Step away from depression-results from a multicenter randomized clinical trial with a pedometer intervention during and after inpatient treatment of depression.

Evidence for the effectiveness of physical activity (PA) in the treatment of depression prevails for outpatients with mild and moderate symptom levels. For inpatient treatment of severe depression, evidence-based effectiveness exists only for structured and supervised group PA interventions. The Step Away from Depression (SAD) study investigated the effectiveness of an individual pedometer intervention (PI) combined with an activity diary added to inpatient treatment as usual (TAU). In this multicenter randomized controlled trial, 192 patients were randomized to TAU or TAU plus PI. The two primary outcomes at discharge were depression-blindly rated with the Montgomery-Åsberg Depression Rating Scale (MADRS)-and average number of daily steps measured by accelerometers. Secondary outcomes were self-rated depression and PA, anxiety, remission and response rates. Multivariate analysis of variance (MANOVA) revealed no significant difference between both groups for depression and daily steps. Mean MADRS scores at baseline were 29.5 (SD = 8.3) for PI + TAU and 28.8 (SD = 8.1) for TAU and 16.4 (SD = 10.3) and 17.2 (SD = 9.9) at discharge, respectively. Daily steps rose from 6285 (SD = 2321) for PI + TAU and 6182 (SD = 2290) for TAU to 7248 (SD = 2939) and 7325 (SD = 3357). No differences emerged between groups in secondary outcomes. For severely depressed inpatients, a PI without supervision or further psychological interventions is not effective. Monitoring, social reinforcement and motivational strategies should be incorporated in PA interventions for this population to reach effectiveness.

Affective Responses to Increasing- and Decreasing-Intensity Resistance Training Protocols.

This study compared the effects of an increasing-intensity (UP) and a decreasing-intensity (DOWN) resistance training protocol on affective responses across six training sessions. Novice participants (Mage 43.5 ± 13.7 years) were randomly assigned to UP (n = 18) or DOWN (n = 17) resistance training groups. Linear mixed-effects models showed that the evolution of affective valence within each training session was significantly moderated by the group (b = -0.45, p ≤ .001), with participants in the UP group reporting a decline in pleasure during each session (b = -0.82) and the DOWN group reporting an improvement (b = 0.97; ps < .001). Remembered pleasure was significantly higher in the DOWN group compared to the UP group (b = 0.57, p = .004). These findings indicate that a pattern of decreasing intensity throughout a resistance exercise session can elicit more positive affective responses and retrospective affective evaluations of resistance training.

The Influence of Affective Priming on the Affective Response During Exercise: A Replication Study.

The affective response during exercise is an important factor for long-term exercise adherence. Pottratz et al. suggested affective priming as a behavioral intervention for the enhancement of exercise-related affect. The present paper aims to replicate and extend upon these findings. We conducted a close replication with 53 participants completing a brisk walking task in two conditions (prime vs. no prime). Affective valence was assessed during exercise, and exercise enjoyment and remembered/forecasted pleasure were assessed postexercise. We could not replicate the findings of Pottratz et al., finding no evidence for positive changes in psychological responses in the priming condition. However, linear mixed models demonstrated significant interindividual differences in how participants responded to priming. These results demonstrate that affective priming during exercise does not work for everyone under every circumstance and, thus, provide an important contribution to the understanding of boundary conditions and moderating factors for priming in exercise psychology.

Increasing physical activity and healthy diet in outpatients with mental disorders: a randomized-controlled evaluation of two psychological interventions.

INTRODUCTION: While physical activity (PA) can play an important role in the treatment of mental disorders (MD), large proportions of patients with MD do not meet PA recommendations. The aim of this trial was to evaluate whether structured psychological intervention (MoVo-LISA) is effective in helping outpatients with MD to increase their level of PA. As active control group (CG) we modified MoVo-LISA to target healthy diet behavior. METHODS: N = 83 outpatients with MD (F1-F4) were randomized to the two conditions. PA (self-report and accelerometry), dietary behavior, social-cognitive determinants of health behavior change, psychiatric symptoms and health-related quality of life were assessed at baseline, 1 and 12 weeks after the intervention. RESULTS: Significant time*group interaction effects for objectively measured PA, dietary behavior and fruit and vegetable consumption indicated differential effects of the interventions on these outcomes. PA increased in the MoVo-LISA group (IG) from baseline to follow-up while it decreased in CG. IG showed a significant higher level of objectively measured PA at follow-up compared to CG. Dietary behavior and fruit and vegetable consumption significantly increased from baseline to follow-up in CG, but not IG. IG showed a significant increase in some, but not all social cognitive determinants of health behavior change. CONCLUSIONS: MoVo-LISA is effective in helping outpatients with MD to increase their level of PA in short- and mid-term. The used intervention strategies are effective for the promotion of healthy diet in patients with MD as well.

Implicit and explicit attitudes towards sport among young elite athletes with high versus low burnout symptoms.

The development of cynical attitudes towards elite sport is a core symptom of athlete burnout and has been associated with dropout from elite sport. To date, this phenomenon has mainly been studied by investigating explicit attitudes towards sport, whereas athletes' automatic evaluations (i.e. implicit attitudes) that have been shown to influence behavior as well were not considered. This study aimed to compare explicit and implicit attitudes towards sport of young elite athletes with high (N = 24) versus low (N = 26) burnout symptoms. Using self-reported measures, general and athlete burnout symptoms were assessed. Additionally, a single-target implicit association test was administered to examine participants' automatic evaluation of sport. Statistical analysis revealed greater emotional/physical exhaustion and sport devaluation in athletes reporting high compared to low burnout symptoms. Implicit attitudes towards sport did not significantly differ between the groups. Furthermore, no significant correlations were observed between different athlete burnout symptoms and implicit attitudes. Athletes with high burnout symptoms show a tendency to explicitly detach themselves from sport, thus fostering sport devaluation as a core symptom of athlete burnout. However, this process does not seem to be reflected in their implicit attitudes towards sport.

Physical activity in outpatients with mental disorders: status, measurement and social cognitive determinants of health behavior change.

INTRODUCTION: Physical activity (PA) can play an important role in improving the mental and physical health in patients with mental disorders but is not well studied in this population. The aim of this study was to assess the status of PA in outpatients with mental disorders, compare the convergence of self-rating and accelerometer measurement and examine the influence of social cognitive variables from the Motivation-Volition (MoVo) model and clinical measures on PA. METHODS: Eighty-four patients were recruited from three psychiatric outpatient clinics and local psychiatrists (Distribution of ICD-10-Diagnoses: F3.x = 59.5%, F4.x = 20.2%, F2.x = 17.9%, F1.x = 2.4%). PA, Self-efficacy, Outcome-expectancies, Intention, Self-concordance, Action- and Coping-planning, Health-related Quality of Life (SF-12) and Psychiatric Symptoms (SCL-27) were assessed through questionnaires. PA was assessed objectively by accelerometers. RESULTS: Most of the participants did not reach PA recommendations. Subjective and objective measurement of PA showed good accordance for total PA on group level but lower accordance on individual level. Motivational and volitional determinants of health behavior change showed a similar pattern of correlations with PA as in populations without mental disorders. CONCLUSION: Outpatients with mental disorders have the ability and are willing to perform PA but a large proportion of our sample did not meet PA recommendations. To assess group levels of PA, subjective and objective measurement seem equally apt, for individual diagnostics, a combination of both should be considered. Social cognitive determinants of health behavior change seem to be as helpful for the design of PA interventions for patients with mental disorders as they are in other populations.

Uninstructed BIAT faking when ego depleted or in normal state: differential effect on brain and behavior.

BACKGROUND: Deception can distort psychological tests on socially sensitive topics. Understanding the cerebral processes that are involved in such faking can be useful in detection and prevention of deception. Previous research shows that faking a brief implicit association test (BIAT) evokes a characteristic ERP response. It is not yet known whether temporarily available self-control resources moderate this response. We randomly assigned 22 participants (15 females, 24.23 ± 2.91 years old) to a counterbalanced repeated-measurements design. Participants first completed a Brief-IAT (BIAT) on doping attitudes as a baseline measure and were then instructed to fake a negative doping attitude both when self-control resources were depleted and non-depleted. Cerebral activity during BIAT performance was assessed using high-density EEG. RESULTS: Compared to the baseline BIAT, event-related potentials showed a first interaction at the parietal P1, while significant post hoc differences were found only at the later occurring late positive potential. Here, significantly decreased amplitudes were recorded for 'normal' faking, but not in the depletion condition. In source space, enhanced activity was found for 'normal' faking in the bilateral temporoparietal junction. Behaviorally, participants were successful in faking the BIAT successfully in both conditions. CONCLUSIONS: Results indicate that temporarily available self-control resources do not affect overt faking success on a BIAT. However, differences were found on an electrophysiological level. This indicates that while on a phenotypical level self-control resources play a negligible role in deliberate test faking the underlying cerebral processes are markedly different.

Learning to Like Exercising: Evaluative Conditioning Changes Automatic Evaluations of Exercising and Influences Subsequent Exercising Behavior.

This multistudy report used an experimental approach to alter automatic evaluations of exercise (AEE). First, we investigated the plasticity of AEE (study 1). A computerized evaluative conditioning task was developed that altered the AEE of participants in two experimental groups (acquisition of positive/negative associations involving exercising) and a control group (η2 part. = .11). Second, we examined connections between changes in AEE and subsequent exercise behavior (chosen intensity on a bike ergometer; study 2) in individuals that were placed in groups according to their baseline AEE. Group differences in exercise behavior were detected (η2 part. = .29). The effect was driven by the performance of the group with preexisting negative AEE that acquired more positive associations. This illustrates the effect of altered AEE on subsequent exercise behavior and the potential of AEE as a target for exercise intervention.

Affective Evaluations of Exercising: The Role of Automatic-Reflective Evaluation Discrepancy.

Sometimes our automatic evaluations do not correspond well with those we can reflect on and articulate. We present a novel approach to the assessment of automatic and reflective affective evaluations of exercising. Based on the assumptions of the associative-propositional processes in evaluation model, we measured participants' automatic evaluations of exercise and then shared this information with them, asked them to reflect on it and rate eventual discrepancy between their reflective evaluation and the assessment of their automatic evaluation. We found that mismatch between self-reported ideal exercise frequency and actual exercise frequency over the previous 14 weeks could be regressed on the discrepancy between a relatively negative automatic and a more positive reflective evaluation. This study illustrates the potential of a dual-process approach to the measurement of evaluative responses and suggests that mistrusting one's negative spontaneous reaction to exercise and asserting a very positive reflective evaluation instead leads to the adoption of inflated exercise goals.

Going to the gym or to the movies?: situated decisions as a functional link connecting automatic and reflective evaluations of exercise with exercising behavior.

The goal of the present paper is to propose a model for the study of automatic cognition and affect in exercise. We have chosen a dual-system approach to social information processing to investigate the hypothesis that situated decisions between behavioral alternatives form a functional link between automatic and reflective evaluations and the time spent on exercise. A new questionnaire is introduced to operationalize this link. A reaction-time-based evaluative priming task was used to test participants' automatic evaluations. Affective and cognitive reflective evaluations, as well as exercising time, were requested via self-report. Path analyses suggest that the affective reflective (beta = .71) and the automatic evaluation (beta = .15) independently explain situated decisions, which, in turn (beta = .60) explain time spent on exercise. Our findings highlight the concept of contextualized decisions. They can serve as a starting point from which the so far seldom investigations of automatic cognition and affect in exercise can be integrated with multitudinous results from studies on reflective psychological determinants of health behavior.

Automatic evaluations and exercise setting preference in frequent exercisers.

The goals of this study were to test whether exercise-related stimuli can elicit automatic evaluative responses and whether automatic evaluations reflect exercise setting preference in highly active exercisers. An adapted version of the Affect Misattribution Procedure was employed. Seventy-two highly active exercisers (26 years ± 9.03; 43% female) were subliminally primed (7 ms) with pictures depicting typical fitness center scenarios or gray rectangles (control primes). After each prime, participants consciously evaluated the "pleasantness" of a Chinese symbol. Controlled evaluations were measured with a questionnaire and were more positive in participants who regularly visited fitness centers than in those who reported avoiding this exercise setting. Only center exercisers gave automatic positive evaluations of the fitness center setting (partial eta squared = .08). It is proposed that a subliminal Affect Misattribution Procedure paradigm can elicit automatic evaluations to exercising and that, in highly active exercisers, these evaluations play a role in decisions about the exercise setting rather than the amounts of physical exercise. Findings are interpreted in terms of a dual systems theory of social information processing and behavior.

Exercise as the sum of our choices between behavioral alternatives: The Decisional Preferences in Exercising (DPEX) test.

Exercising can be theorized as the result of choosing one behavior over alternative behaviors. The Decisional Preferences in Exercising (DPEX) test is a computerized, easy-to-use, publicly available (open source Python code: https://osf.io/ahbjr/) and highly adaptive research tool based on this rationale. In the DPEX, participants are asked to choose between two images by pressing a key on the computer keyboard, one showing a physical exercise and the other showing a non-exercise behavioral alternative in a series of trials. Combinations are randomly assembled from two definable pools of stimuli trial-per-trial. The test can be scored either based on a crossed random effects model (facilitating the use of different stimulus material in different studies without compromising the comparability of test scores) or with a simple proportion score. Data from diverse study samples (N = 451) showed strong correlations of DPEX scores with past and future exercise behavior (r = 0.42 and 0.47 respectively) as well as with affective experiences with exercise (e.g., 'pleasure-displeasure': r = 0.47). DPEX test scores discriminated between exercisers and non-exercisers according to receiver operating curve (ROC) analysis. The DPEX may be used to examine research questions derived from dual process theories, the effects of psychological states on behavioral choices can be tested, or the effects of behavior change interventions can be evaluated. The DPEX helps to avoid common method bias in the assessment of exercise behavior, for example, when psychological variables are measured with questionnaires.

Exercise or not? An empirical illustration of the role of behavioral alternatives in exercise motivation and resulting theoretical considerations.

Objective: Individuals' decisions to engage in exercise are often the result of in-the-moment choices between exercise and a competing behavioral alternative. The purpose of this study was to investigate processes that occur in-the-moment (i.e., situated processes) when individuals are faced with the choice between exercise and a behavioral alternative during a computerized task. These were analyzed against the background of interindividual differences in individuals' automatic valuation and controlled evaluation of exercise. Method: In a behavioral alternatives task 101 participants were asked whether they would rather choose an exercise option or a behavioral alternative in 25 trials. Participants' gaze behavior (first gaze and fixations) was recorded using eye-tracking. An exercise-specific affect misattribution procedure (AMP) was used to assess participants' automatic valuation of exercise before the task. After the task, self-reported feelings towards exercise (controlled evaluation) and usual weekly exercise volume were assessed. Mixed effects models with random effects for subjects and trials were used for data analysis. Results: Choosing exercise was positively correlated with individuals' automatic valuation (r = 0.20, p = 0.05), controlled evaluation (r = 0.58, p < 0.001), and their weekly exercise volume (r = 0.43, p < 0.001). Participants showed no bias in their initial gaze or number of fixations towards the exercise or the non-exercise alternative. However, participants were 1.30 times more likely to fixate on the chosen alternative first and more frequently, but this gaze behavior was not related to individuals' automatic valuation, controlled evaluation, or weekly exercise volume. Conclusion: The results suggest that situated processes arising from defined behavioral alternatives may be independent of individuals' general preferences. Despite one's best general intention to exercise more, the choice of a non-exercise alternative behavior may seem more appealing in-the-moment and eventually be chosen. New psychological theories of health behavior change should therefore better consider the role of potentially conflicting alternatives when it comes to initiating physical activity or exercise.

Autonomous regulation mode moderates the effect of actual physical activity on affective states: an ambulant assessment approach to the role of self-determination.

Studies have shown that physical activity influences affective states. However, studies have seldom depicted these associations in ongoing real-life situations, and there is no investigation showing that motivational states (i.e., more or less autonomously regulated) would moderate these effects in situ. To investigate the interaction of autonomous regulation and actual physical activity (aPA) with affective states, we use an ambulatory assessment approach. The participants were 44 university students (mean age: 26.2 ± 3.2 years). We assessed aPA through 24-hr accelerometry and affective states and autonomous regulation via electronic diaries. Palmtop devices prompted subjects every 45 min during a 14-hr daytime period. We performed hierarchical multilevel analyses. Both aPA and autonomous regulation significantly influenced affective states. The interaction was significant for two affects. The higher the volume of aPA and thereby the more autonomously regulated the preceding bout of aPA was, the more our participants felt energized (r = .16) but agitated (r = -.18).

Using COVID-19 Pandemic as a Prism: A Systematic Review of Methodological Approaches and the Quality of Empirical Studies on Physical Activity Behavior Change.

Background: The COVID-19 pandemic has highlighted the importance of scientific endeavors. The goal of this systematic review is to evaluate the quality of the research on physical activity (PA) behavior change and its potential to contribute to policy-making processes in the early days of COVID-19 related restrictions. Methods: We conducted a systematic review of methodological quality of current research according to PRISMA guidelines using Pubmed and Web of Science, of articles on PA behavior change that were published within 365 days after COVID-19 was declared a pandemic by the World Health Organization (WHO). Items from the JBI checklist and the AXIS tool were used for additional risk of bias assessment. Evidence mapping is used for better visualization of the main results. Conclusions about the significance of published articles are based on hypotheses on PA behavior change in the light of the COVID-19 pandemic. Results: Among the 1,903 identified articles, there were 36% opinion pieces, 53% empirical studies, and 9% reviews. Of the 332 studies included in the systematic review, 213 used self-report measures to recollect prepandemic behavior in often small convenience samples. Most focused changes in PA volume, whereas changes in PA types were rarely measured. The majority had methodological reporting flaws. Few had very large samples with objective measures using repeated measure design (pre and during the pandemic). In addition to the expected decline in PA duration, these studies show that many of those who were active prepandemic, continued to be active during the pandemic. Conclusions: Research responded quickly at the onset of the pandemic. However, most of the studies lacked robust methodology, and PA behavior change data lacked the accuracy needed to guide policy makers. To improve the field, we propose the implementation of longitudinal cohort studies by larger organizations such as WHO to ease access to data on PA behavior, and suggest those institutions set clear standards for this research. Researchers need to ensure a better fit between the measurement method and the construct being measured, and use both objective and subjective measures where appropriate to complement each other and provide a comprehensive picture of PA behavior.

Tracking Self-Control - Task Performance and Pupil Size in a Go/No-Go Inhibition Task.

There is an ongoing debate about how to test and operationalize self-control. This limited understanding is in large part due to a variety of different tests and measures used to assess self-control, as well as the lack of empirical studies examining the temporal dynamics during the exertion of self-control. In order to track changes that occur over the course of exposure to a self-control task, we investigate and compare behavioral, subjective, and physiological indicators during the exertion of self-control. Participants completed both a task requiring inhibitory control (Go/No-Go task) and a control task (two-choice task). Behavioral performance and pupil size were measured during the tasks. Subjective vitality was measured before and after the tasks. While pupil size and subjective vitality showed similar trajectories in the two tasks, behavioral performance decreased in the inhibitory control-demanding task, but not in the control task. However, behavioral, subjective, and physiological measures were not significantly correlated. These results suggest that there is a disconnect between different measures of self-control with high intra- and interindividual variability. Theoretical and methodological implications for self-control theory and future empirical work are discussed.

Continuity and Discontinuity of Sport and Exercise Type During the COVID-19 Pandemic. An Exploratory Study of Effects on Mood.

Involvement in sport and exercise not only provides participants with health benefits but can be an important aspect of living a meaningful life. The COVID-19 pandemic and the temporary cessation of public life in March/April/May 2020 came with restrictions, which probably also made it difficult, if not impossible, to participate in certain types of sport or exercise. Following the philosophical position that different types of sport and exercise offer different ways of "relating to the world," this study explored (dis)continuity in the type of sport and exercise people practiced during the pandemic-related lockdown, and possible effects on mood. Data from a survey of 601 adult exercisers, collected shortly after the COVID-19 outbreak in Finland, were analyzed. Approximately one third (35%) of the participants changed their "worldmaking" and shifted to "I-Nature"-type activities. We observed worse mood during the pandemic in those who shifted from "I-Me," compared to those who had preferred the "I-Nature" relation already before the pandemic and thus experienced continuity. The clouded mood of those experiencing discontinuity may be the result of a temporary loss of "feeling at home" in their new exercise life-world. However, further empirical investigation must follow, because the observed effect sizes were small.

Step Away from Depression-Study protocol for a multicenter randomized clinical trial for a pedometer intervention during and after in-patient treatment of depression.

OBJECTIVES: Increasing the number of daily steps by using a pedometer and a diary leads to an activity increase and improved health outcomes in a variety of somatic disorders. Hence, for the inpatient treatment of depression, supervised exercise interventions are more widespread. We aim to examine if a self-managed pedometer intervention (PI) with the option of being proceeded after discharge leads to reduction of depression and to a physical activity (PA) increase. METHODS: The Step Away from Depression (SAD) study is a multicenter randomized controlled trial targeting 400 patients with major depressive disorder. Treatment as usual (TAU) is compared to TAU plus PI after 4 weeks, at discharge, and 6 months after hospital admission. Primary outcomes are clinically rated depression severity and accelerometer-measured step counts. Secondary outcomes include self-reported depression symptoms and PA level, psychiatric symptoms, health-related quality of life, self-efficacy, and components of the Motivation Volition Process Model. RESULTS: We report the design of the SAD study considering several methodological aspects for exercise studies, in general. CONCLUSIONS: Results of our study will provide information about efficacy of PI for inpatient treatment and about interrelating processes of change concerning depression, PA, and aspects of motivation and volition.

Staying Active under Restrictions: Changes in Type of Physical Exercise during the Initial COVID-19 Lockdown.

The COVID-19 pandemic and the associated governmental restrictions suddenly changed everyday life and potentially affected exercise behavior. The aim of this study was to explore whether individuals changed their preference for certain types of physical exercise during the pandemic and to identify risk factors for inactivity. An international online survey with 13,881 adult participants from 18 countries/regions was conducted during the initial COVID-19 related lockdown (between April and May 2020). Data on types of exercise performed during and before the initial COVID-19 lockdown were collected, translated, and categorized (free-text input). Sankey charts were used to investigate these changes, and a mixed-effects logistic regression model was used to analyze risks for inactivity. Many participants managed to continue exercising but switched from playing games (e.g., football, tennis) to running, for example. In our sample, the most popular exercise types during the initial COVID-19 lockdown included endurance, muscular strength, and multimodal exercise. Regarding risk factors, higher education, living in rural areas, and physical activity before the COVID-19 lockdown reduced the risk for inactivity during the lockdown. In this relatively active multinational sample of adults, most participants were able to continue their preferred type of exercise despite restrictions, or changed to endurance type activities. Very few became physically inactive. It seems people can adapt quickly and that the constraints imposed by social distancing may even turn into an opportunity to start exercising for some. These findings may be helpful to identify individuals at risk and optimize interventions following a major context change that can disrupt the exercise routine.

Self-leadership and volition: distinct and potentially supplemental constructs?

Self-leadership and volition are conceptually similar concepts. Both propose self-influence strategies that aim to improve the motivation and self-direction necessary to perform well. The present study assesses whether self-leadership strategies maintain construct-specific variance when compared with the similar strategies of volition. Results from a questionnaire study (N=320) indicate that self-leadership and volitional strategies are distinguishable and only moderately (r = .33) correlated. Self-leadership, therefore, supplements volition during goal attainment. Findings are discussed in light of the Rubicon model of action phases.