Exercise Interventions for Mental Health: A Quantitative and Qualitative Review

Clinical Psychology Science and Practice (Impact Factor: 2.92). 05/2006; 13(2):179 - 193. DOI: 10.1111/j.1468-2850.2006.00021.x


Associations between exercise and mental well-being have been documented repeatedly over the last two decades. More recently, there has been application of exercise interventions to clinical populations diagnosed with depression, anxiety, and eating disorders with evidence of substantial benefit. Nonetheless, attention to the efficacy of exercise interventions in clinical settings has been notably absent in the psychosocial treatment literature, as have been calls for the integration of these methods within the clinical practice of psychologists. In this article, we provide a quantitative and qualitative review of these efficacy studies in clinical samples and discuss the potential mechanism of action of exercise interventions, with attention to both biological and psychosocial processes. The meta-analysis of 11 treatment outcome studies of individuals with depression yielded a very large combined effect size for the advantage of exercise over control conditions: g = 1.39 (95% CI: .89–1.88), corresponding to a d = 1.42 (95% CI: .92–1.93). Based on these findings, we encourage clinicians to consider the role of adjunctive exercise interventions in their clinical practice and we discuss issues concerning this integration.

    • "The effectiveness of exercise is likely due to the fact that exercise reduces cortisol stress hormone response which is mediated by regulation of serotonin receptors (Stathopoulou et al., 2006). Moreover, exercise releases beta-endorphins which inhibit the central nervous system (Stathopoulou et al., 2006). Together, these mechanisms may help to decrease anxiety and improve mood, although more research is needed to understand this relationship (Asmundson et al., 2013) The most common evidence-based approach for treating social anxiety is cognitive behavioral therapy (CBT) (Veale, 2003), but a selective serotonin reuptake inhibitor (SSRI) may also be prescribed (Ballenger et al., 1998). "
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    ABSTRACT: Animal models and clinical trials in humans suggest that probiotics can have an anxiolytic effect. However, no studies have examined the relationship between probiotics and social anxiety. Here we employ a cross-sectional approach to determine whether consumption of fermented foods likely to contain probiotics interacts with neuroticism to predict social anxiety symptoms. A sample of young adults (N=710, 445 female) completed self-report measures of fermented food consumption, neuroticism, and social anxiety. An interaction model, controlling for demographics, general consumption of healthful foods, and exercise frequency, showed that exercise frequency, neuroticism, and fermented food consumption significantly and independently predicted social anxiety. Moreover, fermented food consumption also interacted with neuroticism in predicting social anxiety. Specifically, for those high in neuroticism, higher frequency of fermented food consumption was associated with fewer symptoms of social anxiety. Taken together with previous studies, the results suggest that fermented foods that contain probiotics may have a protective effect against social anxiety symptoms for those at higher genetic risk, as indexed by trait neuroticism. While additional research is necessary to determine the direction of causality, these results suggest that consumption of fermented foods that contain probiotics may serve as a low-risk intervention for reducing social anxiety. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    04/2015; 228(2). DOI:10.1016/j.psychres.2015.04.023
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    • "These models focus not only on individual trips, where time savings alone are important, but seek to better understand how time is allocated across all trips and activities, allowing the impact on wellbeing of various interrelated factors such as travel patterns, urban form, and time use to be examined concurrently (Abou-Zeid and Ben-Akiva, 2012; Bhat and Koppelman, 1999; Bowman and Ben-Akiva, 2001; McFadden et al., 1977; Pinjari et al., 2011; Sallis et al., 2004). Studies that examine the impact on wellbeing of active travel for recreational purposes, such as visiting friends (Hamer et al., 2009; Humphreys et al., 2013; Mutrie and Faulkner, 2004; Ravulaparthy et al., 2013; Teychenne et al., 2008), or as an intervention in clinical settings (Gusi et al., 2008; Stathopoulou et al., 2006), are more common than those that examine more routine active commuting. However, behaviour change in these non-work domains may be impractical for large numbers of working-aged people for whom the opportunity cost of physical activity outside of work hours is relatively high (House of Commons Health Committee, 2004; Martin et al., 2012; Popham and Mitchell, 2006). "
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    ABSTRACT: Objective To explore the relationship between active travel and psychological wellbeing. Method This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2-2008/9). Fixed effects regression models were used to investigate how (i.) travel mode choice, (ii.) commuting time, and (iii.) switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire (GHQ12). Results After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between the 36-point GHQ12 wellbeing scale and (i.) active travel (0.185, 95% CI: 0.048-0.321) and public transport (0.195, 95% CI: 0.035-0.355) when compared to car travel, (ii.) time spent (per ten minute change) walking (0.083, 95% CI: 0.003-0.163) and driving (− 0.033, 95% CI: − 0.064 – -0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199-0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel. Conclusion The positive psychological wellbeing effects identified in this study should be considered in cost-benefit assessments of interventions seeking to promote active travel.
    Preventive Medicine 12/2014; 69. DOI:10.1016/j.ypmed.2014.08.023 · 3.09 Impact Factor
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    • "Physical activity reduces the risk of many chronic diseases (Blair et al., 2001), including cardiovascular disease (Lee and Skerrett, 2001), depression and anxiety (Biddle et al., 2000; Stathopoulou et al., 2006), diabetes (Williams, 2007), musculoskeletal conditions (Oida et al., 2003), obesity (Foresight, 2007) and some cancers (Wolin et al., 2007). However, most adults do not achieve recommended levels of physical activity (Chief Medical Officer, 2004). "
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    ABSTRACT: Background and objectives: Referring clinicians' experiences of exercise referral schemes (ERS) can provide valuable insights into their uptake. However, most qualitative studies focus on patient views only. This paper explores health professionals' perceptions of their role in promoting physical activity and experiences of a National Exercise Referral Scheme (NERS) in Wales. Design: Qualitative semi-structured group interviews. Setting: General practice premises. Methods: Nine semi-structured group interviews involving 46 health professionals were conducted on general practice premises in six local health board areas. Purposive sampling taking into account area deprivation, practice size and referral rates was employed. Interviews were transcribed verbatim and analysed using the Framework method of thematic analysis. Results: Health professionals described physical activity promotion as important, although many thought it was outside of their expertise and remit, and less important than other health promotion activities such as smoking cessation. Professionals linked decisions on whether to advise physical activity to patients to their own physical activity levels and to subjective judgements of patient motivation. While some described ERS as a holistic alternative to medication, with potential social benefits, others expressed concerns regarding their limited reach and potential to exacerbate inequalities. Barriers to referral included geographic isolation and uncertainties about patient selection criteria, medico-legal responsibilities and a lack of feedback about patient progress. Conclusion: Clinicians' concerns about expertise, priority setting and time constraints should be addressed to enhance physical activity promotion in primary care. Further research is needed to fully understand decision making relating to provision of physical activity advice and use of ERS.
    Health Education Journal 11/2014; 74(6). DOI:10.1177/0017896914559785 · 0.73 Impact Factor
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