Effects of temporary withdrawal from regular running

Mediating Roles of Psychological Distress, Insomnia, and Body Image Concerns in the Association Between Exercise Addiction and Eating Disorders

Purpose

Exercising can promote good health. However, excessive exercising may have downsides. This study examined the association between exercise addiction and eating disorders and whether the identified association was mediated by psychological distress, insomnia (including sleep quality), and body image concern.

Methods

A total of 2088 adolescents (mean age of 15.3 years) participated in this cross-sectional study by questions assessing exercise addiction, eating disorders, psychological distress, insomnia, sleep quality, and body image concern.

Results

There were significantly positive relationships between the variables (r=0.12-0.54, p<0.01) with effect sizes from small to large. The four potential mediators (ie, insomnia, sleep quality, psychological distress, and body image concern), individually and in total, significantly mediated the association between exercise addiction and eating disorders.

Conclusion

The findings suggest that exercise addiction in adolescents may influence eating disorders through multiple pathways, such as insomnia, psychological distress, and body image concerns. Future research should examine these relationships longitudinally and use gathered information to inform intervention development. Clinicians and healthcare workers are encouraged to assess exercise addiction when treating individuals with eating disorders.

The acute, systemic effects of aerobic exercise in recently concussed adolescent student-athletes: preliminary findings

OBJECTIVES

Examine the acute effects (pre-, during, post-intervention) of two different intensities of aerobic exercise or rest on autonomic, oculomotor, and vestibular function and symptom burden in patients with a recent sport-related concussion (SRC) and compare their responses to sex-matched, age-stratified, non-concussed (HEALTHY) student-athletes.

METHODS

Student-athletes between the ages of 13 and 18 that presented to the sports medicine clinic within Day 3-7 post-SRC and from local schools were recruited for a randomized controlled trial (RCT). The participants were administered the Vestibular/Ocular Motor Screening (VOMS), King-Devick (K-D), and Post-Concussion Symptom Scale (PCSS) before and after the intervention. Heart rate variability (HRV) and mean arterial pressure (MAP) were collected before, during, and after the intervention. The intervention was either a single, 20-min session of treadmill walking at 40% (40HR) or 60% of age-predicted max heart rate (60HR), or seated, rest (NOEX).

RESULTS

30 participants completed the intervention with the SRC group treated 4.5 ± 1.3 days post-injury. Pre-exercise HRV and MAP were significantly different (p's < 0.001) during treatment but returned to pre-exercise values within 5 min of recovery in both the SRC and HEALTHY groups. Both the SRC and HEALTHY groups exhibited similar reductions pre- to post-intervention for symptom severity and count (p's < 0.05), three VOMS items (p's < 0.05) but not K-D time.

CONCLUSIONS

To date, this is the first adolescent RCT to report the acute, systemic effects of aerobic exercise on recently concussed adolescent athletes. The interventions appeared safe in SRC participants, were well-tolerated, and provided brief therapeutic benefit.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier NCT03575455.

Injury-related psychological distress and the association with perceived running ability in injured runners

OBJECTIVE

Examine injury-related psychological distress and association with perceived running ability in injured runners.

DESIGN

Prospective longitudinal study.

PARTICIPANTS

Forty-three patients with a running-related injury.

MAIN OUTCOME MEASURES

Data collection at initial physical therapy visit and 12-16 weeks later included Optimal Screening for Prediction of Referral and Outcome - Yellow Flag (OSPRO-YF) and Athlete Fear Avoidance Questionnaire (AFAQ) for injury-related psychological distress, and University of Wisconsin Running and Recovery Index (UWRI) for perceived running ability. OSPRO-YF composite score, total yellow flags, and yellow flags in each domain (negative mood, fear-avoidance, positive affect/coping) were calculated.

RESULTS

UWRI score and OSPRO-YF composite score and yellow flags significantly improved over time, while AFAQ score and yellow flags in OSPRO-YF negative mood domain did not. AFAQ scores were significantly correlated with UWRI score at baseline, follow-up and change over time, while OSPRO-YF composite score and yellow flags were not. Baseline OSPRO-YF composite score and AFAQ score were not correlated with follow-up UWRI score.

CONCLUSIONS

Injury-related psychological distress is elevated when injured runners start rehabilitation, and generally improves; however, negative mood and athletic fear-avoidance may persist. Higher athletic fear-avoidance is associated with lower perceived running ability at the same time point or interval.

Changes in Motivation, Socialization, Wellness and Mental Health in Youth Long-Distance Runners During COVID-19 Social Distancing Restrictions

Purpose: The COVID-19 pandemic impacted the sporting and exercise activities of millions of youth. Running is an activity that could be maintained while social distancing restrictions were implemented during the pandemic. However, a recent study has indicated that youth runners reported lower running distance, frequency, and intensity during COVID-19. The reason for this reduction and the impact on overall well-being is unknown. Therefore, the purpose of this study was to determine if the social distancing restrictions during the 2020 COVID-19 pandemic influenced running motives, socialization, wellness and mental health in youth long-distance runners.

Methods: A customized, open online questionnaire was provided to runners 9–19 years of age who participated in long-distance running activities including team/club cross-country, track and field (distances ≥800 m), road races, or recreational running. Participants responded to questions about demographics, motive for running, and wellness (sleep quality, anxiety, running enjoyment, food consumption quality) 6-months before as well as during social distancing restrictions due to COVID-19. Wilcoxon signed rank tests compared differences for ratio data and Chi-square tests were used to compare proportions before and during COVID-19 social distancing restrictions. Statistical significance was set at p ≤ 0.05.

Results: A total of 287 youth long-distance runners (male = 124, female = 162, unspecified = 1; age = 15.3 ± 1.7 years; running experience = 5.0 ± 2.3 years) participated. Compared to their pre-COVID-19 responses, youth long-distance runners reported lower overall motivation to run (p < 0.001) and changes to most motive rankings (p < 0.001 to p = 0.71). The proportion of youth running alone increased during COVID-19 (65.8%) compared to pre-COVID-19 (13.8%, p < 0.001). Youth long-distance runners also reported less running enjoyment (p = 0.001), longer sleep duration (p < 0.001), lower sleep quality (p = 0.05), more anxiety (p = 0.043), and lower food quality consumed (p < 0.001) during COVID-19 social distance restrictions.

Conclusion: The COVID-19 social distancing restrictions resulted in significant decreases in motivation and enjoyment of running. The removal of competition and team-based interactions likely had a role in these decreases for this population. Continuing team-based activities (e.g., virtual) during social distancing may help with maintaining motivation of youth long-distance runners. Reduced running occurred concurrently with reduced overall well-being of youth long-distance runners during the COVID-19 pandemic.

A Scoping Review of the Relationship between Running and Mental Health

Poor mental health contributes significantly to global morbidity. The evidence regarding physical benefits of running are well-established. However, the mental health impacts of running remain unclear. An overview of the relationship between running and mental health has not been published in the last 30 years. The purpose of this study was to review the literature on the relationship between running and mental health. Our scoping review used combinations of running terms (e.g., Run* and Jog*) and mental health terms (general and condition specific). Databases used were Ovid(Medline), Ovid(Embase), ProQuest and SportDiscus. Quantitative study types reporting on the relationships between running and mental health were included. Database searches identified 16,401 studies; 273 full-texts were analysed with 116 studies included. Overall, studies suggest that running bouts of variable lengths and intensities, and running interventions can improve mood and mental health and that the type of running can lead to differential effects. However, lack of controls and diversity in participant demographics are limitations that need to be addressed. Cross-sectional evidence shows not only a range of associations with mental health but also some associations with adverse mental health (such as exercise addiction). This review identified extensive literature on the relationship between running and mental health.

Contributions of metabolic and temporal costs to human gait selection

Humans naturally select several parameters within a gait that correspond with minimizing metabolic cost. Much less is understood about the role of metabolic cost in selecting between gaits. Here, we asked participants to decide between walking or running out and back to different gait specific markers. The distance of the walking marker was adjusted after each decision to identify relative distances where individuals switched gait preferences. We found that neither minimizing solely metabolic energy nor minimizing solely movement time could predict how the group decided between gaits. Of our twenty participants, six behaved in a way that tended towards minimizing metabolic energy, while eight favoured strategies that tended more towards minimizing movement time. The remaining six participants could not be explained by minimizing a single cost. We provide evidence that humans consider not just a single movement cost, but instead a weighted combination of these conflicting costs with their relative contributions varying across participants. Individuals who placed a higher relative value on time ran faster than individuals who placed a higher relative value on metabolic energy. Sensitivity to temporal costs also explained variability in an individual's preferred velocity as a function of increasing running distance. Interestingly, these differences in velocity both within and across participants were absent in walking, possibly due to a steeper metabolic cost of transport curve. We conclude that metabolic cost plays an essential, but not exclusive role in gait decisions.

Access to voluntary running wheel exercise: Prevention of anxiety-like behavior in chronically stressed rats, but potentiation of ethanol intake/preference

The current study tested the effect of voluntary running on future anxiety-like behavior, physiological response to stress, and ethanol intake/preference, while including a chronically stressed group and healthy group housed conspecifics. When given concurrently, voluntary running reduces ethanol intake, though it is unknown what effect voluntary running will have on anxiety-like behavior, corticosterone response to stress, and ethanol intake/preference when exercise is allowed only prior to ethanol access. Adolescent male Long Evans rats arrived in the lab at postnatal day (PND) 21. At PND 27, rats were either socially isolated (SI; n = 1/cage) or group housed (GH; n = 4/cage). Half of each group was allowed access to a running wheel for 30 min for 24 days from PND 35-66, and half of each group was not allowed access to a running wheel. After the housing/running procedure, we tested anxiety-like behavior using the elevated plus maze and stress responsivity by measuring corticosterone (CORT) levels before and after a swim stressor; then, rats were allowed intermittent access to ethanol in two-bottle choice design for four weeks. In accord with our hypothesis, running reduced anxiety-like behavior in SI runners compared to non-runners. Swim stress increased CORT levels but there was no difference in the response among groups. In regard to ethanol intake and preference, running (irrespective of housing group) increased intake at the 30 min time point and preference at the 24 h time point. Altogether, these data show that access to voluntary exercise was successful in reducing anxiety-like behavior, but withdrawal of exercise access appeared to enhance ethanol intake/preference. We suggest that these data reflect hedonic substitution.

Exercise is Medicine for Concussion

Sport-related concussion (SRC) is a physiological brain injury that produces cerebral and systemic effects, including exercise intolerance. Exercise intolerance after concussion is believed to be the result of autonomic nervous system (ANS) dysfunction. Ventilation is inappropriately low for the level of exercise intensity, raising arterial carbon dioxide (PaCO2) levels. Elevated PaCO2 increases cerebral blood flow (CBF) out of proportion to exercise intensity, which is associated with symptoms that limit exercise performance. Thus, elevated exercise PaCO2 may signal incomplete recovery from SRC. This article reviews recent observational and experimental data and presents the evidence that subthreshold aerobic exercise normalizes the cerebrovascular physiological dysfunction and is "medicine" for patients with concussion and persistent postconcussive symptoms (PPCS). It discusses the systematic evaluation of exercise tolerance after concussion using the Buffalo Concussion Treadmill Test (BCTT) and reviews the utility of the Buffalo Concussion Bike Test (BCBT), the data from which are used to establish an individualized heart rate "dose" of subthreshold exercise to safely speed recovery, which also may work in the acute recovery phase after SRC with the potential to reduce the incidence of PPCS. Evaluation and treatment approaches based on the physiology of concussion suggest that exercise is medicine for concussion, potentially adding a new dimension to concussion care to help safely speed recovery and prevent PPCS in some patients.

Does ceasing exercise induce depressive symptoms? A systematic review of experimental trials including immunological and neurogenic markers

BACKGROUND

Regular exercise in adults improves depressive symptoms (DS) and major depressive disorder (MDD), however the clinical effects of ceasing exercise are largely unknown.

METHODS

Seven databases were searched from inception to December 2017. Eligibility criteria included English language studies investigating the effects of ceasing exercise on DS or MDD in regularly active adults with or without prior DS or MDD. Blood based markers related to exercise cessation (EC) were assessed, if recorded. Studies investigating exercise follow-up periods were excluded.

RESULTS

No studies investigated EC in MDD. Six studies including two RCTS and three studies investigating neurogenic and immune biological markers associated with DS met inclusion criteria (152 healthy adults, females n = 50/32.89%). Compared to baseline, EC increased DS after three days, one week, and two weeks. Female participants had significantly more DS than male participants. Following EC, no changes in brain derived neurotrophic factor (BDNF) or tumour necrosis factor alpha (TNF) were evident, however C-reactive protein (CRP) at week one and interleukin 6 (IL6) at week two were reduced.

LIMITATIONS

Quality concerns including risks of attrition and reporting bias limit our confidence in these results.

CONCLUSIONS

Ceasing regular exercise increases DS in healthy adults, with greater DS in females than males. Contrary to the cytokine/inflammatory hypothesis of depression, DS were associated with reduced CRP and IL6 and without increased TNF. High quality trials are needed to extend this field of research in both healthy and MDD populations.

Mental health consequences of exercise withdrawal: A systematic review

OBJECTIVE

A sedentary lifestyle has been associated with mental health disorders. Many medical conditions result in the cessation of exercise, which may increase the risk of developing mental health problems. The purpose of this article is to systematically review the literature examining the effects of exercise withdrawal on mental health.

METHOD

Literature was searched using PubMed, PsycINFO, and SPORTdiscus for studies that experimentally manipulated the withdrawal of exercise and included mental health as outcome measure.

RESULTS

A total of 19 studies met inclusion criteria (total N=689 with 385 individuals participating in an exercise withdrawal condition). Exercise withdrawal consistently resulted in increases in depressive symptoms and anxiety. Other mental health outcomes were investigated infrequently. Severe mental health issues requiring clinical intervention after experimentally controlled exercise withdrawal was rare. Heterogeneity in methods and outcomes was observed, especially in terms of the duration of exercise withdrawal (range 1 to 42days, median=7days), with stronger effects if exercise withdrawal exceeded 2weeks.

CONCLUSION

Experimentally controlled exercise withdrawal has adverse consequences for mental health. These observations in healthy individuals may help to understand the onset of mental health problems in response to acute and chronic medical conditions associated with reduced physical activity. Future research is needed to investigate potential mechanisms explaining the adverse mental health consequences of cessation of exercise that will provide new targets for clinical interventions.

Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise

OBJECTIVE

There is disagreement about the conceptualization and measurement of pathological exercise (PE). This study seeks to elucidate the nature of this phenomenon as addictive or compulsive in its primary and secondary forms.

METHOD

1,497 adults (608 men, 885 women, 4 other) completed a set of validated surveys, including the Godin Leisure-Time Exercise Questionnaire, the Exercise Dependence Scale-21, the Exercise Addiction Inventory, the Compulsive Exercise Test (CET), the Obligatory Exercise Questionnaire, the Commitment to Exercise Scale, and an exercise specific adaptation of the Dimensional Obsessive-Compulsive Scale (ESDOCS). Participants completed the Eating Disorders Examination Questionnaire, and DSM-5 eating disorder (ED) diagnoses were determined according to published guidelines. Pearson correlation coefficients, independent samples t-tests, χ(2) tests, 1-way ANOVA's, and ANCOVA's were calculated.

RESULTS

All PE measures correlated highly with one another (P < 0.001). Participants with EDs scored higher on all measures than those without (P < 0.001), and those with bulimia nervosa had the highest scores. Participants with PE and an accompanying ED (secondary PE) scored higher than those with PE and no ED symptoms (primary ED) on the CET (P < 0.002) and ESDOCS (P < 0.003). Correlations between EDE-Q and PE scores were stronger among women than men. PE prevalence was 6.4% (1.4% primary PE, 5.0% secondary PE) in our heterogeneous sample.

DISCUSSION

Secondary PE appears to be more compulsive while primary PE is more addictive in nature. Men and women are equally at risk for PE, but in men it is more often primary and addictive and in women it is more often secondary and compulsive. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:778-792).

Cannabis and Exercise Science: A Commentary on Existing Studies and Suggestions for Future Directions

Policies regarding cannabis use are rapidly changing, yet public officials have limited access to scientific information that might inform the creation of these policies. One important area in which to begin investigations is the link between recreational cannabis use and health, specifically exercise. There are common anecdotal reports that cannabis decreases motivation, including motivation to exercise. On the other hand, there are also anecdotal reports that cannabis is used prior to athletic activity. In fact, the World Anti-Doping Agency includes cannabis as a prohibited substance in sport, partly because it is believed that it may enhance sports performance. At the current time, there is limited scientific evidence to support either one of these opposing lay perspectives. Given recent political, cultural, and legal trends, and the growing acceptance of recreational cannabis use, it is important to develop a more nuanced understanding of the relationship between cannabis and exercise, specifically the potential effects of use on exercise performance, motivation, and recovery.

Aerobic exercise training facilitates the effectiveness of cognitive behavioral therapy in panic disorder

BACKGROUND

Physical activity has been discussed as a therapeutic alternative or add-on for the treatment of anxiety disorders. We studied whether aerobic exercise compared to physical activity with low impact can improve the effect of cognitive behavioral therapy (CBT) in patients with panic disorder (PD) with/without agoraphobia.

METHODS

Forty-seven patients received group CBT treatment over 1 month, which was augmented with an 8-week protocol of either aerobic exercise (three times/week, 30 min, 70% VO(2) max; n = 24) or a training program including exercises with very low intensity (n = 23) in a randomized controlled double-blind design. The primary outcome measure was the total score on the Hamilton Anxiety Scale (Ham-A). A 2 × 3 analysis of covariance (ANCOVA) with baseline value as a covariate was conducted for data analysis.

RESULTS

Time × group interaction for the Ham-A revealed a significant effect (P = .047, η(2) p = .072), which represented the significant group difference at a 7-month follow-up. For the other clinical outcome measures no statistical significance emerged, although improvement was more sustained in the exercise group.

CONCLUSIONS

For patients with PD, regular aerobic exercise adds an additional benefit to CBT. This supports previous results and provides evidence about the intensity of exercise that needs to be performed.

Self-selected intensity exercise in the treatment of major depression: A pragmatic RCT

OBJECTIVE

The purpose of the study was to determine the therapeutic effect of physical exercise for patients with unipolar depression. Participants took part in an 8-week walking/running aerobic exercise program at a local sports club.

METHODS

Forty-six outpatients aged 18-65 years and diagnosed with mild to severe depression (ICD-10 criteria) were randomly assigned to an intervention group or wait list. Treatment as usual was continued. The Hamilton Rating Scale for Depression (HRSD-17) served as the main outcome measure. Secondary outcome measures were Beck Depression Inventory (BDI-II), Fitness Index (FI), and VO(2) max as estimated by Urho Kaleka Kekkonen or UKK 2-km Walk Test.

RESULTS

Out of forty-six participants, 24% dropped out. Participants attended 58% of exercise sessions. All randomized participants were included in intention-to-treat (ITT) analysis. Analysis of covariance or ANCOVA showed a large reduction of depressive symptoms in HRSD-17 scores (Cohen's d: 1.8; mean change 8.2, p < .0001). BDI-II (Cohen's d: 0.50; mean change: 4.7, p = 0.09), FI scores (Cohen's d: 0.27; mean change: 5.3, p = 0.08), and VO2 max did not change significantly.

CONCLUSIONS

We observed a large and clinically significant change in HRSD-17 scores. Moderate changes in BDI-II scores without clinical significance and small changes in physical fitness assessments were observed.

Sensorimotor modulation of mood and depression: in search of an optimal mode of stimulation

Depression involves a dysfunction in an affective fronto-limbic circuitry including the prefrontal cortices, several limbic structures including the cingulate cortex, the amygdala, and the hippocampus as well as the basal ganglia. A major emphasis of research on the etiology and treatment of mood disorders has been to assess the impact of centrally generated (top-down) processes impacting the affective fronto-limbic circuitry. The present review shows that peripheral (bottom-up) unipolar stimulation via the visual and the auditory modalities as well as by physical exercise modulates mood and depressive symptoms in humans and animals and activates the same central affective neurocircuitry involved in depression. It is proposed that the amygdala serves as a gateway by articulating the mood regulatory sensorimotor stimulation with the central affective circuitry by emotionally labeling and mediating the storage of such emotional events in long-term memory. Since both amelioration and aggravation of mood is shown to be possible by unipolar stimulation, the review suggests that a psychophysical assessment of mood modulation by multimodal stimulation may uncover mood ameliorative synergisms and serve as adjunctive treatment for depression. Thus, the integrative review not only emphasizes the relevance of investigating the optimal levels of mood regulatory sensorimotor stimulation, but also provides a conceptual springboard for related future research.

Mice from lines selectively bred for high voluntary wheel running exhibit lower blood pressure during withdrawal from wheel access

Exercise is known to be rewarding and have positive effects on mental and physical health. Excessive exercise, however, can be the result of an underlying behavioral/physiological addiction. Both humans who exercise regularly and rodent models of exercise addiction sometimes display behavioral withdrawal symptoms, including depression and anxiety, when exercise is denied. However, few studies have examined the physiological state that occurs during this withdrawal period. Alterations in blood pressure (BP) are common physiological indicators of withdrawal in a variety of addictions. In this study, we examined exercise withdrawal in four replicate lines of mice selectively bred for high voluntary wheel running (HR lines). Mice from the HR lines run almost 3-fold greater distances on wheels than those from non-selected control lines, and have altered brain activity as well as increased behavioral despair when wheel access is removed. We tested the hypothesis that male HR mice have an altered cardiovascular response (heart rate, systolic, diastolic, and mean arterial pressure [MAP]) during exercise withdrawal. Measurements using an occlusion tail-cuff system were taken during 8 days of baseline, 6 days of wheel access, and 2 days of withdrawal (wheel access blocked). During withdrawal, HR mice had significantly lower systolic BP, diastolic BP, and MAP than controls, potentially indicating a differential dependence on voluntary wheel running in HR mice. This is the first characterization of a cardiovascular withdrawal response in an animal model of high voluntary exercise.

Motivation and exercise dependence: a study based on self-determination theory

The objective of this study was to use self-determination theory to analyze the relationships of several motivational variables with exercise dependence. The study involved 531 exercisers, ranging in age from 16 to 60 years old, who responded to differentquestionnaires assessing perception of motivational climate, satisfaction of basic psychological needs, motivation types, and exercise dependence. The results of multiple mediation analysis revealed that ego-involving climate and perceived competence positively predicted exercise dependence in a directed and mediated manner through introjected and external regulation. Gender and age did not moderate the analyzed relationships. These results allow us to better understand the motivational process explaining exercise dependence, demonstrating the negative influence of the ego-involving climate in the context of exercise.

Compulsive exercise and eating disorders

The aim of this review was to develop an empirically supported cognitive behavioural model of compulsive exercise within the context of the eating disorders. A systematic review of the correlates and predictors of compulsive exercise among eating disordered patients identified four key correlates. These were subsequently validated by a second review, incorporating both the clinical and non-clinical as well as the exercise science literatures. A proposed model is presented which is both evidence-based and testable.

The Relationship Between Frontal Brain Asymmetry and Exercise Addiction

Previous research on the causes of exercise addiction has focused primarily on the relationships among personality traits, social influences, and disordered eating ( Bamber, Cockerill, & Carroll, 2000 ; Beals, 2004 ). Few studies, however, have examined the psychophysiological nature of exercise addiction. In a related area of research in which brain activity has been related to affect and mood, results show that frontal asymmetry, as measured by electroencephalogram (EEG), is associated with negative emotions. More specifically, greater activity at right frontal electrode sites is found among individuals suffering from negative affect and depression. Because a defining feature of exercise addiction is the use of exercise to control negative mood states, it is expected that those with exercise addiction exhibit different frontal activity. This study explores the hypothesized relationship between exercise addiction and the level of baseline frontal activity asymmetry, as measured by EEG. Regularly active women (n = 28, M age = 32.43, SD = 10.89) were recruited to participate in the study. Exercise addiction status was determined by the Exercise Addiction Inventory (EAI) ( Terry, Szabo, & Griffiths, 2004 ). After completing the EAI, each participant took part in an EEG session consisting of eight 1-min resting trials, four with eyes open, and four with eyes closed, presented in counterbalanced order. Electrodes were applied to the left and right frontal sites (F3 and F4). A regression analysis, predicting exercise addiction from frontal asymmetry, was significant, F(1, 27) = 6.4, p < .05, and indicated that greater relative left frontal activity with higher exercise addiction scores. There may be a link between frontal asymmetry, as an indicator of negative emotions, and exercise addiction in women.

Inflammatory markers and negative mood symptoms following exercise withdrawal

OBJECTIVE

Physical inactivity is associated with elevated inflammatory markers, but little is known about the time trajectories of reduced physical activity and inflammatory markers. Changes in inflammatory markers in response to withholding regular aerobic exercise were prospectively examined and correlated with increased negative mood symptoms and fatigue that accompany exercise withdrawal.

METHODS

Participants with regular exercise habits (N=40, mean age of 31.3+/-7.5 years, 55% women) were randomized to aerobic exercise withdrawal or to continue regular exercise for 2 weeks. Protocol adherence was documented using ambulatory actigraphy. Inflammatory markers (interleukin-6, C-reactive protein, fibrinogen and soluble intercellular adhesion molecule-1) were assessed at weekly intervals. Negative mood was measured with the Profile of Mood States (POMS) and the Beck Depression Inventory (BDI), and fatigue with the Multidimensional Fatigue Inventory (MFI). Autonomic nervous system activity was examined using heart rate variability-based indices.

RESULTS

Changes in inflammatory markers did not differ between exercise withdrawal and control groups (multivariate p interaction=0.25). Exercise withdrawal resulted in increased negative mood symptoms and fatigue from baseline to day 14 compared to controls (p DeltaPOMS=0.008, p DeltaBDI=0.002; p DeltaMFI=0.003), but these responses were not associated with changes in inflammatory markers (p-values >0.10). Inflammatory markers were also not correlated with autonomic nervous system dysregulation (p-values >0.10).

CONCLUSION

Inflammatory markers were not increased following 2 weeks of exercise withdrawal. Negative mood symptoms and fatigue were not accounted for by changes in inflammatory markers. Compensatory feedback mechanisms may operate among healthy individuals to promote resilience from the effects of reduced exercise.

Psychobiological mechanisms of exercise dependence

Exercise dependence (ED) is characterised by an obsessive and unhealthy preoccupation with exercise. Previous research has focused largely on identifying behavioural aspects of ED, although the biological mechanisms remain unknown and are under researched. We review various ED hypotheses including affect regulation, anorexia analogue, sympathetic arousal and beta-endorphin. We also present a novel hypothesis pertaining to ED and interleukin (IL)-6, which combines previous hypotheses with literature from the field of psycho-neuroimmunology. We explore the notion that IL-6 provides a link from the periphery to the brain, which may mediate the underlying features of ED. We propose a conceptual model indicating that, in individuals prone to ED, exercise results in a transient reduction in negative affect, but concurrently results in excessive production of IL-6 and the activation of neuroendocrine pathways, which are associated with behavioural and psychological disturbances of exercise withdrawal. Our intention is for this model to serve as a basis for further research in the area of ED, which may eventually lead to the development of successful treatment strategies. Recent developments in methods to reliably assess these biological markers from blood and saliva samples should encourage such research to be undertaken in exercise settings.

Obligatory exercise and eating pathology in college females: replication and development of a structural model

Although disordered eating behaviors and obligatory exercise are relatively common among undergraduate females, many questions about their etiology remain unanswered. In the current study, structural equation modeling was used to investigate whether a model of personality, exercise attitudes, and exercise behavior that was previously developed with a clinical sample [Davis, C., Katzman, D.K., & Kirsh, C. (1999). Compulsive physical activity in adolescents with anorexia nervosa: A psychobehavioral spiral of pathology. The Journal of Nervous and Mental Disease, 187, 336-342.] would also fit for a sample of non-clinical college females (n=599). Further, a second model extended the first model to predict exercise behavior and eating/weight restriction. Results indicated that the original structural model fit the non-clinical sample extremely well. Specifically, addictiveness and obsessive-compulsiveness were associated with obligatory attitudes toward exercise, which was then associated with exercise behavior. In the second model, obligatory attitudes toward exercise were equally associated with eating/weight restriction as it was with exercise behavior. In a third model, bootstrapping analyses demonstrated that while obligatory exercise was directly associated with eating and weight restriction, this association was partially mediated by weight-related reasons for exercise. These data suggest that the aforementioned variables are predictive of obligatory exercise and eating pathology in non-clinical samples, and that reasons for exercise is important in understanding the complex relations among disordered eating and exercise attitudes and behaviors.

Heart rate variability as a predictor of negative mood symptoms induced by exercise withdrawal

INTRODUCTION/PURPOSE

Negative mood symptoms occur frequently in sedentary populations, but individual vulnerability factors for developing these complaints have not been systematically evaluated. This investigation examined whether the autonomic nervous system (ANS) serves a role in the development of negative mood after controlled exercise withdrawal.

METHODS

Forty participants (mean age of 31.3 +/- 7.5 yr, 55% women) who exercised regularly (>or= 30 min of continuous aerobic exercise at least three times a week during the past 6 months) were randomized either to withdrawal from regular aerobic exercise (N=20) or to continue regular aerobic exercise (N=20) for 2 wk. Measurements were taken before exercise withdrawal and at 2-wk follow-up. Various dimensions of negative mood were measured with the multidimensional fatigue inventory, profile of mood states, and Beck depression inventory-II. ANS activity was assessed by heart rate variability (HRV) analyses, examining low-frequency (0.04-0.15 Hz: lf) and high-frequency (hf) domains (0.15-0.40 Hz). The lf/hf ratio was used as index of sympathovagal balance. Protocol adherence was documented by ambulatory activity monitoring.

RESULTS

Exercise withdrawal resulted in significantly higher negative mood scores at follow-up compared with control (P<0.05). Baseline lf/hf ratios correlated with the increases in symptoms (r>0.4; P<0.05) in the exercise-withdrawal group independently of gender, age, weight, baseline fitness level, and baseline symptom status. The exercise-withdrawal and control groups displayed no significant change in hf HRV, lf HRV, or lf/hf HRV during the 2 wk.

CONCLUSION

Reduced parasympathetic ANS activity as measured by HRV is predictive of the development of negative mood after deprivation of usual exercise activities. No significant changes in HRV were observed during the 2-wk exercise deprivation period. These findings are relevant to the understanding of mood changes in response to short-term exercise withdrawal, such as sports injuries and recovery from medical procedures.

O estresse físico e a dependência de exercício físico

O objetivo do presente estudo foi verificar os escores referentes à escala de dependência de exercício, qualidade de vida, bem como os escores indicativos de humor em atletas de corrida de aventura (CA). Participaram deste estudo 17 atletas de ambos os gêneros com histórico de prática da modalidade de pelo menos três anos, com experiência em provas nacionais e internacionais e que figuram nas primeiras posições do ranking brasileiro. A média (± desvio-padrão) da idade, altura, massa corporal, índice de massa corpórea (IMC) e consumo de oxigênio foram: 31,11 ± 6,30 anos; 1,73 ± 0,07cm; 70,75 ± 7,96kg; 23,48 ± 1,48kg/m² e 58,70 ± 6,63ml.min¹.kg¹, respectivamente. Os voluntários responderam aos seguintes questionários: Escala de Dependência de Exercício (EDE), Idate Traço e Estado, Profile of Mood States (POMS), SF-36 Pesquisa em Saúde e Questionário de Padrão Social. Os resultados revelaram que os escores observados na EDE foram indicativos de dependência de exercício; já os questionários de humor revelaram ansiedade moderada, enquanto o POMS não detectou escores indicativos de distúrbios de humor. Quanto à qualidade de vida, a média das oito dimensões referentes ao questionário SF-36 se mostrou acima de 85%, sugerindo que, apesar de haver dependência de exercício, parece que esse fato não foi capaz de promover alterações significativas no estado de humor e na qualidade de vida. Esses dados sugerem que atletas de CA apresentam dependência de exercício não associada aos distúrbios de humor.

Depressive mood symptoms and fatigue after exercise withdrawal: the potential role of decreased fitness

OBJECTIVE

Depressive symptomatology is more prevalent among sedentary than physically active individuals. The present prospective study examines whether withdrawal of regular aerobic activity provokes depressive mood symptoms and fatigue, and to what extent reductions in fitness levels contribute to the development of these symptoms.

METHODS

Forty participants (mean age of 31.3 +/- 7.5 years, 55% women) who exercised regularly (> or = 30 minutes aerobic exercise > or = 3 times/week) were randomized to aerobic exercise withdrawal (n = 20) or to continue regular exercise (n = 20) for 2 weeks. Protocol adherence was documented using ambulatory actigraphy. Negative mood was measured with the Profile of Mood States (POMS), depressive symptoms with the Beck Depression Inventory-II (somatic and cognitive-affective components), and fatigue with the Multidimensional Fatigue Inventory (MFI). Fitness levels were documented by cycle ergometry testing.

RESULTS

Fatigue and somatic depressive symptoms emerged after 1 week of exercise withdrawal (p = .05) and subsequently predicted the development of cognitive-affective depressive symptoms at 2 weeks (beta = 0.62; p = .046). Exercise withdrawal also resulted in increased negative mood (POMS; p < or = .01), and this increase was correlated with decreases in fitness level (r = -0.36, p = .03). Decreased fitness was related to increased POMS fatigue (p = .003) when statistically adjusting for baseline fitness levels and group condition.

CONCLUSION

Depressed mood and fatigue are commonly observed in individuals deprived of usual exercise activities, and the increase in fatigue may be partially mediated by reduced fitness levels. These findings may explain mood changes in response to short-term exercise withdrawal such as injuries and recovery from medical procedures that do not require full bedrest.

Physical activity and mental health: the association between exercise and mood

Physical activity is an important public health tool used in the treatment and prevention of various physical diseases, as well as in the treatment of some psychiatric diseases such as depressive and anxiety disorders. However, studies have shown that in addition to its beneficial effects, physical activity can also be associated with impaired mental health, being related to disturbances like "excessive exercise" and "overtraining syndrome". Although the number of reports of the effects of physical activity on mental health is steadily increasing, these studies have not yet identified the mechanisms involved in the benefits and dangers to mental health associated with exercise. This article reviews the information available regarding the relationship between physical activity and mental health, specifically addressing the association between exercise and mood.

Exercise "addiction" in anorexia nervosa: model development and pilot data

BACKGROUND

Excessive exercise has long been observed to be a problematic behavior of many patients with anorexia nervosa (AN). However, many questions remain as to the exact role exercise plays in this disorder. In particular, it has been suggested that exercise holds "addictive" properties in persons with AN, but that remains to be demonstrated.

OBJECTIVE

The aim of this study was to adapt and apply a scale used in addictions research to determine whether symptoms of "dependence" to exercise could be measured in a group of women with AN.

RESULTS

Forty-eight percent of individuals assessed endorsed symptoms consistent with exercise dependence in the previous month. The number of criteria met for exercise dependence was directly correlated with a clinical measure of anxiety.

CONCLUSION

Results support further investigation into addictive properties for exercise in individuals with AN and its relationship to anxiety

Dependência da prática de exercícios físicos: estudo com maratonistas brasileiros

O presente estudo teve como objetivo testar, numa amostra de maratonistas brasileiros, a versão em português da adaptação da Escala de Dependência de Corrida proposta por Hailey e Bailey (1982). Métodos e resultados:59 maratonistas de uma equipe da cidade de São Paulo foram abordados e orientados a preencher a Escala de Dependência de Corrida (EDC). A amostra foi composta, na sua maior parte, por homens (72%) com média de 34 ± 7 anos, sendo que 77% corriam habitualmente havia cerca de dois a oito anos; 42,5% corriam de quatro a cinco vezes/semana e 81% dedicavam-se de uma a duas horas/dia em média para seus treinos. A média na pontuação total da EDC foi de 5 ± 2,5 pontos (escala 0-14 pontos). A correlação entre a pontuação total da EDC com cada uma das 23 questões que compõem o instrumento revelou que 10 questões apresentaram níveis de correlação significativos. As respostas positivas que apresentaram maior sensibilidade foram: "Sinto que me falta algo quando não corro" (r = 0,61); "A corrida tem influenciado meu estilo de vida" (r = 0,58) e "Experimento grande prazer quando corro" (r = 0,56). Conclusão: Observamos na amostra brasileira níveis médios de pontuação na escala semelhantes aos descritos pelos autores do instrumento original, sugerindo que a tradução não alterou a sensibilidade da escala e que este instrumento possa ser útil no estudo da dependência da prática de corrida (ou exercícios físicos) em desportistas brasileiros.

Running increases ethanol preference

Wheel running performed by rats is reinforcing, rewarding and possibly addictive. In this study we analyzed if wheel running could affect ethanol preference. Lewis rats, known to be both addiction-prone and to develop an excessive wheel running behavior, were given access to ethanol in a two-bottle free-choice paradigm. The animals reached a high and stable ethanol intake after 5 weeks. In the next phase, rats were subjected to ethanol withdrawal for 1, 2 or 4 weeks with or without access to running wheels. Finally animals were again given access to ethanol in the same two-bottle free-choice paradigm, combined with access to running wheels. The rats that ran in running wheels during 1 or 2, but not 4, weeks of ethanol withdrawal increased both ethanol intake and preference as compared with the control group that did not have access to the wheels. Previous studies have demonstrated that low doses of morphine increases ethanol preference. Here we show that also running potentiates ethanol intake and preference. Thus, running which shares many of the reinforcing properties with addictive drugs appears to potentiate rats to an increased preference for ethanol. Our results describe a behavioral interaction where running increases ethanol consumption.

Eating and exercise disorders in young college men

The authors used the computerized Eating and Exercise Examination to investigate eating, weight, shape, and exercise behaviors in a convenience sample of 93 male college students. One fifth of the men worried about their weight and shape, followed rules about eating, and limited their food intake. Between 9% and 12% were unhappy with their body shape, felt fat, and seriously wanted to lose weight. Exercise was important for the self-esteem of 48% of the students. Thirty-four percent were distressed when they could not exercise as much as they wanted, 27% followed rules about exercising, and 14% worried about the amount of exercise they were doing. The respondents met clinical diagnoses for objective binge eating (3%), self-induced vomiting (3%), bulimia nervosa (2%), and exercise disorders (8%). Although 9% reported disordered eating, none had sought treatment. Health professionals should be aware that eating and exercise disorders may be present in college men and that screening may help in the early identification of these problems.

Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory

Until recently, claims for the psychological benefits of physical exercise have tended to precede supportive evidence. Acutely, emotional effects of exercise remain confusing, both positive and negative effects being reported. Results of cross-sectional and longitudinal studies are more consistent in indicating that aerobic exercise training has antidepressant and anxiolytic effects and protects against harmful consequences of stress. Details of each of these effects remain unclear. Antidepressant and anxiolytic effects have been demonstrated most clearly in subclinical disorder, and clinical applications remain to be exploited. Cross-sectional studies link exercise habits to protection from harmful effects of stress on physical and mental health, but causality is not clear. Nevertheless, the pattern of evidence suggests the theory that exercise training recruits a process which confers enduring resilience to stress. This view allows the effects of exercise to be understood in terms of existing psychobiological knowledge, and it can thereby provide the theoretical base that is needed to guide future research in this area. Clinically, exercise training continues to offer clinical psychologists a vehicle for nonspecific therapeutic social and psychological processes. It also offers a specific psychological treatment that may be particularly effective for patients for whom more conventional psychological interventions are less acceptable.

Weekly Exercise Consistently Reinstates Positive Mood

Mood improvement immediately after a single bout of exercise is well documented, but less is known about successive and longer term effects. In a “real-life” field investigation, four kinds of exercise class (Beginners, Advanced, Body Funk and Callanetics) met once a week for up to 7 weeks. Before and after each class the members assessed how they felt by completing a questionnaire listing equal numbers of “positive” and “negative” mood words. Subjects who had attended at least five times were included in the analysis, which led to groups consisting of 18, 20, 16, and 16 subjects, respectively. All four kinds of exercise significantly increased positive and decreased negative feelings, and this result was surprisingly consistent in successive weeks. However, exercise seemed to have a much greater effect on positive than on negative moods. The favorable moods induced by each class seemed to have worn off by the following week, to be reinstated by the class itself. In the Callanetics class, positive mood also improved significantly over time. The Callanetics class involved “slower,” more demanding exercises, not always done to music. The Callanetics and Advanced classes also showed significantly greater preexercise negative moods in the first three sessions. However, these differences disappeared following exercise. Possibly, these two groups had become more “tolerant” to the mood-enhancing effects of physical exercise; this may be in part have been due to “exercise addiction.”

Physical exercise and psychological well being: a critical review

The relation between physical exercise and psychological health has increasingly come under the spotlight over recent years. While the message emanating from physiological research has extolled the general advantages of exercise in terms of physical health, the equivalent psychological literature has revealed a more complex relation. The paper outlines the research evidence, focusing on the relation between physical exercise and depression, anxiety, stress responsivity, mood state, self esteem, premenstrual syndrome, and body image. Consideration is also given to the phenomena of exercise addiction and withdrawal, and implications for exercise prescription are discussed.

Exercise enhances creativity independently of mood

OBJECTIVES

It has been widely accepted in the literature that various forms of physical exercise, even in a single session, enhance positive mood. It has also been shown that physical exercise may sometimes enhance creative thinking, but the evidence is inconclusive. Positive moods can favour creative thinking, but the opposite has also been reported and these relations are unclear. There is a large anecdotal literature suggesting that creative people sometimes use bodily movement to help overcome "blocks". The aim of this study was to establish whether post-exercise creative thinking was attributable to improved mood.

METHODS

The responses of 63 participants to an exercise (aerobic workout or aerobic dance) and a "neutral" video watching condition were compared. Mood was measured using an adjective list, and creative thinking was tested by three measures of the Torrance test.

RESULTS

Analysis of variance showed a large and significant increase in positive mood after exercise (P < 0.001) and a significant decrease in positive mood after video watching (P < 0.001). A significant increase between the creative thinking scores of the two conditions was found on the flexibility (variety of responses) measure (P < 0.05). A multifactorial analysis of all data failed to show a significant covariance of creative thinking with the two measures of mood (P > 0.05).

CONCLUSIONS

These results suggest that mood and creativity were improved by physical exercise independently of each other.

Psychological consequences of exercise deprivation in habitual exercisers

Psychological consequences of exercise deprivation in habitual exercisers. The purpose of this investigation was to evaluate the influence of 3 d of exercise deprivation on selected psychological variables. Ten volunteers (4 female and 6 male) who regularly exercised 6-7 d.wk-1 for at least 45 min at a time participated in a 5-d study. Participants completed their regular workout on the first day of the study, refrained from physical activity for the next 3 d, and then resumed their regular exercise on the 5th d of the study. Participants reported to the lab on Monday following their regular workout and completed a series of questionnaires, and these same questionnaires were completed at the same time of day on the next 4 d. The dependent variables consisted of state and trait anxiety (STAI), and tension, depression, anger, vigor, fatigue, confusion, and overall mood (POMS). Increases in total mood disturbance, state anxiety, tension, depression, and confusion across days were significant (P < 0.05), and vigor decreased. The pattern of increasing mood disturbance with exercise deprivation was followed by mood improvement to baseline levels when exercise was resumed. We concluded that a brief period of exercise deprivation in habitual exercisers results in mood disturbance within 24-48 h.

Behavioral frequency and psychological commitment: necessary concepts in the study of excessive exercising

Efforts to understand the associations among exercising, personality factors, and disordered eating have been the focus of much debate. However, research has been plagued by inconsistent findings, and there is evidence that classification and measurement differences are fundamental to these problems. To date, there are no studies which have defined exercise as a multifaceted construct. The purposes of this study were to establish the factor structure of a questionnaire developed to assess the core features believed to characterize excessive exercisers and to assess relationships between exercise (operationally defined as a function of behaviors and attitudes) and a number of putative risk factors. Results indicated that exercise was strongly related to weight preoccupation among women and men and that, among men, obsessive-compulsiveness was also positively related--findings which support claims that exercising and dieting tend to coexist, and they are associated with an obsessive-compulsive personality profile.

Excessive exercise and weight preoccupation in women

A group of adult women (n = 351) were assessed on a number of psychological, behavioral, and body composition measures including weight preoccupation and leisure-time physical activity participation. The purpose of the study was twofold. It was intended (a) to investigate whether excessive exercises have specific characteristics in common other than that they exercise a great deal and (b) to identify the degree of relationship between exercising and weight preoccupation, and the extent to which those classified as excessive on either dimension have psychological characteristics in common. Results indicated that excessive exercisers reported greater body satisfaction and body focus, were less emotionally reactive (neurotic), and more extraverted than nonexercisers. Although some researchers have reported psychological similarities between excessive exercisers and women with eating disturbances, our data do not entirely support that point of view. While excessive exercise was associated with a decrease in body dissatisfaction and was negatively related to neuroticism, weight preoccupation was associated with an increase in body dissatisfaction and was positively related to neuroticism. However, one characteristic that both excessive groups shared, and that significantly differentiated them from their nonexcessive counterparts, was their high level of body focus. These findings led us to test the body focus x neuroticism interaction on both exercise participation and weight preoccupation. Results indicated a highly significant interaction on weight preoccupation. However, only the two main effects were significantly related to exercise.