1. Exercise and Psychological Well–Being

2. Why Exercise for Psychological Well–Being? Stress is part of our daily lives, and more Americans than ever are feeling its ill effects. Exercise may positively influence feelings of well-being.

3. 3 Why Exercise for Psychological Well–Being? Hectic pace of westernized, technological society. 16 million Americans suffer from depression. 12 to 14 million Americans suffer from anxiety or stress reactions. Epidemiological data: Physical activity is positively associated with good mental health in the U.S. and Canadian populations.

4. 4 Reasons to Exercise Weight control Reduced risk of cardiovascular disease Reduction in stress and depression Enjoyment Building self-esteem Socializing

5. 5 Reasons to Exercise Exercise combined with proper eating habits can help people lose weight, but weight loss should be slow and steady, occurring as changes in exercise and eating patterns take place. Key:

6. 6 Reasons for Not Exercising Lack of time - perceived or real? Lack of energy Lack of motivation A MATTER OF PRIORITY Lack of motivation A MATTER OF PRIORITY

7. 7 Individual Barriers to Physical Activity Lack of time, energy, or motivation Excessive cost Illness/injury Feeling uncomfortable Lack of skill Fear of injury Lack of child care

8. Anaerobic Versus Aerobic Exercise Short-term or burst activities not involving the transportation of oxygen (e.g., weight lifting, baseball). Anaerobic Longer-term activities that increase pulmonary and cardiovascular system activity (e.g., cycling, running). Aerobic

9. Exercise and Quality of Life Physically active individuals report a better quality of life. College students participating in an endurance-conditioning program report a significantly higher quality of life than do nonexercisers. Older adults who are physically active report greater life satisfaction.

10. 10 Exercise and Changes in Personality Exercise is related to participants’ self- concept, self-esteem, and self-efficacy. (Fox, 1997) Regular exercise is related to increase self-esteem. Development of the Self

11. Psychological Benefits of Exercise IncreasesDecreases Confidence Assertiveness Memory Self-control Well-being Depression Anger Headaches Psychotic behavior Work errors

12. How Exercise Enhances Psychological Well–Being Increases in cerebral blood flow Physiological explanations Changes in brain neurotransmitters (e.g., norepinephrine, endorphins, seratonin) Increases in maximum oxygen consumption and delivery of oxygen to cerebral tissue (continued)

13. 13 How Exercise Enhances Psychological Well–Being Physiological explanations Reductions in muscle tension Structural changes in the brain

14. How Exercise Enhances Psychological Well–Being “Time-out” or distraction hypothesis Psychological explanations Enhanced feelings of control Feelings of competence and self-efficacy Positive social interactions Improved self-concept and self-esteem

15. Exercise and Changes in Sleep The effects of exercise on enhancing sleep are not as compelling or large as commonly believed. The effects are small, but they are noteworthy.

16. 16 Special Cases of Exercise and Psychological Well– Being “The Runner’s High” The runner’s high is a euphoric sensation, usually unexpected, of heightened well-being, an enhanced appreciation of nature and transcendence of time and space. (continued)

17. 17 “Addiction” to Exercise” Psychological and/or physical dependence on a regular regime of exercise, characterized by withdrawal symptoms after 24 to 36 hours pass without exercise. Withdrawal symptoms include anxiety, irritability, guilt, and muscle twitching.

18. 18 Symptoms of Negative “Addiction” to Exercise Stereotyped pattern of exercise, with a regular schedule of once or more daily. 1. Giving exercise increasing priority over other activities to maintain the pattern. 2. Increased tolerance to the amount of exercise performed. 3. Withdrawal symptoms related to mood disorder following cessation of exercise. 4. (continued)

19. 19 Symptoms of Negative “Addiction” to Exercise Relief of withdrawal symptoms by further exercise. 5. Subjective awareness of a compulsion to exercise. 6. Rapid reinstatement of the previous pattern of exercise and withdrawal symptoms after a period of abstinence. 7.

20. 20 Exercise Behavior and Adherence

21. 21 Why Exercise Behavior and Adherence Are Important 60% of adults are sedentary. 50% of youth (ages 12-21) do not participate in regular physical activity. 25% of children and adults report doing no physical activity. Only 15% of adults participate in vigorous and frequent activity. Only 10% of sedentary adults are likely to begin a program of regular exercise within a year. (continued)

22. 22 Why Exercise Behavior and Adherence Are Important Among boys and girls physical activity declines steadily through adolescence. Physical inactivity is more prevalent among women, African Americans, and Hispanics, as well as older and less affluent adults. 50% of people starting an exercise program will drop out within 6 months. Daily attendance in physical education classes dropped from 42% to 25% between 1990 and 1995.

23. 23 The Problem of Exercise Adherence

24. 24 Exercise professionals should consistently provide sound, scientific information about exercise and physical activity to increase the likelihood of clients’ adhering to a fitness program. The Problem of Exercise Adherence

25. 25 The likelihood of exercising depends on the person’s perception of the severity of health risks and appraisal of the costs and benefits of taking action. Models of Exercise Behavior Health Belief Model (Becker and Maiman, 1975)

26. 26 Theory of Planned Behavior (Ajzen and Madden, 1986) Models of Exercise Behavior Intentions Subjective norms and attitudes Perceptions of ability to perform behavior Exercise behavior

27. 27 Decision Theory Completing a decision balance sheet to increase awareness of the costs and benefits of participating in an exercise program can enhance exercise adherence. Develop balance sheets Models of Exercise Behavior

28. 28 A Decision Balance Sheet

29. 29 Exercise behavior is influenced by both personal and environmental factors, with particular emphasis placed on self-efficacy. Models of Exercise Behavior Social Cognitive Theory (Bandura, 1986)

30. 30 Transtheoretical Model (Prochaska, DiClemente, and Norcross, 1992) Models of Exercise Behavior Precontemplation stage (does not exercise) 1. Contemplation stage (fleeting thought of exercising) 2. Preparation stage (exercises, but not regularly enough) 3. Individuals progress through five stages of change: (continued)

31. 31 Models of Exercise Behavior Action stage (has been exercising regularly, but for less than six months) 4. Maintenance stage (has been exercising regularly for more than six months) WHAT ABOUT RELAPSE? Maintenance stage (has been exercising regularly for more than six months) WHAT ABOUT RELAPSE? 5. Transtheoretical Model

32. 32 Models of Exercise Behavior Different exercise behavior initiation strategies are used during the different transtheoretical stages. Key: Transtheoretical Model

33. 33 Guidelines for Improving Exercise Adherence Match the intervention to the participant’s stage of change. Provide cues for exercises (signs, posters, cartoons). Make exercises enjoyable. Give participants more choice in activity selection and program decisions. Tailor the intensity, duration, and frequency of exercises to person.

34. 34 Guidelines for Improving Exercise Adherence Promote exercising with a group or friend. Have participants sign a contract or statement of intent to comply with the exercise program. Offer a choice of activities. Provide rewards for attendance and participation. (continued) Have participants reward themselves for achieving certain goals.

35. 35 Guidelines for Improving Exercise Adherence Find a convenient place for exercising. Give individualized feedback on progress. Encourage goals to be self-set, flexible, and time-based (rather than distance-based). Suggest keeping daily exercise logs. (self – monitoring) Have participants complete a decision balance sheet before starting the exercise program. Suggest keeping daily exercise logs. (self – monitoring) Have participants complete a decision balance sheet before starting the exercise program.

36. 36 Guidelines for Improving Exercise Adherence Remind participants to focus on environmental cues (not bodily cues) when exercising. Obtain social support from the participant’s spouse, family members, and peers.

37. 37 Factors Associated With Participation in Supervised Exercise Programs Many factors—from demographics to physical and social environment —affect exercise participation.

38. 38 Determinants of Exercise Adherence: Highlights Blue-collar workers typically have lower exercise adherence rates than white- collar workers. However, increased choices can increase their adherence rates. Early involvement in sport and physical activity should be encouraged, because there is a positive relation between childhood exercise and adult physical activity patterns. (continued)

39. 39 Determinants of Exercise Adherence: Highlights Spousal support is critical to enhance adherence rates for people in exercise programs. Spouses should be involved in orientation sessions or in parallel exercise programs. Exercise intensities should be kept at moderate levels to enhance the probability of long-term adherence to exercise programs. (continued)

40. 40 Determinants of Exercise Adherence: Highlights Exercise leaders influence the success of an exercise program. They should be knowledgeable, give lots of feedback and praise, help participants set flexible goals, and show concern for safety and psychological comfort. (continued)

41. 41 Exercise in the Reduction of Anxiety and Depression

42. 42 Exercise in the Reduction of Anxiety and Depression Mental health problems account for 30% of the total days of hospitalization in the U.S. and 10% of the total medical cost. Although a cause-effect relationship has not been established, regular exercise is associated with reductions in anxiety and depression. (continued)

43. 43 Exercise in the Reduction of Anxiety and Depression High-intensity aerobic activity is not the only way to produce positive effects, but compared with other activities (e.g., strength training, yoga), it seems to maximize positive effects.

44. 44 Reduction of Anxiety Exercise intensity of at least 70% of maximal heart rate appears to be associated with the greatest reduction in postexercise state anxiety. Postexercise reductions in state anxiety return to preexercise anxiety levels within 24 hours. “Acute” Effects of Exercise

45. 45 Reduction of Anxiety Typical program to study chronic effects lasts 2–4 months, with 2–4 sessions per week. Exercise is associated with reductions in state anxiety, and the reductions are maintained for up to 15 weeks. “Chronic” Effects of Exercise Greater physiological gain does not necessarily lead to greater psychological gain.

46. 46 Summary of Exercise and Anxiety Reduction Research Although consistent reductions in state anxiety occur with both aerobic and anaerobic exercise, most research has focused on aerobic exercise to reduce anxiety. Exercise is associated with moderate reductions in both state and trait anxiety. Exercise is associated with reductions in muscle tension.

47. 47 Longer training programs (sessions conducted over weeks, rather than hours or days) are more effective than shorter ones in producing positive changes in well-being. Reductions in state anxiety after exercise may be due less to the physical activity than to the “time-out” from daily stresses and hassles.

48. 48 Reductions in anxiety after exercise occur independently of age and health status. Exercise training is particularly effective for individuals who have elevated levels of stress. All durations of exercise significantly reduce anxiety, although larger effects were found for periods up to 30 minutes.

49. 49 Reduction of Depression Possible depression treatments include prescription drugs, psychotherapy, and exercise. Exercise appears most helpful in relieving depression for people who are actually depressed. All modes of exercise are effective, but the greater the duration of the exercise program, the greater the antidepressant effect. Exercise intensity is not related to changes in depression.

50. 50 Key Factors in Maximizing the Effectiveness of Exercise on Depression (Burger, 1996) A pleasing and enjoyable activity Aerobic or rhythmic breathing An absence of interpersonal competition A closed, predictable, and spatially certain environment (e.g., running) Moderate intensity and duration of at least 20 to 30 minutes Regular inclusion in the weekly schedule

51. 51 Effects of Consistent Exercise Summary Physical fitness is positively associated with mental health and well-being. Exercise is associated with the reduction of stress emotions such as state anxiety. Anxiety and depression are common symptoms of failure to cope with mental stress, and exercise has been associated with a decreased level of mild to moderate depression and anxiety. (continued)

52. 52 Effects of Consistent Exercise Summary Long-term exercise is usually associated with reductions in traits such as neuroticism and anxiety. Severe depression usually requires professional treatment, which may include medication, electroconvulsive therapy, psychotherapy, or a combination of these, with exercise as an adjunct. (continued)

53. 53 Effects of Consistent Exercise Summary Current clinical opinion holds that exercise has beneficial emotional effects across ages and genders. Appropriate exercise results in reductions in various stress indicators, such as neuromuscular tension, resting heart rate, and some stress hormones. Physically healthy people who require psychotropic (mood altering) medication may safely exercise under close medical supervision.