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Dekel S, Papadakis JE, Quagliarini B, Pham CT, Pacheco-Barrios K, Hughes F, Jagodnik KM, Nandru R. Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:610-641.e14. [PMID: 38122842 PMCID: PMC11168224 DOI: 10.1016/j.ajog.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder. DATA SOURCES PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for eligible trials published through September 2023. STUDY ELIGIBILITY CRITERIA Trials were included if they were interventional, if they evaluated any therapy for childbirth-related posttraumatic stress disorder for the indication of symptoms or before posttraumatic stress disorder onset, and if they were written in English. METHODS Independent coders extracted the sample characteristics and intervention information of the eligible studies and evaluated the trials using the Downs and Black's quality checklist and Cochrane's method for risk of bias evaluation. Meta-analysis was conducted to evaluate pooled effect sizes of secondary and tertiary prevention trials. RESULTS A total of 41 studies (32 randomized controlled trials, 9 nonrandomized trials) were reviewed. They evaluated brief psychological therapies including debriefing, trauma-focused therapies (including cognitive behavioral therapy and expressive writing), memory consolidation and reconsolidation blockage, mother-infant-focused therapies, and educational interventions. The trials targeted secondary preventions aimed at buffering childbirth-related posttraumatic stress disorder usually after traumatic childbirth (n=24), tertiary preventions among women with probable childbirth-related posttraumatic stress disorder (n=14), and primary prevention during pregnancy (n=3). A meta-analysis of the combined randomized secondary preventions showed moderate effects in reducing childbirth-related posttraumatic stress disorder symptoms when compared with usual treatment (standardized mean difference, -0.67; 95% confidence interval, -0.92 to -0.42). Single-session therapy within 96 hours of birth was helpful (standardized mean difference, -0.55). Brief, structured, trauma-focused therapies and semi-structured, midwife-led, dialogue-based psychological counseling showed the largest effects (standardized mean difference, -0.95 and -0.91, respectively). Other treatment approaches (eg, the Tetris game, mindfulness, mother-infant-focused treatment) warrant more research. Tertiary preventions produced smaller effects than secondary prevention but are potentially clinically meaningful (standardized mean difference, -0.37; -0.60 to -0.14). Antepartum educational approaches may help, but insufficient empirical evidence exists. CONCLUSION Brief trauma-focused and non-trauma-focused psychological therapies delivered early in the period following traumatic childbirth offer a critical and feasible opportunity to buffer the symptoms of childbirth-related posttraumatic stress disorder. Future research that integrates diagnostic and biological measures can inform treatment use and the mechanisms at work.
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Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | | | | | - Christina T Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Francine Hughes
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kathleen M Jagodnik
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Rasvitha Nandru
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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Martinez-Calderon J, Villar-Alises O, García-Muñoz C, Pineda-Escobar S, Matias-Soto J. Multimodal exercise programs may improve posttraumatic stress disorders symptoms and quality of life in adults with PTSD: An overview of systematic reviews with meta-analysis. Clin Rehabil 2024; 38:573-588. [PMID: 38258461 DOI: 10.1177/02692155231225466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE This overview of reviews aimed to summarize the effectiveness of exercise, regular physical activity or mind-body exercises on posttraumatic stress disorder (PTSD) symptoms and comorbidities associated with PTSD (e.g. depression symptoms) among individuals without age, gender, race, ethnicity or setting restrictions. DATA SOURCES The CINAHL, Embase, PubMed and SPORTDiscus databases were searched from inception to November 16, 2023. REVIEW METHODS Systematic reviews with meta-analysis of randomized clinical trials evaluating exercise, regular physical activity or mind-body exercises were considered. Control groups and outcome measures were not restricted. AMSTAR 2 assessed the methodological quality of reviews. The overlap between reviews was calculated. RESULTS A total of 14 systematic reviews were included meta-analyzing 23 distinct randomized clinical trials. There was a very high overlap between reviews (corrected covered area = 16%). PTSD symptoms, depression symptoms, anxiety symptoms, sleep quality, substance abuse and quality of life were meta-analyzed. No reviews meta-analyzed the effects of regular physical activity. Overall, the meta-analyses found multicomponent exercise programs may have positive results in reducing PTSD symptoms and improving quality of life. In addition, the results of yoga were inconsistent across the meta-analyses for PTSD symptoms, and no differences between groups were found in favor of yoga for depression symptoms. Finally, no specific conclusions could be made about anxiety symptoms, sleep quality and substance abuse. CONCLUSION A multicomponent exercise program may be effective in improving PTSD symptoms and quality of life, whereas yoga may be ineffective for depression symptoms in adults with PTSD.
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla, IBiS, Universidad de Sevilla, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Olga Villar-Alises
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla, IBiS, Universidad de Sevilla, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Saul Pineda-Escobar
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Departamento de Ciencias de la Salud y Biomédicas, Universidad Loyola Andalucía, Sevilla, Spain
| | - Javier Matias-Soto
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Department of Physical Therapy, Faculty of Health Sciences, Universidad de Malaga, Malaga, Spain
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Miles LW, Valentine JL, Mabey LJ, Hopkins ES, Stodtmeister PJ, Rockwood RB, Moxley ANH. A Systematic Review of Evidence-Based Treatments for Adolescent and Adult Sexual Assault Victims. J Am Psychiatr Nurses Assoc 2024; 30:480-502. [PMID: 38148646 PMCID: PMC11138126 DOI: 10.1177/10783903231216138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
BACKGROUND Sexual assault (SA) is a serious crime that is a prevalent mental and public health problem. AIMS Addressing the needs of SA victims and providing appropriate treatment are essential to reduce potential adverse short- and long-term outcomes. METHODS Our team undertook an extensive systematic literature review (published between January 2006 and July 2021) to provide evidence-based mental health intervention recommendations for adolescent and adult victims of SA. Where SA-specific research was limited, the literature and clinical practice guidelines on treatments for trauma-induced post-traumatic stress disorder (PTSD) were reviewed to provide additional information to formulate recommendations. RESULTS Findings strongly support several primary psychotherapy treatments: cognitive behavioral therapy, cognitive processing therapy, eye movement desensitization and reprocessing, narrative exposure therapy, and prolonged exposure therapy. Complementary (aerobic exercise, art, drama, and music therapy) and pharmacological treatments were explored. CONCLUSIONS Mental health nurses who provide services for victims of SA can utilize this overview to guide recommendations for treatment of SA trauma and related PTSD symptoms to mitigate the short- and long-term negative impacts after a traumatic event. When victims of SA receive optimal mental health treatments, our communities benefit as victims heal and recover.
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Affiliation(s)
- Leslie W. Miles
- Leslie W. Miles, DNP, PMHNP-BC, Brigham Young University College of Nursing, Provo, UT, USA
| | - Julie L. Valentine
- Julie L. Valentine, PhD, RN, SANE-A, FAAN, University of Utah, Salt Lake City, UT, USA
| | - Linda J. Mabey
- Linda J. Mabey, DNP, PMHCNS-BC, Brigham Young University College of Nursing, Provo, UT, USA
| | | | - Paige J. Stodtmeister
- Paige J. Stodtmeister, DNP, PMHNP-BC Brigham Young University College of Nursing, Provo, UT, USA
| | - Reilly B. Rockwood
- Reilly B. Rockwood, DNP, PMHNP-BC, Brigham Young University College of Nursing, Provo, UT, USA
| | - Alyssa N. H. Moxley
- Alyssa N. H. Moxley, DNP, CNM, WHNP-BC, Brigham Young University College of Nursing, Provo, UT, USA
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Bendau A, Petzold MB, Kaminski J, Plag J, Ströhle A. Exercise as Treatment for "Stress-Related" Mental Disorders. Curr Neuropharmacol 2024; 22:420-436. [PMID: 37779399 PMCID: PMC10845075 DOI: 10.2174/1570159x22666230927103308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 10/03/2023] Open
Abstract
The beneficial impact of physical activity on preventing and treating mental disorders has captured growing (research) interest. This article aims to provide a concise overview of essential evidence regarding the effectiveness and underlying mechanisms of physical activity for individuals with mental disorders clustered as "stress-related" conditions. Empirical findings (e.g., longitudinalprospective studies, interventional randomized-controlled-trials, reviews, meta-analyses) regarding the effects of physical activity in the prevention and treatment of stress-related mental disorders are summarized. Furthermore, potential mechanisms underlying these effects are discussed, and recommendations regarding the use of physical activity are outlined. The majority of studies indicate good efficacy of physical activity in prospectively lowering the risk for the incidence of subsequent stress-related mental disorders as well as in the treatment of manifest disorders. Most evidence targets unipolar depressive disorder and, secondly, anxiety disorders. Research regarding posttraumatic stress disorder, obsessive-compulsive disorders, and somatoform disorders is promising but scarce. Physical activity seems to be useful as a stand-alone-treatment as well as in combination with other psychotherapeutic or pharmacological treatments. Multiple intertwined physiological, psychological, and social mechanisms are assumed to mediate the beneficial effects. Recommendations regarding physical activity can orientate on official guidelines but should consider the individual needs and circumstances of each subject. In summary, physical activity seems to be effective in the prevention and treatment of stressrelated mental disorders and, therefore, should be fostered in healthcare-settings. Future studies are needed to clarify partly inconsistent patterns of results and to close research gaps, e.g., concerning somatoform disorders.
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Affiliation(s)
- Antonia Bendau
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- HMU Health and Medical University Potsdam, Potsdam, Germany
| | - Moritz Bruno Petzold
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Jan Kaminski
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Plag
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- HMU Health and Medical University Potsdam, Potsdam, Germany
- Oberberg Fachklinik Potsdam, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
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Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Alston R, Darroch FE, Gobin RL. Perceived Barriers and Benefits of Exercise Among Men with Histories of Sexual Violence: Impact of PTSD and Physical Activity Status. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11842-11869. [PMID: 37519195 DOI: 10.1177/08862605231188058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This study reported on perceived benefits and barriers of exercise among men with histories of sexual violence (SV) and compared these perceptions by activity level and post-traumatic stress disorder (PTSD) status. An online, cross-sectional, survey of men with histories of SV (N = 198) was completed using Amazon Mechanical Turk. Inclusion criteria were identifying sex at birth as male, age between 18 and 65 years, self-reported history of SV, and living in the United States (U.S.). A total of 1,260 men were screened for the study, of which 316 met the inclusion criteria, and 198 met all data quality requirements and were included in the study. Sociodemographic information, exercise behavior, PTSD symptoms, and perceived exercise barriers/benefits were collected. Comparisons by activity and PTSD status were analyzed. Additionally, two open-ended qualitative research questions were included to provide nuance to perceived barriers/benefits of exercise. The most salient benefits included physical performance, psychological outlook, and preventative health. Open-ended responses also noted the mental and physical benefits of exercise. The most salient barrier was physical exercise, with open-ended responses emphasizing lack of time, chronic pain and health concerns, and poor mental health and lack of motivation as impediments to exercise. Significant differences were found in benefits (psychological outlook, physical performance) and barriers (exercise environment, high time expenditure, and family discouragement) between active and insufficiently active men with histories of SV (ps < .05; Cohen's ds = 0.32-0.57). Significant differences were found by PTSD status on benefits (physical performance, social interaction, and preventative health) and barriers (exercise milieu, time expenditure, hard physical exercise, family discouragement) (ps < .05; Cohen's ds = 0.40-1.10). Findings provide new gender-specific strategies for promoting exercise among men with histories of SV: integrating exercise physiologists into trauma recovery programs, psychoeducation, engaging friends and family members, peer-support, and building self-efficacy.
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Affiliation(s)
- Michelle M Pebole
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
- University of Illinois at Urbana Champaign, Champaign, IL, USA
| | | | - Katherine S Hall
- VA Durham Healthcare System, Durham, NC, USA
- Duke University, Durham, NC, USA
| | | | - Reginald Alston
- University of Illinois at Urbana Champaign, Champaign, IL, USA
| | | | - Robyn L Gobin
- University of Illinois at Urbana Champaign, Champaign, IL, USA
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Barrett BW, Meanley S, Brennan-Ing M, Haberlen SA, Ware D, Detels R, Friedman MR, Plankey MW. The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact. J Aging Health 2023:8982643231215475. [PMID: 37976419 DOI: 10.1177/08982643231215475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus. METHODS Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes. RESULTS Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus. DISCUSSION There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.
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Affiliation(s)
- Benjamin W Barrett
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, The City University of New York, Hunter College, NY, New York, USA
| | - Sabina A Haberlen
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Deanna Ware
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - M Reuel Friedman
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Michael W Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
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Kibler J, Ma M, Hrzich J, Choe J. Pilot Findings Indicate a Cognitive Behavioral Healthy Lifestyle Intervention for PTSD Improves Sleep and Physical Activity. Brain Sci 2023; 13:1565. [PMID: 38002526 PMCID: PMC10669697 DOI: 10.3390/brainsci13111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Research has indicated strong associations between post-traumatic stress and cardiovascular disease (CVD) risk. Individuals with post-traumatic stress disorder (PTSD) tend to show patterns of elevated CVD risk earlier in life than the general population. The need for developing effective interventions for CVD risk reduction in PTSD is increasingly evident. The purpose of the present pilot study was to examine the effects of a healthy lifestyle intervention that addresses CVD-related heath behaviors (physical activity, sleep, stress) among civilian adults with PTSD. Participants were randomized to the healthy lifestyle intervention condition or a wait-list control. A total of 22 women completed the protocol (11 per group). The mean age was 32 (SD ± 14). Evaluations were conducted before and after the 12-week intervention program in the experimental group, and 12 weeks apart for the control group, and included standardized self-report measures of sleep, physical activity, and general stress. The healthy lifestyle group showed an increase in the amount of sleep pre to post (mean of 1.2 h per night), which was significantly different to the control group, who had no change (p < 0.05; effect size = 1.41). Notable pre to post increases in physical activity were observed between the intervention group (mean increase = 115.8 min over 7 days) and control condition (mean = 4.5 min over 7 days); however, this effect was not significant in the small sample (effect size = 0.70). These preliminary findings suggest that a healthy lifestyle intervention is feasible and can produce desired changes in target behaviors/outcomes.
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Affiliation(s)
- Jeffrey Kibler
- Department of Clinical and School Psychology, College of Psychology, Nova Southeastern University, 3300 S. University Dr., Ft. Lauderdale, FL 33328, USA;
| | - Mindy Ma
- Department of Clinical and School Psychology, College of Psychology, Nova Southeastern University, 3300 S. University Dr., Ft. Lauderdale, FL 33328, USA;
| | - Jacquelyn Hrzich
- Psychological Dimensions, 6595 S. Dayton St., Greenwood Village, CO 80111, USA;
| | - Jessica Choe
- James A. Haley Veterans’ Hospital, 13000 Bruce B. Downs Boulevard, Tampa, FL 33612, USA;
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Jeftic I, Furzer B, Dimmock JA, Wright K, Budden T, Boyd C, Simpson A, Rosenberg M, Sabiston CM, deJonge M, Jackson B. The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 69:102507. [PMID: 37665942 DOI: 10.1016/j.psychsport.2023.102507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/17/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023]
Abstract
Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, Mage = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants' pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress.
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Affiliation(s)
- Ivan Jeftic
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia.
| | - Bonnie Furzer
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia; Fremantle Hospital Mental Health Service, South Metropolitan Health Service, Fremantle, Western Australia, Australia
| | - James A Dimmock
- Telethon Kids Institute, Perth, Western Australia, Australia; Department of Psychology, College of Healthcare Sciences, James Cook University, Australia
| | - Kemi Wright
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
| | - Conor Boyd
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia
| | - Aaron Simpson
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Melissa deJonge
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
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Lüder CC, Michael T, Lass-Hennemann J, Schanz CG, Venhorst A, Meyer T, Equit M. Moderate-intensity aerobic exercise training as an adjunct to trauma-focused psychotherapy in traumatized refugees and asylum seekers: study protocol of a randomized controlled trial. Eur J Psychotraumatol 2023; 14:2251777. [PMID: 37860859 PMCID: PMC10591536 DOI: 10.1080/20008066.2023.2251777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/24/2023] [Indexed: 10/21/2023] Open
Abstract
Background: Refugees with exposure to multiple traumatic events are at high risk for developing posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an effective treatment for the core symptoms of PTSD, but it does not reliably reduce depressive symptoms. Endurance exercise on the other hand was consistently found to be effective in treating depression making it a promising adjunct to NET. Up to date, no studies exist investigating the combination of NET and endurance exercise in a sample of refugees with PTSD and comorbid depression.Objectives: In the proposed randomized controlled trial, we aim to investigate whether a combination of NET and moderate-intensity aerobic exercise training (MAET) enhances treatment outcome for refugees with PTSD and comorbid depressive symptoms. We expect a greater improvement in psychopathology in participants who receive the combined treatment.Methods and analysis: 68 refugees and asylum seekers with PTSD and clinically relevant depressive symptoms will be recruited in the proposed study. Participants will be randomly assigned to receive either NET only (NET-group) or NET plus MAET (NET+-group). All participants will receive 10 NET sessions. Participants in the NET+-group will additionally take part in MAET. Primary (PTSD, depression) and secondary (general mental distress, agoraphobia and somatoform complaints, sleep quality) outcome measures will be assessed before treatment, after treatment, and at six-month follow-up. The hypotheses will be tested with multiple 2 × 3 mixed ANOVA's.Trial registration: German Clinical Trials Register identifier: DRKS00022145.
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Affiliation(s)
- Charina C. Lüder
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Christian G. Schanz
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Andreas Venhorst
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Monika Equit
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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10
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Shen B, Cui G, Bo J. How does change in leisure-time physical activity influence the growth trajectory of depressive symptoms in college students? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37722822 DOI: 10.1080/07448481.2023.2252503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/20/2023] [Indexed: 09/20/2023]
Abstract
Objectives: This longitudinal study was designed to examine the growth trajectory of depressive symptoms among early-stage college students and how the development of vigorous, moderate, and light leisure-time physical activity (LTPA) was related to the growth trajectory. Participants: Four hundred and eighty-eight first- and second-year undergraduate students completed measures of depressive symptoms and LTPA at the beginning, middle, and end of a semester. Methods: Latent growth mixture modeling (LGMM) was conducted. Results: On average, students reported mild levels of depressive symptoms with significant variability at the semester start, but the symptoms elevated over time. LGMM identified two trajectories: low/gradual (75.8%) and high/increasing (24.2%). For both groups, neither vigorous nor moderate LTPA development predicted the growth trajectory of depressive symptoms. However, the change of light LTPA was negatively and significantly associated with the growth trajectory. Even when controlling for covariances, increased light LTPA still had a unique effect on buffering depressive symptoms. Conclusion: There is great potential in targeting comprehensive LTPA strategies to improve college students' mental health and promote an active lifestyle.
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Affiliation(s)
- Bo Shen
- Central China Normal University, Wuhan, China
- Wayne State University, Detroit, Michigan, USA
| | | | - Jin Bo
- Eastern Michigan University, Ypsilanti, Michigan, USA
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Young-McCaughan S, Straud CL, Bumstead S, Pruiksma KE, Taylor DJ, Jacoby VM, Yarvis JS, Peterson AL. Aerobic exercise improves sleep in U. S. active duty service members following brief treatment for posttraumatic stress disorder symptoms. Front Psychol 2023; 14:1249543. [PMID: 37794901 PMCID: PMC10546873 DOI: 10.3389/fpsyg.2023.1249543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/25/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Physical exercise is a lifestyle intervention that can positively impact aspects of physical and psychological health. There is a growing body of evidence suggesting that physical exercise, sleep, and PTSD are interrelated. This study investigated possible relationships. Three research questions were posed: (1) Did randomization to an aerobic exercise intervention reduce insomnia more than being randomized to an intervention without exercise, (2) Did change in sleep predict change in PTSD symptoms, and (3) Did change in sleep impact the relationship between exercise and PTSD symptom reductions? Methods Data were collected from 69 treatment-seeking active duty service members with PTSD symptoms randomized into one of four conditions; two conditions included aerobic exercise, and two conditions did not include exercise. Participants in the exercise groups exercised five times per week keeping their heart rate > 60% of their heart rate reserve for 20-25 min. Results At baseline, 58% of participants reported moderate or severe insomnia. PTSD symptom severity decreased following treatment for all groups (p < 0.001). Participants randomized to exercise reported greater reductions in insomnia compared to those in the no exercise group (p = 0.47). However, change in insomnia did not predict change in PTSD symptoms nor did it significantly impact the relationship between exercise and PTSD symptom reductions. Discussion Adding exercise to evidence-based treatments for PTSD could reduce sleep disturbance, a characteristic of PTSD not directly addressed with behavioral therapies. A better understanding of exercise as a lifestyle intervention that can reduce PTSD symptoms and insomnia is warranted.
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Affiliation(s)
- Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Casey L. Straud
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Susannah Bumstead
- Institute for Studies of Religion, Baylor University, Waco, TX, United States
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Kristi E. Pruiksma
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Daniel J. Taylor
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Vanessa M. Jacoby
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jeffrey S. Yarvis
- Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, Killeen, TX, United States
| | - Alan L. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Psychology, University of Texas at San Antonio, San Antonio, TX, United States
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, United States
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12
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Correll T, Gentile J, Correll A. Healthy Lifestyle Interventions Augmenting Psychotherapy in Anxiety and PTSD. INNOVATIONS IN CLINICAL NEUROSCIENCE 2023; 20:18-26. [PMID: 37817811 PMCID: PMC10561983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Lifestyle medicine is a new paradigm that shifts much of the responsibility toward the patient. There is increasing evidence that healthy lifestyle interventions can be effective treatment adjuncts for some of the most common mental illnesses. This article gives examples of how to integrate evidence-based, healthy lifestyle interventions into the overall treatment of common psychiatric conditions, including anxiety and posttraumatic stress disorder (PTSD).
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Affiliation(s)
- Terry Correll
- Dr. T. Correll is Clinical Professor of the Department of Psychiatry at Wright State University in Dayton, Ohio
| | - Julie Gentile
- Dr. Gentile is Professor and Chair of the Department of Psychiatry at Wright State University in Dayton, Ohio
| | - Andrew Correll
- Mr. A. Correll is with Wright State University Boonshoft School of Medicine in Dayton, Ohio
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13
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Jeftic I, Furzer BJ, Dimmock JA, Wright K, Boyd C, Budden T, Rosenberg M, Kramer B, Buist B, Fitzpatrick I, Sabiston C, de Jonge M, Jackson B. Structured exercise programs for higher education students experiencing mental health challenges: background, significance, and implementation. Front Public Health 2023; 11:1104918. [PMID: 37181716 PMCID: PMC10167056 DOI: 10.3389/fpubh.2023.1104918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
The incidence of mental illness is greatest among young adults, and those enrolled in higher education may be particularly vulnerable compared to the general young adult population. Many higher education institutions employ student support staff tasked with implementing strategies to improve student wellbeing and mental illness. However, these strategies tend to be focused on clinical therapies and pharmacological interventions with limited lifestyle approaches. Exercise is an effective method for addressing mental illness and promoting wellbeing, yet widespread provision of structured exercise services to support treatment options for students with mental health challenges has not been fully realized. In an effort to guide exercise strategies for student mental health, we synthesize considerations for developing and delivering exercise programs in higher education settings. We draw directly from the evidence base on existing exercise programs in higher education; and the broader behavior change, exercise adherence, health psychology, implementation science, and exercise prescription literatures. Our broad considerations cover issues regarding program engagement and behavior change, exercise 'dose' and prescription, integration with other on-campus services, and robust research and evaluation. These considerations may provide impetus for widespread program development and implementation, as well as informing research focused on protecting and improving student mental health.
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Affiliation(s)
- Ivan Jeftic
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Bonnie J. Furzer
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - James A. Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Kemi Wright
- Department of Exercise Physiology, School of Health Sciences, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Conor Boyd
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ben Kramer
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Brett Buist
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ian Fitzpatrick
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Catherine Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Melissa de Jonge
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
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14
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Li SJ, Zhang LX, Zou GJ, Ma MH, Zhou SF, Lu XY, Li F, Li CQ. Infralimbic YTHDF1 is necessary for the beneficial effects of acute mild exercise on auditory fear extinction retention. Cereb Cortex 2023; 33:1814-1825. [PMID: 35511705 DOI: 10.1093/cercor/bhac174] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/12/2022] Open
Abstract
Exposure therapy is the most effective approach of behavioral therapy for anxiety and post-traumatic stress disorder (PTSD). But fear is easy to reappear even after successful extinction. So, identifying novel strategies for augmenting exposure therapy is rather important. It was reported that exercise had beneficial effects on cognitive and memory deficits. However, whether exercise could affect fear memory, especially for fear extinction remained elusive. Here, our results showed that exposure to acute mild exercise 1 or 2 h before extinction training can augment recent fear extinction retention and 2 h for the remote fear extinction retention. These beneficial effects could be attributed to increased YTHDF1 expression in medial prefrontal cortex (mPFC). Furthermore, by using an AAV-shRNA-based approach to silence YTHDF1 expression via stereotactic injection in prelimbic cortex (PL) or infralimbic cortex (IL), respectively, we demonstrated that silence YTHDF1 in IL, but not in PL, blunted augmentation of exposure therapy induced by acute mild exercise and accompanied with decreased NR2B and GluR1 expression. Moreover, YTHDF1 modulated dendritic spines remodeling of pyramidal neuron in IL. Collectively, our findings suggested that acute mild exercise acted as an effective strategy in augmenting exposure therapy with possible implications for understanding new treatment underlying PTSD.
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Affiliation(s)
- Song-Ji Li
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Lin-Xuan Zhang
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Guang-Jing Zou
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Min-Hui Ma
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Shi-Fen Zhou
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Xiao-Yu Lu
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Fang Li
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
| | - Chang-Qi Li
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan Province 410013, China
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15
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McKeon G, Wells R, Steel Z, Hadzi-Pavlovic D, Teasdale S, Vancampfort D, Rosenbaum S. An online mental health informed physical activity intervention for emergency service workers and their families: A stepped-wedge trial. Digit Health 2023; 9:20552076221149294. [PMID: 36703879 PMCID: PMC9871982 DOI: 10.1177/20552076221149294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 12/18/2022] [Indexed: 01/20/2023] Open
Abstract
Objective Emergency service workers are at risk of experiencing poor mental health due to repeated exposure to potentially traumatic events. Promoting healthy lifestyle factors may help improve health outcomes and quality of life among this population. This study aimed to evaluate the efficacy of a 10-week physical activity (PA) and diet programme delivered via Facebook for sedentary emergency service workers and their support partners on levels of psychological distress. Methods We delivered a 10-week intervention via a private Facebook group facilitated by exercise physiologists, a dietitian and peer-facilitators. Weekly education modules and telehealth calls were delivered, and participants were provided with a PA tracking device (Fitbit accelerometer). A stepped-wedge design was applied to compare levels of psychological distress (K6) during baseline, to intervention by comparing slopes of change. Secondary pre-post outcomes included mental health symptoms, PA, quality of life, social support to exercise, sleep quality and suicidal ideation. Results In total, N=90 participants (n=47 emergency service workers and n=43 support partners) were recruited in 4 cohorts (aged 42.3±11.5 years, 51% male). Levels of psychological distress did not change significantly during the baseline (control) slope and reduced significantly during the first 6 weeks of intervention (intervention slope 1). The slopes were significantly different, b=-0.351, p = 0.003 (i.e. the trajectories of change) and improvements plateaued until follow up. Retention was high (92%) and improvements in mental health symptoms, minutes of PA, sedentary time and quality of life were significant. Conclusions Our intervention delivered via social media is feasible and associated with reduced levels of psychological distress among emergency service workers and support partners. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN): 12619000877189.
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Affiliation(s)
- Grace McKeon
- Discipline of Psychiatry and Mental Health,
University of
New South Wales, Sydney, Australia,School of Population Health, University of New South
Wales, Sydney, Australia,Grace McKeon, University of New South
Wales, Randwick, NSW 2052, Australia.
| | - Ruth Wells
- Discipline of Psychiatry and Mental Health,
University of
New South Wales, Sydney, Australia
| | - Zachary Steel
- Discipline of Psychiatry and Mental Health,
University of
New South Wales, Sydney, Australia,St John of God Health Care North Richmond Hospital, North Richmond,
Australia
| | - Dusan Hadzi-Pavlovic
- Discipline of Psychiatry and Mental Health,
University of
New South Wales, Sydney, Australia
| | - Scott Teasdale
- Discipline of Psychiatry and Mental Health,
University of
New South Wales, Sydney, Australia,Mingardens Neuroscience Network, Sydney, Australia
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven,
Belgium,University Psychiatric Center KU Leuven, Leuven-Kortenberg,
Belgium
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health,
University of
New South Wales, Sydney, Australia
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16
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Wang Z, Jiang B, Wang X, Li Z, Wang D, Xue H, Wang D. Relationship between physical activity and individual mental health after traumatic events: a systematic review. Eur J Psychotraumatol 2023; 14:2205667. [PMID: 37134018 PMCID: PMC10158556 DOI: 10.1080/20008066.2023.2205667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Background: Traumatic events can cause social tension, anxiety, panic and other psychological crises, and can even cause post-traumatic stress disorder (PTSD) and suicide. Physical activity has a good role in promoting mental health, and has a great application prospect in individual psychological intervention after traumatic events. However, no systematic review of the relationship between physical activity and individual mental health after traumatic events affecting many people has been published so far, which makes it impossible for people to understand the research status in this field from a holistic perspective.Objective: This review explores the relationship between physical activity and individual psychology, physiology, subjective quality of life and well-being after traumatic events, so as to provide some valuable clues or enlightenment for individual psychological intervention after traumatic events.Method: Relevant literature was searched in five databases, summarised, sorted and studied.Results: Thirty-three study papers were included in this review, the main study findings include: (1) Physical activity is positively correlated with individual mental resilience and subjective well-being after traumatic events, and negatively correlated with anxiety, depression, tension and PTSD. (2) Individuals with higher levels of physical activity have better mental health status after traumatic events than those who do not regularly engage in physical activity. (3) Physical activity can promote sleep quality, self-efficacy, subjective quality of life and various physiological functions of those experiencing traumatic events. (4) Physical activity (including exercise) is regarded as one of the preferred nursing measures to buffer against mental stress and maintain physical and mental health for those experiencing traumatic events.Conclusion: The level of physical activity is positively correlated with individual physical and mental health before and after traumatic events. Physical activity can be used as one of the effective measures to improve individual mental health after traumatic events.
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Affiliation(s)
- ZhiFeng Wang
- Department of Physical Education, Xi'an Polytechnic University, Shaanxi, People's Republic of China
| | - Bing Jiang
- Department of Physical Education, Xi'an Polytechnic University, Shaanxi, People's Republic of China
| | - Xingtong Wang
- Department of General Education, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, People's Republic of China
| | - Zhixiang Li
- Department of Physical Education, Xi'an Polytechnic University, Shaanxi, People's Republic of China
| | - Dongxu Wang
- Department of Physical Education, Xinyang University, Xinyang, People's Republic of China
| | - HaiHong Xue
- Department of Physical Education, Xi'an Polytechnic University, Shaanxi, People's Republic of China
| | - Dongmei Wang
- College of Sports Medicine and Rehabilitation, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, People's Republic of China
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17
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Baskerville R, McGrath T, Castell L. The effects of physical activity on glutamate neurotransmission in neuropsychiatric disorders. Front Sports Act Living 2023; 5:1147384. [PMID: 36949894 PMCID: PMC10025343 DOI: 10.3389/fspor.2023.1147384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Physical activity (PA) is an effective way of increasing cognitive and emotional health and counteracting many psychiatric conditions. Numerous neurobiological models for depression have emerged in the past 30 years but many struggle to incorporate the effects of exercise. The hippocampus and pre-frontal cortex (PFC) containing predominantly glutamate neurotransmission, are the centres of changes seen in depression. There is therefore increasing interest in glutamatergic systems which offers new paradigms of understanding mechanisms connecting physical activity, stress, inflammation and depression, not explained by the serotonin theories of depression. Similar hippocampal glutamate dysfunction is observed in many other neuropsychiatric conditions. Excitatory glutamate neurones have high functionality, but also high ATP requirements and are therefore vulnerable to glucocorticoid or pro-inflammatory stress that causes mitochondrial dysfunction, with synaptic loss, culminating in depressed mood and cognition. Exercise improves mitochondrial function, angiogenesis and synaptogenesis. Within the glutamate hypothesis of depression, the mechanisms of stress and inflammation have been extensively researched, but PA as a mitigator is less understood. This review examines the glutamatergic mechanisms underlying depression and the evidence of physical activity interventions within this framework. A dynamic glutamate-based homeostatic model is suggested whereby stress, neuroinflammation and PA form counterbalancing influences on hippocampal cell functionality, which manifests as depression and other neuropsychiatric conditions when homeostasis is disrupted.
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Affiliation(s)
- Richard Baskerville
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
- Correspondence: Richard Baskerville
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18
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Jou YC, Pace-Schott EF. Call to action: Addressing sleep disturbances, a hallmark symptom of PTSD, for refugees, asylum seekers, and internally displaced persons. Sleep Health 2022; 8:593-600. [PMID: 36511279 PMCID: PMC9757843 DOI: 10.1016/j.sleh.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 12/13/2022]
Abstract
Sleep difficulty is a recognized hallmark symptom of post-traumatic stress disorder (PTSD) yet often remains an enduring and neglected problem post-treatment. Around 4.4%- 88.0% of refugees, asylum seekers, and internally displaced persons report PTSD, of which 39%- 99% report sleep difficulties. These percentages substantially exceed those of the general population. Yet there has been a lack of research examining evidence-based stand-alone and add-on treatments for PTSD and related sleep disturbances among this population. Barriers to treatment encountered by this population often vary by their legal status or location, but generally include lack of access due to insufficient evidence-based treatments or mental health practitioner shortages, lack of psychoeducation on mental health, cultural stigma, language barriers, situational instability, and racial bias. The refugee population has been on the rise over the past 10 years, and the United Nations estimated the recent Ukraine-Russia conflict would lead to an additional 12 million people needing humanitarian assistance inside Ukraine and more than 6.9 million refugees fleeing to neighboring countries in the coming months. Given that refugees, asylum seekers, and internally displaced persons repeatedly encounter barriers to mental health care specific to their predicament, interventions designed to accommodate their situation are imperative for improving their sleep and mental health. We therefore call for there to be more research on integrative programs incorporating evidence-based treatments that allow for scalability, adaptability, and rapid dissemination to maximize impact in this population. Further, we encourage trainings among clinicians and researchers to increase knowledge and confidence in working with this population.
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Affiliation(s)
| | - Edward F Pace-Schott
- Harvard Extension School, Cambridge, Massachusetts, USA; Massachusetts General Hospital, Department of Psychiatry, Charlestown, Massachusetts, USA; Harvard Medical School, Department of Psychiatry, Charlestown, Massachusetts, USA; Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, USA.
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19
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Sidiropoulos AN, Glasberg JJ, Moore TE, Nelson LM, Maikos JT. Acute influence of an adaptive sporting event on quality of life in veterans with disabilities. PLoS One 2022; 17:e0277909. [PMID: 36441761 PMCID: PMC9704555 DOI: 10.1371/journal.pone.0277909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 11/06/2022] [Indexed: 11/29/2022] Open
Abstract
Veterans with disabilities can experience poor quality of life following military service due to the associated negative physical and psychological ramifications. However, participation in physical activities has shown to induce both physical and mental benefits and improve the quality of life of this population. Adaptive sports, an innovative approach to address the unique physical and psychosocial needs of veterans with disabilities, are becoming more widely used as a rehabilitation tool to improve the quality of life for these veterans. This study aimed to determine the acute influence of participation in a single-day, veteran-based, adaptive kayaking and sailing event on the perceived overall health, quality of life, and quality of social life of veterans with varying disabilities. It was hypothesized that all three categories and the sum score of quality of life would reflect a positive acute response after participation in the community-based physical activity event. Veterans responded to three quality of life-related questions using a 5-point Likert scale before and directly after participating in the event. Findings indicated that an adaptive sporting event can have an acute positive influence on the quality of life of veteran participants, with improvements observed in all three categories of perceived quality of life. Therefore, it is advantageous for the whole-health rehabilitation of veterans with disabilities for the Department of Veterans Affairs to continue to provide opportunities for veterans to participate in non-traditional, community-based activities.
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Affiliation(s)
- Alexis N. Sidiropoulos
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York, United States of America
- * E-mail:
| | - Jonathan J. Glasberg
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York, United States of America
| | - Timothy E. Moore
- Statistical Consulting Services, Center for Open Research Resources and Equipment, University of Connecticut, Storrs, CT, United States of America
| | - Leif M. Nelson
- Department of Veterans Affairs, National Veterans Sports Programs and Special Events, Washington, DC, United States of America
| | - Jason T. Maikos
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, New York, United States of America
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20
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Yu Q, Wong KK, Lei OK, Nie J, Shi Q, Zou L, Kong Z. Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:135. [PMID: 36308622 PMCID: PMC9617247 DOI: 10.1186/s40798-022-00529-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The efficacy of exercise interventions in the treatment of mental health disorders is well known, but research is lacking on the most efficient exercise type for specific mental health disorders. OBJECTIVE The present study aimed to compare and rank the effectiveness of various exercise types in the treatment of mental health disorders. METHODS The PubMed, Web of Science, PsycINFO, SPORTDiscus, CINAHL databases, and the Cochrane Central Register of Controlled Trials as well as Google Scholar were searched up to December 2021. We performed pairwise and network meta-analyses as well as meta-regression analyses for mental health disorders in general and each type of mental health disorder, with alterations in symptom severity as the primary outcome. RESULTS A total of 6456 participants from 117 randomized controlled trials were surveyed. The multimodal exercise (71%) had the highest probability of being the most efficient exercise for relieving depressive symptoms. While resistance exercise (60%) was more likely to be the most effective treatment for anxiety disorder, patients with post-traumatic stress disorder (PTSD) benefited more from mind-body exercise (52%). Furthermore, resistance exercise (31%) and multimodal exercise (37%) had more beneficial effects in the treatment of the positive and negative symptoms of schizophrenia, respectively. The length of intervention and exercise frequency independently moderated the effects of mind-body exercise on depressive (coefficient = 0.14, p = .03) and negative schizophrenia (coefficient = 0.96, p = .04) symptoms. CONCLUSION Multimodal exercise ranked best for treating depressive and negative schizophrenic symptoms, while resistance exercise seemed to be more beneficial for those with anxiety-related and positive schizophrenic symptoms. Mind-body exercise was recommended as the most promising exercise type in the treatment of PTSD. However, the findings should be treated with caution due to potential risk of bias in at least one dimension of assessment and low-to-moderate certainty of evidence. Trial Registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews (CRD42022310237).
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Affiliation(s)
- Qian Yu
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
| | - Ka-Kit Wong
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
| | - On-Kei Lei
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
| | - Jinlei Nie
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Qingde Shi
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Liye Zou
- grid.263488.30000 0001 0472 9649Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, 518060 China
| | - Zhaowei Kong
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
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21
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Jadhakhan F, Evans D, Falla D. Early interventions for post-traumatic stress following musculoskeletal trauma: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e065590. [PMID: 36153010 PMCID: PMC9511568 DOI: 10.1136/bmjopen-2022-065590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Post-traumatic stress symptoms (PTSS) can be triggered following exposure to a traumatic event, such as violence, disasters, serious accidents and injury. Little is known about which interventions provide the greatest benefit for PTSS. This systematic review aims to estimate the effects of early interventions on PTSS following musculoskeletal trauma. METHODS/ANALYSIS Development of this review protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. This review will include randomised controlled trials and non-randomised controlled studies evaluating the effect of early (within 3 months of a traumatic event) non-pharmacological and non-surgical interventions on PTSS in adults (aged ≥18 years). MEDLINE, PsycINFO, Embase, CINAHL, Zetoc, PROSPERO, Web of Science, PubMed and Google Scholar, as well as key journals/grey literature, will be searched from inception to 31 July 2022. Only articles published in English will be considered. Two independent reviewers will search, screen studies, extract data and assess risk of bias using the Cochrane Risk of Bias tool V.2 (RoB 2) and the Risk Of Bias in Non-randomised Studies of Interventions (ROBINS-I), respectively. Mean difference or standardised mean difference (SMD) will be extracted with accompanying 95% CIs and p values where these are reported. Group effect size will be extracted and reported. Symptoms of PTSS will be ascertained using SMDs (continuous) and diagnosis of PTSS using risk ratio (dichotomous). If possible, study results will be pooled into a meta-analysis. A narrative synthesis of the results will be presented if heterogeneity is high. The overall quality of evidence and risk of bias will be assessed using the Grading of Recommendations Assessment, Development and Evaluation, RoB 2 and ROBINS-I guidelines, respectively. ETHICS AND DISSEMINATION Ethical approval is not required for this systematic review since data from published studies will be used. This review is expected to provide a better understanding of the effect of early intervention for PTSS following musculoskeletal trauma. Findings of this review will be disseminated in peer-reviewed publications and through national and international conferences. PROSPERO REGISTRATION NUMBER CRD42022333905.
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Affiliation(s)
- Ferozkhan Jadhakhan
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - David Evans
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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22
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Bichler CS, Niedermeier M, Hüfner K, Gálffy M, Gostner JM, Nelles P, Schöttl SE, Sperner-Unterweger B, Kopp M. Climbing as an Add-On Treatment Option for Patients with Severe Anxiety Disorders and PTSD: Feasibility Analysis and First Results of a Randomized Controlled Longitudinal Clinical Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11622. [PMID: 36141895 PMCID: PMC9517148 DOI: 10.3390/ijerph191811622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Exercise has considerable effects on physical and psychological health. Anxiolytic effects of climbing exercise have been found in people suffering from depression. However, there are no studies on patients with severe anxiety disorders or post-traumatic stress disorder (PTSD) practicing climbing as add-on treatment. Additionally, many studies on physical therapy fail to use adequate active control groups. Therefore, this study aimed to investigate the feasibility of a four-week climbing exercise program for patients with anxiety disorders or PTSD in comparison to a standard exercise treatment and a social control group. METHODS Outpatients diagnosed with anxiety disorders or PTSD (F 40, F 41, F 43.1 according to ICD-10) were randomly assigned to (a) climbing exercise (n = 27), (b) Nordic walking exercise (n = 23), or (c) control condition (n = 23) providing the same amount of social contact for eight sessions of 90 minutes each. Psychological parameters (symptom severity, worry symptoms, self-efficacy, quality of life) and biological parameters were assessed at the beginning and at the end of the four-week program. Additionally, follow-up assessments were conducted three and six months after the program ended. RESULTS Sixty outpatients (75% female) aged 18-65 years with a longstanding history of a mental disorder (>10 years) and classified as treatment-resistant (95%) and with averaging 3.8 psychiatric comorbidities completed the pilot trial. After participation, symptoms of anxiety disorders were significantly reduced (p = 0.003), and health-related characteristics significantly improved (depression symptoms: p < 0.001, worry symptoms: p < 0.001, self-efficacy: p < 0.001, quality of life-physical health: p = 0.002, quality of life-psychological health: p = 0.006) in all groups. The feasibility of conducting climbing exercises for the patient groups could be demonstrated, and a general acceptance in the groups was recorded. No significant time-by-group interactions were found. At the completion of the program, psychological parameters improved, while biological parameters remained the same in all three groups. CONCLUSIONS Participation in the climbing group as well as in Nordic walking and social contact groups demonstrated beneficial results in patients with anxiety disorders and PTSD with severe mental burden. Nevertheless, climbing did not show any additional clinically relevant benefits compared to Nordic walking or social contact. Studies with larger sample sizes and qualitative insights are needed to further evaluate the possible benefits of climbing in this population.
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Affiliation(s)
- Carina S. Bichler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Mátyás Gálffy
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Johanna M. Gostner
- Institute of Medical Biochemistry, Biocenter, Medical University of Innsbruck, Innrain 80-82, 6020 Innsbruck, Austria
| | - Philipp Nelles
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Stefanie E. Schöttl
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, 6020 Innsbruck, Austria
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23
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Prior short-term exercise prevents behavioral and biochemical abnormalities induced by single prolonged stress in a rat model of posttraumatic stress disorder. Behav Brain Res 2022; 428:113864. [DOI: 10.1016/j.bbr.2022.113864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/27/2022] [Accepted: 03/27/2022] [Indexed: 11/21/2022]
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24
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Zhu L, Li L, Li XZ, Wang L. Mind–Body Exercises for PTSD Symptoms, Depression, and Anxiety in Patients With PTSD: A Systematic Review and Meta-Analysis. Front Psychol 2022; 12:738211. [PMID: 35153889 PMCID: PMC8833099 DOI: 10.3389/fpsyg.2021.738211] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aims to systematically analyze the effects of mind–body exercises on post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in patients with PTSD. Furthermore, it intends to provide scientific evidence-based exercise prescriptions. Methods Chinese (i.e., China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, and Wanfang) and English (i.e., Web of Science, PubMed, the Cochrane Library, and EMBASE) databases were used as data sources to search for studies on the effects of mind–body exercises on symptoms associated with patients with PTSD from January 1980 to November 2020. After a rigorous screening, 16 eligible randomized controlled trials (RCTs) were included in the meta-analysis. Results Mind–body exercises exerted a significant effect on PTSD symptoms [standard mean difference (SMD) = −0.41, 95% confidence interval (CI) −0.64 to −0.19, p < 0.001], depression (SMD = −0.35, 95% CI: −0.55 to −0.15, p < 0.001), and anxiety (SMD = −0.31, 95% CI: −0.74 to −0.12, p < 0.001) among patients with PTSD. Subgroup analysis demonstrated that 60–150 min per session for 8–16 weeks of mindfulness was more effective in improving symptoms in patients with PTSD under 45 years of age compared with other subgroups. For depression, 150–180 min of yoga exercises once per week was effective. For anxiety, the frequency, timing, duration, and type of mind–body exercises that are most effective in relieving anxiety in patients with PTSD cannot be determined at this time due to the limited number of eligible RCTs. Conclusions Mind–body exercises were found to be significantly effective in improving PTSD symptoms, depression, and anxiety in patients with PTSD. Therefore, they can be used as an adjunct to intervention for symptoms of patients with PTSD. However, this conclusion requires further confirmation through additional scientific and objective RCTs. Systematic Review Registration: Unique Identifier: INPLASY2020120072.
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Affiliation(s)
- Lin Zhu
- School of Wushu and Art, Nanjing Sport Institute, Nanjing, China
| | - Long Li
- School of Wushu and Art, Nanjing Sport Institute, Nanjing, China
- *Correspondence: Long Li
| | - Xiao-zhi Li
- Department of Physical Education, Southeast University, Nanjing, China
| | - Lin Wang
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
- Lin Wang
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25
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Young-McCaughan S, Peterson AL, Mintz J, Hale WJ, Dondanville KA, Borah EV, Blount TH, Blankenship AE, Fina BA, Hall-Clark BN, Hernandez AM, Jacoby VM, Malach SL, Williams JM, Compton KE, Bingham MO, Vriend CA, Inman AW, Brundige A, Arzola SM, Lapiz-Bluhm MD, Williamson DE, Litz BT, Hembree EA, Roache JD, Taylor DJ, Pruiksma KE, Borah AM, Yarvis JS. Testing the role of aerobic exercise in the treatment of posttraumatic stress disorder (PTSD) symptoms in U.S. active duty military personnel: a pilot study. Cogn Behav Ther 2022; 51:309-325. [PMID: 35001842 DOI: 10.1080/16506073.2021.2001689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The purpose of this pilot study was to determine if the efficacy of imaginal exposure for symptoms of posttraumatic stress disorder (PTSD) could be improved by adding aerobic exercise. We hypothesized that aerobic exercise would enhance the efficacy of exposure therapy. Active duty service members with clinically significant symptoms of posttraumatic stress (PTSD Checklist-Stressor-Specific Version, [PCL-S], ≥25) were randomized into one of four conditions: exercise only; imaginal exposure only; imaginal exposure plus exercise; no exercise/no exposure therapy (control). Participants (N = 72) were primarily male, Army, noncommissioned officers ranging in age from 22 to 52. PTSD symptom severity decreased over time (p < .0001); however, there were no significant differences between the experimental conditions. The prediction that imaginal exposure augmented with aerobic exercise would be superior to either imaginal exposure alone or aerobic exercise alone was not supported, suggesting that engaging in exercise and imaginal exposure simultaneously may not be any better than engaging in either activity alone. A better understanding of individually administered and combined exercise and exposure therapy interventions for PTSD is warranted.
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Affiliation(s)
- Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Alan L Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Jim Mintz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Willie J Hale
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Department of Psychology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Katherine A Dondanville
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Elisa V Borah
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Steve Hicks School of Social Work, the University of Texas at Austin, Austin, TX, USA
| | - Tabatha H Blount
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Abby E Blankenship
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Brooke A Fina
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Brittany N Hall-Clark
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ann Marie Hernandez
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Valiant Mental Health PLLC, San Antonio, TX, USA
| | - Vanessa M Jacoby
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Steffany L Malach
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Department of Primary Care, Joint Base San Antonio - Fort Sam Houston, TX, USA
| | - Jacob M Williams
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Department of Psychology/Neuropsychology, TIRR Memorial Hermann Hospital, Houston, TX, USA
| | - Katherine E Compton
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mona O Bingham
- Department of Nursing, Brooke Army Medical Center, Joint Base San Antonio - Fort Sam Houston, TX, USA
| | - Catherine A Vriend
- Department of Behavioral Health, Brooke Army Medical Center, Joint Base San Antonio - Fort Sam Houston, TX, USA
| | - Alice W Inman
- Department of Behavioral Health, Brooke Army Medical Center, Joint Base San Antonio - Fort Sam Houston, TX, USA
| | - Antoinette Brundige
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | | | - M Danet Lapiz-Bluhm
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Douglas E Williamson
- Department of Psychiatry and Behavioral Sciences, Duke Health, Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA
| | - Brett T Litz
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry and Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | | | - John D Roache
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Kristi E Pruiksma
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Adam M Borah
- Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, TX, USA.,Department of Behavioral Medicine and Health Services, Central Texas Veterans Health Care System, Temple, TX, USA
| | - Jeffrey S Yarvis
- Department of Behavioral Health, Carl R. Darnall Army Medical Center, Fort Hood, TX, USA.,Department of Social Work, Texas A&M University - Central Texas, Killeen, TX, USA
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26
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Moon I, Han J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:668. [PMID: 35055490 PMCID: PMC8775782 DOI: 10.3390/ijerph19020668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.
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Affiliation(s)
- Ingyu Moon
- School of Social Work, Nyack College, New York, NY 10004, USA
| | - Junghee Han
- Department of Social Work, University of Southern Indiana, Evansville, IN 47712, USA;
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27
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Voorendonk EM, Sanches SA, Tollenaar MS, De Jongh A, Van Minnen A. Augmenting PTSD treatment with physical activity: study protocol of the APPART study (Augmentation for PTSD with Physical Activity in a Randomized Trial). Eur J Psychotraumatol 2022; 13:2016219. [PMID: 35126881 PMCID: PMC8812732 DOI: 10.1080/20008198.2021.2016219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND New intensive trauma-focused treatment (TFT) programmes that incorporate physical activity have been developed for people with post-traumatic stress disorder (PTSD). However, the unique contribution of physical activity within these intensive TFT programmes has never been investigated in a controlled manner. OBJECTIVES This randomized controlled trial will investigate the effectiveness of physical activity added to an intensive TFT programme. In addition, the study aims to investigate the underlying mechanisms of the effects of physical activity on the change in PTSD symptoms. METHODS Individuals with PTSD (N = 120) will be randomly allocated to two conditions: a physical activity or a non-physical active control condition. All participants will receive the same intensive TFT lasting eight days within two consecutive weeks, in which daily prolonged exposure and EMDR therapy sessions, and psycho-education are combined. The amount of physical activity will differ per condition. While the physical activity condition induces daily physical activities with moderate intensity, in the non-physical active control condition no physical activity is prescribed; but instead, a controlled mixture of guided (creative) tasks is performed. The two primary outcome measures are change in PTSD symptoms from pre- to post-treatment and at six months follow-up, measured with the Clinician-Administered PTSD Scale (CAPS-5), and the PTSD Checklist for DSM-5 (PCL-5). Additionally, self-reported sleep problems, depressive symptoms, emotion regulation, dissociation symptoms and anxiety sensitivity will be measured as potential underlying mechanisms. CONCLUSIONS This study will contribute to the research field of augmentation strategies for PTSD treatment by investigating the effectiveness of physical activity added to intensive TFT. TRIAL REGISTRATION This trial is registered in the Netherlands Trial Register (Trial NL9120).
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Affiliation(s)
- E M Voorendonk
- Research Department, PSYTREC, Bilthoven, The Netherlands.,Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands
| | - S A Sanches
- Phrenos Centre of Expertise for Severe Mental Illness, Utrecht, The Netherlands
| | - M S Tollenaar
- Clinical Psychology and the Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - A De Jongh
- Research Department, PSYTREC, Bilthoven, The Netherlands.,Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands.,School of Psychology, Queen's University, Belfast, Northern Ireland.,Institute of Health and Society, University of Worcester, Worcester, UK
| | - A Van Minnen
- Research Department, PSYTREC, Bilthoven, The Netherlands.,Behavioural Science Institute (BSI), Radboud University Nijmegen, Nijmegen, The Netherlands
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28
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McKeon G, Steel Z, Wells R, Fitzpatrick A, Vancampfort D, Rosenbaum S. Exercise and PTSD Symptoms in Emergency Service and Frontline Medical Workers: A Systematic Review. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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29
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Özümerzifon Y, Ross A, Brinza T, Gibney G, Garber CE. Exploring a Dance/Movement Program on Mental Health and Well-Being in Survivors of Intimate Partner Violence During a Pandemic. Front Psychiatry 2022; 13:887827. [PMID: 35722545 PMCID: PMC9204421 DOI: 10.3389/fpsyt.2022.887827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The aim of this study was to explore the feasibility and benefits of a 12-session dance/movement program for intimate partner violence survivors' mental health and PTSD symptoms during the COVID-19 Pandemic. The specific purposes were fourfold: (1) To determine the feasibility of delivering a virtual dance/movement workshop program; (2) to examine the effects of the program on symptoms of PTSD and psychological distress; (3) to determine whether heart rate variability improves; and (4) to describe the individual and shared experiences of a subgroup of participants of the program. METHODS Forty-five women ages 23-48 years were randomized to a 12-session virtual creative dance/movement program or a usual care control group, and completed questionnaires about PTSD and mental health symptoms, general health, physical activity, and underwent a brief measurement of heart rate variability. A subset of the intervention group participated in a semi-structured focus group. RESULTS The results of the study showed that the female survivors of intimate partner violence who participated in the virtual workshops felt better, and they experienced improved affect and reduced tension. They found new ways to express themselves, attune to their bodies, learn new self-care habits, and build community as they engaged in the workshops. Over the course of the study, the participants' symptoms of PTSD and psychological distress lessened. There were no changes in heart rate variability. CONCLUSIONS This complex study was successfully completed during a global pandemic and resulted in improvements in some mental health symptoms and overall well-being. Given the importance of this work with intimate partner violence survivors, further work exploring dance/movement workshops for participants virtually and in-person is needed.
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Affiliation(s)
| | - Allison Ross
- Sanctuary for Families, Inc., New York, NY, United States
| | - Tessa Brinza
- Gina Gibney Dance, Inc., New York, NY, United States
| | - Gina Gibney
- Gina Gibney Dance, Inc., New York, NY, United States
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
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30
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Gibert L, Coulange M, Reynier JC, Le Quiniat F, Molle A, Bénéton F, Meurice V, Micoulaud JA, Trousselard M. Comparing meditative scuba diving versus multisport activities to improve post-traumatic stress disorder symptoms: a pilot, randomized controlled clinical trial. Eur J Psychotraumatol 2022; 13:2031590. [PMID: 35145610 PMCID: PMC8823687 DOI: 10.1080/20008198.2022.2031590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Post-Traumatic Stress Disorder (PTSD) is a chronic and disabling disease that currently has no fully effective therapeutic solution. Complementary approaches, such as relaxation, sport, or meditation, could be therapeutic aids for symptom reduction. Scuba diving combines sport and mindfulness training and has been found to have a positive effect on chronic stress and PTSD. OBJECTIVES The first objective of this pilot study is to compare the effectiveness of diving associated with mindfulness exercises (the Bathysmed® protocol) with multisport activity in reducing PTSD symptoms. The secondary objective is to compare the impact of the Bathysmed® protocol on mindfulness functioning in the two groups of subjects suffering from PTSD. METHOD This proof-of-concept took the form of a controlled randomized clinical trial. The primary endpoint was the severity of PTSD symptoms, measured by the PCL-5 (PTSD Check List) scale. Half of the group were exposed to the Bathysmed® protocol (the experimental condition), and the other half to a non-specific multisport program. RESULTS Bathysmed® protocol improved PCL-5 scores more than the multisport program but the result was not significant. The protocol was significantly better than the multisport activity in reducing intrusion symptoms of PTSD after one month. Globally, trait mindfulness scores improved up to one month after the course, but the result was not significant. Three months after the course, there was no difference between the two groups with regard to PCL-5 and Freiburg Mindfulness Inventory scores.. CONCLUSION Our study demonstrates the value of the Bathysmed® protocol even though it suffers from a lack of power and could only obtain partial but encouraging results. Mindfulness must be practiced over the long term to achieve stable benefits. This probably explains why no differences persisted three months after the course. Further work is needed to confirm the initial results obtained with this pilot study.
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Affiliation(s)
- Lionel Gibert
- PsycoMadd, Université Paris Saclay, France.,Stress neurophysiology, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,Hopital Paul Brousse, Aphp, Villejuif, France
| | - Mathieu Coulange
- Service de Médecine Hyperbare, Subaquatique Et Maritime, Assistance Publique Des Hôpitaux de Marseille, France.,Hyperbaric medicine, Institut de Physiologie Et de Médecine En Milieu Maritime Et En Environnement Extrême, Phymarex, Marseille, France.,Inserm 1263 - Inra 1260, Team V: Adenosinergic System and Cardiovascular Disease, Aix Marseille Université, France
| | - Jean-Charles Reynier
- Service de Médecine Hyperbare, Subaquatique Et Maritime, Assistance Publique Des Hôpitaux de Marseille, France.,Hyperbaric medicine, Institut de Physiologie Et de Médecine En Milieu Maritime Et En Environnement Extrême, Phymarex, Marseille, France
| | - Frédéric Le Quiniat
- Service de Médecine Hyperbare, Subaquatique Et Maritime, Assistance Publique Des Hôpitaux de Marseille, France.,Hyperbaric medicine, Institut de Physiologie Et de Médecine En Milieu Maritime Et En Environnement Extrême, Phymarex, Marseille, France
| | - Aymeric Molle
- Stress neurophysiology, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | | | | | - Jean Arthur Micoulaud
- Sleep medicine, Services Universitaire de Médecine du Sommeil, Sums, Chu de Bordeaux, Bordeaux, France.,Usr Cnrs 3413 Sanpsy, Chu Pellegrin, Université de Bordeaux, France
| | - Marion Trousselard
- Stress neurophysiology, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
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31
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Björkman F, Ekblom Ö. Physical Exercise as Treatment for PTSD: A Systematic Review and Meta-Analysis. Mil Med 2021; 187:e1103-e1113. [PMID: 34850063 DOI: 10.1093/milmed/usab497] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/27/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults. MATERIALS AND METHODS Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI. RESULTS Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (>20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: -0.15 to 0.51), and no sign of publication bias was found. CONCLUSIONS Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.
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Affiliation(s)
- Frida Björkman
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm 114 86, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm 114 86, Sweden
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Bichler CS, Niedermeier M, Gufler A, Gálffy M, Sperner-Unterweger B, Kopp M. A case-control study on physical activity preferences, motives, and barriers in patients with psychiatric conditions. Compr Psychiatry 2021; 111:152276. [PMID: 34600310 DOI: 10.1016/j.comppsych.2021.152276] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Physical activity in individuals diagnosed with psychiatric conditions (patients) has antidepressant and anxiolytic effects, but levels of physical activity are still low in this population. This study aimed to identify physical activity preferences, motives, and perceived barriers in patients compared to individuals without a diagnosed psychiatric condition (controls). METHODS A total of 230 patients (age = 39.5 ± 14.0 years, 80% female) with major depression (34%), anxiety disorders (38%), or post-traumatic stress disorder (28%) completed a cross-sectional online survey to assess preferences, motives, and perceived barriers to physical activity (measured by the EMI-2). This group consisted of 100 patients with a clinical diagnosis (clinical subset) and 130 with self-reported psychiatric conditions (confirmed by the PHQ-4) from online help forums (online subset). Comparisons between patients of the clinical and the online subsets were performed and are referenced whenever significant. The patients group was compared to a healthy control group matched by sex and age (n = 230, age = 39.4 ± 14.9 years, 80% female). RESULTS More patients reported insufficient physical activity levels and more daily sitting hours (measured by the IPAQ) compared to controls. Patients reported lower preference in more ambitious types of physical activity, such as hiking, cycling, and running. The commonly most preferred type of physical activity in both groups was walking and yoga. Patients had fewer motives and more perceived barriers to physical activity in comparison to the control group. Some differences in motives and perceived barriers to physical activity were also found between patients of the clinical and the online subset. CONCLUSIONS Findings of low physical activity levels in patients are consistent with the literature. Due to the patients' lack of motivation and perception of barriers, health care providers should consider offering different and individualized forms of physical activity. Easier types of physical activity, such as walking and yoga, appear to be the most feasible and provide a good starting point to overcome perceived barriers to physical activity.
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Affiliation(s)
- Carina S Bichler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
| | - Andrea Gufler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
| | - Mátyás Gálffy
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
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Pebole M, Gobin RL, Hall KS. Trauma-informed exercise for women survivors of sexual violence. Transl Behav Med 2021; 11:686-691. [PMID: 32535635 DOI: 10.1093/tbm/ibaa043] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Compared to their male counterparts, women experience alarmingly high rates of sexual violence (SV). Nearly 20% of women in the USA have been victims of SV, and prevalence of sexual assault among female service members is reported to be even higher, up to 50%. SV results in negative health outcomes like posttraumatic stress disorder, depression, obesity, poor body image, and pain-related disability. Exercise has been shown to positively impact both mental and physical health outcomes in populations experiencing posttraumatic symptoms, yet women survivors of SV are often excluded from exercise trials in trauma-affected populations. The purpose of this paper is to comment on the importance of incorporating women-specific trauma-informed principles in the content and delivery of exercise interventions in trauma-affected populations, particularly as it relates to SV. Researchers discuss the implications of female-specific and trauma-informed exercise considerations for SV survivors. This commentary highlights the need for trauma-informed implementation efforts and outcome measurements in exercise interventions involving women affected by SV. Researchers call for (a) increased qualitative work on trauma-specific implementation efforts across exercise intervention domains and (b) increased assessment of trauma-specific outcomes in exercise trials.
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Affiliation(s)
- Michelle Pebole
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, IL, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, IL, USA
| | - Katherine S Hall
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, NC, USA.,Department of Medicine, Duke University, Durham, NC, USA
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Sun L, Zhang W, Ye R, Liu L, Jiang L, Xi C. Catalpol enhanced physical exercise-mediated brain functional improvement in post-traumatic stress disorder model via promoting adult hippocampal neurogenesis. Aging (Albany NY) 2021; 13:18689-18700. [PMID: 34326271 PMCID: PMC8351689 DOI: 10.18632/aging.203313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a serious psychiatric disorder characterized by hyper-response to environmental cues as well as the associated depressive and cognitive dysfunctions. According to the key roles of hippocampus for cognitive and emotional regulation, improving hippocampal functions, particularly hippocampal neural plasticity, is the necessary pathway to attenuate the core symptoms of PTSD. The effects of the alternative therapies such as exercise and natural compounds to reduce PTSD symptoms and promote adult hippocampal neurogenesis have been widely demonstrated. However, what is the effect of combining the exercise with traditional Chinese medical compounds remains unknown. In current study, we evaluated the effects of catalpol, which showed the pro-neurogenic effects in previous report, in regulating exercise-mediated PTSD therapeutic effects. With behavioral tests, we found that catalpol treatment promoted the effects of exercise to reduce the response of mice to dangerous cues, and simultaneously enhanced the antidepressant and cognitive protection effects. Moreover, by immunofluorescence we identified that catalpol promoted exercise-mediated hippocampal neurogenesis by enhancing the neural differentiation and mature neuronal survive. We further found that the promote effects of catalpol to exercise-induced environmental hyper-response, antidepressant effects and cognitive protective effects were all compromised by blocking neurogenesis with temozolomide (TMZ). This result indicates that hippocampal neurogenesis is prerequisite for catalpol to promote exercise-mediated brain functional improvement in PTSD model. In conclusion, our research identified the new function of natural compounds catalpol to promote the exercise-mediated brain functional changes in PTSD model, which depend on its effect promoting adult hippocampal neurogenesis.
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Affiliation(s)
- Lina Sun
- School of Physical Education, Beijing Normal University, Beijing, China
| | - Weiwei Zhang
- Department of Anesthesiology, Shanxi Bethune Hospital, Beijing, China
| | - Ruiqi Ye
- School of Physical Education, Beijing Normal University, Beijing, China
| | - Lei Liu
- School of Physical Education, Beijing Normal University, Beijing, China
| | - Lili Jiang
- School of Physical Education, Beijing Normal University, Beijing, China
| | - Chao Xi
- School of Life Science, Beijing Normal University, Beijing, China
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Browne J, Medenblik A, Pebole M, Gregg JJ, Hall KS. Qualitative Analysis of a Supervised Exercise Program for Older Veterans With PTSD. Am J Geriatr Psychiatry 2021; 29:565-572. [PMID: 33162307 DOI: 10.1016/j.jagp.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Older veterans with post-traumatic stress disorder (PTSD) experience substantial physical and mental health challenges. Given the well-known and wide-reaching benefits of exercise, exploring the impact of interventions designed specifically for this population would be valuable. As such, the present study explored perspectives from older veterans with PTSD who participated in Warrior Wellness, a 12-week supervised exercise intervention designed for older veterans with PTSD. This study was aimed at evaluating 1) facilitators of engagement, 2) perceived benefits from the intervention, and 3) recommendations about possible modifications to the intervention. DESIGN Qualitative study. SETTING Face-to-face semistructured interviews conducted after the Warrior Wellness trial was completed. PARTICIPANTS Fifteen veterans (100% male, 93% African American or Black, 100% non-Hispanic or Latinx, average age = 68.7 years) who completed the Warrior Wellness exercise program. MEASUREMENTS Semistructured interviews were conducted using an interview guide that assessed veterans' experience in Warrior Wellness and recommendations for future intervention modifications. Interviews were subsequently transcribed and analyzed by thematic analysis. RESULTS Shared experience, program features, camaraderie during workouts, and accountability emerged as facilitators of engagement. Perceived benefits spanned physical health, mental health, and behavioral domains. Finally, veterans provided several suggestions for modifying the intervention such as increasing its duration, adding a nutritional component, and including significant others in enrollment. CONCLUSIONS This study offers valuable insights into the intervention and interpersonal factors that veterans view as important for their engagement in exercise, the perceived benefits of exercise, and the ways in which interventions designed for this population can be refined.
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Affiliation(s)
- Julia Browne
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System (JB, MP, KH), Durham, NC
| | - Alyssa Medenblik
- Department of Psychology, University of Tennessee (AM), Knoxville, TN
| | - Michelle Pebole
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System (JB, MP, KH), Durham, NC; Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign (MP), Champaign, IL
| | - Jeffrey J Gregg
- Mental and Behavioral Health Service, Durham VA Health Care System (JJG), Durham, NC; Geriatrics Division, Department of Medicine, Duke University (JJG, KH), Durham, NC
| | - Katherine S Hall
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System (JB, MP, KH), Durham, NC; Geriatrics Division, Department of Medicine, Duke University (JJG, KH), Durham, NC; Center for the Study of Aging and Human Development, Duke University (KH), Durham, NC.
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Morina N, Hoppen TH, Kip A. Study quality and efficacy of psychological interventions for posttraumatic stress disorder: a meta-analysis of randomized controlled trials. Psychol Med 2021; 51:1260-1270. [PMID: 33975654 PMCID: PMC8223238 DOI: 10.1017/s0033291721001641] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/09/2021] [Accepted: 04/13/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Research indicates that higher study quality may be associated with smaller treatment effects. Yet, knowledge about the association between study quality and treatment efficacy for posttraumatic stress disorder (PTSD) is limited. We aimed at evaluating the efficacy of psychological interventions for adult PTSD and the association between study quality and treatment effects. METHODS We conducted a systematic search to identify randomized controlled trials (RCTs) that examined the efficacy of psychological interventions for chronic PTSD symptoms in adult samples with at least 70% of patients being diagnosed with PTSD by means of a structured interview. We assessed study quality using the following eight criteria from prior research: N ⩾ 50, all patients met criteria for PTSD, a treatment manual was used, therapists were trained, treatment integrity was checked, intent-to-treat analyses were applied, randomization was conducted by an independent party, and treatment outcome was conducted by blind assessors. RESULTS The search resulted in 136 RCTs with 8978 patients. Active treatment conditions were largely effective in reducing PTSD symptoms at posttreatment and follow-up (Hedges' g = 1.09 and 0.81, respectively) when compared to passive control conditions. The comparison to active control conditions at posttreatment and follow-up resulted in medium effect sizes. A total of 14 trials met all study quality criteria and these trials produced large effect sizes when compared to passive control conditions at posttreatment and follow-up. CONCLUSIONS Overall, study quality was not significantly associated with effect size. The findings indicate that psychological interventions can effectively reduce PTSD symptoms irrespective of study quality.
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Affiliation(s)
- Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| | - Thole H. Hoppen
- Institute of Psychology, University of Münster, Münster, Germany
| | - Ahlke Kip
- Institute of Psychology, University of Münster, Münster, Germany
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Koontz BF, Levine E, McSherry F, Niedzwiecki D, Sutton L, Dale T, Streicher M, Rushing C, Owen L, Kraus WE, Bennett G, Pollak KI. Increasing physical activity in Cancer Survivors through a Text-messaging Exercise motivation Program (ICanSTEP). Support Care Cancer 2021; 29:7339-7349. [PMID: 34050402 DOI: 10.1007/s00520-021-06281-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Cancer survivors are often sedentary. Self-monitoring may promote physical activity through self-activation. We conducted a pilot trial to evaluate whether wearable activity tracker with personalized text message feedback would increase physical activity. METHODS We enrolled 30 patients with solid tumor cancers into a non-randomized prospective intervention trial (NCT02627079): 15 had completed treatment in the past year and 15 under active treatment. Each participant received an activity tracker and daily text messages personalized to their activity level. We assessed patient-reported outcomes and 6-min walk (6 MW) at baseline and 3 months. RESULTS Twenty-six participants completed the study. There was substantial variation in baseline activity. Overall, 39% of participants increased their steps taken by at least 20%, and 23% increased their 6 MW distance by 20% or more. More participants who had completed treatment strongly agreed (73%) that the intervention increased their exercise levels than those receiving active treatment (47%). At 3 months, there was a significant improvement in median Beck Depression Inventory-II and Godin Leisure Index composite scores. At 6 months, 72% still wore their activity tracker at least 4 days per week. CONCLUSION We found that the intervention was well-accepted with a high completion rate at 3 months and continued self-use at 6 months. In this pilot study of combined activity tracker and motivational messaging, we found a signal for increased physical activity over a 3-month period. Future research is needed to study this technique for its impact on activity and other physical and psychological measures of well-being. IMPLICATION FOR CANCER SURVIVORS Activity tracker with personalized motivational messaging may be useful in promoting physical activity in cancer survivors.
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Affiliation(s)
- Bridget F Koontz
- Department of Radiation Oncology,, Duke Cancer Institute, DUMC Box 3085, NC, 27710, Durham, USA.
| | - Erica Levine
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, NY, New York, USA.,Duke Digital Health Science Center, Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
| | - Frances McSherry
- Duke Department of Biostatistics and Bioinformatics, Duke Cancer Institute Biostatistics, Durham, NC, 27710, USA
| | - Donna Niedzwiecki
- Duke Department of Biostatistics and Bioinformatics, Duke Cancer Institute Biostatistics, Durham, NC, 27710, USA
| | - Linda Sutton
- Department of Medicine, Duke School of Medicine, Durham, NC, 27710, USA.,Duke Cancer Network, Durham, NC, 27710, USA
| | - Tykeytra Dale
- Department of Radiation Oncology,, Duke Cancer Institute, DUMC Box 3085, NC, 27710, Durham, USA
| | - Martin Streicher
- Department of Population Health Sciences, Duke School of Medicine, Durham, NC, 27710, USA
| | - Christel Rushing
- Duke Department of Biostatistics and Bioinformatics, Duke Cancer Institute Biostatistics, Durham, NC, 27710, USA
| | - Lynda Owen
- Duke Cancer Network, Durham, NC, 27710, USA
| | - William E Kraus
- Department of Medicine, Duke School of Medicine, Durham, NC, 27710, USA.,Department of Population Health Sciences, Duke School of Medicine, Durham, NC, 27710, USA
| | - Gary Bennett
- Duke Digital Health Science Center, Duke Global Health Institute, Duke University, Durham, NC, 27710, USA.,Cancer Control and Population Sciences Program, Duke Cancer Institute, Durham, NC, 27710, USA
| | - Kathryn I Pollak
- Department of Population Health Sciences, Duke School of Medicine, Durham, NC, 27710, USA.,Cancer Control and Population Sciences Program, Duke Cancer Institute, Durham, NC, 27710, USA
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Maroufi K, Razavi R. Nurses' mental health and COVID-19 pandemic: Is there any approach? Nurs Open 2021; 8:2004-2006. [PMID: 33979027 PMCID: PMC8242563 DOI: 10.1002/nop2.930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/20/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- Khashayar Maroufi
- Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Rashin Razavi
- Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
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Symptom profiles following combat injury and long-term quality of life: a latent class analysis. Qual Life Res 2021; 30:2531-2540. [PMID: 33884568 DOI: 10.1007/s11136-021-02836-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to identify symptom profiles among U.S. military personnel within 1 year after combat injury and assess the relationship between the symptom profiles and long-term quality of life (QoL). METHODS The study sample consisted of 885 military personnel from the Expeditionary Medical Encounter Database who completed (1) a Post-Deployment Health Assessment (PDHA) within 1 year following combat injury in Iraq or Afghanistan, and (2) a survey for the Wounded Warrior Recovery Project (WWRP), a longitudinal study tracking patient-reported outcomes (e.g., QoL) in injured military personnel. Fifteen self-reported symptoms from the PDHA were assessed using latent class analysis to develop symptom profiles. Multivariable linear regression assessed the predictive effect of symptom profiles on QoL using the physical (PCS) and mental (MCS) component summary scores from the 36-Item Short Form Survey included in the WWRP. Time between PDHA and WWRP survey ranged from 4.3 to 10.5 years (M = 6.6, SD = 1.3). RESULTS Five distinct symptom profiles were identified: low morbidity (50.4%), multimorbidity (15.6%), musculoskeletal (14.0%), psycho-cognitive (11.1%), and auditory (8.9%). Relative to low morbidity, the multimorbidity (β = - 5.45, p < 0.001) and musculoskeletal (β = - 4.23, p < 0.001) profiles were associated with lower PCS, while the multimorbidity (β = - 4.25, p = 0.002) and psycho-cognitive (β = - 3.02, p = 0.042) profiles were associated with lower MCS. CONCLUSION Multimorbidity, musculoskeletal, and psycho-cognitive symptom profiles were the strongest predictors of lower QoL. These profiles can be employed during screening to identify at-risk service members and assist with long-term clinical planning, while factoring in patient-specific impairments and preferences.
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Green J, Huberty J, Puzia M, Stecher C. The Effect of Meditation and Physical Activity on the Mental Health Impact of COVID-19-Related Stress and Attention to News Among Mobile App Users in the United States: Cross-sectional Survey. JMIR Ment Health 2021; 8:e28479. [PMID: 33788698 PMCID: PMC8045775 DOI: 10.2196/28479] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been declared an international public health emergency, and it may have long-lasting effects on people's mental health. There is a need to identify effective health behaviors to mitigate the negative mental health impact of COVID-19. OBJECTIVE The objectives of this study were to (1) examine the regional differences in mental health and COVID-19-related worry, attention to news, and stress, in light of the state-level prevalence of COVID-19 cases; (2) estimate the associations between mental health and COVID-19-related worry, attention to news, and stress and health behavior engagement (ie, physical activity, mindfulness meditation); and (3) explore the mediating effect of health behavior engagement on the associations between mental health and COVID-19-related worry, attention to news, and stress. METHODS A cross-sectional survey was distributed to a sample of US adult paying subscribers to the Calm app (data were collected from April 22 to June 3, 2020). The survey assessed COVID-19-related worry, attention to news, and stress; health behavior engagement; and mental health (ie, perceived stress, posttraumatic stress disorder, and anxiety and depression). Statistical analyses were performed using R software. Differences in COVID-19-related worry, attention to news, and stress and mental health by location were assessed using t tests and chi-square tests. Logistic and ordinary least squares models were used to regress mental health and health behavior on COVID-19-related worry, attention to news, and stress; moreover, causal mediation analysis was used to estimate the significance of the mediation effects. RESULTS The median age of the respondents (N=8392) was 47 years (SD 13.8). Participants in the Mid-Atlantic region (New Jersey, New York, and Pennsylvania) reported higher levels of stress, more severe depression symptoms, greater worry about COVID-19, paying more attention to COVID-19-related news, and more stress related to social distancing recommendations than participants living in other regions. The association between worry about COVID-19 and perceived stress was significantly mediated by changes in physical activity (P<.001), strength of meditation habit (P<.001), and stopping meditation (P=.046). The association between worry about COVID-19 and posttraumatic stress disorder symptoms was significantly mediated by changes in physical activity (P<.001) and strength of meditation habit (P<.001). CONCLUSIONS Our findings describe the mental health impact of COVID-19 and outline how continued participation in health behaviors such as physical activity and mindfulness meditation reduce worsening of mental health due to the COVID-19 pandemic. These data have important implications for public health agencies and health organizations to promote the maintenance of health habits to reduce the residual mental health burden of the COVID-19 pandemic.
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Affiliation(s)
- Jennifer Green
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Megan Puzia
- Behavioral Research and Analytics, LLC, Salt Lake City, UT, United States
| | - Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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Whitworth JW, Hayes SM, Andrews RJ, Fonda JR, Beck BM, Hanlon LB, Fortier CB, Milberg WP, McGlinchey RE. Cardiorespiratory Fitness Is Associated With Better Cardiometabolic Health and Lower PTSD Severity in Post-9/11 Veterans. Mil Med 2021; 185:e592-e596. [PMID: 32060558 DOI: 10.1093/milmed/usaa005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/13/2019] [Accepted: 01/07/2020] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular and metabolic diseases and physical inactivity. Cardiorespiratory fitness (CRF), which is modifiable by physical activity, is a strong independent predictor of cardiometabolic health. However, the relationship between CRF and cardiometabolic health in veterans with PTSD is unknown. Thus, this study aimed to explore the cross-sectional relationships among CRF, indices of cardiometabolic health (ie, HbA1c, blood lipids, blood pressure, waist-hip ratio, and body mass index), and PTSD severity in veterans with PTSD. MATERIALS AND METHODS This study was approved by the local Institutional Review Board. All participants were informed of the study risks and provided consent prior to participation. Participants (n = 13) completed a cardiopulmonary exercise test, a fasting blood draw, and the Clinician Administered PTSD Scale. Correlations between CRF and cardiometabolic health were examined with Spearman's rank correlations, and differences in PTSD symptom severity were explored as a function of CRF (ie, low-to-moderate vs. high CRF), using multiple linear regression. RESULTS Peak oxygen uptake ($\dot{\mathrm{V}}$O2peak) was correlated with high-density lipoproteins rho = 0.60, P = 0.04 and diastolic blood pressure rho = -0.56, P = 0.05. Ventilatory threshold was correlated with HbA1c rho = -0.61, P = 0.03 and diastolic blood pressure rho = -0.56, P = 0.05. Higher CRF was associated with lower total PTSD severity standardized β = -0.84, P = 0.01, adjusted R2 = 0.47, total Cluster C symptoms (avoidance/numbing) β = -0.71, P = 0.02, adjusted R2 = 0.49, and total Cluster D symptoms (hyperarousal) β = -0.89, P = 0.01, adjusted R2 = 0.41, while adjusting for age and smoking status. CONCLUSIONS These preliminary findings suggest that CRF and by proxy physical activity may be important factors in understanding the increased risk of cardiovascular and metabolic disease associated with PTSD.
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Affiliation(s)
- James W Whitworth
- National Center for PTSD, Boston, MA.,Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA.,Boston University School of Medicine, Boston, MA
| | - Scott M Hayes
- Department of Psychology, The Ohio State University, Columbus, OH.,Chronic Brain Injury Initiative, The Ohio State University, Columbus, OH
| | - Ryan J Andrews
- Massachusetts General Hospital Institute of Health Professions, Boston, MA
| | - Jennifer R Fonda
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA.,Boston University School of Medicine, Boston, MA.,Harvard Medical School, Boston, MA
| | - Brigitta M Beck
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA
| | - Lilly B Hanlon
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA
| | - Catherine B Fortier
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA.,Harvard Medical School, Boston, MA
| | - William P Milberg
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA.,Harvard Medical School, Boston, MA
| | - Regina E McGlinchey
- Translational Research Center for Traumatic Brain Injury and Stress Disorders, and Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Boston Healthcare System, 150 S. Huntington Ave, Boston, MA.,Harvard Medical School, Boston, MA
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Johnson A, Weeks M, Loewen B, Byrd M, Ryan GA. Training Considerations and Recommendations for Tactical Professionals With Posttraumatic Stress Disorder. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
OBJECTIVES Indigenous Australians experience higher levels of psychological distress compared to the general population. Physical activity is a culturally acceptable approach, associated with reduction of depressive symptoms. The protective properties of physical activity for depressive symptoms are yet to be evaluated in older Indigenous Australians. DESIGN A two-phase study design comprised of a qualitative thematic analysis following a quantitative regression and moderation analysis. PARTICIPANTS Firstly, a total of 336 Indigenous Australians aged 60 years and over from five NSW areas participated in assessments on mental health, physical activity participation, and childhood trauma. Secondly, a focus group of seven Indigenous Australians was conducted to evaluate barriers and facilitators to physical activity. MEASUREMENTS Regression and moderation analyses examined links between depression, childhood trauma, and physical activity. Thematic analysis was conducted exploring facilitators and barriers to physical activity following the focus group. RESULTS Childhood trauma severity and intensity of physical activity predicted depressive symptoms. Physical activity did not affect the strength of the relationship between childhood trauma and depression. Family support and low impact activities facilitated commitment to physical activity. In contrast, poor mental health, trauma, and illness acted as barriers. CONCLUSION Physical activity is an appropriate approach for reducing depressive symptoms and integral in maintaining health and quality of life. While situational factors, health problems and trauma impact physical activity, accessing low-impact group activities with social support was identified to help navigate these barriers.
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Activation of the orbitofrontal cortex by both meditation and exercise: A near-infrared spectroscopy study. PLoS One 2021; 16:e0247685. [PMID: 33621250 PMCID: PMC7901739 DOI: 10.1371/journal.pone.0247685] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022] Open
Abstract
In some types of meditation, such as mindfulness and Zen, breathing is the focus of attention, whereas during an excessive, short-period of anaerobic exercise, the muscles become the focus of attention. Thus, during both efforts, one’s attention is focused on a certain feature of the body. Both meditation and exercise generally provide mental refreshment to humans. We hypothesized that the same brain regions are activated by both efforts in humans. To examine this hypothesis, we engaged participants in 3 tasks: meditation, exercise, and a control task. After each task, the participants underwent a 2-back test to concentrate their thoughts, while changes in their blood hemoglobin levels were simultaneously monitored using near-infrared spectroscopy (NIRS). Seventeen participants (20–24 years of age; 11 men, 6 women) were enrolled. We applied a fast-Fourier transform (FFT) analysis to the NIRS wave data and calculated the correlation coefficients of the FFT data between (1) meditation and control, (2) exercise and control, and (3) meditation and exercise, at the orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex (DLPFC), brain areas that are generally involved in mental refreshment. A significant difference in the correlation coefficients between the OFC and DLPFC was detected in the meditation and exercise analysis, and signal source analysis confirmed that the NIRS waves spread from the right and left OFC edges (i.e., right and left temples) toward the center. Our results suggest that both meditation and exercise activate the OFC, which is involved in emotional reactions and motivation behavior, resulting in mental refreshment.
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Zhu L, Li L, Li XZ, Wang L. Effects of mind-body exercise on PTSD symptoms, depression and anxiety in PTSD patients: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24447. [PMID: 33530251 PMCID: PMC7850731 DOI: 10.1097/md.0000000000024447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 01/05/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The present study aimed to systematically analyze the effects of mind-body exercise on PTSD symptom, depression and anxiety among patients with post-traumatic stress disorder (PTSD) and to provide a scientific evidence-based exercise prescription. Meanwhile, it will also help reduce the global mental health burden of COVID-19. METHODS Both Chinese and English databases (PubMed, Web of Science, the Cochrane Library, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were used as sources of data to search for randomized controlled trials (RCTs) published between January 1980 to September 2020 relating to the effects of mind-body exercise on PTSD symptom, depression and anxiety in PTSD patients. CONCLUSION This systematic review and meta-analysis will provide stronger evidence on the effectiveness and safety of mind-body exercise for PTSD symptoms in PTSD patients. SYSTEMATIC REVIEW REGISTRATION INPLASY2020120072.
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Affiliation(s)
- Lin Zhu
- School of Physical Education, Soochow University, Suzhou
| | - Long Li
- School of Physical Education, Soochow University, Suzhou
| | - Xiao-Zhi Li
- Department of Physical Education, Southeast University, Nanjing, Jiangsu
| | - Lin Wang
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
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46
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Belrose C, Duffaud A, Levy D, Beji A, Jacob S, Lorion G, Martin-Krumm C, Trousselard M. Self-Representations of Military Veterans Suffering From Chronic Post-traumatic Stress Disorder: The Role of Sport. Front Psychiatry 2021; 12:766515. [PMID: 34803774 PMCID: PMC8602847 DOI: 10.3389/fpsyt.2021.766515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) is a psychiatric illness that is very prevalent in both civilian and military environments. The clinical course, regardless of management, is chronic for a number of patients, especially veterans. Persistent PTSD symptoms interact with representations of the person and their body, and may negatively impact rehabilitation. Sport is known to help psychiatric patients such as those suffering from PTSD, as it improves the connection with the body, and supports physiological and emotional regulation. However, the impact of sport on self-representations has not yet been studied. The first aim of this study is to explore person and body representations in a population of military veterans suffering from chronic PTSD, as a function of clinical severity. Second, it aims to explore how a 9-day sport program, which includes an element of socio-professional rehabilitation, changes representations of the person and their body. Methods: This exploratory qualitative study examined the self-representation of veterans with chronic PTSD before a sport rehabilitation program. Veterans were given the prompts "body" and "person" and asked to free associate. PTSD severity and the mind-body connection were assessed using the Posttraumatic Stress Disorder Checklist for DSM-5, and the Freiburg Mindfulness Inventory, respectively. Parasympathetic activity was recorded at rest. A subgroup of the population volunteered to participate in a post-program session to record the same semantic, psychological, and physiological variables. Results: Although before the program, veterans gave more negatively than positively valenced words, no relation was observed between the overall number of negative words and PTSD severity. Post-program, changes were observed in terms of valence. Specifically, some negatively-valenced categories of words disappeared, and some positive categories appeared. At the same time, there was a fall in PTSD severity, an increase in the mind-body connection, and a decrease in parasympathetic activation. Conclusions: This study highlighted that veterans with chronic PTSD have a negative representation of the self. A dedicated, 9-day program that included regular sport improved self-representations related to both the person and their body, and reduced PTSD symptoms. The findings underline the importance of ensuring that programs for patients suffering from chronic PTSD should include sporting activity, and highlight the benefits. Sport appears to be a path to the reappropriation of a positive image of the self, by improving the representation of the body. This relationship could be consistent with improved interoception, but our results need further investigation.
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Affiliation(s)
- Celia Belrose
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,Réseau ABC des Psychotraumas, Montpellier, France
| | - Anais Duffaud
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,Réseau ABC des Psychotraumas, Montpellier, France
| | | | | | - Sandrine Jacob
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | | | - Charles Martin-Krumm
- APEMAC/EPSAM, EA 4360, Metz, France.,Laboratoire VCR, École de Psychologues Praticiens de Institut Catholique de Paris (Catholic Institute of Paris), EA 7403, Paris, France
| | - Marion Trousselard
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France.,Réseau ABC des Psychotraumas, Montpellier, France.,APEMAC/EPSAM, EA 4360, Metz, France.,French Military Health Service Academy, Paris, France
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47
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Adams TG, Forte J, Fogle BM, Southwick SM, Pietrzak RH. Self-reported exercise frequency and PTSD: results from the National Health and Resilience in Veterans Study. Acta Psychiatr Scand 2020; 142:486-495. [PMID: 32961606 DOI: 10.1111/acps.13234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Physical exercise may serve as a protective factor for posttraumatic stress disorder (PTSD), but little is known about whether physical exercise is associated with PTSD in population-based samples of military veterans. METHODS We analyzed cross-sectional data on the relation between self-reported physical exercise frequency and the prevalence of probable PTSD in a nationally representative sample of 2832 U.S. military veterans who participated in the National Health and Resilience in Veterans Study. RESULTS A "U-shaped" association best explained the relation between self-reported exercise frequency and the prevalence of probable PTSD. Compared to veterans without probable PTSD, those with probable PTSD were nearly twice as likely to report no weekly exercise (52.3% vs. 29.3%) or daily (7 days/week) exercise (15.2% vs. 8.5%) and were nearly half as likely to report exercising a median of 3.5 days/week (32.6% vs. 62.1%). No exercise was associated with greater severity of emotional numbing and lower severity of anxious arousal symptoms, while daily exercise was associated with greater severity of re-experiencing symptoms. CONCLUSIONS Results of this study suggest a "U-shaped" association between self-reported exercise frequency and the prevalence of probable PTSD among U.S. veterans. Veterans with probable PTSD were more likely than those without probable PTSD to report not exercising at all or exercising every day and were less likely to report exercising 1-6 days per week. Clinical implications of these findings are discussed.
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Affiliation(s)
- T G Adams
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.,Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - J Forte
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Psychology, Binghamton University, Binghamton, NY, USA
| | - B M Fogle
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - S M Southwick
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - R H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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48
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Smith PJ, Merwin RM. The Role of Exercise in Management of Mental Health Disorders: An Integrative Review. Annu Rev Med 2020; 72:45-62. [PMID: 33256493 DOI: 10.1146/annurev-med-060619-022943] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A large and growing body of evidence suggests that physical activity (PA) may hold therapeutic promise in the management of mental health disorders. Most evidence linking PA to mental health outcomes has focused on the effects of aerobic exercise training on depression, although a growing body of work supports the efficacy of both aerobic and resistance exercise paradigms in the treatment of anxiety and post-traumatic stress disorder. Despite abundant evidence linking PA and mental health, use of exercise training as a mental health treatment remains limited due to three important sources of uncertainty: (a) large individual differences in response to exercise treatment within multiple mental health domains; (b) the critical importance of sustained PA engagement, not always achieved, for therapeutic benefit; and (c) disagreement regarding the relative importance of putative therapeutic mechanisms. Our review of treatment data on exercise interventions and mental health outcomes focuses primarily on depression and anxiety within a health neuroscience framework. Within this conceptual framework, neurobiological and behavioral mechanisms may have additiveor synergistic influences on key cognitive and behavioral processes that influence mental health outcomes. We therefore highlight sources of treatment heterogeneity by integrating the critical influences of (a) neurobiological mechanisms enhancing neuroplasticity and (b) behavioral learning of self-regulatory skills. Understanding the interrelationships between dynamic neurobiological and behavioral mechanisms may help inform personalized mental health treatments and clarify why, and for whom, exercise improves mental health outcomes. The review concludes with recommendations for future studies leveraging individual differences to refine treatment approaches to optimize mental health benefits.
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Affiliation(s)
- Patrick J Smith
- Department of Psychiatry and Behavioral Sciences.,Department of Medicine, and.,Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina 27708, USA;
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Scioli ER, Smith BN, Whitworth JW, Spiro A, Esterman M, Dutra S, Bogdan KM, Eld A, Rasmusson AM. Moderated mediation for exercise maintenance in pain and posttraumatic stress disorder: A randomized trial. Health Psychol 2020; 39:826-840. [PMID: 32833484 PMCID: PMC8559731 DOI: 10.1037/hea0000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study utilizes the Science of Behavior Change (SOBC) experimental medicine approach to evaluate the effects of a 3-month, individually prescribed progressive exercise training program on neurobiological, cognitive and motivational mechanisms by which our exercise-training paradigm may foster exercise maintenance. We will investigate hypothesized relationships between exercise-training associated augmentation of neuropeptide Y (NPY) system function and improvements in self-regulation and reward sensitivity-cognitive control and motivational processes posited to promote self-efficacy and intrinsic motivation, which have been shown to predict exercise maintenance. This study will recruit Veterans with chronic low back pain and posttraumatic stress disorder (PTSD). Procedures include a baseline, acute cardiopulmonary exercise challenge assessment that will inform the exercise prescription for a 12-week progressive exercise training program comprised of three 45-minute aerobic exercise sessions per week-all of which will be supervised by an exercise physiologist. Additionally, a week-7 and week-14 exercise challenge assessment will track changes in NPY system function and the variables of interest. We hypothesize that increases in the capacity to release NPY in response to acute exercise testing will be associated with improvements in self-regulation and reward sensitivity, which will in turn be associated with self-efficacy and intrinsic motivation to maintain regular exercise. Ninety participants will be randomized either to the "active exercise training condition" or to the "wait list symptom monitoring condition". The study aims to demonstrate the feasibility of procedures and elucidate mechanisms relevant to developing individually prescribed, motivationally based exercise regimens to reduce negative consequences of PTSD and low back pain over the long-term. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Erica R Scioli
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | - Brian N Smith
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | | | - Avron Spiro
- Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) VA Boston Healthcare System
| | | | - Sunny Dutra
- Clinical Psychology Department, William James College
| | - Kristina M Bogdan
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | - Alex Eld
- Affiliate of Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
| | - Ann M Rasmusson
- Women's Health Sciences Division, National Center for PTSD, Research Service, VA Boston Healthcare System
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50
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Draper A, Marcellino E, Ogbonnaya C. Fast Feet Forward: Sports training and running practice to reduce stress and increase positive cognitions in unaccompanied asylum‐seeking minors. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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