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Hong CS, Shen YC, Chang ET, Hou HC, Chen YJ. Exercise training influence on cognitive capacity and mental health within chronic obstructive pulmonary disease - A pilot study. Tzu Chi Med J 2024; 36:188-194. [PMID: 38645787 PMCID: PMC11025594 DOI: 10.4103/tcmj.tcmj_128_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/13/2023] [Accepted: 09/23/2023] [Indexed: 04/23/2024] Open
Abstract
Objective Although pulmonary rehabilitation and regular exercise have improved negative emotions and cognitive capacity within cases of chronic obstructive pulmonary disease (COPD), influence by exercise training upon different cognitive and memory functions in COPD is still controversial. This investigation aimed to assess whether cognitive performance and mental health are affected by the benefits of exercise training within cases of COPD. Materials and Methods This pilot investigation included thirty-three patients with Global Initiative for Chronic Obstructive Lung Disease stage ≥B. Based on the subjects' rights, all included patients could choose to join either the exercise group or the control group, according to their free will. Twelve patients were assigned to receive exercise treatment over a 2-month period, while the remaining 16 patients were assigned to the control group. Cognitive capacity outcomes were measured using the Wechsler Memory Scale-III Word List Test, Stroop task, and psychomotor vigilance task (PVT). Mood states were assessed through the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results Most cases demonstrated major improvement for BDI and BAI scorings post-60-day therapy. During PVT, the omission rate decreased, while the hit rate increased, indicating an improvement in attention performance. Furthermore, this investigation found a significant increase in immediate verbal and recognition memory for word-list test. However, no major performance shifts were found on Stroop analysis. Conclusion This investigation demonstrated that a 2-month exercise training program resulted in significant improvement in negative emotions, immediate memory, recognition memory, and attention.
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Affiliation(s)
- Cheng-Siao Hong
- Department of Human Development and Psychology, Tzu Chi University, Hualien, Taiwan
| | - Yu-Chih Shen
- Department of Psychiatry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - En-Ting Chang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Chest Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Hui-Chuan Hou
- Department of Chest Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yi-Jen Chen
- Department of Chest Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
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Physical exercise as an add-on treatment to cognitive behavioural therapy for anxiety: a systematic review. Behav Cogn Psychother 2021; 49:626-640. [PMID: 33678210 DOI: 10.1017/s1352465821000126] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is currently the treatment of choice for most anxiety disorders. Yet, with recovery rates of approximately 50%, many patients fail to achieve complete remission. This has led to increased efforts to enhance treatment efficacy. Physical exercise (PE) has in recent years been advocated as means to augment the effects of CBT for anxiety disorders. PE appears to reduce anxiety through other mechanisms than CBT, some of which might also have the potential to augment the effects of psychological treatment. AIMS The current review aimed to summarize and discuss the current research status on CBT augmented with PE for anxiety. METHOD A systematic literature search was conducted in the databases PsychInfo, Medline and Web of Science to evaluate the potential augmentative effect of combining PE with CBT for anxiety disorders. These effects were intended to be evaluated in a meta-analysis, but findings from the few and diverse studies were better summarized in a systematic review. RESULTS Eight articles were included in this review, of which two had no control group, while six had from two to four experimental arms. Six of the studies concluded in favour of benefits of add-on PE, while two studies found no added benefits of the combined interventions. CONCLUSIONS The combination of PE and CBT appears feasible. Add-on PE seems to be more beneficial for clinical populations, when administered regularly several times per week, across several weeks. Future studies should investigate further how and for whom to best combine PE and CBT.
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Rith-Najarian LR, Boustani MM, Chorpita BF. A systematic review of prevention programs targeting depression, anxiety, and stress in university students. J Affect Disord 2019; 257:568-584. [PMID: 31326690 DOI: 10.1016/j.jad.2019.06.035] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/05/2019] [Accepted: 06/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Given the prevalence of anxiety, depression, and stress among university students, it is important to assess the effectiveness of prevention programs for these problems. Beyond examining effect sizes, applying a common elements approach can enhance our understanding of which practice elements are most frequently included in symptom-reducing programs. METHOD This review examined effective (i.e., outcome-producing) prevention programs targeting depression, anxiety, and/or stress in university students. Programs could be delivered in a group-based, online/computer-delivered, or self-administered format and at the universal, selective, or indicated prevention level. RESULTS The resulting sample of 62 articles covered 68 prevention programs for college, graduate, or professional students across 15 countries. Average effect sizes for programs were moderate (overall g = 0.65), regardless of delivery format or prevention level. The most common practice elements (overall and for programs producing large effects) were: psychoeducation (72%), relaxation (69%), and cognitive monitoring/restructuring (47%). Many programs were limited by: (a) symptom target-outcome mismatches, (b) disproportionately female samples, and (c) inconsistently reported adherence data. LIMITATIONS Commonness of practice elements across outcome-producing interventions does not imply their extensiveness nor unique contribution to effectiveness. Coding was based on information in articles rather than manuals, and inter-rater reliability was moderate for some practice elements. CONCLUSION The outcome-producing prevention programs in our sample had common practice elements and produced moderate reduction in symptoms overall. Future research of depression, anxiety, and stress prevention programs for university students can investigate practice elements' unique and combined impact on outcomes, further explore under-tested practice elements, and use findings to inform intervention design.
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Affiliation(s)
| | - Maya M Boustani
- Department of Psychology, Loma Linda University, United States
| | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, United States
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4
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Trotman GP, Veldhuijzen van Zanten JJCS, Davies J, Möller C, Ginty AT, Williams SE. Associations between heart rate, perceived heart rate, and anxiety during acute psychological stress. ANXIETY STRESS AND COPING 2019; 32:711-727. [PMID: 31382769 DOI: 10.1080/10615806.2019.1648794] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Acute psychological stress elicits increases in heart rate (HR) and anxiety. Theories propose associations between HR, perceived HR, and anxiety during stress. However, anxiety is often measured as a unidimensional construct which limits a comprehensive understanding of these relationships. Objectives: This research explored whether HR reactivity or perceived HR change was more closely associated with cognitive and somatic anxiety during acute psychological stress. Design: Two laboratory-based studies were conducted. Methods: In a single laboratory session, healthy male (N = 71; study 1) and female (N = 70; study 2) university students completed three laboratory psychological stress tasks (counterbalanced), each with a preceding baseline. Heart rate, perceived HR change, and cognitive and somatic anxiety intensity and interpretation of anxiety symptoms were assessed immediately following each task. Data were aggregated across tasks. Results: Actual HR change was unrelated to anxiety intensity, but was associated with more debilitative interpretations of anxiety (study 2). Perceptions of HR change were consistently associated with greater intensity of cognitive (study 1) and somatic (study 1 and 2) anxiety. Conclusions: Perceived HR rather than actual HR is more closely associated with anxiety intensity during psychological stress. The findings have implications for stress management and the clinical treatment of anxiety symptoms.
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Affiliation(s)
- Gavin P Trotman
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
| | | | - Jack Davies
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
| | - Clara Möller
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University , Waco , TX , USA
| | - Sarah E Williams
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham , Birmingham , UK
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Stavestrand SH, Sirevåg K, Nordhus IH, Sjøbø T, Endal TB, Nordahl HM, Specht K, Hammar Å, Halmøy A, Martinsen EW, Andersson E, Hjelmervik H, Mohlman J, Thayer JF, Hovland A. Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial. Trials 2019; 20:174. [PMID: 30885256 PMCID: PMC6423789 DOI: 10.1186/s13063-019-3268-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 02/28/2019] [Indexed: 12/20/2022] Open
Abstract
Background Generalised anxiety disorder (GAD) is a frequent and severe anxiety disorder among older adults. GAD increases the risk of developing other disorders such as depression and coronary heart disease. Older adults with GAD exhibit a poorer response to cognitive behaviour therapy (CBT) compared to younger patients with GAD. The normal age-related cognitive decline can be a contributor to reduced treatment efficacy. One strategy for improving treatment efficacy is to combine CBT with adjunctive interventions targeted at improving cognitive functions. Physical exercise is a viable intervention in this regard. Increased levels of brain-derived neurotrophic factor may mediate improvement in cognitive function. The present study aims to investigate the proposed effects and mechanisms related to concomitant physical exercise. Methods The sample comprises 70 participants aged 60–75 years, who have GAD. Exclusion criteria comprise substance abuse and unstable medication; inability to participate in physical exercise; and conditions which precludes GAD as primary diagnosis. The interventions are individual treatment in the outpatient clinic at the local psychiatric hospital, with two experimental arms: (1) CBT + physical exercise and (2) CBT + telephone calls. The primary outcome measure is symptom reduction on the Penn State Worry Questionnaire. Other measures include questionnaires, clinical interviews, physiological, biological and neuropsychological tests. A subset of 40 participants will undergo magnetic resonance imaging (MRI). After inclusion, participants undergo baseline testing, and are subsequently randomized to a treatment condition. Participants attend five sessions of the add-on treatment in the pre-treatment phase, and move on to interim testing. After interim testing, participants attend 10 sessions of CBT in parallel with continued add-on treatment. Participants are tested post-intervention within 2 weeks of completing treatment, with follow-up testing 6 and 12 months later. Discussion This study aims to develop better treatment for GAD in older adults. Enhancing treatment response will be valuable from both individual and societal perspectives, especially taking the aging of the general population into account. Trial registration ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3268-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Silje Haukenes Stavestrand
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway. .,Solli DPS, Osvegen 15, NO-5228, Nesttun, Norway.
| | - Kristine Sirevåg
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway.,Solli DPS, Osvegen 15, NO-5228, Nesttun, Norway
| | - Inger Hilde Nordhus
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway.,Faculty of Medicine, University of Oslo, Box 1078, Blindern, NO-0316, Oslo, Norway
| | - Trond Sjøbø
- Solli DPS, Osvegen 15, NO-5228, Nesttun, Norway
| | | | - Hans M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Box 8905, NO-7491, Trondheim, Norway.,St.Olavs Hospital HF, Nidaros DPS, Box 3250, Sluppen, NO-7006, Trondheim, Norway
| | - Karsten Specht
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway
| | - Åsa Hammar
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway
| | - Anne Halmøy
- Faculty of Medicine, K.G. Jebsen Centre for Neuropsychiatric Disorders, University of Bergen, Box 7800, NO-5020, Bergen, Norway.,Kronstad DPS/Division of Psychiatry, Haukeland University Hospital, Box 1400, NO-5021, Bergen, Norway
| | - Egil W Martinsen
- Faculty of Medicine, University of Oslo, Box 1078, Blindern, NO-0316, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Eva Andersson
- The Swedish School of Sport and Health Sciences, GIH, Box 5626, SE-114 86, Stockholm, Sweden
| | - Helene Hjelmervik
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway
| | - Jan Mohlman
- Department of Psychology, William Paterson University, 300 Pompton Road, Wayne, NJ, 07470, USA
| | - Julian F Thayer
- Department of Psychology, Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Anders Hovland
- Faculty of Psychology, University of Bergen, Box 7800, NO-5020, Bergen, Norway.,Solli DPS, Osvegen 15, NO-5228, Nesttun, Norway
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Ólafsdóttir KB, Kristjánsdóttir H, Saavedra JM. Effects of Exercise on Depression and Anxiety. A Comparison to Transdiagnostic Cognitive Behavioral Therapy. Community Ment Health J 2018; 54:855-859. [PMID: 29168106 DOI: 10.1007/s10597-017-0213-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 11/19/2017] [Indexed: 11/30/2022]
Abstract
The aims of this study were (i) to know the effects of an exercise program on a group of people with depression and anxiety and (ii) to compare theses effects with a transdiagnostic cognitive behavioral group therapy (TCBGT). The participants were 15 people with depression and/or anxiety symptoms. The participants followed an exercise program. Depression and anxiety symptoms were assessed with validated questionnaires. An exercise program can be used as a treatment option for people with depression and/or anxiety with good results in comparison with TCBGT.
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Affiliation(s)
- Kristín B Ólafsdóttir
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department; School of Science and Engineering,, Reykjavik University, Reykjavik, Iceland.,Landspitali, The University Hospital of Iceland, Reykjavĺk, Iceland
| | - Hafrún Kristjánsdóttir
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department; School of Science and Engineering,, Reykjavik University, Reykjavik, Iceland.
| | - Jose M Saavedra
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department; School of Science and Engineering,, Reykjavik University, Reykjavik, Iceland
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7
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Williams SE, Carroll D, Veldhuijzen van Zanten JJCS, Ginty AT. Anxiety symptom interpretation: A potential mechanism explaining the cardiorespiratory fitness-anxiety relationship. J Affect Disord 2016; 193:151-6. [PMID: 26773908 DOI: 10.1016/j.jad.2015.12.051] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 10/29/2015] [Accepted: 12/04/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Higher cardiorespiratory fitness is associated with lower trait anxiety, but research has not examined whether fitness is associated with state anxiety levels and the interpretation of these symptoms. The aim of this paper was to (1) reexamine the association between cardiorespiratory fitness and general anxiety and (2) examine anxiety intensity and perceptions of these symptoms prior to an acute psychological stress task. METHODS Participants (N=185; 81% female; Mage=18.04, SD=0.43 years) completed a 10-minute Paced Serial Addition Test. General anxiety was assessed using the anxiety subscale of the Hospital Anxiety Depression Scale. Cognitive and somatic anxiety intensity and perceptions of symptoms was assessed immediately prior to the acute psychological stress task using the Immediate Anxiety Measures Scale. Cardiorespiratory fitness was calculated using a validated standardized formula. RESULTS Higher levels of cardiorespiratory fitness were associated with lower levels of general anxiety. Path analysis supported a model whereby perceptions of anxiety symptoms mediated the relationship between cardiorespiratory fitness and levels of anxiety experienced during the stress task; results remained significant after adjusting for general anxiety levels. Specifically, higher levels of cardiorespiratory fitness were positively associated with more positive perceptions of anxiety symptoms and lower levels of state anxiety. LIMITATIONS A standard formula rather than maximal testing was used to assess cardiorespiratory fitness, self-report questionnaires were used to assess anxiety, and the study was cross-sectional in design. CONCLUSIONS Results suggest a potential mechanism explaining how cardiorespiratory fitness can reduce anxiety levels.
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Affiliation(s)
- Sarah E Williams
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Douglas Carroll
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | | | - Annie T Ginty
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh 15260, USA
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8
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Conley CS, Durlak JA, Kirsch AC. A Meta-analysis of universal mental health prevention programs for higher education students. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 16:487-507. [PMID: 25744536 DOI: 10.1007/s11121-015-0543-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This meta-analysis investigated the effectiveness of universal mental health prevention programs for higher education students on a range of adjustment outcomes. A systematic literature search identified 103 controlled published and unpublished interventions involving college, graduate, or professional students. As hypothesized, skill-training programs that included a supervised practice component were significantly more effective overall (mean effect size = 0.45, confidence interval (CI) = 0.39 to 0.52) compared to skill-training programs without supervised practice (0.11, CI = -0.01 to 0.22) and psychoeducational (information-only) programs (0.13, CI = 0.06 to 0.21). When comparisons on specific outcomes were possible, skill-training programs including supervised practice were significantly more effective than the other two groups of programs in reducing symptoms of depression, anxiety, stress, and general psychological distress, and in improving social-emotional skills, self-perceptions, and academic behaviors and performance. The magnitude of effects achieved in several outcome areas is comparable to or higher than that reported in other reviews of universal programs, suggesting that skill-training programs for higher education students that incorporate supervised practice now join the ranks of other effective preventive mental health interventions. This review offers several recommendations to improve the experimental rigor of future research.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA,
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Kashdan TB, Adams LM, Farmer AS, Ferssizidis P, McKnight PE, Nezlek JB. Sexual healing: daily diary investigation of the benefits of intimate and pleasurable sexual activity in socially anxious adults. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:1417-1429. [PMID: 23982567 DOI: 10.1007/s10508-013-0171-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 03/20/2013] [Accepted: 06/06/2013] [Indexed: 06/02/2023]
Abstract
A growing literature attests to deficits in social and romantic life quality in people with elevated social anxiety, but no research to date has explored how intense intimate encounters influence social anxiety symptoms. This study investigated whether the presence and quality of sexual activity on a given day predicted less social anxiety and negative cognitions on a subsequent day. We also explored whether the benefits of sexual activity would be stronger for more socially anxious individuals. Over 21 days, 172 undergraduate students described the presence and quality of sexual activity, social anxiety symptoms, and use of social comparisons on the day in question. Time-lagged analyses determined that being sexually active on one day was related to less social anxiety symptoms and the generation of fewer negative social comparisons the next day. Furthermore, more intense experiences of pleasure and connectedness during sex predicted greater reductions in social anxiety the next day for people high in trait social anxiety, compared to those low in trait social anxiety. These results were similar regardless of whether sex occurred in the context of romantic relationships or on weekdays versus weekends. The results suggest that sexual activity, particularly when pleasurable and intimate, may mitigate some of the social anxiety and negative comparisons frequently experienced by people with high trait social anxiety.
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Affiliation(s)
- Todd B Kashdan
- Department of Psychology, George Mason University, MS 3F5, Fairfax, VA, 22030, USA,
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Chalmers JA, Quintana DS, Abbott MJA, Kemp AH. Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis. Front Psychiatry 2014; 5:80. [PMID: 25071612 PMCID: PMC4092363 DOI: 10.3389/fpsyt.2014.00080] [Citation(s) in RCA: 502] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 06/26/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis. METHOD Studies comparing resting-state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. RESULTS Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterized by lower HRV [high frequency (HF): Hedges' g = -0.29. 95% CI: -0.41 to -0.17, p < 0.001; time domain: Hedges' g = -0.45, 95% CI: -0.57 to -0.33, p < 0.001] than controls. Panic disorder (n = 447), post-traumatic stress disorder (n = 192), generalized anxiety disorder (n = 68), and social anxiety disorder (n = 90), but not obsessive-compulsive disorder (n = 40), displayed reductions in HF HRV relative to controls (all ps < 0.001). CONCLUSION Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size. Findings have important implications for future physical health and well-being of patients, highlighting a need for comprehensive cardiovascular risk reduction.
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Affiliation(s)
- John A Chalmers
- School of Psychology, University of Sydney , Sydney, NSW , Australia
| | - Daniel S Quintana
- Brain and Mind Research Institute, University of Sydney , Sydney, NSW , Australia ; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo , Oslo , Norway ; Division of Mental Health and Addiction, Oslo University Hospital , Oslo , Norway
| | | | - Andrew H Kemp
- School of Psychology, University of Sydney , Sydney, NSW , Australia ; University Hospital and Faculty of Medicine, University of São Paulo , São Paulo , Brazil ; Discipline of Psychiatry, University of Sydney , Sydney, NSW , Australia
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11
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Jayakody K, Gunadasa S, Hosker C. Exercise for anxiety disorders: systematic review. Br J Sports Med 2013; 48:187-96. [DOI: 10.1136/bjsports-2012-091287] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Conley CS, Durlak JA, Dickson DA. An evaluative review of outcome research on universal mental health promotion and prevention programs for higher education students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:286-301. [PMID: 23768226 DOI: 10.1080/07448481.2013.802237] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This review is the first large-scale attempt to evaluate the effectiveness of universal promotion and prevention programs for higher education students on a range of adjustment outcomes. PARTICIPANTS/METHODS The current review examined 83 controlled interventions involving college, graduate, and professional students, with a focus on 3 main outcomes: social and emotional skills, self-perceptions, and emotional distress. RESULTS/CONCLUSIONS Skill-oriented programs that included supervised practice demonstrated the strongest benefits, thus showing promise as a successful mental health promotion and preventive intervention. In comparing different intervention strategies, mindfulness training and cognitive-behavioral techniques appear to be the most effective. Furthermore, interventions conducted as a class appear to be effective, suggesting the potential for exposing higher education students to skill training through routine curricula offerings. This review offers recommendations for improving the experimental rigor of future research, and implications for enhancing campus services to optimize student success in psychosocial--and thus ultimately academic--domains.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, Illinois 60626, USA.
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Conley CS, Travers LV, Bryant FB. Promoting psychosocial adjustment and stress management in first-year college students: the benefits of engagement in a psychosocial wellness seminar. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:75-86. [PMID: 23409857 DOI: 10.1080/07448481.2012.754757] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE/METHODS This research evaluates the effectiveness of a psychosocial wellness seminar for first-year college students, from 2009 to 2011, using an 8-month prospective quasi-experimental design. PARTICIPANTS/RESULTS Compared with controls (n = 22) involved in an alternative seminar, intervention participants (n = 29) showed no differences at baseline, but reported significantly greater perceived improvements over the course of the intervention, in psychosocial adjustment and stress management. Furthermore, specific aspects of intervention engagement (attendance and student-rated skills practice, but not didactic mastery or facilitator-rated skills practice) differentially predicted beneficial outcomes: (1) psychosocial adjustment (increases in psychosocial well-being, decreases in psychological distress), after adjusting for baseline levels of these outcomes; (2) college-related stress management (lower college-related stress, greater adaptation to college); and (3) perceived improvements in psychosocial adjustment and stress management. CONCLUSIONS This research indicates promising avenues for programmatic efforts to promote psychosocial adjustment and stress management in college students, during this critical developmental juncture.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, Illinois 60626, USA.
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14
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Goldin P, Ziv M, Jazaieri H, Hahn K, Gross JJ. MBSR vs aerobic exercise in social anxiety: fMRI of emotion regulation of negative self-beliefs. Soc Cogn Affect Neurosci 2013; 8:65-72. [PMID: 22586252 PMCID: PMC3541489 DOI: 10.1093/scan/nss054] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 04/30/2012] [Indexed: 12/11/2022] Open
Abstract
Mindfulness-based stress reduction (MBSR) is thought to reduce emotional reactivity and enhance emotion regulation in patients with social anxiety disorder (SAD). The goal of this study was to examine the neural correlates of deploying attention to regulate responses to negative self-beliefs using functional magnetic resonance imaging. Participants were 56 patients with generalized SAD in a randomized controlled trial who were assigned to MBSR or a comparison aerobic exercise (AE) stress reduction program. Compared to AE, MBSR yielded greater (i) reductions in negative emotion when implementing regulation and (ii) increases in attention-related parietal cortical regions. Meditation practice was associated with decreases in negative emotion and social anxiety symptom severity, and increases in attention-related parietal cortex neural responses when implementing attention regulation of negative self-beliefs. Changes in attention regulation during MBSR may be an important psychological factor that helps to explain how mindfulness meditation training benefits patients with anxiety disorders.
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Affiliation(s)
- Philippe Goldin
- Department of Psychology, Stanford University, Stanford, CA 94305, USA.
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15
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Swain RA, Berggren KL, Kerr AL, Patel A, Peplinski C, Sikorski AM. On aerobic exercise and behavioral and neural plasticity. Brain Sci 2012; 2:709-44. [PMID: 24961267 PMCID: PMC4061809 DOI: 10.3390/brainsci2040709] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/01/2012] [Accepted: 11/13/2012] [Indexed: 12/28/2022] Open
Abstract
Aerobic exercise promotes rapid and profound alterations in the brain. Depending upon the pattern and duration of exercise, these changes in the brain may extend beyond traditional motor areas to regions and structures normally linked to learning, cognition, and emotion. Exercise-induced alterations may include changes in blood flow, hormone and growth factor release, receptor expression, angiogenesis, apoptosis, neurogenesis, and synaptogenesis. Together, we believe that these changes underlie elevations of mood and prompt the heightened behavioral plasticity commonly observed following adoption of a chronic exercise regimen. In the following paper, we will explore both the psychological and psychobiological literatures relating to exercise effects on brain in both human and non-human animals and will attempt to link plastic changes in these neural structures to modifications in learned behavior and emotional expression. In addition, we will explore the therapeutic potential of exercise given recent reports that aerobic exercise may serve as a neuroprotectant and can also slow cognitive decline during normal and pathological aging.
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Affiliation(s)
- Rodney A Swain
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Kiersten L Berggren
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Abigail L Kerr
- Department of Psychology, Illinois Wesleyan University, Bloomington, IL 61702, USA.
| | - Ami Patel
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Caitlin Peplinski
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Angela M Sikorski
- Department of Psychology, Texas A & M University-Texarkana, Texarkana, TX 75503, USA.
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Jazaieri H, Goldin PR, Werner K, Ziv M, Gross JJ. A randomized trial of MBSR versus aerobic exercise for social anxiety disorder. J Clin Psychol 2012; 68:715-31. [PMID: 22623316 DOI: 10.1002/jclp.21863] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Effective treatments for social anxiety disorder (SAD) exist, but additional treatment options are needed for nonresponders as well as those who are either unable or unwilling to engage in traditional treatments. Mindfulness-based stress reduction (MBSR) is one nontraditional treatment that has demonstrated efficacy in treating other mood and anxiety disorders, and preliminary data suggest its efficacy in SAD as well. METHOD Fifty-six adults (52% female; 41% Caucasian; age mean [M] ± standard deviation [SD]: 32.8 ± 8.4) with SAD were randomized to MBSR or an active comparison condition, aerobic exercise (AE). At baseline and post-intervention, participants completed measures of clinical symptoms (Liebowitz Social Anxiety Scale, Social Interaction Anxiety Scale, Beck Depression Inventory-II, and Perceived Stress Scale) and subjective well-being (Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Self-Compassion Scale, and UCLA-8 Loneliness Scale). At 3 months post-intervention, a subset of these measures was readministered. For clinical significance analyses, 48 healthy adults (52.1% female; 56.3% Caucasian; age [M ± SD]: 33.9 ± 9.8) were recruited. MBSR and AE participants were also compared with a separate untreated group of 29 adults (44.8% female; 48.3% Caucasian; age [M ± SD]: 32.3 ± 9.4) with generalized SAD who completed assessments over a comparable time period with no intervening treatment. RESULTS A 2 (Group) x 2 (Time) repeated measures analyses of variance (ANOVAs) on measures of clinical symptoms and well-being were conducted to examine pre-intervention to post-intervention and pre-intervention to 3-month follow-up. Both MBSR and AE were associated with reductions in social anxiety and depression and increases in subjective well-being, both immediately post-intervention and at 3 months post-intervention. When participants in the randomized controlled trial were compared with the untreated SAD group, participants in both interventions exhibited improvements on measures of clinical symptoms and well-being. CONCLUSION Nontraditional interventions such as MBSR and AE merit further exploration as alternative or complementary treatments for SAD.
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Affiliation(s)
- Hooria Jazaieri
- Stanford University, Department of Psychology, 420 Jordan Hall, Room 430, Stanford, CA 94305-2130, USA.
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Abstract
Depression and anxiety are the most common psychiatric conditions seen in the general medical setting, affecting millions of individuals in the United States. The treatments for depression and anxiety are multiple and have varying degrees of effectiveness. Physical activity has been shown to be associated with decreased symptoms of depression and anxiety. Physical activity has been consistently shown to be associated with improved physical health, life satisfaction, cognitive functioning, and psychological well-being. Conversely, physical inactivity appears to be associated with the development of psychological disorders. Specific studies support the use of exercise as a treatment for depression. Exercise compares favorably to antidepressant medications as a first-line treatment for mild to moderate depression and has also been shown to improve depressive symptoms when used as an adjunct to medications. While not as extensively studied, exercise has been shown to be an effective and cost-efficient treatment alternative for a variety of anxiety disorders. While effective, exercise has not been shown to reduce anxiety to the level achieved by psychopharmaceuticals.
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Affiliation(s)
- Peter J Carek
- Department of Family Medicine, Medical University of South Carolina, Charleston 29406, USA.
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18
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Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm (Vienna) 2008; 116:777-84. [DOI: 10.1007/s00702-008-0092-x] [Citation(s) in RCA: 680] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 06/24/2008] [Indexed: 11/29/2022]
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19
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Jorm AF, Christensen H, Griffiths KM, Parslow RA, Rodgers B, Blewitt KA. Effectiveness of complementary and self-help treatments for anxiety disorders. Med J Aust 2004; 181:S29-46. [PMID: 15462640 DOI: 10.5694/j.1326-5377.2004.tb06352.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2003] [Accepted: 02/27/2004] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To review the evidence for the effectiveness of complementary and self-help treatments for anxiety disorders. DATA SOURCES Systematic literature search using PubMed, PsycLit, and the Cochrane Library. DATA SYNTHESIS 108 treatments were identified and grouped under the categories of medicines and homoeopathic remedies, physical treatments, lifestyle, and dietary changes. We give a description of the 34 treatments (for which evidence was found in the literature searched), the rationale behind the treatments, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. CONCLUSIONS The treatments with the best evidence of effectiveness are kava (for generalised anxiety), exercise (for generalised anxiety), relaxation training (for generalised anxiety, panic disorder, dental phobia and test anxiety) and bibliotherapy (for specific phobias). There is more limited evidence to support the effectiveness of acupuncture, music, autogenic training and meditation for generalised anxiety; for inositol in the treatment of panic disorder and obsessive-compulsive disorder; and for alcohol avoidance by people with alcohol-use disorders to reduce a range of anxiety disorders.
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Affiliation(s)
- Anthony F Jorm
- Centre for Mental Health Research, Australian National University, Building 63, Eggleston Road, Acton, ACT 0200, Australia.
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Broman-Fulks JJ, Berman ME, Rabian BA, Webster MJ. Effects of aerobic exercise on anxiety sensitivity. Behav Res Ther 2004; 42:125-36. [PMID: 14975776 DOI: 10.1016/s0005-7967(03)00103-7] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2002] [Revised: 03/17/2003] [Accepted: 03/25/2003] [Indexed: 10/27/2022]
Abstract
Anxiety sensitivity is a known precursor to panic attacks and panic disorder, and involves the misinterpretation of anxiety-related sensations. Aerobic exercise has been shown to reduce generalized anxiety, and may also reduce anxiety sensitivity through exposure to feared physiological sensations. Accordingly, 54 participants with elevated anxiety sensitivity scores completed six 20-min treadmill exercise sessions at either a high-intensity aerobic ( n = 29 ) or low-intensity ( n = 25 ) level. Self-ratings of anxiety sensitivity, fear of physiological sensations associated with anxiety, and generalized anxiety were obtained at pre-treatment, post-treatment, and one-week follow-up. Results indicated that both high- and low-intensity exercise reduced anxiety sensitivity. However, high-intensity exercise caused more rapid reductions in a global measure of anxiety sensitivity and produced more treatment responders than low-intensity exercise. Only high-intensity exercise reduced fear of anxiety-related bodily sensations. The implications of these findings are discussed.
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Affiliation(s)
- Joshua J Broman-Fulks
- Department of Psychology, The University of Southern Mississippi, P.O. Box 5025, Hattiesburg, MS 39406-5025, USA
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