Reducing anxiety sensitivity with exercise

Background: Exercise interventions repeatedly have been shown to be efficacious for the treatment of depression, and initial studies indicate similar efficacy for the treatment of anxiety conditions. To further study the potential beneficial role of prescriptive exercise for anxiety‐related conditions, we examined the role of exercise in reducing fears of anxiety‐related sensations (anxiety sensitivity). Methods: We randomly assigned 60 participants with elevated levels of anxiety sensitivity to a 2‐week exercise intervention, a 2‐week exercise plus cognitive restructuring intervention, or a waitlist control condition. Assessment of outcome was completed at pretreatment, midtreatment, 1‐week posttreatment, and 3‐week follow‐up. Results: We found that both exercise conditions led to clinically significant changes in anxiety sensitivity that were superior to the waitlist condition, representing a large controlled effect size (d=2.15). Adding a cognitive component did not facilitate the effects of the exercise intervention. Consistent with hypotheses, changes in anxiety sensitivity mediated the beneficial effects of exercise on anxious and depressed mood. Conclusions: We discuss these findings in terms of the potential role of exercise as an additional psychosocial intervention for conditions such as panic disorder, where anxiety sensitivity is a prominent component of pathology. Depression and Anxiety 25:689–699, 2008. © 2008 Wiley‐Liss, Inc.

[1]  Jasper A. J. Smits,et al.  Exercise for mood and anxiety disorders. , 2014, The Journal of clinical psychiatry.

[2]  Mark B. Powers,et al.  Translating Empirically Supported Strategies into Accessible Interventions: The Potential Utility of Exercise for the Treatment of Panic Disorder. , 2007 .

[3]  Jasper A. J. Smits,et al.  Exercise for mood and anxiety disorders. , 2007, Primary care companion to the Journal of clinical psychiatry.

[4]  E. Stice,et al.  Testing mediators of intervention effects in randomized controlled trials: An evaluation of two eating disorder prevention programs. , 2007, Journal of consulting and clinical psychology.

[5]  M. Zvolensky,et al.  Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology. , 2006, Journal of psychiatric research.

[6]  David C. Atkins,et al.  Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. , 2006, Journal of consulting and clinical psychology.

[7]  Mark B. Powers,et al.  Exercise interventions for mental health: A quantitative and qualitative review , 2006 .

[8]  K. Wilson,et al.  Unique contributions of anxiety sensitivity to avoidance: a prospective study in adolescents. , 2006, Behaviour research and therapy.

[9]  M. Fiatarone Singh,et al.  A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. , 2005, The journals of gerontology. Series A, Biological sciences and medical sciences.

[10]  Laura M. Stapleton,et al.  A Comparison of Methods to Test for Mediation in Multisite Experiments , 2005, Multivariate behavioral research.

[11]  Jasper A. J. Smits,et al.  Changes in anxiety sensitivity with pharmacotherapy for panic disorder. , 2004, Journal of psychiatric research.

[12]  Mark B. Powers,et al.  Mechanism of change in cognitive-behavioral treatment of panic disorder: evidence for the fear of fear mediational hypothesis. , 2004, Journal of consulting and clinical psychology.

[13]  Jasper A. J. Smits,et al.  Cognitive-behavioral therapy for the treatment of anxiety disorders. , 2004, The Journal of clinical psychiatry.

[14]  Michael J Webster,et al.  Effects of aerobic exercise on anxiety sensitivity. , 2004, Behaviour research and therapy.

[15]  David P Mackinnon,et al.  Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods , 2004, Multivariate behavioral research.

[16]  C. Lejuez,et al.  Contemporary behavioral activation treatments for depression: procedures, principles, and progress. , 2003, Clinical psychology review.

[17]  P. Shrout,et al.  Mediation in experimental and nonexperimental studies: new procedures and recommendations. , 2002, Psychological methods.

[18]  R. McNally,et al.  Anxiety sensitivity and panic disorder , 2002, Biological Psychiatry.

[19]  A. Arntz Cognitive therapy versus interoceptive exposure as treatment of panic disorder without agoraphobia. , 2002, Behaviour research and therapy.

[20]  S. West,et al.  A comparison of methods to test mediation and other intervening variable effects. , 2002, Psychological methods.

[21]  M. Telch,et al.  The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation. , 2002, Behaviour research and therapy.

[22]  M. Craske,et al.  Prevention of panic disorder , 2001 .

[23]  N. Jacobson,et al.  Depression in Context: Strategies for Guided Action , 2001 .

[24]  H. Kraemer,et al.  How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. , 2001, The American journal of psychiatry.

[25]  L. McWilliams,et al.  Is there a negative association between anxiety sensitivity and arousal-increasing substances and activities? , 2001, Journal of anxiety disorders.

[26]  G. Devilly,et al.  Psychometric properties of the credibility/expectancy questionnaire. , 2000, Journal of behavior therapy and experimental psychiatry.

[27]  Yuk Fai Cheong,et al.  HLM 6: Hierarchical Linear and Nonlinear Modeling , 2000 .

[28]  N. Schmidt,et al.  Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: replication and extension. , 1999, Journal of abnormal psychology.

[29]  E. Martinsen,et al.  Tolerance to intensive exercise and high levels of lactate in panic disorder. , 1998, Journal of anxiety disorders.

[30]  C. Cotman,et al.  Physical activity increases mRNA for brain-derived neurotrophic factor and nerve growth factor in rat brain , 1996, Brain Research.

[31]  R. Armstrong,et al.  Brain norepinephrine and metabolites after treadmill training and wheel running in rats. , 1996, Medicine and science in sports and exercise.

[32]  R. Meeusen,et al.  Exercise and Brain Neurotransmission , 1995, Sports medicine.

[33]  L. Peyrin,et al.  Norepinephrine release in the rat frontal cortex under treadmill exercise: a study with microdialysis. , 1995, Journal of applied physiology.

[34]  P. K. Dey,et al.  Exercise training: Significance of regional alterations in serotonin metabolism of rat brain in relation to antidepressant effect of exercise , 1992, Physiology & Behavior.

[35]  C. Pantelis,et al.  Aerobic Exercise in the Adjunctive Treatment of Depression: A Randomized Controlled Trial , 1992, Journal of the Royal Society of Medicine.

[36]  S. Reiss,et al.  Anxiety sensitivity in 1984 and panic attacks in 1987 , 1992 .

[37]  R. McNally,et al.  How does anxiety sensitivity vary across the anxiety disorders , 1992 .

[38]  Anthony S. Bryk,et al.  Hierarchical Linear Models: Applications and Data Analysis Methods , 1992 .

[39]  N. Jacobson,et al.  Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. , 1991, Journal of consulting and clinical psychology.

[40]  A. Beck,et al.  An inventory for measuring clinical anxiety: psychometric properties. , 1988, Journal of consulting and clinical psychology.

[41]  R. McNally,et al.  Anxiety sensitivity in agoraphobics. , 1987, Journal of behavior therapy and experimental psychiatry.

[42]  Herbert Solomon,et al.  Selected Tables in Mathematical Statistics. , 1986 .

[43]  E. Doyne,et al.  Aerobic exercise as a treatment for depression in women , 1983 .

[44]  W. Morgan,et al.  Anxiety reduction following exercise and meditation , 1978, Cognitive Therapy and Research.

[45]  George P. H. Styan,et al.  Selected Tables in Mathematical Statistics , 1971 .

[46]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[47]  Jasper A. J. Smits,et al.  Emotional vulnerability as a function of physical activity among individuals with panic disorder , 2006, Depression and anxiety.

[48]  M. Trivedi,et al.  Exercise treatment for depression: efficacy and dose response. , 2005, American journal of preventive medicine.

[49]  L. Peyrin,et al.  Physical conditioning in rats influences the central and peripheral catecholamine responses to sustained exercise , 2004, European Journal of Applied Physiology and Occupational Physiology.

[50]  N. van Beek,et al.  Anxiety sensitivity and modulation of the serotonergic system in patients with PD. , 2004, Journal of anxiety disorders.

[51]  P. O’Connor,et al.  Physical activity, anxiety and anxiety disorders. , 2000 .

[52]  P. Truax,et al.  A component analysis of cognitive-behavioral treatment for depression. , 2000 .

[53]  N. Waller The Beck Anxiety Inventory , 1998 .

[54]  F. Chaouloff Effects of acute physical exercise on central serotonergic systems. , 1997, Medicine and science in sports and exercise.

[55]  Janet Buckworth,et al.  Adherence to physical activity. , 1997 .

[56]  Steven Taylor,et al.  Anxiety sensitivity, trait anxiety, and the anxiety disorders , 1991 .

[57]  J. Lucas,et al.  Anxiety sensitivity: Unitary personality trait or domain-specific appraisals? , 1989 .

[58]  A. Beck,et al.  Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation , 1988 .

[59]  William P. Morgan,et al.  Exercise and mental health , 1987 .

[60]  W. Sime Exercise in the prevention and treatment of depression. , 1987 .

[61]  S. Reiss,et al.  Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. , 1986, Behaviour research and therapy.

[62]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[63]  M. Cox,et al.  An analysis of "Par-Q" responses in an office population. , 1981, Canadian journal of public health = Revue canadienne de sante publique.

[64]  J. Greist,et al.  Running as treatment for depression. , 1979, Comprehensive psychiatry.

[65]  D. Chambless,et al.  A reanalysis of agoraphobia. , 1978 .