exercise addiction (EA) risk and investigates the relationship among self-esteem, body image concern, psychological distress, and primary EA risk in Taiwanese adult regular exercisers. It is a cross-sectional study investigates participants using online questionnaires. Demographic data, Exercise Dependence Scale- Revised, Rosenberg Self-Esteem Scale, Body Image Concern Inventory, and the Kessler Psychological Distress Scale (K10) were included in the online survey. Two hundred and twenty-nine responses (126 females, M age = 30.08, SD = 9.51; 102 males, M age = 30.55, SD = 8.94; 1 transgender male) were obtained. Six point six percent of participants were identified at-risk of primary EA. Correlational analysis shows a significant negative correlation between EA symptoms and self-esteem, self-esteem and body image concern, and self-esteem and psychological distress; and a significant positive correlation between EA symptoms and psychological distress and body image concern and psychological distress. Path analysis for all participants indicated that low self-esteem and body image concern contributed to psychological distress independently, and both variables further lead to primary EA risk through the mediation of psychological distress. In male participants, body image concern causes psychological distress through self-esteem, and psychological distress further leads to EA risk. The interactions of low self-esteem, body image concern, and psychological distress did not lead to EA in female participants. It is suggested that self-esteem may be an important protective factor but also a contributing factor in the development of primary EA risk. Future studies were recommended to include coping resources in the analysis.

Albert, P. R. (2015). Why is depression more prevalent in women? Journal of Psychiatry and Neuroscience, 40(4), 219–221. https://doi.org/10.1503/jpn.150205
Allegre, B., Therme, P., & Griffiths, M. (2007). Individual factors and the context of physical activity in exercise dependence: A prospective study of 'ultra-marathoners'. International Journal of Mental Health and Addiction, 5(3), 233–243. https://doi.org/10.1007/s11469-007-9081-9
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR. https://doi.org/10.1176/appi.books.9780890425787
Andreassen, C. S., Griffiths, M. D., Gjertsen, S. R., Krossbakken, E., Kvam, S., & Pallesen, S. (2013). The relationships between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2(2), 90–99. https://doi.org/10.1556/jba.2.2013.003
Arzeen, S., & Arzeen, N. (2021). Body image and psychological distress among university students. Journal of Postgraduate Medical Institute, 35(3), 181–184. https://doi.org/10.54079/jpmi.35.3.2695
Back, J., Josefsson, T., Ivarsson, A., & Gustafsson, H. (2019). Psychological risk factors for exercise dependence. International Journal of Sport and Exercise Psychology, 19(4), 461–472. https://doi.org/10.1080/1612197X.2019.1674902
Baker, J. P., & Berenbaum, H. (2007). Emotional approach and problem-focused coping: A comparison of potentially adaptive strategies. Cognition and Emotion, 21(1), 95–118. https://doi.org/10.1080/02699930600562276
Basso, J. C., & Suzuki, W. A. (2017). The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: A review. Brain Plasticity, 2(2), 127–152. https://doi.org/10.3233/bpl-160040
Bell, H. S., Donovan, C. L., & Ramme, R. (2016). Is athletic really ideal? An examination of the mediating role of body dissatisfaction in predicting disordered eating and compulsive exercise. Eating Behaviors, 21, 24–29. https://doi.org/10.1016/j.eatbeh.2015.12.012
Berczik, K., Szabó, A., Griffiths, M. D., Kurimay, T., Kun, B., Urbán, R., & Demetrovics, Z. (2012). Exercise addiction: Symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47(4), 403–417. https://doi.org/10.3109/10826084.2011.639120
Booher, M. A., & Smith, B. W. (2003). Physiological effects of exercise on the cardiopulmonary system. Clinics in Sports Medicine, 22(1), 1–21. https://doi.org/10.1016/S0278-5919(02)00034-0
Brennan, M., Lalonde, C., & Bain, J. (2010). Body image perceptions: Do gender differences exist? Psi Chi Journal of Psychological Research, 15(3), 130–138. https://doi.org/10.24839/1089-4136.JN15.3.130
Breton, É., Juster, R. P., & Booij, L. (2023). Gender and sex in eating disorders: A narrative review of the current state of knowledge, research gaps, and recommendations. Brain and Behavior, 13(4). https://doi.org/10.1002/brb3.2871
Brown, R. (1993). Some contributions of the study of gambling to the study of other addictions. In J. A. Cornelius (Ed.), Gambling behavior and problem gambling (pp. 241–272). University of Nevada.
Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Reports, 100(2), 126–131.
Centers for Disease Control and Prevention. (2024, April 24). Benefits of physical activity. Centers for Disease Control and Prevention.
Chen, M.-H. (2016). Relationships among weight difference, body image concern and self-esteem: The moderaion of gender and physical education types. Bulletin of Sport and Exercise Psychology in Taiwan, 16(2), 1–20. https://doi.org/10.6497/BSEPT2016.1602.01
Cholankeril, R., Xiang, E., & Badr, H. (2023). Gender differences in coping and psychological adaptation during the COVID-19 pandemic. International Journal of Environment Research and Public Health, 20(2), Article 993. https://doi.org/10.3390/ijerph20020993
Colledge, F., Sattler, I., Schilling, H., Gerber, M., Pühse, U., & Walter, M. (2020). Mental disorders in individuals at risk for exercise addiction- a systematic review. Addictive Behaviors Reports, 12. https://doi.org/10.1016/j.abrep.2020.100314
Cook, B., Karr, T. M., Zunker, C., Mitchell, J. E., Thompson, R., Sherman, R., Erickson, A., Cao, L., & Crosby, R. D. (2015). The influence of exercise identity and social physique anxiety on exercise dependence. Journal of Behavioral Addictions, 4(3), 195–199. https://doi.org/10.1556/2006.4.2015.020
Costa, S., Hausenblas, H. A., Oliva, P., Cuzzocrea, F., & Larcan, R. (2013). The role of age, gender, mood states and exercise frequency on exercise dependence. Journal of Behavioral Addictions, 2(4), 216–223. https://doi.org/10.1556/jba.2.2013.014
Cousineau, D., Ferguson, R. J., de Champlain, J., Gauthier, P., Côté, P., & Bourassa, M. (1977). Catecholamines in coronary sinus during exercise in man before and after training. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, 43(5), 801–806. https://doi.org/10.1152/jappl.1977.43.5.801
D'Onofrio, G., Kirschner, J., Prather, H., Goldman, D., & Rozanski, A. (2023). Musculoskeletal exercise: Its role in promoting health and longevity. Progress in Cardiovascular Diseases, 77, 25–36. https://doi.org/https://doi.org/10.1016/j.pcad.2023.02.006
de Coverley Veale, D. M. (1987). Exercise dependence. British Journal of Addiction, 82(7), 735–740. https://doi.org/10.1111/j.1360-0443.1987.tb01539.x
deVries, H. A. (1981). Tranquilizer effect of exercise: A critical review. The Physician of Sportsmedicine, 9(11), 46–55. https://doi.org/10.1080/00913847.1981.11711206
Directorate General of Budget Accounting and Statistics. (2023, January 1). Earnings exploration and information system. Executive Yuan. https://earnings.dgbas.gov.tw/experience_sub_01.aspx
Downs, D. S., Hausenblas, H. A., & Nigg, C. R. (2004). Factorial validity and psychometric examination of the exercise dependence scale-revised. Measurement in Physical Education and Exercise Science, 8(4), 183–201. https://doi.org/10.1207/s15327841mpee0804_1
Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11–17. https://doi.org/10.1016/j.eatbeh.2015.12.006
Eather, N., Wade, L., Pankowiak, A., & Eime, R. (2023). The impact of sports participation on mental health and social outcomes in adults: A systematic review and the ‘Mental Health through Sport’ conceptual model. Systematic Reviews, 12(1), 102–128. https://doi.org/10.1186/s13643-023-02264-8
Egorov, A. Y., & Szabo, A. (2013). The exercise paradox: An interactional model for a clearer conceptualization of exercise addiction. Journal of Behavioral Addictions, 2(4), 199–208. https://doi.org/10.1556/JBA.2.2013.4.2
Farrell, P. A., Gates, W. K., Maksud, M. G., & Morgan, W. P. (1982). Increases in plasma beta-endorphin/beta-lipotropin immunoreactivity after treadmill running in humans. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, 52(5), 1245–1249. https://doi.org/10.1152/jappl.1982.52.5.1245
Ganson, K. T., Mitchison, D., Rodgers, R. F., Cunningham, M. L., Murray, S. B., & Nagata, J. M. (2021). Compulsive exercise among college students: 5-year time trends in prevalence and demographic, substance use, and mental health correlates. Eating and Weight Disorders, 27(2), 717–728. https://doi.org/10.1007/s40519-021-01210-8
Goodwin, H., Haycraft, E., & Meyer, C. (2014). Sociocultural risk factors for compulsive exercise: A prospective study of adolescents. European Eating Disorders Review, 22(5), 360–365. https://doi.org/10.1002/erv.2309
Goodwin, H., Haycraft, E., Willis, A. M., & Meyer, C. (2011). Compulsive exercise: The role of personality, psychological morbidity, and disordered eating. International Journal of Eating Disorders, 44(7), 655–660. https://doi.org/10.1002/eat.20902
Gori, A., Topino, E., & Griffiths, M. D. (2021). Protective and risk factors in exercise addiction: A series of moderated mediation analyses. International Journal of Environmental Research and Public Health, 18(18). https://doi.org/10.3390/ijerph18189706
Gorrell, S., Flatt, R. E., Bulik, C. M., & Le Grange, D. (2021). Psychosocial etiology of maladaptive exercise and its role in eating disorders: A systematic review. International Journal of Eating Disorders, 54(8), 1358–1376. https://doi.org/10.1002/eat.23524
Grandi, S., Clementi, C., Guidi, J., Benassi, M., & Tossani, E. (2011). Personality characteristics and psychological distress associated with primary exercise dependence: An exploratory study. Psychiatry Research, 189(2), 270–275. https://doi.org/10.1016/j.psychres.2011.02.025
Griffiths, M. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19–25. https://doi.org/10.1108/13665629610116872
Griffiths, M. (1997). Exercise addiction: A case study. Addiction Research, 5(2), 161–168. https://doi.org/10.3109/16066359709005257
Griffiths, M. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10(4), 191–197. https://doi.org/10.1080/14659890500114359
Griffiths, S., Hay, P., Mitchison, D., Mond, J. M., McLean, S. A., Rodgers, B., Massey, R., & Paxton, S. J. (2016). Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress. Australian and New Zealand Journal of Public Health, 40(6), 518–522. https://doi.org/10.1111/1753-6405.12538
Habelt, L., Kemmler, G., Defrancesco, M., Spanier, B., Henningsen, P., Halle, M., Sperner-Unterweger, B., & Hüfner, K. (2023). Why do we climb mountains? An exploration of features of behavioural addiction in mountaineering and the association with stress-related psychiatric disorders. European Archives of Psychiatry and Clinical Neuroscience, 273(3), 639–647. https://doi.org/10.1007/s00406-022-01476-8
Hafstad, S. M., Bauer, J., Harris, A., & Pallesen, S. (2023). The prevalence of orthorexia in exercising populations: A systematic review and meta-analysis. Journal of Eating Disorders, 11(1), Article 15. https://doi.org/10.1186/s40337-023-00739-6
Hall, H. K., Hill, A. P., Appleton, P. R., & Kozub, S. A. (2009). The mediating influence of unconditional self-acceptance and labile self-esteem on the relationship between multidimensional perfectionism and exercise dependence. Psychology of Sport and Exercise, 10(1), 35–44. https://doi.org/10.1016/j.psychsport.2008.05.003
Hamer, M., Karageorghis, C. I., & Vlachopoulos, S. P. (2002). Motives for exercise participation as predictors of exercise dependence among endurance athletes. The Journal of Sports Medicine and Physical Fitness, 42(2), 233–238.
Hausenblas, H. A., & Downs, D. S. (2002a). How much is too much? The development and validation of the exercise dependence scale. Psychology & Health, 17(4), 387–404. https://doi.org/10.1080/0887044022000004894
Hausenblas, H. A., & Downs, D. S. (2002b). Relationship among sex, imagery and exercise dependence symptoms. Psychology of Addictive Behaviors, 16(2), 169–172. https://doi.org/10.1037/0893-164X.16.2.169
Hausenblas, H. A., & Fallon, E. A. (2006). Exercise and body image: A meta-analysis. Psychology & Health, 21(1), 33–47. https://doi.org/10.1080/14768320500105270
Hausenblas, H. A., & Giacobbi, P. R. (2004). Relationship between exercise dependence symptoms and personality. Personality and Individual Differences, 36(6), 1265–1273. https://doi.org/10.1016/S0191-8869(03)00214-9
Hausenblas, H. A., & Symons, D. D. (2002, January 1). Exercise dependence scale-21 manual. Razi Educational and Therapeutic Psychiatric Center.
Homan, K. (2010). Athletic-ideal and thin-ideal internalization as prospective predictors of body dissatisfaction, dieting, and compulsive exercise. Body Image, 7(3), 240–245. https://doi.org/10.1016/j.bodyim.2010.02.004
Johansen, R., Espetvedt, M. N., Lyshol, H., Clench-Aas, J., & Myklestad, I. (2021). Mental distress among young adults- gender differences in the role of social support. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-12109-5
Kan, Y. L., & Tsai, C. J. (2015). Sports as a demonstration of masculinity- arguments and controversies. Quarterly of Chinese Physical Education, 29(2), 145–151. https://doi.org/10.3966/102473002015062902008
Kelly, M. M., Tyrka, A. R., Price, L. H., & Carpenter, L. L. (2008). Sex differences in the use of coping strategies: Predictors of anxiety and depressive symptoms. Depression and Anxiety, 25(10), 839–846. https://doi.org/10.1002/da.20341
Kessler, R. C. (n.d.). Kessler 10 chinese traditional. Transcultural Mental Health Centre. https://www.dhi.health.nsw.gov.au/transcultural-mental-health-centre-tmhc/resources/multilingual-resources-by-title/kessler-10
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., Walters, E. E., & Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. https://doi.org/10.1017/s0033291702006074
Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S. L., Manderscheid, R. W., Walters, E. E., & Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives Of General Psychiatry, 60(2), 184–189. https://doi.org/10.1001/archpsyc.60.2.184
Kim, H., & Millsap, R. (2014). Using the bollen-stine bootstrapping method for evaluating approximate fit indices. Multivariate Behavioral Research, 49(6), 581–596. https://doi.org/10.1080/00273171.2014.947352
Klaperski, S., Koch, E., Hewel, D., Schempp, A., & Müller, J. (2019). Optimizing mental health benefits of exercise: The influence of the exercise environment on acute stress levels and wellbeing. Mental Health & Prevention, 15. https://doi.org/10.1016/j.mhp.2019.200173
Krane, V., Waldron, J., Michalenok, J., & Stiles-Shipley, J. (2001). Body image concerns in female exercisers and athletes: A feminist cultural studies perspective. Women in Sport and Physical Activity Journal, 10(1), 17–54. https://doi.org/10.1123/wspaj.10.1.17
Kun, B., Urbán, R., Szabo, A., Magi, A., Eisinger, A., & Demetrovics, Z. (2022). Emotion dysregulation mediates the relationship between psychological distress, symptoms of exercise addiction and eating disorders: A large-scale survey among fitness center users. Sport, Exercise, and Performance Psychology, 11(2), 198–213. https://doi.org/10.1037/spy0000274
Levit, M., Weinstein, A., Weinstein, Y., Tzur-Bitan, D., & Weinstein, A. (2018). A study on the relationship between exercise addiction, abnormal eating attitudes, anxiety and depression among athletes in Israel. Journal of Behavioral Addictions, 7(3), 800–805. https://doi.org/10.1556/2006.7.2018.83
Lichtenstein, M. B., Hinze, C. J., Emborg, B., Thomsen, F., & Hemmingsen, S. D. (2017). Compulsive exercise: Links, risks and challenges faced. Psychology Research and Behavior Management, 10, 85–95. https://doi.org/10.2147/prbm.S113093
Littleton, H. L., Axsom, D., & Pury, C. L. S. (2005). Development of the body image concern inventory. Behaviour Research and Therapy, 43(2), 229–241. https://doi.org/10.1016/j.brat.2003.12.006
Liu, C. Y., Tseng, M. C., Chen, K. Y., Chang, C. H., Liao, S. C., & Chen, H. C. (2015). Sex difference in using the SCOFF questionnaire to identify eating disorder patients at a psychiatric outpatient clinic. Comprehensive Psychiatry, 57, 160–166. https://doi.org/10.1016/j.comppsych.2014.11.014
Lu, J. H., Hsu, Y. W., Tsai, F. C., & Chen, S. C. (2010). Relationship among exercise dependence, commitment, identity and behavior. Sports & Exercise Research, 12(2), 23–31. https://doi.org/10.5297/ser.1202.003
Lubis, N., Hasnida, & Mallongi, A. (2020). The influence of body image towards self-esteem, self compassion and psychological well-being in female exerciser. Medico Legal Update, 20(3), 876–881. https://doi.org/10.37506/mlu.v20i3.1512
Lukács, A., Sasvári, P., Varga, B., & Mayer, K. (2019). Exercise addiction and its related factors in amateur runners. Journal of Behavioral Addictions, 8(2), 343–349. https://doi.org/10.1556/2006.8.2019.28
Lydecker, J. A., Shea, M., & Grilo, C. M. (2018). Driven exercise in the absence of binge eating: Implications for purging disorder. International Journal of Eating Disorders, 51(2), 139–145. https://doi.org/10.1002/eat.22811
Mangweth-Matzek, B., Decker, B., Erschbaumer, I., Wurnig, V., Kemmler, G., Bichler, C. S., & Rupp, C. I. (2022). Disordered eating symptoms in Austrian men of different ages in the context of fitness centers. Eating and Weight Disorders- Studies on Anorexia, Bulimia and Obesity, 27(5), 1765–1773. https://doi.org/10.1007/s40519-021-01317-y
Mann, M., Hosman, C. M., Schaalma, H. P., & de Vries, N. K. (2004). Self-esteem in a broad-spectrum approach for mental health promotion. Health Education Research, 19(4), 357–372. https://doi.org/10.1093/her/cyg041
Marques, A., Peralta, M., Sarmento, H., Loureiro, V., Gouveia, É. R., & Gaspar de Matos, M. (2019). Prevalence of risk for exercise dependence: A systematic review. Sports Medicine, 49(2), 319–330. https://doi.org/10.1007/s40279-018-1011-4
Martin, S. J., & Racine, S. E. (2017). Personality traits and appearance-ideal internalization: Differential associations with body dissatisfaction and compulsive exercise. Eating Behaviors, 27, 39–44. https://doi.org/10.1016/j.eatbeh.2017.11.001
Martyniak, E., Wyszomirska, J., Krzystanek, M., Piekarska-Bugiel, K., & Stolarczyk, A. (2021). Can't get enough. Addiction to physical exercises: Phenomenon, diagnostic criteria, etiology, therapy and research challenges. Psychiatria Polska, 55(6), 1357–1372. https://doi.org/10.12740/pp/127499
Matud, M. P. (2004). Gender differences in stress and coping styles. Personality and Individual Differences, 37(7), 1401–1415. https://doi.org/10.1016/j.paid.2004.01.010
Matud, M. P., Bethencourt, J. M., & Ibáñez, I. (2015). Gender differences in psychological distress in Spain. The International Journal of Social Psychiatry, 61(6), 560–568. https://doi.org/10.1177/0020764014564801
Mavrandrea, P., & Gonidakis, F. (2022). Exercise dependence and orthorexia nervosa in Crossfit: Exploring the role of perfectionism. Current Psychology, 42, 25151–25159. https://doi.org/10.1007/s12144-022-03585-y
Mellor, D., Fuller-Tyszkiewicz, M., McCabe, M. P., & Ricciardelli, L. A. (2010). Body image and self-esteem across age and gender: A short-term longitudinal study. Sex Roles, 63(9), 672–681. https://doi.org/10.1007/s11199-010-9813-3
Menczel, Z., Griffiths, M., Vingender, I., Eisinger, A., Farkas, J., Magi, A., Mervo, B., Kokonyei, G., & Demetrovics, Z. (2016). Exercise dependence in amateur competitors and non-competitor recreational exercisers. International Journal of Mental Health and Addiction, 15, 580–587. https://doi.org/10.1007/s11469-016-9661-7
Meulemans, S., Pribis, P., Grajales, T., & Krivak, G. (2014). Gender differences in exercise dependence and eating disorders in young adults: A path analysis of a conceptual model. Nutrients, 6(11), 4895–4905. https://doi.org/10.3390/nu6114895
Miller, A. J., Turner, M. J., Ollier, W., & Hattersley, A. A. (2023). Understanding the influence of irrational beliefs and body image inflexibility on exercise dependence and psychological well-being: A latent profile analysis approach. Journal of Sports Science, 41(3), 291–297. https://doi.org/10.1080/02640414.2023.2208952
Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. British Medical Journal, 319(7223), 1467–1468. https://doi.org/10.1136/bmj.319.7223.1467
Nystoriak, M. A., & Bhatnagar, A. (2018). Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine, 5, Article 135. https://doi.org/10.3389/fcvm.2018.00135
O'Dea, J. A. (2012). Body image and self-esteem. In T. F. Cash (Ed.), Encyclopedia of body image and human appearance (pp. 141–147). Elsevier Academic Press.
Orth, U., Robins, R. W., & Meier, L. L. (2009). Disentangling the effects of low self-esteem and stressful events on depression: Findings from three longitudinal studies. Journal of Personality and Social Psychology, 97(2), 307–321. https://doi.org/10.1037/a0015645
Randal, A. (1996). Health or appearance? Reasons for exercise, body image and self-esteem in males [Unpublished master's thesis]. University of Canterbury.
Restrepo, J., & Castañeda, T. (2020). Risk of eating disorder in Colombian women who go to the gym. Interacciones, 6(2).
Rogers, M. L., Duffy, M. E., Buchman-Schmitt, J. M., Datoc, A. E., & Joiner, T. E. (2019). Exercise dependence: Associations with capability for suicide and past suicidal behavior. Journal of Clinical Psychology, 75(1), 165–177. https://doi.org/10.1002/jclp.22696
Rosenberg, M. (1989). Society and the adolescent self-image. Wesleyan University Press.
Rudolph, S. (2018). The connection between exercise addiction and orthorexia nervosa in German fitness sports. Eating and Weight Disorders- Studies on Anorexia, Bulimia and Obesity, 23(5), 581–586. https://doi.org/10.1007/s40519-017-0437-2
Seedat, S., Scott, K. M., Angermeyer, M. C., Berglund, P., Bromet, E. J., Brugha, T. S., Demyttenaere, K., de Girolamo, G., Haro, J. M., Jin, R., Karam, E. G., Kovess-Masfety, V., Levinson, D., Medina Mora, M. E., Ono, Y., Ormel, J., Pennell, B. E., Posada-Villa, J., Sampson, N. A., Williams, D., & Kessler, R. C. (2009). Cross-national associations between gender and mental disorders in the world health organization world mental health surveys. Archives of General Psychiatry, 66(7), 785–795. https://doi.org/10.1001/archgenpsychiatry.2009.36
Sicilia, A., Alcaraz-Ibáñez, M., Chiminazzo, J. G. C., & Fernandes, P. T. (2020). Latent profile analysis of exercise addiction symptoms in Brazilian adolescents: Association with health-related variables. Journal of Affective Disorders, 273, 223–230. https://doi.org/10.1016/j.jad.2020.04.019
Spano, L. (2001). The relationship between exercise and anxiety, obsessive-compulsiveness, and narcissism. Personality and Individual Differences, 30(1), 87–93. https://doi.org/10.1016/S0191-8869(00)00012-X
Sports Administration. (2022). 111 nian yundong xian kuang diao cha jie an bao gao shu [Final report of prevalence survey of physical activity in 2022]. Ministry of Education. https://isports.sa.gov.tw/Apps/Download.aspx?SYS=TIS&MENU_CD=M07&ITEM_CD=T01&MENU_PRG_CD=4&ITEM_PRG_CD=2
Starcevic, V., & Khazaal, Y. (2017). Relationships between behavioural addictions and psychiatric disorders: What is known and what is yet to be learned? Frontiers in Psychiatry, 8, 53. https://doi.org/10.3389/fpsyt.2017.00053
Strahler, J., Wachten, H., & Mueller-Alcazar, A. (2021). Obsessive healthy eating and orthorexic eating tendencies in sport and exercise contexts: A systematic review and meta-analysis. Journal of Behavioral Addictions, 10(3), 456–470. https://doi.org/10.1556/2006.2021.00004
Strahler, J., Wachten, H., Stark, R., & Walter, B. (2021). Alike and different: Associations between orthorexic eating behaviors and exercise addiction. International Journal of Eating Disorders, 54(8), 1415–1425. https://doi.org/10.1002/eat.23525
Szabo, A. (1995). The impact of exercise deprivation on well-being of habitual exercises. Australian Journal of Science and Medicine in Sport, 27(3), 68–75.
Szabo, A., Griffiths, M. D., Aarhus Høglid, R., & Demetrovics, Z. (2018). Drug, nicotine, and alcohol use among exercisers: Does substance addiction co-occur with exercise addiction? Addictive Behaviors Reports, 7, 26–31. https://doi.org/10.1016/j.abrep.2017.12.001
Terry, A., Szabo, A., & Griffiths, M. (2004). The exercise addiction inventory: A new brief screening tool. Addiction Research & Theory, 12(5), 489–499. https://doi.org/10.1080/16066350310001637363
Thompson, J. K., & Blanton, P. (1987). Energy conservation and exercise dependence: A sympathetic arousal hypothesis. Medicine & Science in Sports & Exercise, 19(2), 91–99.
Thompson, J. K., & Pasman, L. (1991). The obligatory exercise questionnaire. The Behavior Therapist, 14, 137.
Thyfault, J. P., & Bergouignan, A. (2020). Exercise and metabolic health: Beyond skeletal muscle. Diabetologia, 63(8), 1464–1474. https://doi.org/10.1007/s00125-020-05177-6
Trott, M., Jackson, S. E., Firth, J., Fisher, A., Johnstone, J., Mistry, A., Stubbs, B., & Smith, L. (2020). Exercise addiction prevalence and correlates in the absence of eating disorder symptomology: A systematic review and meta-analysis. Journal of Addiction Medicine, 14(6), 321–329. https://doi.org/10.1097/ADM.0000000000000664
Trott, M., Yang, L., Jackson, S. E., Firth, J., Gillvray, C., Stubbs, B., & Smith, L. (2020). Prevalence and correlates of exercise addiction in the presence vs. absence of indicated eating disorders. Frontiers in Sports and Active Living, 2, Article 84. https://doi.org/10.3389/fspor.2020.00084
Wågan, F. A., Darvik, M. D., & Pedersen, A. V. (2021). Associations between self-esteem, psychological stress, and the risk of exercise dependence. International Journal of Environmental Research and Public Health, 18(11). https://doi.org/10.3390/ijerph18115577
Weinstein, A., Maayan, G., & Weinstein, Y. (2015). A study on the relationship between compulsive exercise, depression and anxiety. Journal of Behavioral Addictions, 4(4), 315–318. https://doi.org/10.1556/2006.4.2015.034
Weinstein, A., & Weinstein, Y. (2014). Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues. Current Pharmaceutical Design, 20(25), 4062–4069. https://doi.org/10.2174/13816128113199990614
World Health Organization. (2022). ICD-11: International classification of diseases.
Yesildemir, O., & Tek, N. A. (2022). Risk of eating disorders and body dissatisfaction among gym-goers in Ankara, Turkey. Revista Brasileira de Medicina do Esporte, 28(4), 291–294. https://doi.org/10.1590/1517-8692202228042021_0316
Zheng, Y. Z., & Luh, W. M. (2011). A revised Chinese version of the Rosenberg self-esteem scale [Unpublished master's thesis]. National Cheng Kung University.