Eating disorder pathology and compulsive exercise during the COVID‐19 public health emergency: Examining risk associated with COVID‐19 anxiety and intolerance of uncertainty
Open accessAbstract
Objective: COVID‐19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID‐19 anxiety. The current study examined associations between COVID‐19 anxiety, trait intolerance of uncertainty, and COVID‐19 intolerance of uncertainty and ED pathology and compulsive exercise. Method: Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020. Results: COVID‐19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID‐19 intolerance of uncertainty moderated associations between COVID‐19 anxiety and compulsive exercise and ED pathology. COVID‐19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty. Discussion: COVID‐19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID‐19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.
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Written from the paper’s full text.
TL;DR
In 295 undergraduates surveyed March–April 2020, COVID-19 anxiety and intolerance of uncertainty were associated with eating disorder pathology, but not compulsive exercise. Contrary to hypotheses, COVID-19 anxiety was more strongly related to ED pathology and compulsive exercise among those with lower trait and COVID-19 intolerance of uncertainty.
Key findings
- EDE-Q scores were positively associated with COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty; CET scores were positively associated with trait intolerance of uncertainty but not COVID-19 anxiety or COVID-19 intolerance of uncertainty.
- Interaction terms in regression models predicting CET and EDE-Q scores were significant; associations between COVID-19 anxiety and CET/EDE-Q scores were stronger for individuals with lower trait and COVID-19 intolerance of uncertainty.
- Post hoc dominance analyses indicated trait intolerance of uncertainty was the strongest predictor of compulsive exercise, and trait anxiety most strongly predicted ED pathology.
- Participants reported moderate physical activity on the GLETQ (M = 33.96, SD = 33.70), and dependent samples t-tests indicated reductions in exercise associated with COVID-19, t(243) = 6.43, p < .001, d = .41.
Methods
- Cross-sectional online questionnaire study of undergraduate participants (N = 295; 65.1% female; Mage = 19.7, SD = 2.0) recruited through a research pool at a large northeastern U.S. university; 95.0% resided in New York state and 92.5% reported social distancing during data collection in March–April 2020.
- Measures included the EDE-Q global score (α = .95), a modified Fear of Illness and Virus Evaluation scale referencing the “coronavirus public health emergency” (α = .94), STAI-T (α = .91), Compulsive Exercise Test total score (α = .87), IUS-12 (α = .93), a modified IUS-12 assessing COVID-19 uncertainty (α = .94), and the Godin Leisure-Time Exercise Questionnaire.
- Analyses used bivariate correlations and multiple linear regressions controlling for gender and STAI-T, using Hayes’ PROCESS to test interactions between COVID-19 anxiety and trait/COVID-19 intolerance of uncertainty in models predicting ED pathology and compulsive exercise; post hoc dominance analyses examined relative predictor importance.
Limitations
- Stated by the paper: cross-sectional design prevents causal conclusions; nonclinical sample; exercise behaviors were assessed by retrospective self-report; COVID-19 intolerance of uncertainty is a novel construct with unknown validity; future work is needed on race/ethnicity, employment, objective exercise assessment, clinical samples, and longitudinal designs.
- Evident from the text: the sample was predominantly female undergraduates at one northeastern U.S. university, mostly residing in New York, limiting generalizability; no clinical ED diagnoses were reported; and the cross-sectional, self-report design also limits temporal and objective inference.
Model-written summary. Check it against the paper before relying on it.
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Cites
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Claims the paper makes
0 of 33 cited sources checked · 0 supported · 0 flagged
- Findingown data
The association between COVID-19 anxiety and compulsive exercise was stronger for individuals with lower trait intolerance of uncertainty.
“Interaction terms in both models were significant; however, contrary to hypotheses, associations between COVID-19 anxiety and CET/EDE-Q scores were stronger for individuals with lower trait and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
Trait anxiety most strongly predicted eating disorder pathology in dominance analyses.
“Results indicated that trait intolerance of uncertainty was the strongest predictor of compulsive exercise, and trait anxiety most strongly predicted ED pathology (Table 2).”
Quote in the paperSubstantial claim - Findingown data
COVID-19 anxiety was not associated with compulsive exercise (CET scores) in the study sample.
“CET scores were positively associated with trait intolerance of uncertainty but not COVID-19 anxiety and intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
Multiple regression analyses yielded significant models for compulsive exercise and eating disorder pathology.
“Multiple regression analyses yielded significant models for CET and EDE-Q scores (Table 2).”
Quote in the paperSubstantial claim - Findingown data
Trait intolerance of uncertainty was positively associated with eating disorder pathology (EDE-Q scores) in the study sample.
“EDE-Q scores were positively associated with COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim
- Findingown data
COVID-19 intolerance of uncertainty was positively associated with eating disorder pathology (EDE-Q scores) in the study sample.
“EDE-Q scores were positively associated with COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
Trait intolerance of uncertainty was positively associated with compulsive exercise (CET scores) in the study sample.
“CET scores were positively associated with trait intolerance of uncertainty but not COVID-19 anxiety and intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
The association between COVID-19 anxiety and eating disorder pathology was stronger for individuals with lower trait intolerance of uncertainty.
“Interaction terms in both models were significant; however, contrary to hypotheses, associations between COVID-19 anxiety and CET/EDE-Q scores were stronger for individuals with lower trait and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
The interaction terms in the multiple regression models predicting compulsive exercise and eating disorder pathology were significant.
“Interaction terms in both models were significant; however, contrary to hypotheses, associations between COVID-19 anxiety and CET/EDE-Q scores were stronger for individuals with lower trait and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
The association between COVID-19 anxiety and compulsive exercise was stronger for individuals with lower COVID-19 intolerance of uncertainty.
“Interaction terms in both models were significant; however, contrary to hypotheses, associations between COVID-19 anxiety and CET/EDE-Q scores were stronger for individuals with lower trait and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
Trait intolerance of uncertainty was the strongest predictor of compulsive exercise in dominance analyses.
“Results indicated that trait intolerance of uncertainty was the strongest predictor of compulsive exercise, and trait anxiety most strongly predicted ED pathology (Table 2).”
Quote in the paperSubstantial claim - Findingown data
Dependent samples t-tests indicated reductions in exercise associated with COVID-19.
“Results from dependent samples t-tests indicated reductions in exercise associated with COVID-19, t(243) = 6.43, p < .001, d = .41.”
Quote in the paperNot a substantial claim - Findingown data
The association between COVID-19 anxiety and eating disorder pathology was stronger for individuals with lower COVID-19 intolerance of uncertainty.
“Interaction terms in both models were significant; however, contrary to hypotheses, associations between COVID-19 anxiety and CET/EDE-Q scores were stronger for individuals with lower trait and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
COVID-19 anxiety was positively associated with eating disorder pathology (EDE-Q scores) in the study sample.
“EDE-Q scores were positively associated with COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty.”
Quote in the paperSubstantial claim - Findingown data
COVID-19 intolerance of uncertainty was not associated with compulsive exercise (CET scores) in the study sample.
“CET scores were positively associated with trait intolerance of uncertainty but not COVID-19 anxiety and intolerance of uncertainty.”
Quote in the paperSubstantial claim - Premisecitation
Intolerance of uncertainty contributes to understanding the etiology and maintenance of eating disorders.
“Intolerance of uncertainty also contributes to understanding the etiology and maintenance of EDs (for reviews, see Brown et al., 2017; Kesby, Maguire, Brownlow, & Grisham, 2017) and is associated with increased compulsive exercise (Scharmer, Reilly, Gorrell, & Anderson, 2020), such that ED and compulsive exercise behaviors may function to alleviate distress related to uncertainty (Brown et al., 2”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Brown et al., 2017
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- cites Kesby, Maguire, Brownlow, & Grisham, 2017
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- Study design and conductcitation
Participants' mean scores on the EDE-Q, CET, and IUS-12 were within one standard deviation of those from similar samples at the same institution prior to COVID-19.
“Participants' reported mean scores on the EDE-Q, CET, and IUS-12 were within on standard deviation of those from similar samples at the same institution prior to COVID-19 (e.g., Scharmer et al., 2020) (Table 1).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Scharmer et al., 2020
Not checked in the free run.
- Premisecitation
COVID-19 may exacerbate risk for eating disorder pathology and compulsive exercise.
“Given established links between anxiety and eating disorder (ED) pathology (Swithbourne & Touyz, Swinbourne & Touyz, 2007) and compulsive exercise (Meyer, Taranis, Goodwin, & Haycraft, 2011), COVID-19 may exacerbate risk for ED pathology and compulsive exercise (Cooper et al., 2020; Fernández-Aranda et al., 2020; Rodgers et al., 2020; Touyz, Lacey, & Hay, 2020).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Cooper et al., 2020
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- cites Fernández-Aranda et al., 2020
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- cites Rodgers et al., 2020
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- Premisecitation
Preliminary work evidences COVID-19 related increases in compulsive exercise and eating disorder behaviors.
“Preliminary work evidences COVID-19 related increases in compulsive exercise and ED behaviors (Baenas et al., 2020; Branley-Bell & Talbot, 2020; Papandreou, Arija, Aretouli, Tsilidis, & Bulló, 2020; Phillipou et al., 2020; Schlegl, Maier, Meule, & Voderholzer, 2020; Termorshuizen et al., 2020); however, more work is necessary to understand factors impacting risk.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Baenas et al., 2020
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- cites Branley-Bell & Talbot, 2020
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- cites Papandreou, Arija, Aretouli, Tsilidis, & Bulló, 2020
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- Premisecitation
Eating disorder and compulsive exercise behaviors can function to reduce anxiety.
“Additionally, ED and compulsive exercise behaviors can function to reduce anxiety (Engel et al., 2016; Goodwin, Haycraft, & Meyer, 2012), and therefore may assist in managing COVID-19 anxiety.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Engel et al., 2016
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- cites Goodwin, Haycraft, & Meyer, 2012
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- Study design and conductreasoning
The cross-sectional nature of this study prevents drawing causal conclusions.
“The cross-sectional nature of this study prevents our ability to draw causal conclusions; future use of longitudinal designs will further improve our understanding of risk for compulsive exercise pathology and CE associated with COVID-19 and other events that require lifestyle modifications.”
Quote in the paperSubstantial claim - Premisecitation
Eating disorder and compulsive exercise behaviors may function to alleviate distress related to uncertainty.
“Intolerance of uncertainty also contributes to understanding the etiology and maintenance of EDs (for reviews, see Brown et al., 2017; Kesby, Maguire, Brownlow, & Grisham, 2017) and is associated with increased compulsive exercise (Scharmer, Reilly, Gorrell, & Anderson, 2020), such that ED and compulsive exercise behaviors may function to alleviate distress related to uncertainty (Brown et al., 2”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Brown et al., 2017
Not checked in the free run.
- Interpretationown data
These findings may reflect a hierarchical structure for risk, in which individual factors (e.g., intolerance of uncertainty, anxiety) are more important than situational risk factors (e.g., COVID-19 anxiety).
“These findings may reflect a hierarchical structure for risk, in which individual factors (e.g., intolerance of uncertainty, anxiety) are more important than situational risk factors (e.g., COVID-19 anxiety).”
Quote in the paperSubstantial claim - Interpretationreasoning
For those with lower trait risk, COVID-19 anxiety increases eating disorder and compulsive exercise risk.
“In contrast, for those with lower trait risk, COVID-19 anxiety increases ED and compulsive exercise risk.”
Quote in the paperSubstantial claim - Study design and conductown data
The revised Intolerance of COVID-19 uncertainty scale demonstrated good internal consistency in this sample (Cronbach's α = .94).
“Internal consistency for the revised measure was good (Cronbach's α = .94).”
Quote in the paperNot a substantial claim - Interpretationreasoning
Individuals with trait risk factors may experience elevated eating disorder pathology and compulsive exercise regardless of COVID-19 anxiety.
“Thus, individuals with trait risk factors may experience elevated ED pathology and compulsive exercise regardless of COVID-19 anxiety.”
Quote in the paperSubstantial claim - Interpretationcitation
The findings are consistent with existing work documenting associations between trait intolerance of uncertainty, eating disorder pathology, and compulsive exercise.
“Our findings are consistent with existing work documenting associations between trait intolerance of uncertainty, ED pathology, and compulsive exercise (Brown et al., 2017; Kesby et al., 2017; Scharmer et al., 2020).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Brown et al., 2017
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- cites Kesby et al., 2017
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- cites Scharmer et al., 2020
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- Premisecitation
Reactions to uncertainty in specific domains are more strongly associated with maladaptive behaviors and psychological distress.
“Recent work suggests that reactions to uncertainty in specific domains are more strongly associated with maladaptive behaviors and psychological distress (e.g., Mahoney & McEvoy, 2012).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Mahoney & McEvoy, 2012
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- Interpretationreasoning
The acute effects of COVID-19 may resemble reactions to other major events that cause life disruptions.
“Although COVID-19 represents a unique stressor (Gruber et al., 2020), the acute effects of COVID-19 may resemble reactions to other major events that cause life disruptions.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gruber et al., 2020
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- Interpretationown data
Trait anxiety and intolerance of uncertainty are more important than COVID-19 factors in determining risk for compulsive exercise and eating disorder pathology.
“Trait-level predictors “dominated” other predictors in posthoc analyses, suggesting that trait anxiety and intolerance of uncertainty are more important than COVID-19 factors in determining risk for compulsive exercise and ED pathology.”
Quote in the paperSubstantial claim - Premisecitation
Intolerance of uncertainty is associated with increased compulsive exercise.
“Intolerance of uncertainty also contributes to understanding the etiology and maintenance of EDs (for reviews, see Brown et al., 2017; Kesby, Maguire, Brownlow, & Grisham, 2017) and is associated with increased compulsive exercise (Scharmer, Reilly, Gorrell, & Anderson, 2020), such that ED and compulsive exercise behaviors may function to alleviate distress related to uncertainty (Brown et al., 2”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Scharmer, Reilly, Gorrell, & Anderson, 2020
Not checked in the free run.
- Interpretationreasoning
For individuals with higher trait-level risk, situational determinants may be less important.
“In contrast, for individuals with higher trait-level risk, situational determinants may be less important.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 18
- May combine two claims. 5
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PremisecitationIntolerance of uncertainty is a transdiagnostic factor.
“Intolerance of uncertainty is a transdiagnostic factor (Mahoney & McEvoy, 2012) that is hypothesized to promote increased compulsive or “safety” behaviors (Boswell, Thompson-Hollands, Farchione, & Barlow, 2013; Holaway, Heimberg, & Coles, 2006) in response to perceived uncertainty.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Mahoney & McEvoy, 2012
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationIntolerance of uncertainty is hypothesized to promote increased compulsive or 'safety' behaviors in response to perceived uncertainty.
“Intolerance of uncertainty is a transdiagnostic factor (Mahoney & McEvoy, 2012) that is hypothesized to promote increased compulsive or “safety” behaviors (Boswell, Thompson-Hollands, Farchione, & Barlow, 2013; Holaway, Heimberg, & Coles, 2006) in response to perceived uncertainty.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Boswell, Thompson-Hollands, Farchione, & Barlow, 2013
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- cites Holaway, Heimberg, & Coles, 2006
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe COVID-19 pandemic has resulted in high death and unemployment rates and disruptions in daily living, which may contribute to increased mental health concerns, including elevated anxiety.
“The coronavirus (COVID-19) pandemic (WHO, 2020) has resulted in high death and unemployment rates and disruptions in daily living, which may contribute to increased mental health concerns, including elevated anxiety (Wang et al., 2020).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wang et al., 2020
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May combine two claims.
InterpretationcitationThe results indicating that higher levels of COVID-19 anxiety and intolerance of uncertainty were associated with more severe eating disorder pathology are consistent with recent work evidencing COVID-19 increases in eating disorder behaviors and publications predicting increases in eating disorder risk associated with COVID-19 anxiety.
“Results indicating that higher levels of COVID-19 anxiety and intolerance of uncertainty were associated with more severe ED pathology are also consistent with recent work evidencing COVID-19 increases in ED behaviors (e.g., Branley-Bell & Talbot, 2020; Phillipou et al., 2020) and publications predicting increases in ED risk associated with COVID-19 anxiety (e.g., Cooper et al., 2020; Rodgers et a”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Branley-Bell & Talbot, 2020
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- cites Phillipou et al., 2020
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- cites Cooper et al., 2020
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InterpretationreasoningOther acute stressors will have similar impacts: COVID-19 anxiety increases risk for eating disorder pathology and compulsive exercise among individuals with lower trait risk.
“Thus, our finding that COVID-19 anxiety increases risk for ED pathology and compulsive exercise among individuals with lower trait risk may suggest that other acute stressors will have similar impacts.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe importance and validity of COVID-19 intolerance of uncertainty as a variable remains unknown.
“Finally, COVID-19 intolerance of uncertainty represents a novel construct. The operationalization of this construct in the current study resembles definitions of similar constructs in other recent work (e.g., Mahoney & McEvoy, 2012); however, the importance and validity of this variable remains unknown.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Mahoney & McEvoy, 2012
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Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe CET total score demonstrated internal consistency in this sample (Cronbach's α = .87).
“The CET total score was a general measure of compulsive exercise in the current study and demonstrated internal consistency (Cronbach's α = .87).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThis study examined a nonclinical sample.
“This study also examined a nonclinical sample.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe assessment of exercise behaviors may limit conclusions from this study.
“Our assessment of exercise behaviors may also limit conclusions from this study.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe modified FIVE scale demonstrated high internal consistency in this sample (Cronbach's α = .94).
“This scale demonstrated high internal consistency (Cronbach's α = .94).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCOVID-19 represents an important source of stress.
“COVID-19 represents an important source of stress (Gruber et al., 2020) and uncertainty about the pandemic is pervasive.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gruber et al., 2020
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Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataInternal consistency for the STAI-T was good in this sample (Cronbach's α = .91).
“In our sample, internal consistency for the STAI-T was good (Cronbach's α = .91).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
InterpretationreasoningThe findings may have implications for anxiety and stress more generally.
“This study specifically examined COVID-19 distress; however, findings may have implications for anxiety and stress more generally.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductcitationThe Eating Disorder Examination-Questionnaire (EDE-Q) is a widely validated measure of eating disorder symptoms.
“The Eating Disorder Examination-Questionnaire (EDE-Q) is a widely validated (Berg, Peterson, Frazier, & Crow, 2012; Fairburn & Beglin, 1994), 36-item self-report questionnaire that assesses cognitive and behavioral ED symptoms.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Berg, Peterson, Frazier, & Crow, 2012
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- cites Fairburn & Beglin, 1994
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Study design and conductnone givenThe study was approved by the university's institutional review board.
“The study was approved by the university's institutional review board.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe STAI-T is a widely used measure of trait anxiety with strong psychometric properties.
“The State-Trait Anxiety Inventory—trait subscale (STAI-T) is a widely used measure of trait anxiety that has strong psychometric properties (Barnes, Harp, & Jung, 2002; Spielberger, 1983).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Barnes, Harp, & Jung, 2002
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- cites Spielberger, 1983
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Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe global EDE-Q score demonstrated high internal consistency in this sample (Cronbach's α = .95).
“The global EDE-Q score was the primary measure of ED pathology and demonstrated high internal consistency (Cronbach's α = .95).”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationThe results align with participants' reports that compulsive exercise did not increase in response to COVID-19 and recent work indicating COVID-19 related reductions in exercise in nonclinical eating disorder samples.
“Although these results contrast our hypotheses, they align with participants' reports that compulsive exercise did not increase in response to COVID-19 and recent work indicating COVID-19 related reductions in exercise in nonclinical ED samples (e.g., Phillipou et al., 2020).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Phillipou et al., 2020
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Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe IUS-12 demonstrated good internal consistency in this sample (Cronbach's α = .93).
“In our sample, internal consistency was good (Cronbach's α = .93).”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataCOVID-19 anxiety and COVID-19 intolerance of uncertainty do not impact risk for compulsive exercise.
“This finding suggests that COVID-19 anxiety and intolerance of uncertainty do not impact risk for compulsive exercise.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductown dataMultiple linear regression analyses controlled for gender and trait anxiety (STAI-T).
“Additionally, multiple linear regression analyses, controlling for gender and STAI-T, using Hayes' PROCESS (Hayes, 2013) examined interactions between COVID-19 anxiety and trait and COVID-19 intolerance of uncertainty in models predicting ED pathology and compulsive exercise.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hayes, 2013
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The paper relies on this without support.
Uncertainty about the pandemic is pervasive.
“COVID-19 represents an important source of stress (Gruber et al., 2020) and uncertainty about the pandemic is pervasive.”
The paper relies on this without support.
Research examining the impact of COVID-19 on eating disorder pathology and compulsive exercise is limited.
“Currently, research examining the impact of COVID-19 on ED pathology and compulsive exercise is limited.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In Scharmer et al. (2020), compulsive exercise and EDs were influenced by intolerance of uncertainty as a trait.
“By contrast, compulsive exercise and EDs were influenced by the intolerance of uncertainty as a trait.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Scharmer et al. (2020)
Scharmer et al. (2020) authors concluded that stable traits of anxiety and uncertainty were more relevant in worsening EDs and compulsive exercise than the current levels of the same subjective variables.
“In summary, the authors concluded that stable traits of anxiety and uncertainty were more relevant in worsening EDs and compulsive exercise than the current levels of the same subjective variables.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Scharmer et al. (2020)
In Scharmer et al. (2020) sample of 295 undergraduate women, state anxiety and state intolerance of uncertainty were positively related to EDs but not with compulsive exercise.
“The results showed that both the state anxiety and the state of intolerance of uncertainty were positively related to EDs but not with compulsive exercise.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Scharmer et al. (2020)
The mean age of the studies found ranged from 19 to 54 years.
“Thus, the mean age of the studies we found ranged from 19 (Scharmer et al., 2020) to 54 years (Clark Bryan et al., 2020).”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Scharmer et al., 2020
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentt(243) = 6.43reported p < .001 · recomputed p < .001
“t(243) = 6.43, p < .001”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
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Eating disorders in the time of COVID-19
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“Given evidence of COVID-19 related increases in exercise among individuals with current or past ED diagnoses (e.g., Phillipou et al., 2020; Schlegl et al., 2020), future work examining the impacts of COVID-19 anxiety and intolerance of uncertainty on compulsive exercise in clinical samples is…”
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“The operationalization of this construct in the current study resembles definitions of similar constructs in other recent work (e.g., Mahoney & McEvoy, 2012); however, the importance and validity of this variable remains unknown.”
BackgroundResultInfluentialBaenas, I., Caravaca‐Sanz, E., Granero, R., Sánchez, I., Riesco, N., Testa, G., Vintró‐Alcaraz, C., Treasure, J., Jiménez‐Murcia, S., & Fernández‐Aranda, F. (2020) · European Eating Disorders Review · doi:10.1002/erv.2771 · Cited by 102 · see citing works
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- Authors
- Scharmer, C., Martinez, K., Gorrell, S., Reilly, E. E., Donahue, J. M., & Anderson, D. A.
- Affiliations
- State University of New York (US)
- University of California, San Francisco (US)
- Hofstra University (US)
- Corresponding author
- Scharmer, Christina
- ORCID
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2020-10-24
- Volume
- 53
- Issue
- 12
- Pages
- 2049-2054
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC8817895
- OpenAlex
- W3094444096
- Semantic Scholar
- 8ebb8c8062f0793d833bf65066a5f56088432b86
- Cited by
- 79
- References
- 35
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 15 · 2023: 10 · 2022: 18 · 2021: 24
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH126201, T32MH018261)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- eating pathology, compulsive exercise, COVID-19 anxiety, intolerance of uncertainty, COVID-19 emergency, uncertainty, risk factors, undergraduate students
- MeSH terms
- Compulsive Exercise, COVID-19, SARS-CoV-2, Adult, Anxiety, Feeding and Eating Disorders, Female, Humans, Male, Mental Health, Surveys and Questionnaires, Students, United States, Universities, Uncertainty, Young Adult, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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