Publication guide: How exercise impacts on addiction or mental health and illness

Below are some abstracts from publications from the library collection. Please contact us for more information.   

Abrantes, A. M., Blevins, C. E., Battle, C. L., Read, J. P., Gordon, A. L., & Stein, M. D. (2017). Developing a Fitbit-supported lifestyle physical activity intervention for depressed alcohol dependent women. Journal of Substance Abuse Treatment, 80, 88–97. https://doi.org/10.1016/j.jsat.2017.07.006 

Purpose: Women in alcohol treatment are more likely to relapse when in unpleasant, negative emotional states. Given the demonstrated benefits of exercise for decreasing depression, negative affect, and urges to drink, helping women engage in a lifestyle physical activity (LPA) intervention in early recovery may provide them a tool they can utilize “in the moment” in order to cope with negative emotional states and alcohol craving when relapse risk is highest. New digital fitness technologies (e.g., Fitbit activity monitor with web and mobile applications) may facilitate increases in physical activity (PA) through goal setting and self-monitoring.
Method: We piloted a 12-week LPA+Fitbit intervention focused on strategically using bouts of PA to cope with affect and alcohol cravings to prevent relapse in 20 depressed women (mean age=39.5years) in alcohol treatment. 

 Results: Participants wore their Fitbit on 73% of days during the intervention period. An average of 9174 steps/day were taken on the days the Fitbit was worn. Participants completed 4.7 of the 6 scheduled phone PA counseling sessions (78%). Among women who completed the intervention (n=15), 44% remained abstinent throughout the entire course of treatment. On average, women were abstinent on 95% of days during the 12-week intervention. Participants reported an increase in using PA to cope with either negative affect or urges to drink from baseline to end of treatment (p<0.05). Further, participants reported high satisfaction with the LPA+Fitbit intervention and with the Fitbit tracker.
Conclusions: Further research is needed to evaluate the LPA+Fitbit intervention in a more rigorous randomized controlled trial. If the LPA+Fitbit intervention proves to be helpful during early recovery, this simple, low-cost and easily transported intervention can provide a much-needed alternate coping strategy to help reduce relapse risk among women in alcohol treatment.  

Avery, N., & Patterson, S. (2018). Physical Health in Public Mental Health Care: A Qualitative Study Employing the COMB Model of Behaviour to Describe Views and Practices of Australian Psychologists. Australian Psychologist, 53(4), 302. 

Objective: To inform improvement in the process and outcomes of care by describing the views and practices of psychologists working in public mental health services (PMHS) regarding provision of physical healthcare for consumers. Method: Crosssectional qualitative study employing a theoretical model of behaviour (capability, opportunity, motivation, and behaviour; COMB model). Data collected in semistructured interviews with maximum diversity sample of 29 psychologists were analysed using the framework approach. Results: Participants were cognisant of the need to improve physical health among people with severe mental illness (SMI); they endorsed, to varying extents, the obligation of PMHS and potential of psychologists, collectively to contribute to this goal through provision of interventions targeting health behaviours. Within a context in which psychology was generally underutilised, practice varied widely, ranging from avoidance to integration of physical health care in clinical practice. In combination, mixedmessages about service priorities, role ambiguity, competing demands, and concern about adequacy of knowledge and skills inhibited attention to physical health for most participants, particularly those working in generic case management roles. Some highly motivated psychologists, most of whom worked in specialised teams within which attention to physical health was normative, made and capitalised on opportunities to develop and apply skills to enable consumers to change behaviour and improve physical health. Conclusion: While further education and training will enhance capability and motivation of psychologists, realisation of the potential contribution to improvement in physical health of people with SMI will fundamentally, require assertion of the identity and value of the profession within mental health services. Ensuring optimal use of scarce resources necessitates careful consideration of deployment of discipline specific expertise, and clarity about responsibilities of psychologists within teams.  

Colledge, F., Vogel, M., Dürsteler-Macfarland, K., Strom, J., Schoen, S., Pühse, U., & Gerber, M. (2017). A pilot randomized trial of exercise as adjunct therapy in a heroin-assisted treatment setting. Journal of Substance Abuse Treatment, 76, 49–57. https://doi.org/10.1016/j.jsat.2017.01.012v 

Background Although the potential of exercise as an adjunct treatment for substance dependence is persuasive in theory, few controlled trials have assessed its effectiveness. Existing research has also largely focused on individuals aiming towards, or having already achieved, abstinence. This study employed a randomized design in a pilot trial to assess the feasibility, acceptance, and effects of an exercise intervention for individuals receiving outpatient heroin-assisted treatment.  

Results 24 individuals were willing to take part in the study. 92.3% of the exercise condition (n=13) were compliant or semi-compliant with the protocol; by contrast, only 54.6% of participants in the comparison condition (n=11) were compliant or semi-compliant (χ2=7.049; p=0.029). Participants in the exercise condition significantly increased the number of minutes spent exercising at a high intensity level (F(2,44)=3.794; p=0.046; η2=0.159). No other significant interaction effects were observed.  

Conclusions An exercise intervention is a feasible and accepted supplementary therapy to heroin-assisted treatment. Participation rates were high, particularly given the outpatient setting. No evidence regarding the potential mechanisms of exercise as a therapy modality could be identified. Patients in heroin-assisted treatment may require a longer-term exercise programme, specifically targeting particular health parameters, before measurable improvements can be observed.  

Highlights: We examine the feasibility and effects of exercise in heroin-assisted treatment. Participants in the exercise condition were more study-compliant and increased their vigorous physical activity. Exercise is a feasible adjunct therapy for individuals in heroin-assisted treatment.  
Ellingsen, M. M., Johannesen, S. L., Martinsen, E. W., & Hallgren, M. (2018). Effects of acute exercise on drug craving, self-esteem, mood and affect in adults with poly-substance dependence: Feasibility and preliminary findings. Drug and Alcohol Review, 37(6), 789–793. https://doi.org/10.1111/dar.12818 

Introduction and Aims: Novel treatments for substance use disorders are needed. Acute bouts of exercise can improve mood states in non-clinical populations, but effects in those with poly-substance dependence are understudied. We examined the feasibility and short-term effects of three types of exercise on drug cravings, self-esteem, mood and positive/negative affect in nine poly-drug-dependent inpatients.
Design and Methods: Using a cross-over design, changes in the four study outcomes were assessed immediately before exercise and on four separate occasions post-exercise (immediately after, then at 1, 2 and 4 h post-exercise) enabling patterns of change over time (analysis of covariance) to be observed.
Results: Participants were willing and able to engage in different non-laboratory based exercises. Football was associated with non-significant short-term reductions in drug cravings. A similar trend was seen for circuit-training, but not walking. Football and circuit-training were associated with brief improvements in mood and positive/negative affect. No adverse events were reported.
Discussion and Conclusions: Football, circuit training and walking are feasible therapeutic activities for inpatients with poly-substance dependence. Controlled trials are needed to determine the long-term effects of these activities. 

 

Hallam, K. T., Bilsborough, S., & de Courten, M. (2018). “Happy feet”: evaluating the benefits of a 100-day 10,000 step challenge on mental health and wellbeing. BMC Psychiatry, 18(1), 19. 

Background: An increased awareness of the health benefits of walking has emerged with the development and refinement of accelerometer equipment. Evidence is beginning to highlight the value of promoting walking, particularly focusing on the Japanese mark of obtaining 10,000 steps per day. Workplace based step challenges have become popular to engage large cohorts in increasing their daily physical activity in a sustainable and enjoyable way. Findings are now highlighting the positive health effects of these medium-term programs (typically conducted over a few months) in terms of cardiovascular health, reducing diabetes risk and improving lifestyle factors such as weight and blood pressure. As yet, research has not focused on whether similar improvements in psychological health and wellbeing are present. 

Methods: This study investigated the impact of a 100-day, 10,000 step program on signs of depression, anxiety and stress as well as general wellbeing using standardised psychological scales. 

Results: The results indicated a small but consistent effect on all of these measures of mental health over the term of the program. This effect appeared irrespective of whether a person reached the 10,000 step mark. 

Conclusions: These results highlight improved mental health and wellbeing in people undertaking this 100-day 10,000 step program and indicates the efficacy and potential of these programs for a modest, yet important improvement in mental health. Notably, targets reached may be less important than participation itself. 

 

 Ptasznik, A. (2010). fit in and out Community partnerships promote wellness through exercise. CrossCurrents: The Journal of Addiction & Mental Health, 14(1), 14. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=58602566&site=eds-live 

The article reports on the project of Minding Our Bodies, an initiative of the Canadian Mental Health Association, in partnership with the York University Faculty of Health that is funded by the Ministry of Health Promotion Communities in Action Fund in Canada. It reveals that the project will help community mental health organizations develop physical activity programs. It also notes that the project is culminated in the development of a toolkit that promotes wellness through exercise. 

  

Rawson, R. A., Chudzynski, J., Gonzales, R., Mooney, L., Dickerson, D., Ang, A., … Cooper, C. B. (2015). The Impact of Exercise On Depression and Anxiety Symptoms Among Abstinent Methamphetamine-Dependent Individuals in A Residential Treatment Setting. Journal Of Substance Abuse Treatment, 57, 36–40. https://doi.org/10.1016/j.jsat.2015.04.007  

Background: This paper reports data from a study designed to determine the impact of an 8-week exercise program on depression and anxiety symptoms among newly abstinent methamphetamine (MA)-dependent individuals in residential treatment.
Methods: One hundred thirty-five MA-dependent individuals, newly enrolled in residential treatment, were randomly assigned to receive either a 3-times-per-week, 60-minute structured exercise program for 8 weeks (24 sessions) or an equivalent number of health education sessions. Using mixed-modeling repeated-measures regression, we examined changes in weekly total depression and anxiety scores as measured by the Beck Depression Inventory and Beck Anxiety Inventory over the 8-week study period.
Results: Mean age of participants was 31.7 (SD = 6.9); 70.4% were male and 48% Latino. Analyses indicate a significant effect of exercise on reducing depression (β = -0.63, P = 0.001) and anxiety (β = -0.95, P=0.001) symptoms (total scores) over the 8-week period compared to a health education control group. A significant dose interaction effect between session attendance and exercise was found as well on reducing depression (β = -0.61, P < 0.001) and anxiety symptoms (β = -0.22, P=0.009) over time compared to the control group.
Conclusions: Results support the role of a structured exercise program as an effective intervention for improving symptoms of depression and anxiety associated with MA abstinence. 

 

Roberts, R., Lockett, H., Bagnall, C., Maylea, C., & Hopwood, M. (2018). Improving the physical health of people living with mental illness in Australia and New Zealand. The Australian Journal of Rural Health, 26(5), 354–362. https://doi.org/10.1111/ajr.12457  

People diagnosed with mental illness have relatively poor physical health and die earlier than their counterparts in the general population. People living with mental illness in rural Australia have three times the risk of premature death than the total population. This article reviews recent international, Australian and New Zealand research, identifies the increased risk of early death of people living with mental health issues in rural settings and looks at the need for policy and practice responses. The ‘Equally Well’ national initiatives are described in Australia and New Zealand, which seek to systematically address this inequity as a matter of priority. Finally, it argues for co-design and consumer participation in policy development, program implementation and research. Improved understanding of the perspectives and priorities of people with experience of mental illness is vital if change is to be fully realised. 

  

Stoutenberg, M., Warne, J., Vidot, D., Jimenez, E., & Read, J. P. (2015). Attitudes and preferences towards exercise training in individuals with alcohol use disorders in a residential treatment setting. Journal of Substance Abuse Treatment, 49, 43–49. https://doi.org/10.1016/j.jsat.2014.08.008  

Purpose: Alcohol use disorders (AUD) are a major public health concern due to their association with several acute and chronic health conditions. Exercise training offers a myriad of physical and mental health benefits, and may be a promising adjunct intervention for those in AUD treatment. The purpose of this study was to explore the possible role of exercise training as a treatment strategy by examining the attitudes, beliefs, and preferences of individuals entering residential AUD treatment.
Methods: Surveys were administered to eligible individuals with AUD within 2days of intake to one of two residential treatment centers. The survey asked respondents about their attitudes, beliefs, and preferences towards exercise training as a part of their residential treatment.
Results: Respondents were in favor of receiving exercise counseling as part of their treatment (70.6%), in a face-to-face format (90.0%), and from an exercise counselor at the treatment center (55.5%). The top reported benefits included: improved health, feeling good about oneself, and feeling more confident. The most commonly reported barriers to exercise training included transportation issues, lack of motivation, knowledge, and proper equipment, and cost.
Conclusion: Our study supports previous work in individuals with substance abuse disorders and suggests that exercise training would be widely accepted as a part of residential treatment for AUD. This study also identified several strategies that can be used to individualize exercise training programs to better meet the needs of AUD patients and maximize their participation in future interventions. 

 

Weinstock, J., Farney, M. R., Elrod, N. M., Henderson, C. E., & Weiss, E. P. (2017). Exercise as an Adjunctive Treatment for Substance Use Disorders: Rationale and Intervention Description. Journal of Substance Abuse Treatment, 72, 40–47. https://doi.org/10.1016/j.jsat.2016.09.002 

Substance use disorders (SUDs) are maladaptive patterns of substance use that are associated with psychiatric comorbidity, unhealthy lifestyle choices, and high rates of relapse. Exercise is associated with a wide range of acute and long-term benefits for both mental and physical health and is presently being investigated as a promising adjunctive treatment for SUD. Despite positive effects of regular physical activity on treatment outcomes and risk factors for relapse, low adherence and high attrition rates limit the benefits derived from exercise interventions. Lack of motivation is one of many perceived barriers to initiating exercise that contributes to poor adherence to interventions. In the present article, we describe the protocol for a novel, integrated exercise intervention that combines motivational interviewing (MI), a client-centered approach designed to enhance intrinsic motivation and resolve ambivalence toward change, and contingency management (CM), a behavioral treatment that provides monetary incentives for the completion of target behaviors. The protocol seeks to address the challenges surrounding initiation and

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