Exercise Dependence: Diagnostic and Therapeutic Issues for Patients in Psychotherapy

Health promotion and exercise is recognized as an important ingredient in health maintenance. Within the diagnostic category of obsessive-compulsive disorders has been the increased recognition by clinicians of a phenomena best described as exercise dependence. Reviewed herein is its definition, theoretical framework and a spectrum of factors often associated with exercise. Realizing that exercise dependence as a clinical entity is not yet recognized in either the International Classification of Disorders (ICD-9) or the Diagnostic and Statistical Manual (DSM-IV-R), proposed criteria for its inclusion are offered. Where a pattern of behavior shows the presence of symptoms consistent with exercise dependence, clinical diagnosis should be made to assure that appropriate treatment might be offered to manage the condition and continue to make exercise an important part of a healthy lifestyle. Diagnostic and therapeutic considerations are offered for the contemporary psychotherapist.     

Effects of chronic exercise on attentional bias among individuals with methamphetamine use disorder

BackgroundIndividuals with substance use disorder show attentional bias toward drug-related cues, which may be associated with attentional control deficits. Although exercise improves attention in healthy people, whether individuals with substance use disorder also benefit is unknown. We explored the effects of chronic exercise on behavioral and neural correlates of attentional bias in men with methamphetamine use disorder.MethodsSixty-one such men were randomized to high- or moderate-intensity exercise or to a control group with little exercise for 12 weeks. The dot-probe task assessed attentional bias before and after exercise intervention, with event-related potentials recorded during the task to determine underlying neural mechanisms.ResultsAttentional bias scores and event-related potential amplitudes significantly decreased after high- or moderate-intensity chronic exercise, but not in controls.ConclusionsChronic exercise reduces attentional bias in individuals with methamphetamine use disorder by enhancing early identification of drug-related stimuli and diverting attention to reduce conflict processing.     

重复性急性应激对攻击行为的影响及调控机制

关于急性应激对攻击行为的影响, 现有研究多集中于单次急性应激情境下。然而, 相比单次急性应激, 对重复暴露于同一应激源的研究更能反映人们在现实生活中经历的应激事件。与单次应激不同, 重复性急性应激与应激适应有关, 能够节省资源, 具有很强的进化和适应意义, 但目前关于重复性急性应激对攻击行为的影响却知之甚少。鉴于此, 研究运用事件电位相关技术、鼻喷催产素和催产素受体基因型分析方法, 探讨重复性急性应激对攻击行为的影响及内部机制, 并进一步探讨通过内部和外部调控重复性急性应激反应后攻击行为的变化。     

The dynamics of success and failure: how post-behaviour evaluations relate to subsequent exercise intentions and behaviour

Objective: Exercise behaviour change involves multiple experiences with success and failure. The Model of Action Phases (MAP) offers a dynamic account of how success and failure influence both immediate evaluations and future decisions and actions. However, predictions from the MAP have not been formally tested.

Design: A longitudinal daily diary study was used to examine how post-behaviour evaluations of exercise success and failure influence subsequent exercise intentions and behaviour. Participants (N = 104) set exercise goals, and then kept a daily online exercise diary for four weeks.

Main outcome measures: Participants self-reported exercise behaviour, affective response to exercise, self-evaluations after success or failure at following through on intentions to exercise, and intentions to exercise in the next week.

Results: Multilevel modelling revealed significant within- and between-participant relationships among post-behaviour evaluations, intentions and subsequent behaviour. Findings supported MAP-derived predictions about how success and failure at exercise are associated with feelings about exercise and the self, and inform subsequent exercise intentions and behaviour.

Conclusion: Positive post-behaviour evaluations of success or failure may stabilise positive intentions and aid maintenance of exercise behaviour. Implications of these MAP-based findings for intervention design are discussed.     

Post-stroke depression as a predictor of caregivers burden of acute ischemic stroke patients in China

Our aim was to explore the independent attribution of Post-stroke depression (PSD) to caregiver burden of acute ischemic stroke patients. A cross-sectional survey was performed with 271 acute ischemic stroke patients in the Huai-He Hospital and First People’s Hospital of Kaifeng City in China. PSD was assessed by Self-rating Depressive Scale, and caregiver burden was assessed by Zarit Caregiver Burden Interview. Clustered logistic regression was applied to identify the impact of PSD on caregiver burden. As results, female patients, normal muscle strength and PSD were associated with caregiver burden. PSD correlated with an independent influence of 17.2% on the risk of caregiver burden, The independent influence of PSD on caregiver burden was smaller than that of social-demographics of caregivers and clinical factors of stroke patients This study suggests that PSD may have a modest influence on caregiver burden.     

Walking versus biofeedback: a comparison of acute interventions for stressed students

Background: High rates of stress-related problems in college students and low utilization of treatment options demonstrate the need for effective stress-reducing interventions that can be self-regulated. This study compared the effect of brief paced-breathing with biofeedback and exercise interventions on heart rate variability, state anxiety and affect. Methods: Students (n?=?32) with high levels of perceived stress completed three 10-min interventions on separate days: paced-breathing with biofeedback (Biofeedback), a self-paced walk (Exercise), and an attention control condition of quiet studying (Quiet Study). Anxiety and affect were measured before (Pre), immediately after (Post0) and 15 mins after (Post15) the intervention. Heart rate variability was measured pre- and post-intervention using electrocardiogram. Results: Biofeedback reduced anxiety more than the exercise condition (Pre to Post0: Biofeedback d?=??0.48, Exercise d?=??0.13). Secondly, Exercise temporarily increased energy (Pre to Post0: d?=?0.67), whereas Biofeedback temporarily increased calmness (Pre to Post0: d?=?0.51). All conditions significantly increased total heart rate variability (p?Conclusions: Biofeedback and Exercise interventions improved emotional states in high-stress college students, but the type of change observed (i.e. energizing, calming or anxiety reducing) depended upon the condition.     

Brain-derived neurotrophic factor Val66met polymorphism and plasma levels in road traffic accident survivors

Background: Alterations in brain-derived neurotrophic factor (BDNF) expression and release may play a role in the pathogenesis of post-traumatic stress disorder (PTSD). Design: This study evaluated road traffic accident (RTA) survivors to determine whether PTSD and trauma-related factors were associated with plasma BDNF levels and BDNF Val66Met carrier status following RTA exposure. Methods: One hundred and twenty-three RTA survivors (mean age 33.2 years, SD?=?10.6 years; 56.9% male) were assessed 10 (SD?=?4.9) days after RTA exposure. Acute stress disorder (ASD), as assessed with the Acute Stress Disorder Scale, was present in 50 (42.0%) of the participants. Plasma BDNF levels were measured with enzyme-linked immunosorbent assay and BDNF Val66Met genotyping was performed. PTSD, as assessed with the Clinician-Administered PTSD Scale, was present in 10 (10.8%) participants at 6 months follow-up. Results: Neither BDNF Val66Met genotype nor plasma BDNF was significantly associated with the presence or severity of ASD or PTSD. Plasma BDNF levels were, however, significantly correlated with the lifetime number of trauma exposures. Conclusions: In RTA survivors, plasma BDNF levels increased with increasing number of prior trauma exposures. Plasma BDNF may, therefore, be a marker of trauma load.     

Post-exercise pulse pressure is a better predictor of executive function than pre-exercise pulse pressure in cognitively normal older adults

Exercise “stress tests” are widely used to assess cardiovascular function and to detect abnormalities. In line with the view of exercise as a stressor, the present study examined the relationship between cognitive function and cardiovascular activity before and after light physical exercise in a sample of 84 non-demented community-dwelling older adults. Based on known relationships between hypertension, executive function and cerebral white matter changes, we hypothesized that greater post-exercise reactivity, as indexed by higher pulse pressure, would be more related to worse performance on frontal-executive tasks than pre-exercise physiologic measures. All participants were administered a comprehensive neuropsychological battery and underwent a Six Minute Walk Test (6MWT), with blood pressure (BP) measures obtained immediately before and after the walk. Pulse pressure (PP) was derived from BP as an indicator of vascular auto-regulation and composite scores were computed for each cognitive domain assessed. As predicted, worse executive function scores exhibited a stronger relationship with post-exercise PP than pre-exercise PP. Results suggest that PP following system stress in the form of walking may be more reflective of the state of vascular integrity and associated executive dysfunction in older adults than baseline physiologic measures.     

The relationship between habitual physical activity status and executive function in individuals with Alzheimer’s disease: a longitudinal,cross-lagged panel analysis

To determine whether habitual physical activity status specifically influences executive function change in Alzheimer’s disease (AD) over 1 year. In this longitudinal cohort study, 45 participants with AD were recruited and provided follow-up data approximately 1 year later. Executive function measures (map search task, digit symbol substitution task, controlled oral word association task, verbal fluency task) and habitual physical activity measures (Physical Activity Scale for the Elderly (PASE) and handgrip strength) were taken at baseline and follow-up. Individual composites were subsequently created. Additional demographic, lifestyle, and neuropsychiatric measures were also taken. In a structural equation model (χ²(26) = 9.84, p = .998, comparative fit index = 1.00, root mean square error of approximation = .00), a significant association was found between habitual physical activity and executive function change (β = .27, p = .04). In a cross-lagged panel analysis, a significant path was found between the PASE score and executive change (β = .22, p = .01). As higher habitual physical activity levels were associated with reduced executive function change, the promotion of low-intensity habitual physical activities in individuals with a diagnosis of AD may be warranted. Further research is needed, however, to explore the impact of habitual physical activity on the trajectory of change across cognitive domains, and how this relates to the progression of the underlying pathology associated with this disease.