Exercise addiction can also be related to certain personality characteristics and/or psychological distress. In a cross-sectional survey by Guidi et al. 
, a total of 79 participants (recruited in five gyms) completed the following self-report questionnaires: Exercise Dependence Questionnaire (EDQ), Eating Disorder Inventory II (EDI-2), Temperament and Character Inventory (TCI), Attitude Toward Self Scale (ATS), Muscle Dysmorphia Questionnaire (MDQ) and Symptom Questionnaire (SQ). In the sample, exercise addicted subjects were 32, who were compared with control subjects (n = 47). From the results, it was observed significant differences between genres in EDI-2 total score, where women have obtained higher scores than men (p
= 0.048). Participants with primary exercise addiction showed more dysfunctional eating patterns than control group; in fact, significant differences emerged in EDI-2 total score (p
< 0.001). Other differences between these groups are associated to behavioral aspects: participants with primary exercise addiction reached higher scores than control group in these TCI subscales: damage avoidance (p
= 0.038), persistence (p
= 0.024), self-directivity (p
= 0.002). In contrast, lower scores were reached in matureness character index (p
= 0.033). In SQ total score (p
= 0.002) and in anxiety (p
= 0.001) and hostility subscales (p
< 0.001), better scores were found in participants with primary exercise addiction. Considering the issue of body dysmorphia related to exercise addiction, significant differences in ATS dysmorphophobia subscale (p
= 0.010) emerged, with higher scores in participants with primary exercise addiction. Primary exercise addiction resulted significantly associated with higher scores in muscular dysmorphia, evaluated by MDQ (p
< 0.001). Data provided further support to the idea that exercise addiction could be a specific clinical condition associated with psychological symptoms and personality characteristics. These evidences report a relation between excessive physical activity and eating behavioral disorders. Regarding personality characteristics, these results are consistent with those of other studies, in which a negative association between self-esteem and excessive physical activity was highlighted. The results also indicate difficulty in assumption of responsibility and lack of objectives. Finally, the presence of primary exercise addiction is associated with significant higher scores in muscular and body dysmorphia, anxiety and hostility.
In Hausenblas e Giacobbi’s hypothesis 
, some people could start to perform physical activity as a coping strategy towards psychological distress. The researchers therefore examined the relationship between personality and exercise dependence symptoms; participants of the study were 390 university students who completed multidimensional assessments of personality, exercise dependence, and exercise behavior. To examine the predictive relationship of personality for exercise dependence symptoms hierarchical regressions with forced block entry were undertaken. In Block 1, exercise dependence was regressed on exercise behavior. In Block 2, the personality subscales (neuroticism, extraversion, conscientiousness, agreeableness, openness) were entered into the regression. Results showed that extraversion, neuroticism, and agreeableness predicted exercise dependence symptoms.