{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:06:42Z","timestamp":1788282402835,"version":"build-2803163510"},"reference-count":107,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Exercise dependence (ED) is common in endurance athletes and can lead to physical and psychological distress with various health effects. We designed a prospective cross-sectional study to investigate the personality traits associated with ED among ultraendurance athletes. A total of 507 participants (41.6 (9.8) years, men: 73.7%) completed (1) a screening questionnaire about sociodemographic data, sporting habits, and healthcare data, (2) the Exercise Dependence Scale-Revised (EDS-R, 21 items scored from 1 (never) to 6 (always), 7 subscales), (3) the Big Five Inventory (BFI), and (4) 2 items of the SCOFF (Sick-Control-One Stone-Fat-Food) questionnaire regarding possible eating disorders. Based on the EDS-R scores, 37 (7.3%) participants were at risk for ED (scores \u2265 5\/6 on \u22653 subscales), 366 (72.2%) were nondependent but symptomatic (scores \u2265 3\/6 on \u22653 subscales), and 104 (20.5%) were asymptomatic. Participants with ED had a greater training volume and a higher prevalence of possible eating disorders. A higher level of neuroticism was associated with increased EDS-R scores (r = 0.294; p &lt; 0.001), with significantly higher scores in the ED group (F = 14.50, p &lt; 0.001). The association between neuroticism and ED was not moderated by the presence of eating disorders. These findings will help to screen ultraendurance athletes at risk for ED and optimize their care.<\/jats:p>","DOI":"10.3390\/ijerph20021042","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T01:36:17Z","timestamp":1673228177000},"page":"1042","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Personality Traits Associated with the Risk of Exercise Dependence in Ultraendurance Athletes: A Cross-Sectional Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0542-4362","authenticated-orcid":false,"given":"Marion","family":"Remilly","sequence":"first","affiliation":[{"name":"Normandie Univ, UNICAEN, CHU de Caen Normandie, Service de M\u00e9decine du Sport, 14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4862-6531","authenticated-orcid":false,"given":"Benoit","family":"Mauvieux","sequence":"additional","affiliation":[{"name":"Normandie Univ, UNICAEN, INSERM, COMETE, GIP CYCERON, 14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7670-8791","authenticated-orcid":false,"given":"Joffrey","family":"Drigny","sequence":"additional","affiliation":[{"name":"Normandie Univ, UNICAEN, CHU de Caen Normandie, Normandie University, Service de M\u00e9decine du Sport, Service de M\u00e9decine Physique et de R\u00e9adaptation, INSERM, COMETE, GIP CYCERON, 14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Malm, C., Jakobsson, J., and Isaksson, A. (2019). Physical Activity and Sports\u2014Real Health Benefits: A Review with Insight into the Public Health of Sweden. Sports, 7.","DOI":"10.3390\/sports7050127"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"731858","DOI":"10.3389\/fphys.2021.731858","article-title":"Physical Exercise: An Overview of Benefits From Psychological Level to Genetics and Beyond","volume":"12","author":"Wang","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jshs.2019.04.002","article-title":"Exercise as a Prescription for Patients with Various Diseases","volume":"8","author":"Luan","year":"2019","journal-title":"J. Sport Health Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/S2215-0366(18)30227-X","article-title":"Association between Physical Exercise and Mental Health in 1\u00b72 Million Individuals in the USA between 2011 and 2015: A Cross-Sectional Study","volume":"5","author":"Chekroud","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1146\/annurev-med-060619-022943","article-title":"The Role of Exercise in Management of Mental Health Disorders: An Integrative Review","volume":"72","author":"Smith","year":"2021","journal-title":"Annu. Rev. Med."},{"key":"ref_6","first-page":"270","article-title":"Promoting Physical Activity for Mental Health: An Updated Evidence Review and Practical Guide","volume":"35","author":"McKeon","year":"2022","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1136\/bjsports-2014-093885","article-title":"Health Benefits of Different Sport Disciplines for Adults: Systematic Review of Observational and Intervention Studies with Meta-Analysis","volume":"49","author":"Oja","year":"2015","journal-title":"Br. J. Sport. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s40279-019-01187-6","article-title":"Exercise as Medicine for Mental and Substance Use Disorders: A Meta-Review of the Benefits for Neuropsychiatric and Cognitive Outcomes","volume":"50","author":"Firth","year":"2020","journal-title":"Sport. Med. Auckl. NZ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"106667","DOI":"10.1016\/j.addbeh.2020.106667","article-title":"Physical Activity: A Promising Adjunctive Treatment for Severe Alcohol Use Disorder","volume":"113","author":"Pitel","year":"2021","journal-title":"Addict. Behav."},{"key":"ref_10","first-page":"235","article-title":"Frequent Exercise: A Healthy Habit or a Behavioral Addiction?","volume":"2","author":"Chen","year":"2016","journal-title":"Chronic Dis. Transl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"403","DOI":"10.3109\/10826084.2011.639120","article-title":"Exercise Addiction: Symptoms, Diagnosis, Epidemiology, and Etiology","volume":"47","author":"Berczik","year":"2012","journal-title":"Subst. Use Misuse"},{"key":"ref_12","first-page":"1709","article-title":"How Can We Conceptualize Behavioural Addiction without Pathologizing Common Behaviours?","volume":"112","author":"Heeren","year":"2017","journal-title":"Addict. Abingdon Engl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"85","DOI":"10.2147\/PRBM.S113093","article-title":"Compulsive Exercise: Links, Risks and Challenges Faced","volume":"10","author":"Lichtenstein","year":"2017","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_14","unstructured":"Glasser, W. (1976). Positive Addiction, Harper & Row."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"521572","DOI":"10.3389\/fpsyt.2020.521572","article-title":"Excessive Exercise\u2014A Meta-Review","volume":"11","author":"Colledge","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S1469-0292(00)00015-7","article-title":"Exercise Dependence: A Systematic Review","volume":"3","author":"Hausenblas","year":"2002","journal-title":"Psychol. Sport Exerc."},{"key":"ref_17","unstructured":"Veale, D. (1995). Does Primary Exercise Dependence Really Exist?. Exercise Addiction: Motivation for Participation in Sport and Exercise: Proceedings of British Psychology, Sport and Exercise Psychology Section, British Psychological Society."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1176\/appi.ajp.2013.12060782","article-title":"DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale","volume":"170","author":"Hasin","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.addbeh.2013.09.004","article-title":"Non-Substance Addictive Behaviors in the Context of DSM-5","volume":"39","author":"Potenza","year":"2014","journal-title":"Addict. Behav."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s40429-018-0197-8","article-title":"Alcohol Use Disorders in the Draft ICD-11, and How They Compare with DSM-5","volume":"5","author":"Saunders","year":"2018","journal-title":"Curr. Addict. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1002\/wps.20115","article-title":"Impulse Control Disorders and \u201cBehavioural Addictions\u201d in the ICD-11","volume":"13","author":"Grant","year":"2014","journal-title":"World Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1123\/jsep.35.5.464","article-title":"Primary and Secondary Exercise Dependence in a Community-Based Sample of Road Race Runners","volume":"35","author":"Cook","year":"2013","journal-title":"J. Sport Exerc. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1111\/j.1360-0443.1987.tb01539.x","article-title":"Exercise Dependence","volume":"82","year":"1987","journal-title":"Br. J. Addict."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1136\/bjsm.37.5.393","article-title":"Diagnostic Criteria for Exercise Dependence in Women","volume":"37","author":"Bamber","year":"2003","journal-title":"Br. J. Sport. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s40519-019-00842-1","article-title":"A Comparative Meta-Analysis of the Prevalence of Exercise Addiction in Adults with and without Indicated Eating Disorders","volume":"26","author":"Trott","year":"2021","journal-title":"Eat. Weight Disord. EWD"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3389\/fspor.2020.00084","article-title":"Prevalence and Correlates of Exercise Addiction in the Presence vs. Absence of Indicated Eating Disorders","volume":"2","author":"Trott","year":"2020","journal-title":"Front. Sport. Act. Living"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s40337-018-0219-x","article-title":"Compulsive Exercise in Eating Disorders: Proposal for a Definition and a Clinical Assessment","volume":"6","author":"Dittmer","year":"2018","journal-title":"J. Eat. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"751550","DOI":"10.3389\/fpsyt.2021.751550","article-title":"Mental Disorders in Individuals With Exercise Addiction-A Cross-Sectional Study","volume":"12","author":"Meyer","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_29","first-page":"100314","article-title":"Mental Disorders in Individuals at Risk for Exercise Addiction\u2014A Systematic Review","volume":"12","author":"Colledge","year":"2020","journal-title":"Addict. Behav. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/10578310210395","article-title":"Exercise Dependence and Overtraining: The Physiological and Psychological Consequences of Excessive Exercise","volume":"10","author":"Adams","year":"2001","journal-title":"Sport. Med. Train. Rehabil."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Bianco, A., Ravalli, S., Maugeri, G., D\u2019Agata, V., Vecchio, M., D\u2019Amico, A.G., Pavone, V., Lucenti, L., Amato, A., and Gentile, A. (2019). The \u201cJournal of Functional Morphology and Kinesiology\u201d Journal Club Series: Highlights on Recent Papers in Overtraining and Exercise Addiction. J. Funct. Morphol. Kinesiol., 4.","DOI":"10.3390\/jfmk4040068"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Golshani, S., Najafpour, A., Hashemian, S.S., Goudarzi, N., Shahmari, F., Golshani, S., Babaei, M., Firoozabadi, K., D\u00fcrsteler, K.M., and Br\u00fchl, A.B. (2021). When Much Is Too Much-Compared to Light Exercisers, Heavy Exercisers Report More Mental Health Issues and Stress, but Less Sleep Complaints. Healthc. Basel Switz., 9.","DOI":"10.3390\/healthcare9101289"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.addbeh.2018.12.030","article-title":"Which Sports Are More at Risk of Physical Exercise Addiction: A Systematic Review","volume":"93","author":"Poulnais","year":"2019","journal-title":"Addict. Behav."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.3389\/fpsyg.2018.01484","article-title":"Exercise Addiction in Practitioners of Endurance Sports: A Literature Review","volume":"9","author":"Nogueira","year":"2018","journal-title":"Front. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1556\/JBA.2.2013.4.9","article-title":"Exercise Addiction in Spanish Athletes: Investigation of the Roles of Gender, Social Context and Level of Involvement","volume":"2","author":"Szabo","year":"2013","journal-title":"J. Behav. Addict."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"634","DOI":"10.3389\/fphys.2018.00634","article-title":"Physiology and Pathophysiology in Ultra-Marathon Running","volume":"9","author":"Knechtle","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1055\/a-1303-4255","article-title":"Participation and Performance in the Oldest Ultramarathon\u2013Comrades Marathon 1921\u20132019","volume":"42","author":"Nikolaidis","year":"2021","journal-title":"Int. J. Sport. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"St\u00f6hr, A., Nikolaidis, P.T., Villiger, E., Sousa, C.V., Scheer, V., Hill, L., and Knechtle, B. (2021). An Analysis of Participation and Performance of 2067 100-Km Ultra-Marathons Worldwide. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18020362"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Thuany, M., Gomes, T.N., Villiger, E., Weiss, K., Scheer, V., Nikolaidis, P.T., and Knechtle, B. (2022). Trends in Participation, Sex Differences and Age of Peak Performance in Time-Limited Ultramarathon Events: A Secular Analysis. Medicina, 58.","DOI":"10.3390\/medicina58030366"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1017\/S1047951116002304","article-title":"Morbidities in the Ultra-Athlete and Marathoner","volume":"27","author":"Cunningham","year":"2017","journal-title":"Cardiol. Young"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s40279-021-01561-3","article-title":"Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review","volume":"52","author":"Scheer","year":"2022","journal-title":"Sport Med. Auckl. NZ"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4069","DOI":"10.3390\/ijerph8104069","article-title":"Clarifying Exercise Addiction: Differential Diagnosis, Co-Occurring Disorders, and Phases of Addiction","volume":"8","author":"Freimuth","year":"2011","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Godoy-Izquierdo, D., Navarr\u00f3n, E., L\u00f3pez-Mora, C., and Gonz\u00e1lez-Hern\u00e1ndez, J. (2021). Exercise Addiction in the Sports Context: What Is Known and What Is Yet to Be Known. Int. J. Ment. Health Addict.","DOI":"10.1007\/s11469-021-00641-9"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Matthews, G., Deary, I.J., and Whiteman, M.C. (2003). Personality Traits, Cambridge University Press. [2nd ed.].","DOI":"10.1017\/CBO9780511812736"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jrp.2008.12.015","article-title":"Back to the Future: Personality and Assessment and Personality Development","volume":"43","author":"Roberts","year":"2009","journal-title":"J. Res. Personal."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Chen, F., Yang, H., Bulut, O., Cui, Y., and Xin, T. (2019). Examining the Relation of Personality Factors to Substance Use Disorder by Explanatory Item Response Modeling of DSM-5 Symptoms. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0217630"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"662","DOI":"10.3389\/fpsyt.2019.00662","article-title":"Addiction and the Dark Triad of Personality","volume":"10","author":"Jauk","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1556\/JBA.2.2013.003","article-title":"The Relationships between Behavioral Addictions and the Five-Factor Model of Personality","volume":"2","author":"Andreassen","year":"2013","journal-title":"J. Behav. Addict."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1037\/adb0000468","article-title":"Big 5 Personality Traits and Alcohol, Nicotine, Cannabis, and Gambling Disorder Comorbidity","volume":"33","author":"Dash","year":"2019","journal-title":"Psychol. Addict. Behav. J. Soc. Psychol. Addict. Behav."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Terracciano, A., L\u00f6ckenhoff, C.E., Crum, R.M., Bienvenu, O.J., and Costa, P.T. (2008). Five-Factor Model Personality Profiles of Drug Users. BMC Psychiatry, 8.","DOI":"10.1186\/1471-244X-8-22"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1037\/0022-3514.59.6.1216","article-title":"An Alternative\u201d Description of Personality\u201d: The Big-Five Factor Structure","volume":"59","author":"Goldberg","year":"1990","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s11469-018-9939-z","article-title":"Personality Factors in Exercise Addiction: A Pilot Study Exploring the Role of Narcissism, Extraversion, and Agreeableness","volume":"18","author":"Cook","year":"2020","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.psychres.2013.11.010","article-title":"Exercise Addiction: A Study of Eating Disorder Symptoms, Quality of Life, Personality Traits and Attachment Styles","volume":"215","author":"Lichtenstein","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Zeigler-Hill, V., Besser, A., Gabay, M., and Young, G. (2021). Narcissism and Exercise Addiction: The Mediating Roles of Exercise-Related Motives. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18084243"},{"key":"ref_55","first-page":"19","article-title":"Exercise Addiction and Personality: A Two-Decade Systematic Review of the Empirical Literature (1995\u20132015)","volume":"3","author":"Bircher","year":"2017","journal-title":"Balt. J. Sport. Health Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.3389\/fpsyg.2019.02259","article-title":"Mental Toughness and Associated Personality Characteristics of Marathon Des Sables Athletes","volume":"10","author":"Goddard","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.encep.2007.08.004","article-title":"Confirmative study of a French version of the Exercise Dependence Scale-revised with a French population","volume":"34","author":"Allegre","year":"2008","journal-title":"L\u2019Encephale"},{"key":"ref_58","first-page":"425","article-title":"Validation de l\u2019adaptation fran\u00e7aise de l\u2019\u00e9chelle de d\u00e9pendance \u00e0 l\u2019exercice physique: L\u2019EDS-R","volume":"13","author":"Kern","year":"2007","journal-title":"Prat. Psychol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1080\/0887044022000004894","article-title":"How Much Is Too Much? The Development and Validation of the Exercise Dependence Scale","volume":"17","author":"Hausenblas","year":"2002","journal-title":"Psychol. Health"},{"key":"ref_60","first-page":"97","article-title":"Validation par analyse factorielle du Big Five Inventory fran\u00e7ais (BFI-Fr). Analyse convergente avec le NEO-PI-R","volume":"168","author":"Plaisant","year":"2010","journal-title":"Ann. M\u00e9d. Psychol. Rev. Psychiatr."},{"key":"ref_61","unstructured":"John, O.P., Naumann, L.P., and Soto, C.J. (2008). Paradigm Shift to the Integrative Big Five Trait Taxonomy: History, Measurement, and Conceptual Issues. Handbook of Personality: Theory and Research, The Guilford Press. [3rd ed.]."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.paid.2014.05.015","article-title":"Application of Generalizability Theory to the Big Five Inventory","volume":"69","author":"Arterberry","year":"2014","journal-title":"Personal. Individ. Differ."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1136\/bmj.319.7223.1467","article-title":"The SCOFF Questionnaire: Assessment of a New Screening Tool for Eating Disorders","volume":"319","author":"Morgan","year":"1999","journal-title":"BMJ"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"E92","DOI":"10.1017\/sjp.2013.92","article-title":"A Meta-Analysis of the Diagnostic Accuracy of the SCOFF","volume":"16","author":"Botella","year":"2013","journal-title":"Span. J. Psychol."},{"key":"ref_65","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, L. Erlbaum Associates."},{"key":"ref_66","first-page":"5","article-title":"Examining Relationship between Personality Characteristics and Exercise Dependence","volume":"19","author":"Costa","year":"2012","journal-title":"Rev. Psychol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/S0191-8869(03)00214-9","article-title":"Relationship between Exercise Dependence Symptoms and Personality","volume":"36","author":"Hausenblas","year":"2004","journal-title":"Personal. Individ. Differ."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1249\/MSS.0000000000001988","article-title":"Overactivation of the Reward System and Deficient Inhibition in Exercise Addiction","volume":"51","author":"Huang","year":"2019","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1136\/bjsm.34.2.125","article-title":"The Pathological Status of Exercise Dependence","volume":"34","author":"Bamber","year":"2000","journal-title":"Br. J. Sport. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1037\/a0015309","article-title":"Public Health Significance of Neuroticism","volume":"64","author":"Lahey","year":"2009","journal-title":"Am. Psychol."},{"key":"ref_71","first-page":"s72","article-title":"Neuroticism, Life Events and Mental Health: Evidence for Person-Environment Correlation","volume":"40","author":"Park","year":"2001","journal-title":"Br. J. Psychiatry Suppl."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1038\/s41467-018-03242-8","article-title":"Item-Level Analyses Reveal Genetic Heterogeneity in Neuroticism","volume":"9","author":"Nagel","year":"2018","journal-title":"Nat. Commun."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1038\/mp.2016.49","article-title":"Genome-Wide Analysis of over 106\u2009000 Individuals Identifies 9 Neuroticism-Associated Loci","volume":"21","author":"Smith","year":"2016","journal-title":"Mol. Psychiatry"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1038\/s41588-018-0151-7","article-title":"Meta-Analysis of Genome-Wide Association Studies for Neuroticism in 449,484 Individuals Identifies Novel Genetic Loci and Pathways","volume":"50","author":"Nagel","year":"2018","journal-title":"Nat. Genet."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1146\/annurev.clinpsy.2.022305.095257","article-title":"Personality and Risk of Physical Illness","volume":"2","author":"Smith","year":"2006","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1525\/collabra.266","article-title":"Is Healthy Neuroticism Associated with Health Behaviors? A Coordinated Integrative Data Analysis","volume":"6","author":"Graham","year":"2020","journal-title":"Collabra Psychol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jrp.2016.02.005","article-title":"The High Costs of Low Agreeableness: Low Agreeableness Exacerbates Interpersonal Consequences of Rejection Sensitivity in U.S. and Chinese Adolescents","volume":"67","author":"Wang","year":"2017","journal-title":"J. Res. Personal."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1038\/npp.2009.19","article-title":"CNR1 Gene Is Associated with High Neuroticism and Low Agreeableness and Interacts with Recent Negative Life Events to Predict Current Depressive Symptoms","volume":"34","author":"Juhasz","year":"2009","journal-title":"Neuropsychopharmacology"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1016\/j.paid.2007.06.035","article-title":"Agreeableness and the Self-Regulation of Negative Affect: Findings Involving the Neuroticism\/Somatic Distress Relationship","volume":"43","author":"Ode","year":"2007","journal-title":"Personal. Individ. Differ."},{"key":"ref_80","unstructured":"Colangelo, J.A. (2021). Prevalence and Type of Psychopathology in Ultra Endurance Athletes. [Ph.D. Thesis, Harvard University]."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/JSA.0000000000000233","article-title":"Depression in Ultra-Endurance Athletes, A Review and Recommendations","volume":"27","author":"Onate","year":"2019","journal-title":"Sport. Med. Arthrosc. Rev."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.3389\/fpsyg.2018.01275","article-title":"Antecedents of Exercise Dependence in Ultra-Endurance Sports: Reduced Basic Need Satisfaction and Avoidance-Motivated Self-Control","volume":"9","author":"Knechtle","year":"2018","journal-title":"Front. Psychol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1037\/amp0000503","article-title":"The Policy Relevance of Personality Traits","volume":"74","author":"Bleidorn","year":"2019","journal-title":"Am. Psychol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e1748","DOI":"10.1002\/mpr.1748","article-title":"The Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study","volume":"28","author":"Kotyuk","year":"2018","journal-title":"Int. J. Methods Psychiatr. Res."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40473-013-0001-y","article-title":"Addictions and Personality Traits: Impulsivity and Related Constructs","volume":"1","author":"Mitchell","year":"2014","journal-title":"Curr. Behav. Neurosci. Rep."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.neubiorev.2016.08.033","article-title":"Integrating Psychological and Neurobiological Considerations Regarding the Development and Maintenance of Specific Internet-Use Disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) Model","volume":"71","author":"Brand","year":"2016","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.addbeh.2005.05.022","article-title":"Gray\u2019s Model of Personality and Addiction","volume":"31","author":"Franken","year":"2006","journal-title":"Addict. Behav."},{"key":"ref_88","first-page":"375","article-title":"The Relationship Between Adolescents\u2019 Neuroticism, Internet Service Preference, and Internet Addiction","volume":"38","author":"Li","year":"2006","journal-title":"Acta Psychol. Sin."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"104531","DOI":"10.1016\/j.chiabu.2020.104531","article-title":"Mediating Effect of Neuroticism and Negative Coping Style in Relation to Childhood Psychological Maltreatment and Smartphone Addiction among College Students in China","volume":"106","author":"Liu","year":"2020","journal-title":"Child Abus. Negl."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"111260","DOI":"10.1016\/j.paid.2021.111260","article-title":"Neuroticism and Internet Addiction: What Is next? A Systematic Conceptual Review","volume":"185","author":"Marciano","year":"2022","journal-title":"Personal. Individ. Differ."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.comppsych.2014.04.025","article-title":"Relationship of Internet Addiction with Cognitive Style, Personality, and Depression in University Students","volume":"55","author":"Atasoy","year":"2014","journal-title":"Compr. Psychiatry"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1556\/JBA.2.2013.4.2","article-title":"The Exercise Paradox: An Interactional Model for a Clearer Conceptualization of Exercise Addiction","volume":"2","author":"Egorov","year":"2013","journal-title":"J. Behav. Addict."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1556\/2006.6.2017.024","article-title":"Which Dimensions of Impulsivity Are Related to Problematic Practice of Physical Exercise?","volume":"6","author":"Kotbagi","year":"2017","journal-title":"J. Behav. Addict."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Caponnetto, P., Casu, M., Amato, M., Cocuzza, D., Galofaro, V., La Morella, A., Paladino, S., Pulino, K., Raia, N., and Recupero, F. (2021). The Effects of Physical Exercise on Mental Health: From Cognitive Improvements to Risk of Addiction. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413384"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"561713","DOI":"10.3389\/fpsyt.2020.561713","article-title":"Heightened Negative Affects Associated With Neurotic Personality in Behavioral Addiction","volume":"11","author":"Asaoka","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"W\u00e5gan, F.A., Darvik, M.D., and Pedersen, A.V. (2021). Associations between Self-Esteem, Psychological Stress, and the Risk of Exercise Dependence. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115577"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"4062","DOI":"10.2174\/13816128113199990614","article-title":"Exercise Addiction- Diagnosis, Bio-Psychological Mechanisms and Treatment Issues","volume":"20","author":"Weinstein","year":"2014","journal-title":"Curr. Pharm. Des."},{"key":"ref_98","unstructured":"Freimuth, M. (2008). Addicted?: Recognizing Destructive Behaviors before It\u2019s Too Late, Rowman & Littlefield Publishers."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"664071","DOI":"10.3389\/fphys.2021.664071","article-title":"Musculoskeletal Injuries in Ultra-Endurance Running: A Scoping Review","volume":"12","author":"Scheer","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"104160","DOI":"10.1016\/j.jrp.2021.104160","article-title":"Does Successfully Changing Personality Traits via Intervention Require That Participants Be Autonomously Motivated to Change?","volume":"95","author":"Hudson","year":"2021","journal-title":"J. Res. Personal."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1556\/2006.5.2016.043","article-title":"Exercise Addiction in Athletes and Leisure Exercisers: The Moderating Role of Passion","volume":"5","author":"Parastatidou","year":"2016","journal-title":"J. Behav. Addict."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1080\/26408066.2019.1617212","article-title":"An Item Response Theory Analysis of the SCOFF Questionnaire in a High School Population","volume":"16","author":"Bean","year":"2019","journal-title":"J. Evid.-Based Soc. Work"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.beth.2015.12.005","article-title":"Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study","volume":"47","author":"Armstrong","year":"2016","journal-title":"Behav. Ther."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"831992","DOI":"10.3389\/fpsyt.2022.831992","article-title":"Relating Compulsivity and Impulsivity With Severity of Behavioral Addictions: A Dynamic Interpretation of Large-Scale Cross-Sectional Findings","volume":"13","author":"Demetrovics","year":"2022","journal-title":"Front. Psychiatry"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"903777","DOI":"10.3389\/fspor.2022.903777","article-title":"Understanding Exercise Addiction, Psychiatric Characteristics and Use of Anabolic Androgenic Steroids among Recreational Athletes\u2014An Online Survey Study","volume":"4","author":"Gunnarsson","year":"2022","journal-title":"Front. Sport. Act. Living"},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Corazza, O., Simonato, P., Demetrovics, Z., Mooney, R., van de Ven, K., Roman-Urrestarazu, A., R\u00e1cmoln\u00e1r, L., De Luca, I., Cinosi, E., and Santacroce, R. (2019). The Emergence of Exercise Addiction, Body Dysmorphic Disorder, and Other Image-Related Psychopathological Correlates in Fitness Settings: A Cross Sectional Study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0213060"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.psychres.2017.06.065","article-title":"Muscle Dysmorphia and Psychopathology: Findings from an Italian Sample of Male Bodybuilders","volume":"256","author":"Longobardi","year":"2017","journal-title":"Psychiatry Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/2\/1042\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:01:19Z","timestamp":1760119279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/2\/1042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,6]]},"references-count":107,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["ijerph20021042"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20021042","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,6]]}}}