Körperliche Aktivität in der Prävention und Behandlung von Angsterkrankungen

The relationship between nighttime exercise and problematic smartphone use before sleep and associated health issues: a cross-sectional study

OBJECTIVE

Physical exercise has the potential to mitigate addictive behaviors and relevant health issues. However, the nighttime exercise has not been studied regarding this research topic. This study aims to explore the association between nocturnal physical exercise and problematic smartphone use before sleep, as well as related health issues.

METHODS

To explore the association between nighttime physical exercise and problematic smartphone use before sleep as well as related health issues, we conducted a cross-sectional survey among 1,334 college students. Their daily exercise behaviors (including timeframe, rationale, frequency, and duration), smartphone use before sleep, sleep quality, smartphone addiction, anxiety, and depression were measured by questionnaires. The associations were assessed using generalized linear models.

RESULTS

Our findings indicate that nearly 70% of participants chose to perform exercise at nighttime. Among these individuals who exercised at nighttime, the frequency and duration of nighttime exercise were significantly associated with decreased probabilities of smartphone use before sleep. Additionally, the frequency and duration of nighttime exercise were associated with lower levels of smartphone addiction and anxiety disorders.

CONCLUSION

Nighttime Exercise behaviors can effectively reduce sleep delays caused by problematic smartphone use before bedtime. These findings contribute to understanding the potential effects of nighttime exercise on problematic smartphone use and relevant health issues. Future research should employ more precise methodologies to examine these associations.

Exercise as Treatment for "Stress-Related" Mental Disorders

The beneficial impact of physical activity on preventing and treating mental disorders has captured growing (research) interest. This article aims to provide a concise overview of essential evidence regarding the effectiveness and underlying mechanisms of physical activity for individuals with mental disorders clustered as "stress-related" conditions. Empirical findings (e.g., longitudinalprospective studies, interventional randomized-controlled-trials, reviews, meta-analyses) regarding the effects of physical activity in the prevention and treatment of stress-related mental disorders are summarized. Furthermore, potential mechanisms underlying these effects are discussed, and recommendations regarding the use of physical activity are outlined. The majority of studies indicate good efficacy of physical activity in prospectively lowering the risk for the incidence of subsequent stress-related mental disorders as well as in the treatment of manifest disorders. Most evidence targets unipolar depressive disorder and, secondly, anxiety disorders. Research regarding posttraumatic stress disorder, obsessive-compulsive disorders, and somatoform disorders is promising but scarce. Physical activity seems to be useful as a stand-alone-treatment as well as in combination with other psychotherapeutic or pharmacological treatments. Multiple intertwined physiological, psychological, and social mechanisms are assumed to mediate the beneficial effects. Recommendations regarding physical activity can orientate on official guidelines but should consider the individual needs and circumstances of each subject. In summary, physical activity seems to be effective in the prevention and treatment of stressrelated mental disorders and, therefore, should be fostered in healthcare-settings. Future studies are needed to clarify partly inconsistent patterns of results and to close research gaps, e.g., concerning somatoform disorders.

Exposure traced in daily life: improvements in ecologically assessed social and physical activity following exposure-based psychotherapy for anxiety disorders

BACKGROUND

Although exposure-based cognitive-behavioral therapy for anxiety disorders has frequently been proven effective, only few studies examined whether it improves everyday behavioral outcomes such as social and physical activity.

METHODS

126 participants (85 patients with panic disorder, agoraphobia, social anxiety disorder, or specific phobias, and 41 controls without mental disorders) completed smartphone-based ambulatory ratings (activities, social interactions, mood, physical symptoms) and motion sensor-based indices of physical activity (steps, time spent moving, metabolic activity) at baseline, during, and after exposure-based treatment.

RESULTS

Prior to treatment, patients showed reduced mood and physical activity relative to healthy controls. Over the course of therapy, mood ratings, interactions with strangers and indices of physical activity improved, while reported physical symptoms decreased. Overall results did not differ between patients with primary panic disorder/agoraphobia and social anxiety disorder. Higher depression scores at baseline were associated with larger changes in reported symptoms and mood ratings, but smaller changes in physical activity CONCLUSIONS: Exposure-based treatment initiates increased physical activity, more frequent interaction with strangers, and improvements in everyday mood. The current approach provides objective and fine-graded process and outcome measures that may help to further improve treatments and possibly reduce relapse.

Effect of Latin dance on physical and mental health: a systematic review

BACKGROUND

Latin dance is a well-liked physical activity. It has gained increasing attention as an exercise intervention for improving physical and mental health outcomes. This systematic review examines the effects of Latin dance on physical and mental health.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used to report the data for this review. To gather research from the literature, we used recognized academic and scientific databases such SportsDiscus with Full Text, PsycINFO, Cochrane, Scopus, PubMed, and Web of Science. The systematic review only included 22 studies out of the 1,463 that matched all inclusion criteria. The PEDro scale was used to rate each study's quality. 22 research received scores between 3 and 7.

RESULTS

Latin dance has been demonstrated to promote physical health by helping people lose weight, improve cardiovascular health, increase muscle strength and tone, and improve flexibility and balance. Furthermore, Latin dance can benefit mental health by reducing stress, improving mood, social connection, and cognitive function.

CONCLUSIONS

Finding from this systematic review provide substantial evidence that Latin dance has effect on physical and mental health. Latin dance has the potential to be a powerful and pleasurable public health intervention.

SYSTEMATIC REVIEW REGISTRATION

CRD42023387851, https://www.crd.york.ac.uk/prospero .

Aktiv und zufrieden? Körperliche Aktivität und berufsbezogene Lebensqualität bei Psycholog:innen

Hintergrund

Klinisch tätige Psycholog:innen sind in ihrer Arbeit mit Menschen mit psychischen Erkrankungen oft zahlreichen Stressoren ausgesetzt; diese können sich in psychischer Belastung und einer verringerten Lebensqualität niederschlagen. Körperliche Aktivität könnte eine protektive Ressource darstellen, diesbezüglich fehlen jedoch bisher empirische Befunde.

Methoden

Im Rahmen einer querschnittlichen Online-Befragung über SoSci-Survey (Januar bis April 2020) wurden die körperliche Aktivität und die berufsbezogene Lebensqualität (positive Dimension: Mitgefühlszufriedenheit; negative Dimension: Mitgefühlsmüdigkeit) einer Gelegenheitsstichprobe aus 443 klinisch tätigen Psycholog:innen mithilfe etablierter Selbstberichtfragebogen (International Physical Activity Questionnaire – Short Form [IPAQ-SF], Professional Quality of Life Scale [ProQOL]) erfasst.

Ergebnisse

Der Großteil der befragten Psycholog:innen erfüllte das von der Weltgesundheitsorganisation empfohlene Mindestmaß an körperlicher Aktivität. Die Mitgefühlszufriedenheit war im Schnitt relativ hoch, während eher geringe bis moderate Ausprägungen an Burn-out-Symptomatik sowie sekundärem traumatischem Stress (Facetten der Mitgefühlsmüdigkeit) berichtet wurden. Außer vereinzelten kleinen negativen Korrelationen zwischen körperlicher Inaktivität und Mitgefühlszufriedenheit bei Psycholog:innen in Weiterbildung sowie Burn-out-Symptomen und körperlicher Gesamtaktivität bei Psychologischen Psychotherapeut:innen waren keine Zusammenhänge zwischen körperlicher Aktivität und berufsbezogener Lebensqualität ersichtlich.

Schlussfolgerungen

Psycholog:innen scheinen zu großen Teilen eine körperlich aktive und tendenziell zufriedene Berufsgruppe darzustellen. Zusammenhänge zwischen körperlicher Aktivität und Lebensqualität könnten teilweise durch Deckeneffekte verdeckt sein. Des Weiteren könnte eine Analyse der Ursachen für diese adaptiven Ausprägungen in Aktivität und Lebensqualität Anhaltspunkte für Maßnahmen zur Förderung anderer Professionen liefern.

Motivational Climate, Anxiety and Physical Self-Concept in Trainee Physical Education Teachers-An Explanatory Model Regarding Physical Activity Practice Time

There is an increase in sedentary lifestyles among young people. However, the development of a certain motivational climate can play a key role in the prevention of such lifestyles. Taking into account the aforementioned, the present research aims to establish the relationship between the motivational climate towards sport, anxiety and physical self-concept and to identify and clarify the existing relationships between anxiety, motivational climate and physical self-concept, by breaking down this objective into (a) developing an explanatory model of the motivational climate towards sport and its relationship with anxiety and physical self-concept and (b) contrasting the structural model by means of a multi-group analysis, according to the time spent doing physical activity per week. For this purpose, a cross-sectional descriptive and comparative study was carried out with a total of 568 university students (M = 25.09; SD = 6.22). A sociodemographic questionnaire, the Spanish version of the Perceived Motivation Climate Questionnaire in Sport, the Self-Concept Form-5 and the Beck Anxiety Inventory were used for data collection. The results show that more time spent doing physical activity brings benefits in terms of physical self-concept and homework climate, helping to reduce anxiety levels. As conclusions, it is observed that a longer time spent doing physical activity brings benefits in the channelling of disruptive states and improvements in physical self-concept.

[Sports psychiatry and psychotherapy]

Sports psychiatry and psychotherapy is a relatively young field and is comprised of two key segments: the special features of the diagnostics and therapy of mental disorders in elite athletes and the use of exercise and sports in the development and treatment of mental disorders. Although all mental disorders can in principle also occur in (elite) athletes, there are additionally sport-specific mental disorders, such as anorexia athletica and other eating disorders, chronic traumatic encephalopathy, misuse of and dependency on performance-enhancing substances (doping) and muscle dysmorphia. Many high-quality clinical trials over the past two decades have been able to demonstrate a therapeutic efficacy of physical activity and sport in the treatment of various mental disorders. All clinicians active in psychiatry and psychotherapy should possess a basic knowledge of sports psychiatry.

[Anxiety Disorders in Rehabilitation]

Anxiety disorders are among the most common and socio-medically relevant mental illnesses. Correct diagnosis and initiation of appropriate therapy are of the utmost importance for patients' prognosis and for ensuring their social and occupational participation. This article therefore aims to provide an overview of new developments in the field of anxiety disorders relevant to rehabilitation.Within the framework of the changes in ICD-11, anxiety disorders now receive an independent chapter with a focus appropriate to their frequency and relevance. Further innovations concern the revised S3 guideline (2020) with the increasing consideration of digital therapy options, such as virtual reality exposure therapy (VER) as well as Internet-supported therapy methods as part of the therapy recommendations. Systemic therapy is also considered for the first time. However, the evidence for both procedures is significantly lower than for behavioral therapy, psychodynamic therapy, or pharmacotherapy. Online interventions are therefore not recommended as the sole therapy.Important for the practice in rehabilitation is the knowledge of the core symptoms of each of the above mentioned diagnoses as well as the diagnostic possibilities taking into account especially the correlations and interactions with physical diseases.Both psychotherapy and psychopharmacotherapy are available for treatment. In the field of psychotherapy, cognitive behavioral therapy (CBT) is the therapy of first choice due to the broadest base of evidence. In consideration of comorbid somatic diseases, attention must be paid to possible contraindications for antidepressants. Psychosomatic rehabilitation is an important resource in the overall treatment spectrum, especially if chronification or a threat to participation is foreseeable, in order to give the affected person confidence and motivation for further successful treatment of the anxiety disorder in an intensified treatment setting, in addition to teaching anxiety management strategies and socio-medical clarification. An important task of somatic rehabilitation is to recognize comorbid anxiety disorders and to provide the affected persons with an appropriate explanatory model of their complaints and to be able to initiate targeted treatment.

Emotional Reactions and Adaptation to COVID-19 Lockdown (or Confinement) by Spanish Competitive Athletes: Some Lesson for the Future

The Coronavirus Covid 19 (SARS-CoV-2) pandemic has produced terrible effects in the world economy and is shaking social and political stability around the world. The world of sport has obviously been severely affected by the pandemic, as authorities progressively canceled all level of competitions, including the 2020 Olympic Games in Tokyo. In Spain, the initial government-lockdown closed the Sports High-performance Centers, and many other sports facilities. In order to support athlete's health and performance at crises like these, an online questionnaire named RECOVID-19, was designed to assess how athletes were living their lives during such periods of home confinement. The main purpose of the questionnaire was to assess the impact of prolongued confinement on athlete's psychological, emotional, and behavioral performance. One thousand, two hundred forty-eight athletes participated in the survey. They had the fllowing characteristics: (Mean age = 22.31 ± 11.49, Female: 53%), who compete at National (N: 1017, Mean age = 21.58 ± 11.42, Female: 52%) and International level (N: 231, Mean age = 25.56 ± 11.22, Female: 57%). Results showed that during the confinement period, those athletes who lacked motivation reported a higher level of stressful thoughts, more behavioral problems, and greater emotional upheaval (anger, fatigue, tension, and depression). However, those athletes who accepted confinement measures as necessary, and were in favor of respecting the rules of social isolation, fostered positive emotional states such as feelings of friendship. In addition, the availability of some sport equipment together with the ability to continue some training, were (1) protective factors against emotional stress, lack of motivation and behavioral problems; and (2) they were associated with greater respect for, and adherence to, confinement rules. Gender differences, tested by multigroup analysis, revealed that coping activities were more often associated to negative emotional states among women, whereas the ongoing availability of training information and future conditions were equally protective factors for both genders. This study also showed that receiving coaching, support and completing frequent training routines seem to be valuable tools to prevent or reduce some of the harmful effects of isolation on athlete's emotional well-being. The conclusions derived from this research would possibly help sport authorities to design supporting policies and plans to support athletes and trainers in future disruptive health crises.

Physical Activity Supporting Connection to Nature, and Helping to Maintain Wellbeing during the Covid-19 Restrictions in England

The Covid-19 pandemic and the restrictions put in place to prevent or reduce the spread of the disease led to anxiety, concern and stress for many people. In England restrictions varied at different times of the year, and throughout this time there was a lot of attention focused on the importance of exercise and on engaging with nature to maintain wellbeing. We undertook an online survey that ran for six weeks in June/July 2020 and gained a response from 2115 people, of which 25% were male and 74% female, with 35% aged 16-44 and 65% aged 45+. This survey focused on people who were already interested or engaged with nature. We explored whether being physically activity changed or not, if being active impacted people's wellbeing and whether those who were active benefited from connecting to nature. We found that those meeting the government recommended levels of physical activity in the previous week, of 150 min, were more likely to maintain their overall wellbeing through feeling that the things they did in their life were worthwhile (p < 0.0001) and reported an increase in feelings of connection to nature (p < 0.0001). While those who did less than 30 min of physical activity in the previous week were less happy (p < 0.0001) and more anxious than usual (p < 0.0001). The research highlights the importance of physical activity and contact with nature and how these can play important roles in maintaining people's everyday wellbeing under extremely difficult national circumstances.

Mental Health in Health Professionals in the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has posed enormous challenges to the healthcare systems worldwide, which are mainly shouldered by healthcare workers from all professions. This chapter outlines the potential stressors of the COVID-19 pandemic for health professionals and describes possible consequences for their mental health as well as potential interventions and coping strategies. The chapter is based on preliminary research on the psychosocial implications of the COVID-19 pandemic in health professionals and is complemented by findings from previous outbreaks of high-risk infectious diseases. High proportions of healthcare workers report acute symptoms of anxiety, depression, high psychological stress, and insomnia in the context of the COVID-19 pandemic. Coping strategies and self-care on an individual level, interventions on an institutional level such as specific training and institutional support, as well as social and psychological support can help to mitigate psychological strain. Further reliable and prospective studies regarding the mental health of health professionals, as well as further measures to protect their short- and long-term mental health, are required.

Therapeuteneffekte bei der ambulanten Behandlung sozialer Ängste

Hintergrund

Die Studie untersuchte Therapeuteneffekte bei der Psychotherapie der sozialen Angststörung unter Verwendung von 3 methodischen Ansätzen: 1. Varianzen zufälliger Effekte, 2. Effekte soziodemografischer Variablen und 3. eine Disaggregation von therapeutischer Beziehung und nonverbaler Synchronisation in einen „Between“- und einen „Within“-Anteil der Therapeutenvarianz sowie deren Vorhersage des Outcome.

Material und Methoden

Die Patienten wurden mit manualisierter supportiver-expressiver Therapie (n = 54), manualisierter kognitiver Verhaltenstherapie (n = 102) oder naturalistischer kognitiver Verhaltenstherapie (n = 111) behandelt (insgesamt n = 267). Es wurden Patientenbeurteilungen interpersonaler Probleme (Inventar zur Erfassung interpersonaler Probleme, IIP-32), von Depressionssymptomen (Beck-Depressions-Inventar, BDI) und der therapeutischen Beziehung (Helping Alliance Questionnaire, HAQ) erfasst. Die nonverbale Synchronisation wurde mithilfe der Motion Energy Analysis und zeitreihenanalytischer Verfahren quantifiziert. Die Zusammenhangsanalysen erfolgten mit Mehrebenenmodellen.

Ergebnisse

Alter und Geschlecht des Therapeuten waren nicht prädiktiv für die zum Therapieende gemessenen IIP-32- und BDI-Werte. Therapeuteneffekte in Form zufälliger Effekte (Intra-Klassen-Korrelation [ICC] = 23,4 % bzw. 30,1 %) erklärten ein Vielfaches mehr an Outcome-Varianz als das Therapieverfahren (ICC = 6 % bzw. ICC = 1,6 %). Bei der nonverbalen Synchronisation waren Between-therapist- und Within-therapist-Anteil mit der Reduktion des IIP-32 assoziiert. Der Between-therapist-Anteil des HAQ sagte eine Reduktion des BDI vorher.

Schlussfolgerung

Bei der Behandlung sozialer Ängste sind Therapeuteneffekte bedeutsamer als das Therapieverfahren. Desgleichen waren die Therapeutenanteile bei den prozessrelevanten Variablen therapeutische Beziehung und nonverbale Synchronisation bedeutsamer als die patienten- bzw. dyadenspezifischen Anteile.

The Effect of COVID-19 Confinement in Behavioral, Psychological, and Training Patterns of Chess Players

The outbreak of COVID-19 has triggered a pandemic, jeopardizing global health. The sports world is also suffering enormous consequences, such as the suspension of the Olympic Games in Tokyo or, in chess, the cancelation of the World Candidates Tournament 2020. Chess is a sport characterized by high psychophysiological demands derived from long training durations, tournaments, and games, leading to mental, emotional, and physical stress. These characteristics could provide chess players a certain advantage in facing quarantine situations. This study aimed to analyze the effect of COVID-19 confinement on behavioral, psychological, and training patterns of chess players based on their gender, level of education, and level of chess played. We analyzed chess players (N: 450; age = 38.12 ± 14.01 years) in countries where confinement was mandatory: Professional players (N: 55; age = 43.35 ± 13), high-performance players (N: 53; age = 38.57 ± 13.46), competitive players (N: 284; age = 36.82 ± 13.91), and amateur players (N: 58; age = 39.10 ± 14.99). Results showed that chess players significantly decreased physical activity per day while increased chess practise during the confinement period. However, anxiety levels remained moderate despite the anti-stress effects of physical activity. Amateur players showed a significantly higher level of social alarm than professional and high-performance players. Moreover, professional players showed higher values of extraversion than high-performance players and amateur players. In neuroticism, professional players showed higher values than high-performance players. In addition, the professional players showed higher scores in psychological inflexibility than competitive players. Finally, chess players with the highest academic level showed higher levels of personal concern and anxiety due to COVID-19 as well as lower psychological inflexibility compared to those with a lower academic level. In conclusion, chess players, especially those with a higher academic level, might have adapted their psychological profile to fit confinement situations and the worrying levels of physical inactivity.

Ärztliche Vorbildfunktion bezüglich körperlicher Aktivität für Patienten mit psychischen Erkrankungen

Hintergrund

Körperliche Aktivität spielt eine bedeutende Rolle bei der Behandlung psychischer Störungen. Psychiatern/ärztlichen Psychotherapeuten kommt eine Schlüsselrolle dabei zu, ihren Patienten körperliche Aktivität zu empfehlen. Zum Empfehlungsverhalten dieses Kollektivs liegen bisher keine Untersuchungen vor.

Ziele der Arbeit

Das Empfehlungsverhalten in Bezug auf körperliche Aktivität sowie verhaltensbezogene und motivationale Korrelate, die das Empfehlungsverhalten potenziell beeinflussen, bei deutschen Psychiatern/ärztlichen Psychotherapeuten sollte untersucht werden.

Material und Methoden

Insgesamt beantworteten 151 deutsche Psychiater/ärztliche Psychotherapeuten (Alter: M = 32,5 Jahre; Geschlecht: 47,0 % weiblich) einen Onlinefragebogen bezüglich körperlicher Aktivität. Dabei wurden das Empfehlungsverhalten körperlicher Aktivität, die Einstellung, das eigene Aktivitätsverhalten und die Selbstkonkordanz eigener Motivation, körperlich aktiv zu sein, erfasst.

Ergebnisse

Die meisten Psychiater/ärztliche Psychotherapeuten gaben an, körperliche Aktivität einigen (54,5 %, n = 82) oder all ihren Patienten zu empfehlen (33,8 %, n = 51). Das Empfehlungsverhalten korrelierte signifikant positiv mit der Selbstkonkordanz der Motivation (r = 0,19) sowie mit der Einstellung zur Bedeutsamkeit körperlicher Aktivität (r = 0,16). Hingegen bestand keine signifikante Korrelation zwischen dem eignen Aktivitätsniveau und dem Empfehlungsverhalten der Psychiater/ärztlichen Psychotherapeuten (r = 0,04).

Schlussfolgerung

Ein Großteil der Psychiater/ärztlichen Psychotherapeuten empfiehlt körperliche Aktivität. Positiv auf das Empfehlungsverhalten wirkten sich insbesondere die Einschätzung der körperlichen Aktivität als bedeutsam sowie eine hohe Selbstkonkordanz der eigenen Motivation, körperlich aktiv zu sein, aus. Interventionsprogramme, die das Empfehlungsverhalten von Psychiatern/ärztlichen Psychotherapeuten steigern wollen, sollten auf die Selbstkonkordanz der Motivation der Psychiater/ärztlichen Psychotherapeuten, körperlich aktiv zu sein, fokussieren und sich nicht nur auf die Bedeutsamkeit körperlicher Aktivität konzentrieren.