Characterizing the affective responses to an acute bout of moderate-intensity exercise among outpatients with schizophrenia

Feasibility and Acceptability of a Physical Activity Group Program Using telerehabilitation during the COVID-19 Pandemic in Multiple early Intervention for Psychosis Services

BACKGROUND

Although physical activity (PA) is beneficial to young people with early psychosis (YEP) to improve physical health and psychiatric symptoms, few YEP initiate and maintain PA. The sports group interventions offered in early psychosis services had to be suspended due to the COVID-19 pandemic. Telehealth has shown promising results in different fields of health services including for patients with mental health disorders.

METHODS

Descriptive retrospective study aiming to determine the feasibility and acceptability of a telekinesiology intervention among YEP and to describe its multicenter implementation. The PA sessions were delivered to YEP by a kinesiologist and peer support workers. Feasibility was measured by the number of programs approached which referred participants, and the proportion of referred YEP who participated to at least one PA session. Acceptability was measured by the proportion of participants who attended more than one PA session, the number of sessions attended per participant and by surveys on patient satisfaction.

RESULTS

Of the 35 clinics approached, 150 YEP (of 214 referred) from 13 clinics participated to at least one of the 204 telekinesiology sessions (offered 2-3 times/week from May 2020 to May 2022) The mean number per participant was 5.5 sessions. 106 YEP engaged in more than one session (mean of 7.3 sessions per persistent participant). The mean number of participants per session was 4 (1-12). 99 % of the survey respondents were very satisfied/or satisfied with the sessions.

CONCLUSION

Telekinesiology appears to be an acceptable and feasible option to be implemented simultaneously in multiple early intervention services.

Clarifying the overlap between motivation and negative symptom measures in schizophrenia research: A meta-analysis

Motivation and negative symptom research has recently been hampered by a series of inconsistent findings, leading to calls for a greater consensus on the type of measures used across studies. To inform this issue, we conducted a meta-analysis that quantified the association between motivation measures (self-report, performance-based) and clinician-rated negative symptom measures as well as a series of moderator analyses to develop a greater understanding of the measurement factors impacting this relationship. Forty-seven eligible studies with people with schizophrenia-spectrum disorders were included. Using a random-effects meta-analytic model, a small but significant overall effect size emerged between motivation and clinician-rated negative symptoms (r = -0.18). Several significant moderators were identified, including the generation of negative symptom measures such that there was a significantly stronger relationship between motivation and second-generation (r = -0.38) than first-generation negative symptom measures (r = -0.17). Further, the type of performance-based measure used moderated the relationship, with effort discounting tasks most strongly related to negative symptoms (r = -0.44). The domain of motivation assessed (intrinsic, extrinsic, amotivation) also moderated the relationship. These findings help to identify sources of inconsistencies observed in prior studies and point to both second-generation and effort discounting tasks as the most promising types of measures, particularly for those interested in validating motivation measures or assessing the effectiveness of motivation treatments. Although additional research is needed, our results suggest that using these measures may help to reduce inconsistencies across studies and move the field forward.

The Utility of the Health Action Process Approach Model for Predicting Physical Activity Intentions and Behavior in Schizophrenia

Research is needed to develop evidence-based behavioral interventions for preventing and treating obesity that are specific to the schizophrenia population. This study is the precursor to such intervention research where we examined the utility of the social cognitions outlined within the Health Action Process Approach (HAPA) model for predicting moderate to vigorous physical activity (MVPA) intentions and behavior among individuals with schizophrenia or schizoaffective disorder. A prospective cohort design [baseline (T1), week 2 (T2), and week 4 (T3)] was used to examine the HAPA constructs and MVPA across a sample of 101 adults (Mage = 41.5 ± 11.7 years; MBMI = 31.2 ± 7.8 kg/m2; 59% male). Two hierarchical regression analyses were conducted controlling for age, gender, BMI, and previous self-reported MVPA. In the first regression, intentions at T1 were regressed onto the T1 motivational HAPA constructs (risk perception, affective attitudes, task self-efficacy) and social support; MVPA status (meeting vs. not meeting the MVPA guidelines) assessed via accelerometry at T3 was regressed onto T1 social support and intentions followed by T2 action and coping planning, and maintenance self-efficacy in the second analysis. Overall, the motivational and social support variables accounted for 28% of the variance in intentions, with affective attitudes (β = 0.33, p < 0.01) and task self-efficacy (β = 0.25, p < 0.05) exhibiting significant, positive relationships. For MVPA status, the model as a whole explained 39% of the variance, with the volitional HAPA constructs explaining a non-significant 3% of this total variance. These findings suggest a need for interventions targeting self-efficacy and affective attitudes within this clinical population.