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The relationship between physical activity and self-image and problem behavior among adolescents

  • International Centre for the Study of Occupational and Mental Health

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Although there are a vast array of studies which have demonstrated the psychological and physical health benefits of regular aerobic exercise for adults, few studies have focussed on children and adolescents. The current study examined associations between the extent of participation in endurance sport, and self-report data on self-image, physical and psychological health and overall lifestyle in a large representative sample of German high-school students. Almost 1000 German adolescents (aged 14-18 years) were administered a comprehensive series of questionnaires aimed at assessing anxiety-depression, trait addiction, smoking and drinking behaviour, physical ill-health reports, and self-perception of self-image, parental acceptance and educational attainment. Regular practice of endurance exercise was related to a more favourable self-image. There was a strong association between participation in sports and the type of personality that tends to be resistant to drug and alcohol addiction. Physical exercise was further significantly related to scores for physical and psychological well-being. Adolescents who engaged regularly in physical activity were characterised by lower anxiety-depression scores, and displayed much less social behavioural inhibition than their less active counterparts. It is likely that discussion of recreational or exercise involvement may provide a useful point of entry for facilitating dialogue among adolescents about concerns relating to body image and self-esteem. In terms of psychotherapeutic applications, physical activity has many additional rewards for adolescents. It is probable that by promoting physical fitness, increased physical performance, lessening body mass and promoting a more favourable body shape and structure, exercise will provide more positive social feedback and recognition from peer groups, and this will subsequently lead to improvement in an individual's self-image.
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Soc Psychiatry Psychiatr Epidemiol (2002) 37:544550 DOI 10.1007/s00127-002-0554-7
Abstract Background Although there are a vast array
of studies which have demonstrated the psychological
and physical health benefits of regular aerobic exercise
for adults, few studies have focussed on children and
adolescents. The current study examined associations
between the extent of participation in endurance sport,
and self-report data on self-image,physical and psycho-
logical health and overall lifestyle in a large representa-
tive sample of German high-school students.Method Al-
most 1000 German adolescents (aged 14–18 years) were
administered a comprehensive series of questionnaires
aimed at assessing anxiety-depression, trait addiction,
smoking and drinking behaviour, physical ill-health re-
ports, and self-perception of self-image, parental accep-
tance and educational attainment. Results Regular prac-
tice of endurance exercise was related to a more
favourable self-image. There was a strong association
between participation in sports and the type of person-
ality that tends to be resistant to drug and alcohol ad-
diction. Physical exercise was further significantly re-
lated to scores for physical and psychological
well-being.Adolescents who engaged regularly in phys-
ical activity were characterised by lower anxiety-de-
pression scores, and displayed much less social behav-
ioural inhibition than their less active counterparts.
Conclusion It is likely that discussion of recreational or
exercise involvement may provide a useful point of en-
try for facilitating dialogue among adolescents about
concerns relating to body image and self-esteem. In
terms of psychotherapeutic applications,physical activ-
ity has many additional rewards for adolescents. It is
probable that by promoting physical fitness, increased
physical performance, lessening body mass and pro-
moting a more favourable body shape and structure,ex-
ercise will provide more positive social feedback and
recognition from peer groups, and this will subse-
quently lead to improvement in an individual’s self-im-
Key words adolescence – physical activity self-im-
age – physical health – psychological well-being – social
problems – anxiety-depression
In a comprehensive review of the literature exploring
the advantages of regular physical activity [1] it has been
asserted that “among a long list of postulated psycho-
logical benefits, we note positive shifts of mood state
and perceived health, an increased sense of self-suffi-
ciency, greater personal adjustment,enhanced body im-
age, and impaired self-concept. Cognitive and percep-
tual processing is said to be facilitated,type A behaviour
is reduced, stress management skills are improved, and
overall psychological performance is bolstered.Exercise
has further been recommended as a tool in the therapy
of frank psychiatric ailments,including chronic depres-
sion and anxiety states”.
Unfortunately, the majority of these studies have
tended to focus on adult populations, with a disregard
for children and adolescents. There has been little at-
tempt to attest to whether adolescents who exercise
more regularly really display superior self-image, edu-
cational attainment, enhanced interpersonal relations,
B. D. Kirkcaldy · R. J.Shephard · R. G.Siefen
The relationship between physical activity and self-image
and problem behaviour among adolescents
Accepted: 28 February 2002
SPPE 554
Bruce Kirkcaldy, PhD ()
International Center for the Study of Occupational
and Mental Health
Haydnstr. 61
40593 Duesseldorf, Germany
Tel.: +49-211/7 1842 20
Fax: +49-2 11/7 18 5133
R. J. Shephard, MD
Faculty of Physical Education and Health
Dept. of Public Health Sciences
Faculty of Medicine
University of Toronto
R. G. Siefen,MD
Westfalia Clinic for Child and Adolescent Psychiatry
and Psychosomatic
Marl-Sinsen, Germany
physical and psychological health when compared to
their less active counterparts.
Some studies have demonstrated that participation
in school sports programmes can have a positive imme-
diate effect upon self-image during the adolescent years,
particularly if the chosen activity is some form of team
sport such as American football,soccer, handball or vol-
leyball with a high profile among the peer group [2].The
effects of such adulation and social status may be rein-
forced by socially-accepted changes in body build – in-
creases in muscularity (particularly in boys) and reduc-
tions in surplus body fat (particularly in girls) [3].
Conversely, there may be a substantial negative impact
on self-image among the majority of students who (be-
cause of an unfavourable body build, or other interests)
do not gain a celebrityposition on the school team [4].
In this connection, perceived self-confidence and self-
efficacy have greater influence than actual physical com-
petence [5].
Field [6] examined the exercise habits of adolescents,
as well as relationship with peers and parents,depressive
tendencies, drug use and educational attainment. Indi-
viduals who exercised more reported better relation-
ships with parents (greater quality, increased touching
and intimacy),less depression,less frequent use of drugs
and higher class average performance grades than the
less physical active individuals. It has been suggested
that since substance abuse (a major problem among
young adolescents) occurs during leisure time, involve-
ment in physical activity may serve as a healthy substi-
tute allowing time-out and serving to enhance sense of
accomplishment and self-esteem [7].
In an extensive review [8] of the literature on leisure
and adolescence it was reported that over 90% of the 13-
to 14-year-olds participate in weekly sport,but this level
falls to 67 % for males and 49 % for females some 6 years
later. Competitive sport and group physical pursuits be-
come replaced by regular physical exercise in the form
of swimming, jogging, aerobics or walking. Girls have
been shown to drop out quickly, especially among com-
petitive sports, presumably because of concern about
bodily changes. More recent statistics published by the
US Surgeon General [9] suggest that only about one-half
of young American people aged 12–21 years participate
in vigorous physical activity regularly, and one fourth
report no involvement in vigorous activity. Only 19% of
high-school students reported being physically active
for 20 min or more per day in physical education classes.
Moreover,physical activity declines sharply during ado-
Much of the analysis to date has focussed on young
adults, and although endurance exercise is much more
likely to have a positive impact upon long-term health,
the impact of such activity upon self-image has received
less attention.It seems likely that if the chosen pattern of
physical activity has a favourable effect upon self-image,
the student will be less likely to become involved in ad-
verse lifestyles (smoking, drinking alcohol and abuse of
drugs), but again there has been little experimental ex-
ploration of this issue. Accordingly, we have examined
associations between the extent of participation in en-
durance sport, self-image, physical and psychological
health and overall lifestyle in a substantial sample of
German high-school students.
We postulated a positive association between en-
gagement in regular physical exercise and health, and
from this viewpoint we formulated five sub-hypotheses:
H1 Young adolescents who engage in regular sporting
activities will display a more favourable self-image
than their sedentary counterparts;
H2 Physically active adolescents will exhibit less nega-
tive affect, in terms of anxiety and depression, than
more sedentary individuals;
H3 Physical ailments will be less prevalent in the exer-
cising than in the sedentary group, and this will be
most apparent on those somatic scales related to
physical exhaustion and tiredness (emotionality);
H4 Individuals who report frequent problems in their
social interactions with others are likely to be
H5 Relative to their sedentary peers, adolescents who
engage in regular forms of exercise will display
lower addiction scores and be less likely to smoke,
to consume alcohol or to take illicit drugs.
Subjects and methods
Subjects and experimental plan
Data were collected from nine of the ten secondary schools in the
Marl area of West Germany, a semi-rural region in the northern,
Protestant part of Germany. The geographical region is typical of
middle-sized urban communities in the Rhine-Ruhr industrial area.
The sample included pupils from both technical schools, three sec-
ondary schools, two comprehensive schools, and two of three gram-
mar schools.The directors of the schools were informed about the na-
ture, aims and procedures of the assessment programme, which was
conducted in accordance with a protocol reviewed by the institutional
committee on human experimentation. In addition to the main sur-
vey, written material in the form of letters and survey descriptions
was mailed to parents and teachers.Tests were administered between
21.02.2000 and 09.062000, and were limited to pupils in the 9
grades. Four trained university students were involved in con-
ducting the questionnaire sessions. Two hours were allowed for “ex-
planation and delivery of test instruments”, but in practice the time
required to complete the questionnaires varied from 30 to 65 min.The
response rate represented 63.4% of pupils of that class group in the
schools sampled.
Students ranged in age from 14 to 18 years (Table 1), with a mean
age (SD) of 15.6 years [0.8]. The total sample of 988 adolescents in-
cluded an approximately equal proportion of boys and girls (47.2 and
52.8%,respectively).About half of the students were attending either
a technical or a grammar school, and the remainder a secondary or
comprehensive school. The typical one-way distance from the stu-
dents homes to their respective schools was 3–6 km, travel being by
bus, or more frequently by the parents car.
The questionnaires, which were written in the German language,
explored socio-demographic variables (gender,age,nationality,num-
ber of siblings and educational status); family variables (e.g. self-im-
age); mental well-being (problems of introversion and anxiety/de-
pression); physical health (exhaustion, gastric disorders, limb pains,
circulatory problems and colds”) and a personality construct of ad-
Assessment of involvement in endurance sport
Involvement in endurance sport was assessed by a simple question-
naire developed by the authors (note that in Europe, the term sport
covers all types of physical activity,rather than simply involvement in
team sports such as soccer).Students are asked about their degree of
regular, continuous involvement in general recreational activities
(running, swimming and cycling). Ratings were in step-wise, gradu-
ated increments (never, seldom, often, always).
Physical health
Physical health was assessed by the Giessen Subjective Complaints
List [10, 11]. This instrument comprises 59 items relating to physical
ailments.Each item is rated on a 1–5 Likert scale (never,rarely, some-
times, often and always).The inventory includes items from the areas
of general well-being, autonomic complaints, bodily pains, emotion-
ality and common childhood problems. Factor analysis has previ-
ously revealed a five-factor solution of “ailments”, with seven items
loading on each of the following areas: exhaustion, gastric com-
plaints, pains in the limbs, circulatory problems and symptoms of
colds”. By aggregating scores across all items, a global measure of
physical discomfort/distress is derived (alpha coefficient 0.938).
Personality: “addiction”
Liability to the development of a drug dependency was assessed us-
ing the addiction scale of Gossop and Eysenck [12]. This inventory
contains 32 constituent items taken from the EPQ (Eysenck Personal-
ity Questionnaire) [13].It is able to distinguish between normal males
and male drug-dependent individuals at the probability level of 0.001.
The majority of these same items were also effective in discriminat-
ing female addicts from a control group of non-addicts. The score is
essentially a conglomerate of introversion,neuroticism and psychoti-
cism, and its internal reliability is satisfactory (alpha= 0.76). This
measure showed a consistent significant positive association with
adolescents self-report of drug abuse.
Psychological health (social problems and anxiety-depression)
The German version of the Achenbach Child Behaviour Checklist
[14] was used to assess problem social behaviour and anxiety/de-
pression. For this purpose, two of the eight YSR [13] scales were
scored on a 3-point scale (“0”not applicable,“1” occasionally and “2”
frequently): social problems (8 items) “anxiety/depression (16
items relating to introversion, perfectionism, guilt-proneness, anxi-
ety,emotionality,etc.).Alpha coefficients were 0.69 (social problems)
and 0.85 (anxiety-depressive), respectively.
Social and educational attitudes
In addition to the standardised questionnaires (addiction scale of the
EPQ; Achenbachs Child Behaviour Checklist – subscales social prob-
lems, and anxiety-depression, Giessen Subjective Complaints List for
Children and Adolescents), an attempt was made to extract relevant
data concerning social and school life. Eighteen items were included:
school grades in German language, history or politics, mathematics,
natural sciences and foreign languages; number of times school was
changed, or a school year was repeated; self-image (reported level of
self-satisfaction, number of friends, self-rejection and self-impor-
tance); family relationships (parental expectations, parental conflict,
maternal acceptance, paternal acceptance). This section was con-
structed in a nationwide survey among German adolescents to mon-
itor more transient changes in the social-educational domain. The
psychometric properties of this section of the questionnaire are dis-
cussed in detail in Kirkcaldy, Siefen, Surall and Bischoff [15]. The
scales had demonstrated satisfactory internal consistency and related
in a meaningful way to other psychological constructs.
Self-reported use of drugs
The self-reported level of drug usage (smoking cigarettes, drinking
beer [the main alcoholic beverage in this part of Germany] and using
cannabis) was assessed by asking “Have you ever tried the following?”
Possible responses were never” 1; only tried” 2,“yes, occasional us-
age 3, and “yes, regular use 4.
Statistical methods
All univariate and multivariate statistical analyses (linear discrimi-
nant analysis and ANOVA) were computed using SPSS 10 (2001).Male
and female subjects indicated closely comparable exercise participa-
tion (“never”males 10.3%, females 11.2%; “seldom males 34.2%,fe-
males 42.6%; “often males 31.5% females 29.2%; “frequently”males
23.9%, females 17%, chi-squared (3) = 10.98, p <0.05). In all initial
analyses we examined the impact of the main terms gender and exer-
cise separately, and then the interactive term gender x exercise for the
first set of variables (personality, parental attitudes and health out-
come).There was no evidence of a statistically significant interaction
for the first set (Pillai’s trace =0.049, F [30,2136] =1.19, p >0.05), nor
indeed for the physical ailment profiles (Pillai’s trace=0.013, F [15,
2634] =0.75, p > 0.05). Subsequent covariate analysis controlled for
potentially confounding effects of gender and,if anything, the effects
attributed to exercise were accentuated in consequence. Hence, we
concluded that overall gender did not confound the effects attributed
to exercise per se.Thus,for ease of exposition,we decided to focus on
between-exercise group differences.
Associations between various levels of participation in endurance
sport and the other variables have been tested by a series of discrim-
inant analyses. Where significant differences have been demon-
strated, these have been explored post-hoc, using the least significant
difference method.Linear discriminant analysis was conducted in or-
der to examine all personality and attitudinal variables simultane-
ously; this method possesses distinct advantages over the classical
univariate procedure of profile analysis in the event of non-orthogo-
nality of scales. It minimises the likelihood of making a type 1 error
by adjoining multiple measures as a single cluster,thus taking into ac-
count interrelationships between dimensions,individual subject vari-
ance around the group means on the profile elements and group vari-
ability on the individual variables [16].
Participation in endurance sports
One section of the questionnaire focussed on whether
the subject engaged in endurance sports and, if so, to
what extent. Overall, 10.7% (n = 106) of the students re-
ported “never”undertaking endurance/aerobic sporting
activities, 38.6% (n=381) reported seldom”, about
one-third 30.3% (n= 299) often and the final 20.2%
(n= 202) “frequently”.
Table 1 Socio-demographic variables
Male 477 48.3%
Female 511 51.7%
14–15 years 449 45.4%
16–18 539 54.6%
Educational status
Secondary school 213 21.5%
Comprehensive 257 26.0%
Technical-grammar 348 35.2%
Grammar 171 17.3%
For subsequent analyses, the figures vary depending
on the number of respondents to a particular groups of
Personality, parental attitudes, physical
and psychological health
A between-group linear discriminant analysis was next
applied to the reported levels of participation in en-
durance sport (Table 2).The first canonical variate [1–3]
was statistically significant (eigenvalue=0.905, chi-
squared [30] = 72.12, Rc =0.242, p <0.001), as was the
second variate (eigenvalue= 0.961, chi-squared [18] =
28.65, p < 0.06, Rc= 0.155). Overall, the profiles differed
between groups (Pillai’s trace = 0.074, [15, 2163]= 3.652,
p <0.001).
For those F-tests which were statistically significant,
we have presented the figures for the highest scoring
group in bold, and the lowest scoring group is shown in
italics (e.g. overall physical symptoms were reported
most frequently among the group of adolescents who
reported “never” being involved in endurance sports)
(Table 3). On all scales associated with personality and
self-perceptions, individuals with differing degrees of
involvement in endurance/aerobic sports revealed quite
distinct differences (Table 3). For example, although no
difference in reported physical ailments was observed
between the two sets of extreme groups (“never” vs.
seldom exercising, or often vs. “regularly” exercis-
ing), differences were observed when comparing the
“low” and “high activity groups,with the less active in-
dividuals reporting significantly more physical com-
Physical ailments
The next stage of the analysis examined associations be-
tween participation in endurance sport and subclasses
of physical ailments (Tables 4 and 5). The between-
groups physical ailment profiles were compared using
multivariate statistical analysis.The groups differed sig-
nificantly in their respective profiles of reported physi-
cal illnesses (Pillai’s trace=0.056, F [15, 2646]=3.37, p
Table 2 Relationships between participation in endurance sport, self-image and problem behaviour. Significance of relationships is tested by discriminant analysis (see
Group category 1 (n = 80) 2 (n = 286) 3 (n = 218) 4 (n = 143)
Never Seldom Often Frequently F (3,723)
Mean SD Mean SD Mean SD Mean SD
Self-image 5.10 2.92 5.07 2.81 5.76 2.82 6.25 2.84 6.68***
Paternal acceptance 5.30 2.96 5.29 2.89 5.85 2.99 5.55 2.74 1.72
Mathematical competency 5.06 2.99 5.53 2.76 5.59 2.69 6.06 2.92 2.31
Educational threat 5.90 3.12 5.36 2.91 5.52 2.83 5.45 2.76 0.75
Maternal rejection 5.28 3.11 5.64 2.76 5.36 2.91 5.62 2.83 0.63
Linguistic competency 4.94 3.06 5.37 2.87 5.91 2.77 5.53 2.94 2.67*
Addiction 12.36 4.83 11.02 4.51 9.69 4.57 9.62 5.04 5.40***
Physical well-being
Physical illness 121.34 27.13 120.86 25.94 113.58 25.36 112.53 27.67 5.09**
Psychological well-being
Anxiety-depression 23.09 5.31 23.09 5.78 22.30 5.26 21.05 4.56 2.95*
Social problems 10.25 2.57 9.70 1.99 9.59 2.08 9.43 1.75 9.29***
* p < 0.05; ** p < 0.01; *** p < 0.001
Table 3 A post-hoc comparison of scores on the various personality scales between specific groups, classified in terms of their participation in endurance sport (Least Sig-
nificant Difference Method)
Never/seldom Never/often Never/frequently Seldom/often Seldom/frequently Often/frequently
1–2 1–3 1–4 2–3 2–4 3–4
Addiction 0.05* 0.001*** 0.001*** 0.01** 0.01** n. s.
Self-image n. s. n. s. 0.01** 0.01** 0.001*** n. s.
Ailments n. s. 0.05* 0.05* 0.01** 0.01** n. s.
Anxiety-depression n. s. n. s. 0.001*** n. s. 0.001*** 0.05*
Social problems 0.05* 0.05* 0.001*** 0.05* n. s. n. s.
* p < 0.05; ** p < 0.01; *** p < 0.001
Smoking, drinking and drug usage
The final stage of statistical analysis focussed on self-re-
ports of drug and alcohol consumption (Table 6); we se-
lected categories of usage which are common among
German adolescents.Overall,the groups differed signif-
icantly in drug and alcohol usage (eigenvalue= 0.961, F
[9,2373]= 4.35,p <0.001***).Adolescents who were reg-
ularly involved in endurance sport also reported a sig-
nificantly lower usage of cigarettes. There was no main
effect associating “sport”and drinking beer.Conversely,
cannabis use was significantly more frequent among
those adolescents who “never” engaged in endurance
The present study shows substantial associations be-
tween the regular practice of endurance sport and atti-
tudes, personality, scores for physical and psychological
well-being and the adoption of a healthy lifestyle. Nev-
ertheless, causality should not be inferred from a cross-
sectional survey of this type. It could be that a poor self-
image or impaired physical or psychological health is a
cause of physical inactivity rather than the converse, or
it could be that a favourable home environment gives
parental encouragement of physical activity, together
with a good self-image, physical and psychological
health and avoidance of drug usage.Proof of a causal re-
lationship will require further research using either a
sophisticated path analysis,or a trial where a proportion
of the students in randomly selected classes is per-
suaded to adopt an increased level of endurance sport.
As regards the mechanisms, it may be that the social
aspects of physical activity among adolescents are im-
portant determinants of mental and psychological
health. Vikjalmsson and Thorlindsson [17] found evi-
dence that those adolescents who were affiliated to a
sport’s club displayed lower anxiety and depression
scores compared to those pursuing individual sports.
They concluded that the social adhesive properties of
group (sport) participation may have been the key in-
gredients contributing to psychological well-being,
rather than physical activity per se.
The association between sport participation and self-
image is substantial and highly significant statistically.
In the school context, involvement in endurance activi-
Table 4 Physical ailments and participation in endurance sport. Significance of relationships is tested by discriminant analysis (see text)
Group category 1 (n = 99) 2 (n = 344) 3 (n = 268) 4 (n = 178)
Never Seldom Often Frequently F (3,885)
Mean SD Mean SD Mean SD Mean SD
Exhaustion 27.18 8.16 25.74 7.16 24.09 6.69 23.49 7.49 8.27***
Gastric complaints 14.01 4.17 14.51 4.12 13.78 3.93 13.27 4.56 3.80**
Pains in limbs 12.67 3.89 12.74 3.94 12.39 3.89 12.53 4.17 0.41
Circulatory problems 11.39 3.83 10.72 3.96 9.75 3.60 10.00 3.74 6.33***
Cold symptoms 18.36 4.83 18.88 5.00 17.59 4.59 17.23 4.56 6.56***
* p < 0.05; ** p < 0.01; *** p < 0.001
Table 5 A post-hoc comparison of scores for various ailments between specific groups, classified in terms of their participation in endurance sport (Least Significant Dif-
ference Method)
Never/seldom Never/often Never/frequently Seldom/often Seldom/frequently Often/frequently
1–2 1–3 1–4 2–3 2–4 3–4
Exhaustion n. s. 0.001*** 0.001*** 0.01** 0.001*** n. s.
Gastric complaints n. s. n. s. n. s. 0.05* 0.001*** n. s.
Pains in limbs n. s. n. s. n. s. n. s. n. s. n. s.
Circulatory problems n. s. 0.001*** 0.01** 0.01** 0.05* n. s.
Cold symptoms n. s. n. s. 0.06 0.001*** n. s. n. s.
* p < 0.05; ** p < 0.01; *** p < 0.001
Table 6 Relationships between participation in endurance sport, drinking and drug usage. Statistical analysis is as in Tables 2 and 3
Never 1 Seldom 2 Often 3 Regular 4 F 3,977 1/2 1/3 1/4 2/3 2/4 3/4
Smoke 2.95 2.95 2.88 2.56 5.37*** n. s. n. s. 0.01 n. s. 0.001 0.01
Beer 3.03 2.95 2.95 2.90 0.91 n. s. n. s. n. s. n. s. n. s. n. s.
Cannabis 2.02 1.64 1.59 1.58 6.58*** 0.001 0.001 0.001 n. s. n. s. n. s.
Note: post-hoc between group comparisons (“LSD”) are presented on the right-hand side of the table; *p < 0.05, **p < 0.01; ***p < 0.001
ties rarely leads to the adulation that a leader of a soccer
or handball team might receive from members of the op-
posite sex. If physical activity is indeed playing a posi-
tive causal role,it may act by increasing feelings of mas-
tery and self-efficacy [18]. Previous investigators have
noted a positive effect of curricular physical education
upon academic performance [19].The link with linguis-
tic competency that was observed in the present study
could also indicate an underlying “high-achiever” per-
sonality. In the adult world, some companies seek out
people who are involved in endurance sport because
they tend to be employees with an outstanding perfor-
mance on the job [20].Alternatively,being verbally more
competent may reflect superior social and communica-
tion skills which may be beneficial in social sporting ac-
There is also a strong link between participation in
endurance sport and the type of personality that is re-
sistant to addictions. Surveys of the adult population
have found a relatively weak impact of physical activity
upon smoking habits, more obvious for those involved
in endurance than in “social” sports such as tennis [21].
Some people indicate that involvement in distance run-
ning is helpful in stopping smoking, but the low per-
centage of smokers among this population also reflects
many individuals who stopped smoking before they be-
gan running [22]. Several studies suggest that individu-
als with heavy involvement in physical activity were less
likely to take up smoking than the sedentary members
of this population [23, 24, 25].
Hays [26] referred to Glasser’s [27] research distin-
guishing between positive and negative addiction. She
suggested that in contrast to negative, self-debilitating
addictions such as substance abuse, the positive addic-
tion to regular exercise such as swimming or running
may serve as a replacement or distraction from smoking
or alcohol abuse,strengthening an individual’s self-effi-
cacy and enhancing their life satisfaction.
Finally, there are strong relationships between en-
durance activity and reported scores for physical and
psychological well-being. The most significant physical
complaint of sedentary individuals is exhaustion, and
this could be either a consequence of a poor level of fit-
ness (so that they have difficulty in keeping up with their
fitter peers), or it could be the cause of the inactivity.
Given that the analysis is based upon self-reports,a final
possibility is that the more anxious members of the
group engaged in symptom-reporting to a greater extent
than did their more active peers [26, 28]. In regard to
symptoms of the common cold,there has been much in-
terest recently concerning possible effects of endurance
exercise upon immune function [28]. The current con-
sensus is that moderate participation in endurance ex-
ercise enhances the immune response, but that beyond
an individually determined critical threshold, en-
durance activity can have a deleterious effect. The
threshold for an adverse effect is generally quite high,
and is unlikely to be reached except by high perform-
ance athletes, so that a favourable effect of endurance
activity upon the prevalence of cold symptoms is to be
anticipated in ordinary school students.
Limitation of physical activity is a common manifes-
tation of depression; in this association, the psychologi-
cal disturbance may well be the primary manifestation,
and the limitation of physical activity the consequence.
Furthermore, one of the limitations of our measure of
physical health is that it does not ascertain the presence
of an actual chronic physical illness which may concei-
vably have restricted opportunities for exercising (esti-
mates suggest that 5–10% of children would fall into this
category). If such is the case, however, the associations
we reported will be attenuated (an underestimate of the
association between exercise-health).
The magnitude of effect sizes reveals that it was prob-
lems of self-perception and social adjustment (socially
avoidant temperament) and to a lesser extent the trend
to anxiety-depression and exhaustion which most dis-
tinguished adolescents who were physically inactive
from those who were (more or less) regularly in physi-
cal exercise.
As might be expected, parental attitudes and educa-
tional achievement did not appear to be associated with
proclivity towards physical activity.
The present data support the potential therapeutic
benefits of physical activity for children and adoles-
cents. In addition to enhanced physical health, Hayes
[27] has proposed that engagement in physical pursuits
or discussion of recreational or exercise involvement
may serve as a useful point of entry for facilitating dis-
cussion among adolescents about issues relating to body
image and self-esteem. In terms of psychotherapeutic
applications, physical activity has many further advan-
tages, particularly among children and adolescents. It is
likely that by enhancing physical fitness,increased phys-
ical performance,decreasing body mass and promoting
a more favourable body shape and structure, exercise
will provide more positive social feedback/recognition
from peer groups, and this in turn will improve an indi-
vidual’s self-image.The increased opportunity for social
interaction and group participation allows a challenging
of socially avoidant behavioural propensities and the
development of positive expectations. Regular involve-
ment in physical exercise reduces the risk of fatigue by
augmenting physiological functions such as maximal
oxygen transport and maximal muscle force that would
otherwise limit performance; a reduction of fatigue over
a normal day may in turn induce a positive change in
mood state. Finally, physical activity serves to distract
from depressive thoughts and self-debilitating cogni-
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... Practising PA positively impacts physical perception and increases self-efficacy, confidence and BI [8]. Other authors emphasise that perceived improvements in physical capacities play an essential role [21] as individuals with positive BI are more likely to engage in PA [22]. Fitness training interventions or programs may also improve positive BI by encouraging individuals to focus more on their functionality and less on their physical appearance [23]. ...
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Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman’s Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students’ body image through physical activity programmes, education and sex-specific individualised attention.
... Exercise adherence, or exercise persistence, is one of the efficient approaches that can significantly accentuate physical health (Janssen and Leblanc, 2010;Glowacki et al., 2017). Previous studies found that children and adolescents benefited from high exercise adherence by improving their physical and mental health, sleep quality, brain development, skeletal health, and social, psychological, and cognitive health (Brown and Lawton, 1986;Scully et al., 1998;Kirkcaldy et al., 2002;Andersen, 2006). There is ongoing research to support the importance of at least 60 min/day of moderate to vigorous physical activity for disease prevention and health promotion in children and adolescents (Ekelund et al., 2012;Poitras et al., 2016). ...
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Although the close positive relationship between well-being and exercise adherence has been confirmed by numerous studies, it is still unclear whether this relationship exists for children and adolescents, because previous research mainly focuses on adults. The present review systematically explored the relationship between well-being ranging from individual to social aspects and exercise adherence based on extant studies. Seven studies including both quantitative and qualitative studies were analyzed. The results showed that well-being was not related to exercise adherence as strongly as expected. In some cases, well-being was even negatively associated with exercise adherence. Limited sample size, insensitive measurement of exercise adherence, gender, and mental and physical condition of children and adolescents might partially influence the relationship between well-being and exercise studies. However, the studies at hand are still in their infancy. More studies on the relationship between well-being and exercise adherence are needed for children and adolescents, especially in non-western countries.
... However, in addition to the important role of fitness on the physical health of children and adolescents, an increasing number of researchers are paying attention to the effects of fitness on the psychological wellbeing of young people. Thus, research has shown that physical activity in childhood and adolescence contributes to the development of cognitive processes [28,29], of physical and personal self [30,31], socioemotional skills, prosocial behavior [27,32], self-regulation, leadership skills, and better mental health [33]. ...
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The main aim of this study is to examine age and gender differences in cardiorespiratory fitness (CRF) among Serbian secondary school children. The secondary aim is to explore the association between CRF and quality of life in Serbian adolescents. The sample consisted of 579 adolescents (285 males), aged from 14 to 18 years old. To evaluate their anthropometric measurements, body height and body weight were examined, the 20 m shuttle run test was used to access CRF, and the standardized global measure of wellbeing KIDSCREEN was used to access the wellbeing of adolescents. The results show that the boys possessed higher CRF compared to the girls, as well as higher scores on variable distance, but there were no significant differences according to age. CRF was positively associated with physical wellbeing, psychological wellbeing, total score HRQL, body height and body weight, and negatively correlated with BMI. Conversely, physical wellbeing showed positive correlation with the other subscales of KIDSCREEN (psychological wellbeing, autonomy and parents, peers and social support, and school environment), and total score of (Health–Related Quality of Life) HRQL. The results showed that better CRF would be beneficial for quality of life among Serbian adolescents, especially among girls. Moreover, the relationship between CRF and BMI shows that adolescents with regular values of BMI have better physical fitness and wellbeing.
... A greater number of adolescents who were physically active three or more times per week perceived their wellbeing as positive relative to less active or inactive adolescents. Other studies have reported that lower PA levels are significantly associated with worse mental wellbeing (Kirkcaldy et al., 2002;Brodersen et al., 2005), which is in accordance with the results of our study. Given the salutogenic approach used in our study, we focused on positive wellbeing instead of poor wellbeing; however, the pathogenic side of the phenomenon is also shown: low PA levels were associated with poor wellbeing. ...
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This study aimed to investigate self-reported physical activity levels, perceived body appearance, and body functioning in relation to perceived wellbeing among adolescents. A cross-sectional survey was performed in four upper secondary schools in one municipality in southern Sweden. Data were obtained from questionnaires completed by 1,491 adolescents (55.4% females; median age 16; range 15–17 years) during school hours. The participation rate was 71.4%. Logistic regression analyses were carried out with wellbeing as the dependent variable. The independent variables included gender, perceived family financial situation, perceived body appearance, perceived body function, and physical activity level. Perceived positive wellbeing was associated with being satisfied with their body's appearance (OR 3.4; CI 2.6–4.4) and function (OR 3.1; CI 2.2–4.2), being physically active three or more times per week (OR 1.5; CI 1.1–2.0), and a good perceived family financial situation (OR 3.3; CI 1.6–6.7). Gender was not significantly associated with wellbeing. A positive body image, which include both body appearance and body function, and high physical activity levels were significantly associated with wellbeing in adolescents, corroborating the importance of promoting physical activity among younger populations.
... Healthy lifestyles, including more aerobic exercises and home meals, were reported to be associated with better adolescent SRH, self-image and health-related quality of life. [36][37][38] Conversely, those with good SRH had the selfidentity as being healthy, which promote them to adopt better health behaviours and maintain healthy lifestyles. 28 Notably, although lifestyles and weight status in youth may have mutual effects and both are associated with socioeconomic status, 39 40 we found breakfast habits, frequency and duration of physical exercise and weight status were still associated with trends in SRH after adjustment, which Open access was consistent with previous findings. ...
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Objectives To examine the 15-year secular trends of self-rated health (SRH) and correlates in Chinese adolescents in Hong Kong. Design A territory-wide population-based panel data study. Setting Anonymised records of the annual health examination from the Student Health Service, Department of Health in Hong Kong. Participants 397 324 students in Secondary 2 (US grade 8), 335 902 in Secondary 4 and 113 892 in Secondary 6 during the academic year 1999/2000 and 2014/15. Outcome measures SRH and lifestyles were self-reported using standardised questionnaires. Sex-standardised and age-standardised prevalence of very poor/poor SRH and its secular annual changes across sex, grade, weight status, breakfast habits, and frequency/duration of aerobic exercises were examined. Their disparities over time were examined by interactions with the academic year in generalised estimating equations. Results The overall prevalence of very poor/poor SRH increased from 9.3% (95% CI: 8.9% to 9.7%) in 1999/2000 to 15.5% (15.1% to 15.8%) in 2014/15. Very poor/poor SRH was more prevalent in girls (adjusted OR: 1.02), in those having unemployed parents (1.29), being overweight (1.42) or obese (2.62), eating breakfast away from home (1.27) and skipping breakfast (1.49) or doing <1 time/week or ≤60 min/week aerobic exercises (1.78 and 1.88, respectively) than others. The corresponding disparities increased over time (ratios of OR: 1.006–1.042). Conclusions Increasing prevalence of very poor/poor SRH from 1999/2000 to 2014/15 was found among Hong Kong Chinese adolescents, which was greater in girls, adolescents being overweight/obese and those having unemployed parents or unhealthy lifestyles. Strategies to reduce health inequality should consider multiple factors, especially modifiable factors including lifestyles.
... Improving levels of self-compassion in adolescents has been observed to promote positive body image in this group [31,82]. Body image is recognized as a barrier to physical activity for adolescents [28], and individuals with higher levels of body image are more inclined to participate in physical activity than those adolescents with lower levels of body image [56]. The HWBG program had a positive impact on body image, with participants' responses averaging 4.5 out of 5 when asked whether body image lessons helped them to realize that they do not need to be perfect. ...
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Background The primary aim of this pilot study was to evaluate the feasibility and preliminary efficacy of a school-based health and well-being program (Health and Well-being for Girls: HWBG) on adolescent girls’ well-being, mindfulness, screen-time, and physical activity. Method The HWBG program was evaluated using a group randomized controlled trial (RCT) in one secondary school. A convenience sample of female students in Grade 8 (mean age 14 ± 0.5 years) was recruited for the study (n=4 classes; 89 girls). The 20-week multi-component HWBG program, guided by Self-Determination Theory and Acceptance and Commitment Therapy, was designed and delivered by a member of the research team. Randomization occurred prior to baseline assessments at the class level (n=4 classes) into dose-matched treatment conditions (i.e., two classes received the HWBG intervention and two classes received an alternate elective course as a wait-list control group). Process evaluation measures of recruitment, retention, adherence, and satisfaction were used to determine program feasibility. This study was designed to assess feasibility (primary outcome) and preliminary efficacy (secondary outcomes), rather than effectiveness. Preliminary efficacy of HWBG for improving mental and social health, screen-time, and physical activity were measured and analyzed using linear mixed-models. Results “The health and well-being program” targeting adolescent girls was found to be feasible for implementation as an elective course in a secondary school setting. Participants in the HWBG program reported high levels of satisfaction, the majority of lessons (45 out of 50), were implemented as planned and adherence to the planned HWBG program content was very high. Medium positive effects on mental health (d=0.45) and social health (d=0.50) were observed. Small effects were observed for physical activity, and no significant intervention effects were found for levels of recreational screen time. Participant ratings showed high levels of perceived benefit and enjoyment as indicated in the evaluation data (mean rating of 4.44 out of a possible 5.0) when asked whether the program was enjoyable. Conclusion The study provides preliminary support for HWBG as a potentially feasible and enjoyable program suitable for use with adolescent girls in the secondary school setting. Potential of the study for facilitating improvements in pro-social and psychological well-being is also supported. Trial registration ACTRN12617000157370. The trial was registered with the Australian New Zealand Clinical Trials Registry.
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Mbo-studenten komen (net als ieder ander) onherroepelijk in aanraking met vraagstukken gerelateerd aan hun persoonlijke gezondheid. Daarnaast is het stimuleren van gezondheid en een actieve leefstijl soms onderdeel van de professie waarvoor de student wordt opgeleid, zoals in de sectoren onderwijs, (gezondheid)zorg, welzijn en sport. Het practoraat Gezondheid, Sport en Bewegen van Landstede MBO heeft allereerst als doel om gezondheid en een actieve leefstijl te stimuleren bij mboprofessionals (in opleiding) gerelateerd aan hun (toekomstig(e)) gezondheid en welzijn. Het onderzoek van dit practoraat is gethematiseerd langs drie onderzoeklijnen: 1. Sport en bewegen als belangrijke pijler voor gezondheid. 2. Technologie in relatie tot gezondheid, sport en bewegen. 3. De toerusting van de (toekomstige) mbo-professional.
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Research supports that people of color in the U.S. have poorer outcomes after burn injury compared to White individuals. The current study sought to explore burn health disparities by testing the relationship between racial and ethnic minority status, a proxy for systemic discrimination due to race and ethnicity, with two key constructs linked to functional outcomes, satisfaction with appearance and social community integration. Participants included 1,318 burn survivors from the Burn Model System National Database (mean age = 40.2, SD = 12.7). Participants completed measures of satisfaction with appearance and social community integration at baseline, 6-, 12-, and 24-months post burn injury. Linear regressions revealed that racial and ethnic minority status significantly related to lower satisfaction with appearance and social community integration compared to White individuals at all time points. In addition, satisfaction with appearance continued to significantly relate to greater social community integration even while controlling for race and ethnicity, age, sex, burn size, and physical disability at 6-, 12-, and 24-month time points. Overall, the study supports that racial and ethnic minority burn survivors report greater dissatisfaction with their appearance and lower social community reintegration after burn injury.
Presents an integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment. This theory states that psychological procedures, whatever their form, alter the level and strength of self-efficacy. It is hypothesized that expectations of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experiences. Persistence in activities that are subjectively threatening but in fact relatively safe produces, through experiences of mastery, further enhancement of self-efficacy and corresponding reductions in defensive behavior. In the proposed model, expectations of personal efficacy are derived from 4 principal sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological states. Factors influencing the cognitive processing of efficacy information arise from enactive, vicarious, exhortative, and emotive sources. The differential power of diverse therapeutic procedures is analyzed in terms of the postulated cognitive mechanism of operation. Findings are reported from microanalyses of enactive, vicarious, and emotive modes of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes. (21/2 p ref)
This study examined the interrelationships among perceived physical competence, motor competence, and participation in organized sport in young children. Males and females in Grades K through 4 (n = 250) were given The Perceived Competence Scale for Children (Harter, 1979) or The Pictoral Scale for Perceived Competence and Social Acceptance for Young Children (Harter, Pike, Efron, Chao, & Bierer, 1983), a 9-item motor competence assessment battery, and a questionnaire regarding their participation in sport. Results revealed that perceived physical competence for children in these grade levels was not significantly related to their participation in organized sport programs. Motor competence was significantly related to participation in that participants in organized sport programs performed selected gross motor tasks better than did nonparticipants. Further, children's reported perceptions of physical competence were significantly related to their demonstrated motor competence. Discussion focused on the theoretical and practical implications of the results.
The purpose of this project was to undertake a long-term follow-up of participants in the Trois-Rivieres Growth and Development Study. Some 20 years after their initial involvement in the program, two groups were compared: experimental subjects (n = 150) who had received 5 one-hour sessions of specialized physical education per week throughout their 6 years of primary school, and the original control group (n = 103). All subjects completed a questionnaire regarding current patterns of physical activity (PA), attitudes and beliefs about PA, and perceived barriers to PA. Principal results indicate: (a) More experimental than control women exercise 3 times or more per week, (b) experimental subjects more commonly perceived their health to be very good to excellent, (c) control subjects in general felt less psychological dependency on exercise, and (d) women in the experimental group had a lower relative risk of back problems.
Advocates of quality daily physical education for prepubescent children frequently encounter the argument that such initiatives will harm academic progress. The impact of daily physical education upon the academic performance of primary school students is thus reviewed with particular reference to studies conducted in Vanves (France), Australia, and Trois Rivières (Québec). When a substantial proportion of curricular time (14-26%) is allocated to physical activity, learning seems to proceed more rapidly per unit of classroom time, so that academic performance matches, and may even exceed, that of control students. Children receiving additional physical education show an acceleration of their psychomotor development, and this could provide a mechanism for accelerated learning of academic skills. Other potential mechanisms include increased cerebral blood flow, greater arousal, changes in hormone levels, enhanced nutrient intake, changes in body build, and increased self esteem. Academic teachers may also favor the enhanced physical education program, creating "halo" effects, and the resulting release time may enhance their academic teaching. Irrespective of mechanisms, the implication for public policy is that daily required physical education can be introduced when a child enters primary school without compromising academic development. Given the importance of establishing positive health habits from an early age, school boards should be encouraged to follow a policy of required daily physical activity in primary schools. Evidence of specific benefit in students with learning disabilities remains less convincing.
The Giessen Subjective Complaints List for Children (GSCL-C), a questionnaire on physical complaints in self-image form, was developed out of the adult GSCL. The questionnaire contains items from the areas; general wellbeing, vegetative complaints, pains, emotionality and children's complaints. The subjects is asked to estimate the degree of distress caused by each complaint (never/rarely/sometimes/often/always). Factor analysis based on a sample of 1047 schoolchildren aged 9 to 15 revealed five complaint complexes containing seven items each, which were subsequently grouped into the following scales: (1) Exhaustion, (2) Gastric Complaints, (3) Pains in Limbs, (4) Circulatory Problems, (5) Cold Symptoms. The sum of the five scales makes up the sixth scale score, overall distress. Besides describing the development of the instrument and its scales, sex- and age-related norms are given and the assessment criteria explained. Procedure and areas of application are also discussed
This book is intended to inspire mental health professionals to bring to their work a clearer understanding of, interest in, and enthusiasm for exercise in the process of recovery from mental or emotional problems. It blends theory, research, and practice experience. The primary theme directs psychotherapists toward the value of exercise in the treatment of most psychiatric conditions. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Explores the impact of exercise on psychological well-being. Issues discussed include problems associated with the evaluation of the benefits of exercise, advantages of exercise therapy over alternative therapeutic forms, and specificity of responses to exercise (e.g., elevated arousal, secretion of mood-altering chemicals, self-efficacy, body image, fatigue and mood state). Also considered are the interindividual differences in susceptibility (e.g., personality and life-styles, nature and extent of mood disturbances), and the benefits vs risks of exercise therapy. Evidence suggests that regular physical activity is of benefit to both physical and psychological health. (French, Spanish, German & Italian abstracts) (PsycINFO Database Record (c) 2012 APA, all rights reserved)