Physical exercise interventions improve quality of life in people with mental disorders and improve abstinence and cravings in substance use disorders patients in both the short term and long term. ...In people with mental illness, physical exercise interventions significantly reduce psychiatric symptoms of schizophrenia and symptoms of anxiety. For forensic psychiatry, there is little empirical evidence supporting mental health-enhancing effects of physical exercise interventions. Interventional studies in forensic psychiatry deal mainly with three problems: heterogeneity of the individuals, a small sample size, and a low compliance rate. Intensive longitudinal case studies could be a suitable approach to address these methodological challenges in forensic psychiatry. This study uses an intensive longitudinal design to determine whether forensic psychiatric patients are content to complete several data assessments per day over the course of several weeks. The feasibility of this approach is operationalized by the compliance rate. Additionally, single-case studies examine the effects of sports therapy (ST) on momentary affective states (energetic arousal, valence, and calmness). The results of these case studies reveal one aspect of feasibility and offer insights into the effects of forensic psychiatric ST on the affective states among patients with different conditions. The patients' momentary affective states were recorded before (PRE), after (POST) and 1 h after (FoUp1h) ST by questionnaires. Ten individuals (M
= 31.7, SD = 11.94; 60% male) participated in the study. A total of 130 questionnaires were completed. To perform the single-case studies, data of three patients were considered. Repeated-measures ANOVA was performed for the individual affective states to test for main effects of ST. Due to the results, ST has no significant effect on none of the three affect dimensions. However, effect sizes varied between small to medium (energetic arousal: η
= 0.01, η
= 0.07, η
= 0.06; valence: η
= 0.07; calmness: η
= 0.02) in the three patients. Intensive longitudinal case studies are a possible approach to address heterogeneity and the low sample size. The low compliance rate in this study reveals that the study design needs to be optimized for future studies.
Living in urban environments is associated with several health risks (e.g., noise, and air pollution). However, there are also beneficial aspects such as various opportunities for social activities, ...which might increase levels of social participation and (physically) active mobility that in turn have positive effects on health and well-being. However, how aspects of the environment, active mobility, and social participation are associated is not well established. This study investigates the moderating effect of low vs. high walkability neighborhoods on the associations between active mobility, and social participation and integrates individuals' subjective perception of the neighborhood environment they are living in.
Cross-sectional data from 219 adults (48% female, mean age = 46 ± 3.8 years) from 12 urban neighborhoods (six low, six high walkability) were analyzed: First, social participation, active mobility, and subjective neighborhood perceptions were compared between people living in a low vs. high walkability neighborhood via t-tests. Second, multigroup path analyses were computed to explore potential differences in the associations between these variables in low vs. high walkability neighborhoods.
Social participation, active mobility, and subjective neighborhood perceptions didn't differ in low vs. high walkability neighborhoods (p: 0.37 - 0.71). Active mobility and subjective neighborhood perceptions were significantly stronger related to social participation in low vs. high walkability neighborhoods (active mobility in low: ß = 0.35, p < .01 vs. high: ß = 0.09, p = .36; subjective neighborhood perceptions in low: ß = 0.27, p < .01 vs. high: ß = 0.15, p = .18).
Despite living in neighborhoods with objectively different walkability, participants rated social participation and active mobility equally and perceived their neighborhoods similarly. However, zooming into the interrelations of these variables reveals that social participation of residents from low walkability neighborhoods depends stronger on active mobility and perceiving the environment positively. Positive perceptions of the environment and active mobility might buffer the objectively worse walkability. Future research should focus on underlying mechanisms and determinants of subjective neighborhood perceptions and active mobility, especially in low walkability neighborhoods.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Sedentary behaviors (SB) and especially prolonged sitting bouts are highly prevalent in daily life and studies indicated an association with an increased risk for several ...non-communicable diseases. Consequently, guidelines to reduce SB were developed. At the same time, an in-depth knowledge regarding SB such as where, what and with whom people spend time sedentary as well as correlates such as affective states of prolonged sitting bouts, is still lacking. A more differentiated view on SB is necessary to identify detrimental and modifiable sedentary bouts. We addressed this gap by conducting an ambulatory assessment study including accelerometer and sedentary-triggered e-diaries that captures data during prolonged sitting bouts (> 20 min). We investigated how contextual factors of prolonged sitting bouts are associated with momentary affective states.
Method
Four studies were combined with a final sample of 308 participants (50.3% female, M
age
, 27.4, range, 17–66). SB was assessed objectively with thigh-worn accelerometers for four to five days. Whenever a participant was sitting for 20 or 30 min the accelerometer triggered questions assessing social (not alone vs. alone) and environmental (leisure vs. working) factors as well as momentary affective states (valence, energetic arousal and calmness). Multilevel analyses were used to examine within-person associations between different contexts and mood during prolonged sitting.
Results
Momentary affective states varied significantly due to different social and environmental contexts (
p
s
< 0.001): Sitting together with others was associated with higher levels of valence and energetic arousal. Furthermore, sitting during leisure time was associated with higher levels of valence and calmness and lower levels of energetic arousal. Significant interaction analyses revealed that participants had the highest ratings while sitting during leisure episodes together with others.
Conclusion
Findings showed that prolonged sitting bouts differ regarding their association with affect. Sitting with others, sitting during leisure time and especially sitting during leisure time and with others, was associated with higher levels of momentary affective states, respectively. Thus, SB guidelines should focus on reducing those SB episodes that are associated with lower levels of affect, for example during working episodes.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background
Light to moderate physical activity, which includes walking, is associated with positive effects on physical and mental health. However, concerning mental health, social and physical ...environmental factors are likely to play an important role in this association. This study investigates person-place interactions between environmental characteristics (greenness, social interaction) and momentary affective states during walking episodes. A within-subject design is implemented, in which affective states and environmental characteristics are assessed while participants are walking outside.
Methods
On smartphones, coupled with a motion sensor (move3), e-diaries were triggered as soon as people walked 100 m outside. E-diaries assessed momentary affective states (valence, calmness, energetic arousal), and social interaction (walking alone; seeing other people while walking; interacting with other people; walking with a known person) between 6 am and 10 pm over nine days. The percentage of greenness was determined afterward from recorded GPS and GIS data. Demographics were collected in advance
via
an online questionnaire. Multilevel models were calculated with R for 46 individuals (age = 41.2, ± 13.2; 52% female).
Results
Affective state dimension energetic arousal showed a significant association with social interaction and greenness, i.e., participants rated energetic arousal lower when walking alone, and if there was less greenness vs. when interacting shortly with someone while walking (
β
= 0.13,
p
= 0.02), and being in situations with more greenness (
β
= 0.08,
p
= 0.02). Furthermore, associations with social interaction and greenness were found for dimension calmness: walking together with someone was associated with higher calmness (
β
= 0.16,
p
= 0.02), and the higher the proportion of surrounding greenness during a walk, the higher calmness was rated, i.e., participants were calmer (
β
= 0.09,
p
= 0.01). Significant associations with valence were not present.
Conclusion
The findings indicate that the affective states varied significantly due to different social and physical environmental factors. In the future, the importance of environmental factors should be further investigated, e.g., by assessing environmental factors right in situations contrary to a subsequent imputation. Within-subject designs, and in particular triggered assessments with the addition of GPS, can aid in developing interventions for health-promoting urban environments.
Introduction: Some evidence showed positive effects of sports therapy in forensic settings. Most of these evaluation studies analyzed between-subject relations and used RCTs (randomized controlled ...trials) to investigate intervention effects. RCTs normally randomize participants to an intervention and a control group with the intention to compare averaged group-findings. However, such averaged results, which are based on group effects may not apply to every single forensic patient as they do not adequately address that these patients are unique due to their complex psychopathology. Thus, RCTs do not adequately address the following circumstances especially relevant in forensic settings: heterogeneity and low sample size of therapy groups and low compliance rate of forensic patients. To address these challenges, it could be worthwhile to focus on within-subject relations by using N-of-1 studies. Methods: This viewpoint summarizes the possibilities and limitations of N-of-1 study designs regarding the challenges heterogeneity, low sample size and a low compliance rate when evaluating forensic sports therapy. Results: N-of-1 studies offer a useful addition in the evaluation of sports therapy in forensic psychiatry. They are able to evaluate individual effects and they increase the power of the study by increasing the number of measurements. Nevertheless, they are associated with limitations, for example increased effort due to frequent measurements and long study duration or the difficulty to generalize the results. Conclusion: Future studies should implement N-of-1 study designs in forensic psychiatric sports therapy to gain evidence and should find solutions to deal with the limitations (e.g., digital technology).
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UL, UM, UPUK
Several interventions aiming to enhance physical activity in everyday life showed mixed effects. Affective constructs are thought to potentially support health behavior change. However, little is ...known about within-subject associations between momentary affect and subsequent physical activity in everyday life. This study analyzed the extent to which three dimensions of affective states (valence, calmness, and energetic arousal) were associated with different components of daily activity trajectories. Sixty-five undergraduates' students (Age: M = 24.6; SD = 3.2; females: 57%) participated in this study. Physical activity was assessed objectively through accelerometers during 24 h. Affective states assessments were conducted randomly every 45 min using an e-diary with a six-item mood scale that was especially designed for ambulatory assessment. We conducted three-level multi-level analyses to investigate the extent to which momentary affect accounted for momentary volume, prospective trends, and stability vs. fluctuation of physical activity in everyday life. All three affect dimensions were significantly associated with momentary activity volumes and prospective trends over 45 min periods. Physical activity didn't fluctuate freely, but featured significant autocorrelation across repeated measurements, suggesting some stability of physical activity across 5-min assessments. After adjusting for the autoregressive structure in physical activity assessments, only energetic arousal remained a significant predictor. Feeling energized and awake was associated with an increased momentary volume of activity and initially smaller but gradually growing decreases in subsequent activity within the subsequent 45 min. Although not related to trends in physical activity, higher valence predicted lower stability in physical activity across subsequent 45 min, suggesting more short-term fluctuations in daily activity the more participants reported positive affective valence. The current analyses afford interesting insight into within-subject associations between momentary affect and activity-trajectories in everyday life. Energetic arousal emerged as the only meaningful predictor of physical activity in daily life after adjusting for autoregression. A significant effect of valence on short-term activity fluctuations might indicate that activity interventions would benefit from taking into account enhancement of positive affective valence in everyday life. Moments of enhanced valence may scaffold attempts helping inactive people to get started with daily activities and overcome periods of inactivity in everyday life.
Despite the well-documented positive effect of exercise on health outcomes, most people do not succeed in exercising regularly. In addition to several other influences, affective states seem to ...support exercise participation. Associations between exercise and affect have been shown in the laboratory. However, the dynamic relation between affect and exercise in daily life is not yet well-understood. The objective of this study was to investigate the bi-directional effect of momentary affective states on naturally occurring exercise and vice versa in healthy participants in real-life environments by applying an ecological momentary assessment design. We hypothesized that (1) exercise duration is positively associated with affective states on a day level, (2) affective states in the morning predict subsequent exercise duration, and (3) exercise duration predicts affective states in the evening on that respective day. Data from N = 60 students aged between 19 and 32 years were analyzed. Affect and exercise duration were assessed daily over a period of 20 days via an electronic diary. Multilevel analysis revealed that positive affective valence was positively associated with exercise duration (p = 0.003) on a day level. In addition, the more the participants exercised that respective day, the better and more content they felt in the evening (p = 0.009). Energetic arousal in the morning significantly predicted subsequent exercise duration (p = 0.045). The findings indicate that it would be worthwhile to focus more on within-subject analyses when analyzing the dynamic relation between affect and exercise. Furthermore, affective states should be taken into account in creating effective interventions to foster exercise behavior and enhance maintenance. (Autor).
Multiple studies suggest that physical activity causes positive affective reactions and reduces depressive mood. However, studies and interventions focused mostly on structured activity programs, but ...rarely on actual physical activity (aPA) in daily life. Furthermore, they seldom account for the context in which the aPA occur (e.g., work, leisure). Using a prospective, real-time assessment design (ambulatory assessment), we investigated the effects of aPA on affective states (valence, energetic arousal, calmness) in real-time during everyday life while controlling for the context. Eighty-seven undergraduates students (Age: M = 24.6; SD = 3.2, females: 54%) participated in this study. aPA was assessed through accelerometers during 24-h. Palmtop devices prompted subjects approximately every 45 min during a 14-h daytime period to assess their affective states and the context. We analyzed within- and between-person effects with hierarchical modeling (HLM 6.0). Multilevel analyses revealed that both aPA and context influenced subsequent affective states. The interaction of aPA and context did predict energetic arousal only. State levels of affects did not differ between men and women. For both men and women, aPA in everyday life has an effect on individual's affective states. For valence and calmness, it seems to be independent of the context in which the aPA occur. For energetic arousal, men reported to have lower feelings of energy and women reported to have more feelings of energy during leisure time compared to working episodes.
Research has shown that affect is associated with everyday movement behaviors in children and adults. However, limited work to date has investigated dyadic influences of momentary affect on ...moderate-to-vigorous physical activity (MVPA) and sedentary time among children and their mothers using ecological momentary assessment (EMA).
Mothers and their children (eight to 12-years-old at baseline) from the Los Angeles metropolitan area participated in a longitudinal study with six semi-annual measurement waves across three years. During each measurement wave, mothers and children reported momentary negative and positive affect via a custom smartphone-based EMA application across seven days (randomly sampled up to eight times per day). Each dyad member's momentary affective states were used to predict their own and the other dyad member's accelerometer-measured MVPA and sedentary time in the prompt-matched 45-min time window. Multilevel modeling within the actor-partner interdependence model (APIM) framework was applied to accommodate the nested dyadic nature of the data.
At the within-subject level, when children had higher-than-usual positive affect, they engaged in greater MVPA and less sedentary time in the prompt-matched 45-min window (actor effects; ps < .001). When mothers experienced higher-than-usual positive affect, they engaged in more sedentary time in the same 45-min window (actor effect; p < .001). Children's higher-than-usual positive affect also predicted more MVPA time of their mothers (partner effect; p < .05). At the between-subjects level, for mothers who reported higher average negative affect than other mothers, their children overall had less MVPA and more sedentary time (partner effects ps < .05).
This study extends the literature by demonstrating that mothers' and children's everyday physical activity and sedentary time are not only associated with their own affective states, but also may be influenced by the affective states of each other. Our findings suggest that affective states have the potential to influence movement behaviors in mother-child dyads' everyday lives. Affective underpinnings of physical activity and sedentary behaviors should be further studied in order to develop family-based intervention strategies to influence these behaviors.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Physical activity has gained importance in psychiatric and psychosomatic treatment schemes, but there is little knowledge on the use of physical activity for forensic rehabilitation, including ...psychosocial outcomes. A systematic review of the literature on PubMed and Livivo found only one study that specifically addressed the effects of physical activity in forensic patients. Twenty-three studies reported on physical activity in the context of non-forensic patients suffering from mental illnesses similar to those commonly diagnosed in forensic patients. We summarize the effects of physical activity with respect to therapeutic objectives suggested by German sport therapists working with forensic patients. In forensic patients or patients suffering from mental illness typical of forensic patients, physical activity promotes social skills (4 studies), self-image, body experience, and personality growth (9 studies). Physical activity also helps to activate patients (12 studies), while reducing their tension and anger (1 study). Yet, there is a significant lack of specific scientific evidence as to whether sport therapy for forensic patients is effective in terms of the therapeutic objectives of this patient group. Future research must focus on longitudinal dose-effect outcome studies on forensic patients and should also concentrate on studies in the area of psychosis, personality disorders and addiction in relation to forensic sport therapeutic objectives.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UL, UM, UPUK
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