L12 - Exercise & Psych Well-Being Part 2

• Mental Health Continuum 

  • What is the role of PA in this continuum 
  • PA can help to treat & prevent mental illness & promote positive psychological well-being 
  • We only want to use things that work 
  • So, research is needed to know what works for whom & how 
  • PA for treatment, promotion & prevention 
  • eg for prevention: COVID was stress, looked t role of regulating stress & anxiety during lockdown

  
• Common Types of Data in Psychology 

  • Psychometrics (eg depression, anxiety)
  • Self-reported behaviour (eg PA - IPAQ)
  • Qualitative research 
  • Some objective measurements 
• Common Types of Data in Psychology 

  • Psychometrics (eg depression, anxiety)
  • Over the last 2 weeks; I have felt calm & relaxed (5 = all of the time, 0 = none of the time)
  • Reframing depression - looking at positive instead of negative 
  • Measures for depression & anxiety 
  • Using the right measure for the right population 
  • A lot of different measures, need to use right one for the right population
• Common Types of Data in Psychology 

  • Psychometrics (eg depression, anxiety)
  • WHO-5 = wellbeing index 
  • Most commonly used; really short, so really good 
  • Is positively worded (reframing depression); good predictor of risk of depression 
  • Is good measure, good for big/general population, more info the better 
• Common Types of Data in Psychology 

  • Self-reported behaviour (eg PA - IPAQ)
  • How many minutes have you spent undertaking vigorous PA in the past 7 days 
  • Reliance on recall, people recalling past 7 days (issue with may not be able to remember)
  • Decrease accuracy 
  • Social desirability (answering to please what you think other people want to know)
  • Ask question; interview format more validity 
• Common Types of Data in Psychology 

  • Qualitative research 
  • eg interviews 
  • Focus groups
  • Get richer data
  • Some objective measurements 
  • eg ECG - looking at brain waves during walking (MRIs, brain scans)
  • Still trying to figure out these things - figuring out technology for objective measures

  
• Research Methods - Correlational research

  • Looking for association bw/ 2 (or more) variables measured at the same time 
  • eg when PA is high is psych well being high 
  • Often quicker & less resource intensive, & great as an initial step, but…
  • Just send out a survey (number focused)
  • Chicken & egg scenario 
  • We can’t tell which comes 1st 

  
• Research Methods - Correlational research

  • Correlation is NOT causation
  • Doesn’t mean one cause the other  
  •  eg PA → mental health or mental health → PA 
  • Does it mean physical inactivity (self reported) lead to poor mental health (psychometric) OR poor mental health leads to physical inactivity 
  • Something may be correlated, need to understand theories & mechanisms of action for that correlation 
  • Good for exploring methods

  
• Correlation NOT Causation

  • Tyler looked at data points that measure up against each other that are significantly correlated but they’re not usually paired (eg sour cream consumption w/ motorcycle deaths)
• Research Methods - Experimental Design

  • An exercise intervention is provided 
  • Pre-test + post-test 
  • Variable of interest (dependent variable) (eg depression, anxiety) is measured before & after exercise 
  • Introduced a temporal (time) component, so easier to find a causal effect 
  • When we introduce x, then y happens 
  • eg x = PA; y = reduce depression 
  • ie only when we introduce exercise, does depression decrease 
  • Can be resource intensive 
  • Needs to be tightly controlled brings in issue of external validity 
  • If relationship will also exist in real world (really important, esp in psych)

  
• Research Methods - Randomised Controlled Trial (RCT)

  • Gold standard of evidence 
  • Compare against other types of treatments 
  • Randomise what condition they go into to compare groups 
  • Psychotherapy (any psychological therapy, takjung, cognitive etc) or Medication or Exercise intervention 
  • Compare mental health change bw/ groups 
  • Common in drug trials (someone gets placebo, other gets active drugs)

  
• Research Methods

  • Correlational Research
  • Relationship bw/ 2 variables
  • Experimental Design
  • Pre-test & post-test (before & after intervention)
  • Randomised Controlled Trial (RCT)
  • Gold Standard
  • Compare groups
  • Qualitative Research
  • Obtain peoples stories, give rich data
  • Quantitative + Qualitative Research
  • Prove strongest evidence, mixed methods
• Research Methods - Randomised Controlled Trial (RCT)

  • RCTs also allow us to look at dose-response relationship 
  • eg acute vs chronic or 5 mins vs 10 mins
  • Does that does have an influence on depression (important when looking at mode, intensity & duration)
• Research Methods - Randomised Controlled Trial (RCT)

  • RCTs also allow us to look at dose-response relationship
  • Acute effects
  • Immediate effect of a single bout of exercise 
  • eg does 1 bout of exercise decrease anxiety?
  • Chronic effects 
  • Effects of multiple exercise bouts/sessions 
  • e.g. how frequently do we have to exercise to decrease anxiety?
  • Very resource intensive (expensive)
• Research Methods - Qualitative Research 

  • Obtaining people's stories about the effects of PA on mental health & applying rigorous methodologies & analysis 
  • Semi-structured interviews or focus groups 
  • Results in rich data about participants’ personal experiences 
  • Based on interpretations - multiple coders & reflexivity
  • Can’t generalise findings, but great to explore & generate further questions/hypotheses

  
• Research Methods - Qualitative Research 

  • Obtaining people's stories about the effects of PA on mental health & applying rigorous methodologies & analysis 
  • Semi-structured interviews or focus groups 
  • How collect data 
  • Results in rich data about participants’ personal experiences 
  • Self report - put words in people months; while qualitative they tell their stories

  
• Research Methods - Qualitative Research 

  • Based on interpretations - multiple coders & reflexivity
  • Will have different lens & interpretation
  • Team of people decoding data so have different interpretations 
  • Can’t generalise findings, but great to explore & generate further questions/hypotheses
  •  Therefore can’t use for big populations (can’t generalise findings)
  • Good testing ground

  
• Qualitative research example:

  • Importance of subsidy for people to help them be PA (ig have difficulty getting access)
• Quantitative + Qualitative Research 

  • A combination of qualitative & quantitative can prove the strongest overall evidence 
  • Doesn’t need to be in the same study 
  • ie, The numbers & the stories of individual experiences
  • If this is done in the same study, it is often known as mixed methods
• Components of PA - FITT-C

  • Frequency, Intensity, Time, Type, Context
  • Frequency = how regularly?
  • Intensity = light, moderate & vigorous?
  • Duration/Time = how long?
  • Type = mode
  • Most research focuses on aerobic 
  • Context = where? With who?
  • Dose-response relationships

  
• Components of PA - FITT-C

  • Frequency, Intensity, Time, Type, Context
  • Context = where? With who?
  • Indoor vs outdoor; urban vs nature influence on mental health 
  • Nature based is better for mental health (connection w/ nature)
  • However, was no difference in their research during COVID 
  • Maybe due to fear of encountering someone in nature (during COVID)

  
• Components of PA - FITT-C

  • Frequency, Intensity, Time, Type, Context
  • Dose-response relationships 
  • How much of each component to have an effect 
  • So if gonna prescribe is important to know what frequency, intensity etc 
  • A mechanism of action 
  • Moderation factors (of PA on mental health)

  
• Physical Activity & Depression 

  • A transient mood state & a clinical syndrome or disorder (when chronic)
  • Key signs of depression 
  • Constantly feeling down or hopeless 
  • Having little interest or pleasure in doing things you use to enjoy 
  • Depression is a significant public health issue 
  • NZ prevalence adults - 17% 
  • Depression is a stress-related condition 
  • Treatment options 
  • Medication 
  • Psychotherapy 
  • PA?
• Physical Activity & Depression 

  • A transient mood state & a clinical syndrome or disorder (when chronic)
  • Clinical: go to psychiatrist/psychologist to get diagnosed 
  • All express low moods sometimes but when is chronic becomes a disorder 
  • Key signs of depression 
  • Constantly feeling down or hopeless 
  • Having little interest or pleasure in doing things you use to enjoy 
  • Seasonal (lack of sunlight)
  • Use self-regulation 
• Physical Activity & Depression 

  • Depression is a significant public health issue 
  • NZ prevalence adults - 17% 
  • Leading cause of disability 
  • Depression is a stress-related condition 
  • Depression & anxiety can be comorbidity 
  • Perceived incapability to deal w/ stressful situations 
  • Video: depression is an illness not a weakness
  • 1 in 5 experience depression at some point in their life  
• Research Evidence 

  • Correlational studies show:
  • Moderate inverse relationship 
  • Inactivity precedes depression 
  • Least active → greater incidence of mood disorders 
  • PA is useful for prevention 
  • Randomised Controlled Trials (RCTs) show:
  • Small to large effect of exercise on depression 
  • Small can still be good 
  • But this is not the full story...
• Research Evidence 

  • Correlational studies show:
  • Moderate inverse relationship 
  • Least active → greater incidence of mood disorders  
  • Randomised Controlled Trials (RCTs) show:
  • Small to large effect of exercise on depression 
  • But this is not the full story 
  • People who are highly active can suffer from depression (eg professional sports people)
  • Multiple factors at play 
  • More is not always better

  
• Research Evidence 

  • Mode
  • Meeting aerobic PA guidelines for health → decrease depression 
  • Aerobic + muscle strengthening activities likely optimal

  
• Research Evidence 

  • Intensity 
  • Moderate intensity recommended; but studies have shown results from light/vigorous too 
  • Dependent on individual’s exercise experience
  • Previous experiences  
  • The role of light activities (eg yoga, walking) 
  • If you are moving in any way , you’re not being sedentary which is a separate risk factor for depression

  
• Research Evidence

  • Duration/Frequency
  • Exercising 3 - 5 times per week is advised 
  • Exercise interventions should be at least 10 weeks 
  • Get into habit/daily routine 
  • Dose-response relationship 

  
• Research Evidence

  • Key points
  • All of these factors (mode, intensity, frequency, time, context) interact w/ each other in complex ways they we don’t yet fully understand 
  • Add to this people’s personal experiences, preferences & motivation 
  • Don’t understand everything yet  

  
• PA vs Other Treatments 

  • Clinical outcomes 
  • Exercise is as effective as other treatmentsBUT…
  • Medication ‘works’ faster
  • Quick fix (instant) but doesn’t get to underlying cause

  BUT…

  • Exercise group less likely to relapse (when exercise continued) 
  • Exercise should be considered a valuable tool in the depression treatment ‘toolbox’
  • Can use a combination of both (eg use treatment until start to get long term effects of exercise)

  
• Physical Activity as a Platform 

  • Being physically active is not just about the action itself 
  • It is also a platform for other factors that support positive mental health & reduce depression 
  • Whanaungatanga/social connection 
  • Being in nature 
  • Connecting to culture & wairua 
  • Opportunities for autonomy & self-mastery 
  • Not just about clinical outcomes (is much bigger picture)