Prospective reciprocal relations between physical activity and depression in female adolescents.

Objective: Although an inverse correlation between physical activity and depression among adolescents has been found in research, this relation has seldom been examined prospectively. Thus, we tested whether physical activity reduces risk for future escalations in depression and whether depression decreases likelihood of future change in physical activity. Method: Data from a longitudinal study involving annual assessments of 496 adolescent girls (mean age = 13 years, SD = 0.73) followed over a 6-year period were analyzed to address these questions. Results: Using analyses that controlled for several covariates, we found that physical activity significantly reduced risk for future increases in depressive symptoms and risk for onset of major–minor depression. Further, depressive symptoms and major–minor depression significantly reduced future physical activity. However, predictive effects were modest for both. Conclusions: Results support a bidirectional relation between exercise and depression and imply that interventions that increase physical activity may reduce risk for depression among this high-risk population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leisure-time physical activity and marital status in relation to depression between men and women: A prospective study.

Background: Previous studies have identified the preventive effect of leisure-time physical activity (LTPA) on depression. Women and men have different emotional vulnerabilities. The impact of LTPA on depression varies by gender. Little is known about the impact of LTPA on depression for people with different marital status. Objectives: The objective of this study was to assess the long-term effects of LTPA, changes in LTPA, and marital status on the risk of developing depression for general Canadians. Methods: Data from the biennial National Population Health Survey (NPHS) cycles conducted between 1994/95 and 2004/05 were analyzed in 2008. After excluding individuals with preexisting depression at baseline, respondents were classified as physically active or inactive and then followed up in subsequent cycles of the NPHS to look at risk of developing depression. Individuals who changed their activity level were also examined. Subgroup analyses by different marital status were performed to identify high-risk populations. Results: In 1994/1995, 17,276 participants were included in the NPHS longitudinal panel. Respondents who were inactive were more likely to be older, female, obese, widowed/separated/divorced, not working, low income, and lacking social support. After controlling for potential confounding factors, it was found that LTPA reduced the risk of developing depression for women. The modest risk reduction observed for men was not statistically significant. Women who were active at baseline and two years of follow-up were significantly less likely to report depression at four years of follow-up compared to women who were inactive at baseline and at two years of follow-up. A 51% greater probability of developing depression was observed after two years for women who changed their LTPA from active to inactive compared to women who remained active. No significant results were found for men. Divorced/separated/widowed women who stopped LTPA had 4.2 times the risk of developing depression after two years compared to those who remained active. The risk of developing depression after stopping activity did not vary according to marital status among men. Conclusions: LTPA has preventive effects on depression for women. Reduction in LTPA level is associated with subsequent depression for women. Divorced/separated/widowed women are at particularly high risk of developing depression if LTPA is stopped. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A prospective study of the association between obesity and burnout among apparently healthy men and women.

The authors prospectively tested the hypothesis that obesity predicts burnout and the reverse-causation hypothesis that burnout predicts obesity. Respondents were 724 men and 340 women, apparently healthy employees, who underwent routine periodic health examinations at 2 points of time about 18 months apart. Obesity was assessed by body mass index, waist-hip ratio, and waist circumference. In regression analyses, done separately for men and women, the authors controlled for depressive symptomatology, sport activity, and Time 1 levels of the criterion. The hypothesis that burnout predicts obesity was not supported. The authors found that Time 1 measures of obesity predicted reductions rather than the hypothesized elevations of Time 2 burnout levels. The authors also found that for male respondents with relatively higher levels of Time 1 burnout, the higher their level of Time 1 obesity measure, the lower their level of T2 burnout. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived environmental predictors of physical activity over 6 months in adults: Activity Counseling Trial.

[Correction Notice: An erratum for this article was reported in Vol 27(2) of Health Psychology (see record 2008-12766-001). One result in Table 2 was misinterpreted in the text. It was reported that men who responded "yes" to frequently seeing people being active in their neighborhoods did about 75 minutes more physical activity per week (pPurpose: In the present study, the authors extend previous cross-sectional findings by using a prospective design to determine whether physical and social environmental characteristics predict physical activity over 6 months. Design: Inactive adults were recruited to the Activity Counseling Trial, a multicenter, randomized, controlled trial of physical activity intervention in primary care. Participants were 387 women and 474 men aged 35-75 years in 3 regions; 1/3 were minorities; 56% had some college education. Baseline perceived environmental variables were used to predict physical activity at 6 months, adjusting for experimental condition and other potential moderators. Measures: The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. A standardized survey was used to measure social and physical environmental variables around the home and neighborhood. Results: Women reporting no unattended dogs and low crime in their neighborhoods and men reporting frequently seeing people being active in their neighborhoods did 50-75 more minutes of physical activity per week than did those with different environmental characteristics. Interactions of environmental variables with age group suggested that older adults may be more affected by environmental variables than are younger adults. Conclusions: Self-reported social and physical environmental variables were significantly related to moderate to vigorous physical activity among a diverse sample of adults living in 3 regions of the United States. These prospective findings strengthen the conclusion from previous cross-sectional studies that environmental variables are important correlates of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term follow-up of physical activity behavior in older adults.

Objective: To examine the contribution of social-cognitive factors (self-efficacy and affect) in predicting long-term physical activity in a sample of older adults (N = 174). Design: A prospective design assessed physical activity and psychosocial variables at 2 and 5 years following a 6-month randomized, controlled exercise trial. Main Outcome Measures: The primary outcome variable was self-reported physical activity, with previous behavior, self-efficacy, and affect assessed as determinants of physical activity. Results: Covariance modeling analyses indicated that physical activity at Year 2 was the strongest predictor of physical activity at 5-year follow-up. Both self-efficacy and affect at Year 2 were also associated with physical activity at Year 5, as was original treatment condition. Variables accounted for 35% of the variance in Year 5 activity. Conclusion: Older adults with higher levels of physical activity, more positive affect, and higher self-efficacy at Year 2 were more likely to continue to be active at Year 5. This study is one of the longest follow-ups of exercise behavior in older adults and has implications for structuring environments to maximize the maintenance of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term efficacy of two computer-tailored physical activity interventions for older adults: Main effects and mediators.

Objective: Low-cost (e.g., computer-tailored) interventions with sustained effects are needed to increase and maintain physical activity in older adults. This study examined the long-term efficacy of 2 computer-tailored physical activity interventions for older adults and its psychosocial and environmental mediators. Methods: A clustered randomized controlled trial (N = 1,971) was conducted that included 3 research arms: (a) basic computer-tailored print intervention, targeting psychosocial mediators; (b) environmentally computer-tailored print intervention, targeting psychosocial and environmental mediators; and (c) no-intervention control group. Interventions were developed using the intervention mapping approach and consisted of 3 computer-tailored letters delivered over 4 months. Questionnaires assessed the study outcomes (i.e., total weekly days and total weekly minutes of physical activity) at baseline and 12 months. Potential mediators (i.e., awareness, attitude, self-efficacy, intention, social influence, intrinsic motivation, self-regulation, and perceived environment) were assessed at baseline and at 3 or 6 months. Results: Multilevel regression analyses revealed that both interventions significantly changed total weekly days of physical activity compared with the control group, but only the environmentally computer-tailored print intervention significantly changed weekly minutes of physical activity. Multiple mediation models showed that the effects of both interventions on weekly days of physical activity were mediated by changes in awareness and intention. Conclusions: Computer-tailored interventions were effective in inducing long-term behavioral changes in physical activity behavior of older adults. Awareness and intention were found to be important mediators of changing daily physical activity and should be included in future computer-tailored intervention studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Telephone versus mail interventions for maintenance of physical activity in older adults.

Although telephones and the mail are often used to promote physical activity, their ability to produce long-term maintenance is unclear. In this study, 140 men and women aged 50–65 years received 1 year of telephone counseling aimed at the adoption of higher (i.e., more vigorous) versus lower intensity (i.e., moderate) exercise. After 1 year, participants were rerandomized to a 2nd year of contact via (a) telephone and mail or (b) predominantly mail. Participants who were prescribed higher intensity exercise and who predominantly received mail had better exercise adherence during the maintenance year than those who received telephone and mail. Both strategies were effective in promoting maintenance in the lower intensity condition. Results suggest that after successful adoption of physical activity with the help of telephone counseling, less intensive interventions are successful for physical activity maintenance in older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Perceived environmental predictors of physical activity over 6 months in adults: Activity Counseling Trial": Correction to Sallis et al. (2007).

Reports an error in "Perceived environmental predictors of physical activity over 6 months in adults: Activity Counseling Trial" by James F. Sallis, Abby C. King, John R. Sirard and Cheryl L. Albright (Health Psychology, 2007[Nov], Vol 26[6], 701-709). One result in Table 2 was misinterpreted in the text. It was reported that men who responded "yes" to frequently seeing people being active in their neighborhoods did about 75 minutes more physical activity per week (p2007-16656-008.) Purpose: In the present study, the authors extend previous cross-sectional findings by using a prospective design to determine whether physical and social environmental characteristics predict physical activity over 6 months. Design: Inactive adults were recruited to the Activity Counseling Trial, a multicenter, randomized, controlled trial of physical activity intervention in primary care. Participants were 387 women and 474 men aged 35-75 years in 3 regions; 1/3 were minorities; 56% had some college education. Baseline perceived environmental variables were used to predict physical activity at 6 months, adjusting for experimental condition and other potential moderators. Measures: The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. A standardized survey was used to measure social and physical environmental variables around the home and neighborhood. Results: Women reporting no unattended dogs and low crime in their neighborhoods and men reporting frequently seeing people being active in their neighborhoods did 50-75 more minutes of physical activity per week than did those with different environmental characteristics. Interactions of environmental variables with age group suggested that older adults may be more affected by environmental variables than are younger adults. Conclusions: Self-reported social and physical environmental variables were significantly related to moderate to vigorous physical activity among a diverse sample of adults living in 3 regions of the United States. These prospective findings strengthen the conclusion from previous cross-sectional studies that environmental variables are important correlates of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Activity limitation and depression: Perspectives of older African American women and their close companions.

Objective: To compare self-report of activity limitations and depressive symptoms of older African American women following physical rehabilitation with the views of a self-nominated close companion. Participants: Thirty-seven African American women (mean age = 72.57 years) and their designated companions (mean age = 54.81 years). Study Design: Telephone interview with the older female respondents and a parallel interview with their companions. Results: The women and their companions provided comparable information regarding activity limitations and depressive symptoms. An association between activity limitation and depression was detected from the perspectives of both the women and their companions. Conclusions: Findings indicate the utility of proxy reports about the functioning of older adults but also indicate the need to carefully consider criteria used in selection of proxy reporters. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls.

The authors tested whether physical self-concept and self-esteem would mediate cross-sectional relations of physical activity and sport participation with depression symptoms among 1,250 girls in 12th grade. There was a strong positive relation between global physical self-concept and self-esteem and a moderate inverse relation between self-esteem and depression symptoms. Physical activity and sport participation each had an indirect, positive relation with global physical self-concept that was independent of objective measures of cardiorespiratory fitness and body fatness. These correlational findings provide initial evidence suggesting that physical activity and sport participation might reduce depression risk among adolescent girls by unique, positive influences on physical self-concept that operate independently of fitness, body mass index, and perceptions of sports competence, body fat, and appearance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neighborhood effects on physical and mental health: A study of Korean American older adults.

This study explored how the physical and mental health of Korean American older adults were influenced by neighborhood characteristics (i.e., proportion of individuals living below the poverty level, proportion of individuals 65 years of age and older, and proportion of racial/ethnic minorities in the census block groups where each respondent lived). Health perceptions (i.e., the subjective appraisal of one's own health) and depressive symptoms were used as indicators of physical and mental health. Multilevel analyses were performed with 567 individuals (at Level 1) nested within 233 census block groups (at Level 2). After controlling for individual demographic and health characteristics, we found that neighborhood poverty predicted health perceptions. The results add to the growing literature on the influence of the social environment and suggest that neighborhood characteristics should be taken into consideration in developing community-based policies for racially/ethnically diverse populations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pathways between physical activity and quality of life in adults with multiple sclerosis.

Objective: This prospective study examined symptoms of depression, fatigue, pain, self-efficacy, and social support as possible intermediaries in the pathway between changes in physical activity and quality of life (QOL) across a 6-month period in persons with multiple sclerosis (MS). Design and Main Outcome Measures: Adults with a definite diagnosis of MS wore an accelerometer for 7 days and then completed a battery of questionnaires at baseline (n = 292) and 6-months follow-up (n = 276). The data were analyzed using panel analysis and covariance modeling in Mplus 3.0. Results: The initial analysis indicated that change in physical activity was associated with a statistically significant and small residual change in QOL (β = .07). The subsequent analysis indicated that change in physical activity was associated with residual changes in fatigue (γ = ?.17), pain (γ = ?.13), social support (γ = .07), and self-efficacy (γ = .11), and, in turn, changes in fatigue (β = ?.13), pain (β = ?.09), social support (β = .18), and self-efficacy (β = .10) were associated with a residual change in QOL. Conclusion: The observed pattern of relationships supports the possibility that physical activity is indirectly associated with improved QOL through pathways that include fatigue, pain, social support, and self-efficacy in individuals with MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

BDNF genotype moderates the relation between physical activity and depressive symptoms.

Objective: To test whether the BDNF gene interacts with exercise to predict depressive symptoms. Physical activity is associated with a range of positive health outcomes, including fewer depressive symptoms. One plausible mechanism underlying these findings involves Brain-Derived Neurotrophic Factor (BDNF), a protein hypothesized to limit or repair the damage caused by stress. Physical activity increases expression of BDNF, which may enhance brain health. BDNF expression is controlled by the BDNF gene. Compared with individuals without a BDNF met allele, met-allele carriers have a lower expression of BDNF, which has been associated with Major Depressive Disorder. Design: Eighty-two healthy adolescent girls were genotyped for the BDNF val66met polymorphism, and their depressive symptoms and physical activity were assessed using questionnaires. Main Outcome Measures: BDNF genotype, Children’s Depression Inventory, and the Physical Activity Questionnaire for Older Children and Adolescents. Results: The BDNF polymorphism was found to moderate the relation between exercise and depressive symptoms: being physically active was protective for girls with a BDNF met allele (fewer depressive symptoms) but not for girls with the val/val polymorphism. Conclusion: By integrating psychological and biological factors, the present study enhances our understanding of how physical activity contributes to resilience to psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators of physical activity behavior change: A multivariate approach.

Objective: Using a multivariate extension of the Baron and Kenny (1986) mediation framework, we examined the simultaneous effect of variables hypothesized to mediate the relationship between a motivationally tailored physical activity intervention, and 6-month physical activity behavior in 239 healthy, underactive adults (M age = 47.5; 82% women). Design: Participants were randomly assigned to (a) print-based feedback; (b) telephone-based feedback; or (c) contact control. Main Outcome Measures: Psychosocial variables, including self-efficacy, decisional balance, and processes of change. Results: All mediation criteria were satisfied for both intervention arms. A moderate indirect effect of print (0.39, 95% CI = 0.21, 0.57) was found due to increases in behavioral processes (0.54, 95% CI = 0.29, 0.80) being attenuated by decreases due to cognitive processes (-0.17, 95%CI = 0.31,-.03). A moderate indirect effect was observed for telephone (0.47, 95% CI = 0.28, 0.66), with increases due to behavioral processes (0.61, 95% CI = 0.34, 0.87) attenuated by decreases due to cognitive processes (0.15, 95% CI = -0.27, -0.02); self-efficacy and decisional balance mediational paths did not attain statistical significance. Conclusions: These findings highlight the importance of studies that deconstruct the theoretical components of interventions to determine which combination produces the greatest behavior changes at the lowest cost. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cerebrovascular risk factors, activity limitations, and depressed mood in African American older adults.

This study investigated the association between cerebrovascular risk factors (CVRFs), physical activity limitations, and depressed mood. The 12-item Short-Form Health Survey (SF-12) was administered to 1,034 urban African American older adults. A chi-square analysis demonstrated that the prevalence of depressed mood among those with high CVRF burden (13.4%) was significantly higher than among those with low vascular burden (7.6%). Physical activity limitations also predicted depressed mood, but this relationship did not mediate the relationship between cerebrovascular burden and depression. These findings highlight the relationships among cerebrovascular burden, physical activity limitations, and depressed mood among African American older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depression and parenting in relation to child internalizing symptoms and asthma disease activity.

This study tested a hypothesized model of the relationship between maternal depression and child psychological and physical dysfunction mediated by parenting and medication adherence. A sample of 242 children with asthma, aged 7 to 17, participated with their mothers. Maternal depression was assessed by self-report, and parenting was observed during family interaction tasks. Internalizing symptoms were assessed by self- and clinician reports. Asthma disease activity was assessed according to National Heart Lung and Blood Institute guidelines, and medication adherence was evaluated with a 24-hr recall method. Structural equation modeling indicated that negative parenting partially mediated the relationship between maternal depression and child internalizing symptoms. Child internalizing symptoms, in turn, mediated the associations between both maternal depression and negative parenting and asthma disease activity. Medication adherence did not mediate the link from maternal depression to disease activity. Thus, maternal depression was linked to child psychological dysfunction both directly and indirectly via negative parenting but linked to physical dysfunction only indirectly through psychological dysfunction. These findings suggest that diagnosing and treating depression in mothers of children with asthma would enhance child well-being both psychologically and physically. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adherence, body mass index, and depression in adults with type 2 diabetes: The mediational role of diabetes symptoms and self-efficacy.

Objective: Evidence indicates that depression is linked to the development and worsening of diabetes, but the mechanisms underlying this link are not well understood. The authors examined the hypothesis that diabetes-related symptoms mediate the effect of both behavioral adherence and body mass index (BMI) on depression. In addition, they examined whether a prior finding that self-efficacy mediates the effect of behavioral adherence and BMI on depression would replicate with a larger sample size (W. P. Sacco, K. J. Wells, C. A. Vaughan, A. Friedman, S. Perez, & R. Morales, 2005). Also, the relative contributions of diabetes-related symptoms and self-efficacy to depression were evaluated. Design and Participants: Cross-sectional design involving adults diagnosed with Type 2 diabetes (N = 99). Main Outcome Measures: The primary outcome measure was depression (Patient Health Questionnaire: Nine Symptom Depression Checklist). Predictors of depression were diet and exercise adherence (Summary of Diabetes Self-Care Activities Questionnaire), diet and exercise self-efficacy (Multidimensional Diabetes Questionnaire), diabetes symptoms (Diabetes Symptom Checklist), and BMI (based on height and weight data from medical records). Results: Path and mediation analyses indicated that adherence and BMI each contributed to depression indirectly, via their effects on self-efficacy and diabetes-related medical symptoms. Conclusion: Results provide evidence consistent with two independent pathways by which BMI and adherence could increase depression in people with Type 2 diabetes. The first pathway indicates that the effects of higher BMI and poor adherence on depression are mediated by lower self-efficacy perceptions. The second pathway indicates that the effect of higher BMI on depression is mediated by increased diabetes symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between stress and depression in first onsets versus recurrences: A meta-analytic review.

S. M. Monroe and K. L. Harkness (see record 2005-02750-005) reviewed the empirical evidence supporting R. M. Post's (see record 1992-43211-001) kindling model, which suggests the 1st episode of depression is more likely to be preceded by major stressors than are subsequent episodes. Their review highlighted the diverse interpretations of Post's premise in the current literature and the changes in research methods that have contributed to this interpretive shift. The authors conducted a meta-analysis (N=13 studies) to test Post's premise that integrated early and recent research and examined potential moderators. A proportion difference effect size was used. Results indicated that 1st onsets of depression were more likely than recurrences to be preceded by severe life events, supporting Post's premise. The moderator analyses suggested that support may be most evident in patient samples and may vary according to age and gender, with less support for Post's premise evidenced in younger samples and in women. Although these results are preliminary, as the analysis included a small number of studies, they suggest that future research should further examine factors that influence the stress-depression relationship with successive recurrences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association of anxiety and depressive symptoms with cognitive performance in community-dwelling older adults.

The authors examined the association of anxiety, depressive symptoms, and their co-occurrence on cognitive processes in 102 community-dwelling older adults. Participants completed anxiety and depression questionnaires as well as measures of episodic and semantic memory, word fluency, processing speed/shifting attention, and inhibition. Participants with only increased anxiety had poorer processing speed/shifting attention and inhibition, but depressive symptoms alone were not associated with any cognitive deficits. Although coexisting anxiety and depressive symptoms were associated with deficits in 3 cognitive domains, reductions in inhibition were solely attributed to anxiety. Findings suggest an excess cognitive load on inhibitory ability in normal older adults reporting mild anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of depression in older adults in the primary care setting: An evidence-based review.

The objective of this study was to conduct an evidence-based review of treatments for depression in older adults in the primary care setting. A literature search was conducted using PsycINFO and Medline to identify relevant, English language studies published from January 1994 to April 2004 with samples aged 55 and older. Studies were required to be randomized controlled trials that compared psychosocial interventions conducted within the primary care setting with "usual care" conditions. Eight studies with older adult samples met inclusion criteria and were included in the review. Two treatment models were evident: Geriatric Evaluation Management (GEM) clinics and an approach labeled integrated health care models. Support was found for each model, with improvement in depressive symptoms and better outcomes than usual care; however, findings varied by depression severity, and interventions were difficult to compare. Further efforts to improve research and clinical care of depression in the primary care setting for older adults are needed. The authors recommend the use of interdisciplinary teams and more implementation of psychosocial treatments shown to be effective for older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)