About the lab
Exercise and Mental Health
Featured projects (5)
Since the outbreak of the corona virus (SARS-CoV-2) in December 2019, protective measures have been established worldwide to contain COVID-19. A current review reports negative consequences on various psychosocial parameters caused by quarantine, such as emotional imbalance, flattened mood, depressive symptoms, sleep disorders, or posttraumatic stress symptoms. Initial studies show that measures to contain the Covid-19 pandemic (travel restrictions, contact reduction through "social distancing", quarantine, lockdown) are also associated with strong negative psychological effects such as increased anxiety symptoms , depressive symptoms, stress and moderate to severe psychological strain. Numerous studies show preventive effects of exercise and social support social support on the symptoms of mental illness associated with said measures. In order to be able to use the preventive effect of exercise in emergencies such as the Covid-19 pandemic, the preventive effect of exercise on psychological variables during the pandemic needs to be investigated. We address this gap by conducting a longitudinal questionnaire-based survey, that assesses the preventive effects of regular exercise before social distancing as well as the effects of the change in exercise activity during the protective measures on affect and psychopathological symptoms at three time points: during ongoing full protective measures, after loosening of the regulations and after return to the initial state. Goal is using the obtained findings to develop online courses implementing preventive measures.
Physical activity has positive effects on mental health. Several studies report positive effects of a single bout of exercise positive affect and rumination. In addition, first results show positive effects of regular exercise on the subjective and objective stress experience. Cross-sectional and cohort studies report preventive effects of exercise on mental illness. However, up to date there are only few experimental studies that assess the long term preventive effects of exercise. This might be especially beneficial to college students, who are highly exposed to stress and have a higher prevalence of mental the general population. Physical activity levels, however, decline in the transition from adolescence to adulthood. Therefore, we designed a randomized controlled trial to investigate the effects of two different types of exercise (endurance sports, ball sports) in comparison to a passive control group for college students. The change in physical fitness, psychopathological symptoms, subjective and objective stress experience will be assessed pre- and post-intervention as well as at follow-up. In addition, we will assess acute effects on mood and rumination after the exercise sessions. The intervention groups will receive six weeks of supervised exercise sessions (2x/week). In addition, they will receive (online) counseling that promotes the consistent continuation of the physical activity.
A growing body of research suggests moderate to vigorous physical activity (MVPA) to be ef-fecacious in improving psychopathological symptoms of mental disorders with a high preva-lence, such as major depression, anxiety disorders and insomnia. In spite of its efficacy and applicability, no exercise intervention has yet been developed for the outpatient psychothera-peutic context. To fill this gap, we developed the 12-week exercise intervention “ImPuls”, based on the current evidence about the therapeutic efficacy and (sustainable) promotion of MVPA in outpatients with mental disorders. Between February 2018 and October 2019, the department of Clinical Psychology and Psychotherapy, in cooperation with the Institute of Sports Science (Prof. Dr. Gorden Sudeck) of the University of Tuebingen, evaluated the efficacy (i.e., reduc-tion of psychopathological symptoms, increase of the extent of MVPA) of ImPuls in a random-ized controlled trial. A sample of N = 75 outpatients, suffering from at least one diagnosed men-tal disorder (major depression, anxiety disorders, insomnia), aged between 18 and 65 (M = 35.36, SD = 13.28) and waiting for psychotherapeutic treatment, participated in the study. Using stratified block randomization (stratified variables were age and severity of symptoms), partici-pants were allocated to an intervention group (IG; n = 38) or passive control group (CG; n = 37) when 6 to 10 patients were eligible (IG: n = 3-5; CG: n = 3-5) for study participation. To analyze the change in psychopathological symptoms (Symptom-Checklist-90®-Standard; Pittsburgh Sleep Quality Index, heart rate variability), we included group (IG vs. CG) as a between-subject variable and time (T1: pre); T3: post) as a within subject variable. To analyze the extent of sub-jectively reported MVPA (Physical Activity, Exercise, and Sport Questionnaire, BSA-F) we in-cluded group as a between-subject variable and time (T1; T2: week 9; T3) as a within subject var-iable. Objectively assessed MVPA (accelerometer) was analyzed with group as a between-subject variable at one time point (T2). Linear mixed models will be conducted to determine the change of psychopathological symptoms and extent of MVPA at T3. A linear regression model will be conducted to determine whether the change of symptom reduction was predicted by the increase of MVPA at T2 and T3. Analyses will be conducted using the intention-to-treat-sample. TRIAL REGISTRATION: ClinicalTrials.gov NCT03542396. We are currently collecting one-year follow-up data to test the maintenance of effects on psy-chopathological symptoms and the extent of exercise. Furthermore, between June 2020 and June 2023, ImPuls will be implemented and evaluated as an innovative health care project fund-ed by the “Innovationsfonds des Gemeinsamen Bundesausschusses (G-BA)” (see for more in-formation: https://innovationsfonds.g-ba.de/downloads/media/167/Liste-gefoerderte-Projekte-nVF-FBK-19-10-2018.pdf). The aim of the research project will be to evaluate the increase of care efficiency/reduction in waiting time for psychotherapy and the reduction of care costs by the implementation of ImPuls at 10 regional sports and exercise therapy centers in Baden-Württemberg (Germany).
Attention deficit hyperactivity disorder (ADHD) is a common disorder in children and adolescents. Current treatment guidelines recommend pharmacotherapy and psychosocial interventions. However, only a small proportion of patients receive guideline conforming treatment. In addition, currently there is no conclusive evidence for the efficacy of psychosocial interventions and efficacy and tolerability of pharmacotherapy seems to decrease with age. Regular, moderate to vigorous physical activity (MVPA) could be an alternative treatment, since evidence suggests positive effects on the proposed key mechanisms of ADHD core symptoms. In addition, MVPA is easily accessible, has very few side effects and can be integrated in the everyday lives of the patients. Therefore, our first goal is to assess the efficacy of MVPA as standalone or add-on treatment on ADHD core symptoms in children and adolescents. In a second step, we are developing a multicentric, randomized controlled trial. This trial will implement cognitively engaging MVPA to improve efficacy by targeting proposed ADHD symptom dynamics and will focus specifically on adolescents. MVPA as sustainable treatment is particularly relevant for this age group, since percentage of patients receiving guideline-conforming treatment declines with age. Adolescents are often “left alone” in the transition to adulthood. They are therefore in need of an easily accessible treatment option.
Evidence suggest exercise as an effective treatment for depressive patients. Different meta-analytic results show that exercise leads to medium to large effects on depressive symptoms. Even though effects of exercise on depression show good evidence, the underlying mechanisms are not well understood. Rumination is one potential mechanism, that has been reported repeatedly and is characterized as “a mode of responding to distress that involves repetitively and passively focusing on symptoms of distress and the possible causes and consequences of these symptoms” (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008). Evidence, that exercise is beneficial for rumination itself is lacking, because, on the one hand, there are only a few studies to date and, on the other hand, these studies show methodological limitations. As a result, the first goal of our project is to examine, whether exercise can affect rumination within depressed patients and thus be the underlying mechanism of the antidepressant effect of exercise. Newer research also examined neurophysiological correlates of rumination and found that rumination is associated with specific patterns of activation, for example in the PFC. Therefore, the second goal of our study is to use the neurophysiological patterns of rumination to analyse the impact of exercise on rumination. To establish a neurophysiological indicator of ongoing (“state”) rumination, we develop decoding models which decode rumination within depressed patients from neurophysiological EEG and fNIRS data patterns. These decoders are used, to predict rumination after exercise.
Featured research (8)
Background: COVID-19-related confinements pose a threat to mental health. We investigated prevalence rates of symptoms of depression, generalized anxiety and insomnia in German adults. Furthermore, we explored associations of exercise behavior with disorder-specific symptoms and assessed whether specific affect regulation skills enhance the effect of exercise on symptom alleviation. Methods: Cross-sectional survey-based data collected during the first lockdown is presented: 4268 adults completed questionnaires on mental health, exercise behavior and Covid-related lifestyle factors. Primary outcome was depression (PHQ-9), secondary outcomes generalized anxiety (PHQ-D) and sleep quality (PSQI). Multiple linear regression analyses were performed to examine the association of exercise behavior with the outcomes. Results: Analyses resulted in elevated symptoms of psychological distress (probable cases of depressive disorder: 31.2%, anxiety disorder: 7.5%, sleeping disorder: 43.0%). A change towards less exercise during the lockdown was significantly associated with higher levels of depression (t=5.269; β=0.077, p<.001), anxiety (t=3.397; β=0.055, p<.001) and insomnia (t=3.466; β=0.058; p<.001). Physical activity (PA)-related affect regulation enhanced the effect of exercise on mental health. Conclusions: Results suggest a demand for measures which promote the maintenance of exercise during a pandemic and improve PA-related affect regulation to optimize effects of exercise on mental health.
Background The Covid-19 pandemic is affecting the entire world population. During the first spread, most governments have implemented quarantine and strict social distancing procedures. Similar measures during recent pandemics resulted in an increase in post-traumatic stress, anxiety and depression symptoms. The development of novel interventions to mitigate the mental health burden are of utmost importance. Objective In this rapid review, we aimed to provide a systematic overview of the literature with regard to associations between physical activity (PA) and depression and anxiety during the COVID-19 pandemic. Data Source We searched major databases (PubMed, EMBASE, SPORTDiscus, and Web of Science) and preprint servers (MedRxiv, SportRxiv, ResearchGate, and Google Scholar), for relevant papers up to 25/07/2020. Study Eligibility Criteria We included observational studies with cross-sectional and longitudinal designs. To qualify for inclusion in the review, studies must have tested the association of PA with depression or anxiety, using linear or logistic regressions. Depression and anxiety must have been assessed using validated rating scales. Study Appraisal and Synthesis Methods Effect sizes were represented by fully adjusted standardized betas and odds ratios (OR) alongside 95% confidence intervals (CI). In case standardized effects could not be obtained, unstandardized effects were presented and indicated. Results We identified a total of 21 observational studies (4 longitudinal, 1 cross-sectional with retrospective analysis, and 16 cross-sectional), including information of 42,293 (age 6–70 years, median female = 68%) participants from five continents. The early evidence suggests that people who performed PA on a regular basis with higher volume and frequency and kept the PA routines stable, showed less symptoms of depression and anxiety. For instance, those reporting a higher total time spent in moderate to vigorous PA had 12–32% lower chances of presenting depressive symptoms and 15–34% of presenting anxiety. Conclusion Performing PA during Covid-19 is associated with less depression and anxiety. To maintain PA routines during Covid-19, specific volitional and motivational skills might be paramount to overcome Covid-19 specific barriers. Particularly, web-based technologies could be an accessible way to increase motivation and volition for PA and maintain daily PA routines.
Background This systematic review and meta-analysis assesses the efficacy of regular, moderate to vigorous physical activity (MVPA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents in randomized controlled trials (RCTs). Methods RCTs including children and adolescents with clinically diagnosed ADHD, implementing regular MVPA, and assessing ADHD core-symptoms on a valid rating scale post-intervention (primary outcome) were included. Outcomes were pooled through random-effects meta-analysis. Prospero registration: CRD42019142166. Results MVPA had a small effect on total ADHD core symptoms ( n = 11; g = −0.33; 95% CI [−0.63; −0.02]; p = .037). Conclusions MVPA could serve as an alternative treatment for ADHD. New RCTs are necessary to increase the understanding of the effect regarding frequency, intensity, type of MVPA interventions, and differential effects on age groups.
Current meta-analyses demonstrate convincing evidence regarding the efficacy of exercise on depression, insomnia, anxiety disorders, schizophrenia and ADHD. However, exercise and sports therapy approaches for patients with psychological disorders are mostly integrated in psychiatric inpatient or rehabilitation settings, but not applied in the outpatient sector. Thus, the German Health sector does not take the advantage of the compelling therapeutic effects of exercise. This review covers the theoretical and empirical fundamentals of the effects of exercise and illustrates practical implications by means of the presentation of the group-therapeutic exercise program ImPuls, that was specifically designed for patients with psychological disorders in outpatient settings. ImPuls integrates current evidence of the effects of exercise (type of sport, duration, frequency, intensity) and the facilitation of motivational and volitional strategies to support patients to integrate exercise in their daily life routines.