Physical Activity and Anxiety EPHE 348

Anxiety Defined as a negative emotional state –Nervousness –Worry –Apprehension –Arousal State vs. Trait? 1-2% prevalence (panic) at clinical diagnoses and up to 16% for all anxiety disorders.

Anxiety Billions of dollars in economic costs Personal and family suffering Predisposing factor for drug and substance abuse

Panic Attack A discrete period of intense fear or discomfort, in which four or more symptoms occur –Palpitations or chest pain –Sweating –Trembling or choking –Shortness of breath –Nausea/dizziness or chills/hot flushes –Fear of losing control/going crazy –paresthesias

Panic Disorder Recurrent panic attacks Followed by –Persistent concern of other attacks –Worry about the implications of attacks –Change in behaviour related to the attacks –Agoraphobia (with or without)

Treatment Medication (benzodiazepines, tranquilizers, anti-depressants) Psychotherapy Can exercise help?

Anxiety and PA More than 100 studies in the literature but most are correlational 60% of clinicians prescribe exercise to help with anxiety Meta-analyses show inconsistency (ES ). Safe to assume a small effect size

Types of activities Aerobic activities have an effect but strength activities do not (seen in self- report, EMG, HR, EEG) Resistance training may even increase anxiety slightly Intensity and duration do not seem to be overly sensitive to reducing post exercise anxiety

PA and Anxiety? Anxiolytic effect duration is approximately 2 hours (Landers & Petruzzello, 1994) PA seems as powerful a strategy as any other behavioural technique (e.g., relaxation) No strong evidence that it is effective compared to pharmacotherapy

UVic Study (Blacklock, Rhodes, Blanchard & Gaul, in press) 50 participants (cancer, control matched) randomized to days of light or moderate intensity EX (20 min) Measures at baseline, immediately after, and 10 min post-exercise Main effect but no interaction effects on state anxiety

Blacklock et al. (in press)

Long-Term Effects? Evidence that exercise can reduce state anxiety and neuroticism Reduced stress reactivity

Limitations Little control of activity history and fitness Dose and mode standardization Testing and expectation effects Generalizability

Adverse Events? (Rhodes et al.) 8/12 studies reported events 6 panic attacks (< 1%) from 802 participants

PA and other mood states POMS is the most popular mood measure (anger, tension, fatigue, depression, confusion & vigor) What does a bout of PA do? McDonald & Hogdon (1991) meta-analysis found a trivial effect for Anger and small effects for tension, vigor, fatigue, and confusion (2-3 hour effect)

Circumplex of Mood (Tellegen, 1988) Attraction/Pleasure (Valence) Avoidance/ Displeasure Aroused Calm (Intensity)

Basic Emotion States (Shaver, 1987) Anger – irritation, annoyance, fury, rage Fear – apprehension, anxiety, panic, terror Joy – happiness, pleasure, exhileration Sadness – despondency, depression, grief

What affects Affect? Watson & Clark (1994) Exogenous factors – e.g. rain, music Endogenous rhythms – i.e., biological cycles Traits/temperament – i.e. personality Characteristic variability – i.e. magnitude of mood fluctuation stability

Limits of Mood Studies Too many confounding variables! Testing effects Ecological validity No standardization College samples

Why does PA affect anxiety mood? Physiological Mechanisms Thermogenic hypothesis- increased body temp, increases relaxation. Seems plausible for anxiety Monoamine hypothesis – depression decreases norepinephrine & serotonin. Animal models show that PA may moderate this system

Phys Mechanisms Cont. Opponent-process hypothesis – fight or flight system physiological taxing and opposition. May explain depression and anxiety

Cognitive Mechanisms Expectancy – perhaps…some variance can be attributed to this. Distraction – PA was associate with larger mood gains than just time-out (limited evidence)