Driven exercise is a transdiagnostic maladaptive behavior, especially common in eating disorders (ED). We examined established 4- and 5-function models of reinforcement functions that might maintain driven exercise in three studies varying across developmental stages and clinical presentations (Study 1: N = 279 adolescents/adults oversampled for EDs; Study 2: N = 118 adolescent/adult inpatients with severe EDs; Study 3: N = 52 adults oversampled for athletes/EDs). Automatic positive reinforcement was most frequently endorsed, followed by control, automatic negative, social negative, and social positive reinforcement in all studies, except in inpatients (Study 2; control most endorsed). Automatic positive reinforcement was correlated with driven exercise episodes within last month in all studies, whereas associations with ED severity and psychopathology varied between functions and studies. Our findings suggest that driven exercise is maintained by both automatic and social functions. In samples with more severe EDs, control-related motivation might serve an additional maintenance function.
