Content uploaded by Georg Siefen
Author content
All content in this area was uploaded by Georg Siefen on Apr 17, 2014
Content may be subject to copyright.
Soc Psychiatry Psychiatr Epidemiol (2002) 37:544–550 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-
age.
■ Key words adolescence – physical activity – self-im-
age – physical health – psychological well-being – social
problems – anxiety-depression
Introduction
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,
ORIGINAL PAPER
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
E-Mail: Bruce.Kirkcaldy@t-online.de
R. J. Shephard, MD
Faculty of Physical Education and Health
and
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
545
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 “celebrity”position 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-
lescence.
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
sedentary;
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
th
and
10
th
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-
diction.
546
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
adolescent’s 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; Achenbach’s 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].
Results
■ 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
n%
Gender
Male 477 48.3%
Female 511 51.7%
Age
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%
547
For subsequent analyses, the figures vary depending
on the number of respondents to a particular groups of
questions.
■ 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-
plaints.
■ 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
<0.001***).
Table 2 Relationships between participation in endurance sport, self-image and problem behaviour. Significance of relationships is tested by discriminant analysis (see
text)
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
Attitudes
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*
Personality
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
548
■ 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
sports.
Conclusions
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
MM MM
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
549
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-
tivities.
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-
tions.
550
References
1. Kirkcaldy BD,Shephard RJ (1990) Therapeutic aspects of leisure
and sport. Special Edited Issue, International Journal of Sport
Psychology 21 (3): 165–184
2. Bluechardt MH, Wiener J, Shephard RJ (1995) Exercise pro-
grammes in the treatment of children with learning disabilities.
Sports Medicine 19: 55–72
3. Teasdale TW, Sorensen TIA,Stunkard AJ (1992) Intelligence and
educational level in relation to body mass index of adult males.
Human Biology 64: 99–106
4. Shephard RJ, Lavallée H, Larivière G (1978) Competitive selec-
tion among age-class ice-hockey players. British Journal of
Sports Medicine 12: 11–13
5. Ulrich BD (1987) Perceptions of physical competence, motor
competence,and participation in organized sport: their interre-
lationships in young children. Research Quarterly 58: 57–67
6. Field T (2001) Exercise is positively related to adolescent’s rela-
tionship and academics.Adolescence, Spring
7. Murphy TJ,Pagano RR,Marlatt GA (1986) Lifestyle modification
with heavy alcohol drinkers: effects of aerobic exercise and med-
itation.Addictive Behaviors 11: 175–186
8. Argyle M (1996) The Social Psychology of Leisure.Penguin,Lon-
don
9. US Surgeon General (2001) Physical activity and health.Chap.5.
Patterns and trends in physical activity. US Health,Washington
10. Brähler E, Scheer J (1983) Der Giessener Beschwerdebogen
(GBB) – Testhandbuch. Huber, Bern, Stuttgart and Vienna
11. Prehler M,Kupfer J,Brähler E (1992) Der Giessener Beschwerde-
bogen für Kinder und Jugendliche (GBB-KJ). Psychsom Med
Psychol 42: 71–77
12. Gossop MR,Eysenck SBG (1980) A further investigation into the
personality of drug addicts in treatment. British Journal of Ad-
diction 75: 305–311
13. Eysenck HJ,Eysenck SBG (1991) Manual of the Eysenck Person-
ality Scales. Hodder and Stoughton, London
14. Achenbach TM (1991) Deutsche Child Behaviour Checklist.
KJFD (Arbeitsgruppe Kinder-, Jugendlichen- und Familiendia-
gnostik), Cologne
15. Kirkcaldy BD, Siefen G,Surall D,Bischoff RJ (2002) Predictors of
drug and alcohol abuse among children and adolescents. Per-
sonality and individual differences (revised)
16. Kroll W, Crenshaw W (1968) Multivariate personality profile
analysis of four athletic groups. In: Kenyon GS (ed) Proceedings
of the Second International Congress of Sport Psychology. Ath-
letic Institute, Chicago
17. Vijhalmsson R,Thorlindsson T (1992) The integrative and phys-
iological effects of sport participation: a study of adolescents.
Sociol Quart 33: 637–647
18. Bandura A (1997) Self-efficacy: toward a unifying theory for be-
havioural change. Psychol Rev 84: 191–215
19. Shephard RJ (1997) Curricular physical activity and academic
performance. Pediatr Exerc Sci 9: 113–126
20. Baun WB, Bernacki EJ, Tsai SP (1986) A preliminary investiga-
tion of the effect of a corporate fitness program on absenteeism
and health care cost.Journal of Occupational Medicine 28:18–22
21. Norwegian Confederation of Sport (1983) Physical activity in
Norway. Norwegian Confederation of Sport, Oslo
22. Shephard RJ, Kavanagh T, Mertens DJ (1995) Personal health
benefits of athletic competition. British Journal of Sports Medi-
cine 29: 35–40
23. Twisk J, Kemper HCG, Snel J (1995) Tracking of cardiovascular
risk factors in relation to lifestyle. In: Kemper HCG (ed) The
Amsterdam Growth Study. Human Kinetics, Champaign, IL,
pp. 203–224
24. Trudeau F,Laurencelle L,Tremblay J,Rajic M,Shephard RJ (1998)
A long-term follow-up of participants in the Trois Rivières semi-
longitudinal study of growth and development.Pediatr Exerc Sci
10: 366–377
25. Kirkcaldy BD, Cooper CL,Brown J,Athanasou J (1994) Job stress
and health profiles of smokers, ex-smokers and non-smokers.
Stress Medicine 10 (3): 159–166
26. Hays K (1999) Working it out. Using exercise in psychotherapy.
American Psychological Asociation,Washington DC
27. Glasser W (1976) Positive addiction. Harper and Row, New York
28. Pennebacker J (1992) Stress in words: health,linguistic and ther-
apeutic applications.APA Paper,Washington DC
