The role of physical activity enjoyment on the acute mood experience of exercise among smokers with elevated depressive symptoms

ProblemDepressive symptoms are consistently shown to be related to poor smoking cessation outcomes. Aerobic exercise is a potential treatment augmentation that, given its antidepressant and mood enhancing effect, may bolster cessation outcomes for smokers with elevated depressive symptoms. Lower enjoyment of physical activity may inhibit the acute mood enhancing effects of aerobic exercise. The current study investigated the associations between depressive symptoms, physical activity enjoyment and the acute mood experience from exercise among low-active smokers with elevated depressive symptoms.MethodDaily smokers with elevated depressive symptoms (N = 159; M_age = 45.1, SD = 10.79; 69.8% female) were recruited for a randomized controlled exercise-based smoking cessation trial. Participants self-reported levels of depressive symptoms, physical activity enjoyment, and rated their mood experience (assessed as “mood” and “anxiety”) before and after a standardized aerobic exercise test.ResultsHierarchical regression analysis revealed that depressive symptom severity accounted for significant unique variance in physical activity enjoyment (R² = 0.041, t = −2.61, p = 0.010), beyond the non-significant effects of gender and level of tobacco dependence. Additionally, physical activity enjoyment was a significant mediator of the association between depressive symptom severity and acute mood experience (“mood” and “anxiety”) following the exercise test.ConclusionsPhysical activity enjoyment may explain, at least in part, how depressive symptom severity is linked to the acute mood experience following a bout of activity. Interventions that target increasing physical activity enjoyment may ultimately assist in enhancing the mood experience from exercise, and therefore improve smoking cessation likelihood, especially for smokers with elevated depressive symptoms.     

On campus physical activity programming for post-secondary student mental health: Examining effectiveness and acceptability

AimProviding effective support for students with mental health concerns is a priority on post-secondary campuses. Recreational programming including physical activity is an evidence-informed approach that can be used to support mental health and well-being. Yet, limited research has examined effective and acceptable strategies for using campus-based physical activity programs to support the mental health of post-secondary students. Using a mixed-methods approach, the current study addressed the acceptability and effectiveness of a physical activity program for student mental health.MethodsIn collaboration with on-campus mental health services, a 6-week one-on-one and individualized physical activity program tailored towards students seeking mental health support was implemented. A pretest-posttest design was used to test the effectiveness of the program and participants (N = 68; M_age = 22.96 years, SD = 3.42; 82% female) completed self-report questionnaires to assess changes in symptoms of psychological distress, depression, and anxiety. Semi-structured interviews (N = 11) with program participants were conducted to explore the acceptability of the program and were analyzed using thematic analysis.ResultsPaired samples t-tests demonstrated a significant reduction in anxiety symptoms, depression symptoms, and psychological distress pre-post program (ps < .05). The generated themes suggested that the program is an acceptable and effective holistic approach for improving mental health among students.ConclusionsThe results provide implications for implementing on-campus physical activity programs as a mental health and well-being intervention. Implications for further understanding principle program design and delivery strategies are discussed.     

Activity patterns associated with depression symptoms in retired day and night shift workers

ObjectiveEvidence regarding which activity patterns relate to depression symptoms can guide the development of approaches to prevent major depression and related consequences. While prior studies have linked activity pattern disruption and depression symptoms, little is known regarding these relationships in people who were previously exposed to the circadian and sleep-wake challenge of night shift work. We therefore examined: (1) if retired night shift workers (NSWs) and retired day shift workers (DSWs) had different activity pattern characteristics; and (2) which activity pattern characteristics correlate with depression symptoms in these groups.MethodsWe examined cross-sectional associations of activity patterns and depression symptoms in 64 retired NSWs (mean age = 68, standard deviation (SD) = 5) and 75 DSWs (mean age = 69, SD = 6). We used wrist actigraphy (mean days = 6.5, SD = 1.1) to measure activity levels and assessed activity patterns using non-parametric indices; and assessed depression symptoms as Center for Epidemiologic Studies-Depression Scale scores ≥8.ResultsRetired NSWs and retired DSWs did not differ in activity characteristics. Depression symptoms were associated with having less activity between 13:00 h and 17:00 h in retired NSWs (Cohen's D = 1.22) but not retired DSWs (Cohen's D = 0.20).ConclusionActivity patterns of prior NSWs may be comparable to those of prior DSW in retirement. However, uniquely in NSWs, we found that less afternoon activity was associated with depression symptoms. If persistent afternoon inactivity is confirmed as a predictor of depression risk in past NSWs, interventions targeting afternoon inactivity could be developed to prevent depression and its consequences in retired NSWs.     

Physical activity and symptoms of anxiety and depression in adults with and without visual impairments: The HUNT Study

PurposeTo examine the association of leisure-time physical activity (PA) and symptoms of anxiety and depression among adults with and without self-reported visual impairment.MethodsA population-based cohort study including 34,393 participants 20–67 years of age from the second wave of the Nord-Trøndelag Health Study (HUNT2, 1995–1997) who also participated in the follow-up (HUNT3, 2006–2008). Of the participants, 3719 (10.8%) had self-reported visual impairment (SRVI). Unadjusted and fully adjusted generalized linear models were used to calculate relative risks (RR) and corresponding 95% confidence intervals (CIs) of PA with anxiety and depression symptoms (Hospital Anxiety and Depression Scale, HADS) separately for visual impairment and gender.ResultsAt follow-up, a two-folded higher prevalence of HADS-defined anxiety and depression (a score ≥ 8) was found among adults with SRVI than among adults with self-reported no visual impairment (SRNI). In adults with SRVI and SRNI, fewer depression symptoms at follow-up were significantly associated with high baseline PA scores compared with low PA scores, after adjusting for possible confounders (p < 0.05). In adults with SRNI, high baseline PA was related to fewer anxiety symptoms at follow-up compared with their less physically active counterparts, but the associations turned non-significant after adjusting for possible confounders (p > 0.05). PA was not significantly related to anxiety symptoms among adults with SRVI (p > 0.05).ConclusionsRegular PA was associated with fewer depression symptoms in adults with SRVI and SRNI, with less clear associations found for anxiety symptoms.     

Anxiety and depression in association with morbid obesity: changes with improved physical health after duodenal switch

Background  

Patients with morbid obesity have an increased risk for anxiety and depression. The "duodenal switch" is perhaps the most effective obesity surgery procedure for inducing weight loss. However, to our knowledge, data on symptoms of anxiety and depression after the duodenal switch are lacking. Furthermore, it has been hypothesized that self-reported physical health is the major predictor of symptoms of depression in patients with morbid obesity. We therefore investigated the symptoms of anxiety and depression before and after the duodenal switch procedure and whether post-operative changes in self-reported physical health were predictive of changes in these symptoms.     

Associations of overall sitting time and sitting time in different contexts with depression,anxiety, and stress symptoms

Spending a lot of time sitting has been linked to more depressive symptoms and spending a lot of time engaged in screen-based sitting has been linked to greater likelihood of having mental disorders and poorer psychological distress. The purpose of this study was to examine whether overall sitting time and time spent sitting in different contexts was associated with depression, anxiety, or stress symptoms. Sitting time (time spent sitting on typical work- and non-work days while engaged in leisure activities, working, using a computer, watching television, and in transport) and symptom severity of depression, anxiety, and stress were self-reported in a cross-sectional online survey in 2012 by Australian adults (N = 1,104, 55% female, M age = 58 years). Associations were examined using negative binomial regression analyses accounting for the covariates of physical activity, sex, age, income, education, and presence of chronic conditions. Overall sitting time was significantly associated with more severe depression (b = 0.01, 95% CI = 0.00 to 0.02) and anxiety (b = 0.03, 95% CI = 0.02 to 0.04) but not stress (b = 0.01, 95% CI = −0.00 to 0.02) symptoms. Time spent sitting while at a computer was associated with more severe depression (b = 0.04, 95% CI = 0.01 to 0.07) and anxiety (b = 0.03, 95% CI = 0.00 to 0.06) symptoms, and time spent sitting while in transport was associated with more severe anxiety (b = 0.09, 95% CI = 0.05 to 0.13) and stress (b = 0.05, 95% CI = 0.02 to 0.08) symptoms. Limiting overall sitting time and time spent sitting while at a computer or in transport could be potential strategies to improve mental health.     

An examination of the reciprocal associations between physical activity and anxiety,depressive symptoms,and sleep quality during the first 9 weeks of the COVID-19 pandemic in Belgium

During the initial outbreak of the global COVID-19 pandemic, many countries imposed a total lockdown (containment at home). Although it was still allowed in Belgium to be physically active or exercise with people from your household in the vicinity of your home, engaging in sports or physical activity in a group or club context was no longer permitted. To examine whether a lack of physical activity was potentially threatening to the mental well-being of citizens and vice versa, the present study examined concurrent and reciprocal relationships between physical activity and anxiety, depressive symptoms, and sleep quality during the COVID-19 lockdown in a 9-week longitudinal design. In a sample of 983 Belgian adults (75.1% female; M_age = 43.78, range = 18–82 years), we explored these relationships at both the between- and within-person levels through random intercept cross-lagged panel models. The findings indicate that more physical activity was associated with lower symptoms of anxiety and depression and better sleep quality, a finding observed both at the between-person (across weeks; β_anxiety = −0.25, β_depression = −0.30, β_{sleep quality} = 0.24, p < .001) and within-person level (within weeks; β_anxiety = −0.10, β_depression = −0.14, β_{sleep quality} = 0.11, p < .05). Moreover, at the within-person level, an increase in feelings of anxiety and depression at one moment predicted lower levels of physical activity one week later (β_anxiety = −0.04, β_depression = −0.06, p < .05). Since poor mental health poses a threat to the maintenance of physical activity, the current findings suggest that it is critical to invest in the mental health of individuals during distressing times.     

Unravelling the relation between physical activity,self-esteem and depressive symptoms among early and late adolescents: A mediation analysis

PurposeDepression is a serious public health issue among adolescents; however, few studies have examined the role of protective factors, such as engagement in physical activity, on depressive symptoms. Preliminary evidence using community samples of mainly adolescent girls suggests that self-esteem may influence the benefits of physical activity on depressive symptoms. Thus, the objective of this study was to test the hypothesis that the inverse relation between physical activity and depressive symptoms would be mediated by self-esteem in both early and late adolescent boys and girls.MethodsSecondary data analysis was conducted using self-reported measures of physical activity, self-esteem, depressive symptoms, and socio-demographic information completed by a sample of girls (n = 2109) and boys (n = 2095) during early (M_age = 14.7) and late (M_age = 16.2) adolescence selected from the National Longitudinal Study of Adolescent Health. Using the method suggested by Baron and Kenny (1986), mediation was tested separately for boys and girls during early and late adolescence.ResultsDuring early adolescence, self-esteem fully mediated the association between physical activity and depressive symptoms for adolescent boys only. Full mediation was obtained for both boys and girls during late adolescence.ConclusionsIn early and late adolescent boys, and only late adolescent girls, associations between physical activity and depressive symptoms were no longer significant once self-esteem was statistically controlled for. The study has important implications for depression prevention initiatives including the inclusion of physical activity components that are effectively structured to reliably enhance self-esteem, especially among early adolescents.     

Adolescents' exercise and physical activity are associated with mental toughness

Theoretically, mental toughness has the potential to foster mental health either directly or through the promotion of resilient adaptation. Variations in physical activity level are expected to significantly account for variations in mental toughness; which is a prerequisite of toughness-based mediation. The purpose of this study was to compare the mental toughness of adolescents and young adults with self-reported exercise, physical activity and recommended levels of physical activity. A total of 284 high school students (99 males, 185 females, M age = 18.3 years, SD = 4.17) completed the Mental Toughness Questionnaire (MTQ48). They also reported on vigorous exercise and moderate physical activity by completing items from the International Physical Activity Questionnaire (IPAQ). Male participants reported higher toughness scores than females for most subscales. After controlling for gender, participants with higher exercise and physical activity levels scored higher in most MTQ48 subscales. Individuals who fulfilled current physical activity recommendations also reported elevated mental toughness scores compared to those who did not. Acquiring a mindset of mental toughness might be one way that physical activity and exercise can impact an individuals' mental health. Longitudinal and intervention studies are needed to determine direction of causality.     

Depressive symptoms associated with psychological correlates of physical activity and perceived helpfulness of intervention features

The anti-depressive benefits of physical activity are well-evidenced; however little is known about whether people with more frequent depressive symptoms have different psychological correlates of physical activity than people with less frequent symptoms, or whether special consideration is needed in targeting web-based physical activity interventions toward people with frequent depressive symptoms. An online cross-sectional survey was used to collect data from 511 adults (age = 45.99 ± 14.73 years). Two multiple regression analyses were conducted to test the relationship between frequency of depressive symptoms and (1) psychological correlates of physical activity (i.e., intentions, perceived behavioral control, affective attitudes, instrumental attitudes, and perceived physical activity effectiveness), and (2) perceived helpfulness of a variety of web-based physical activity intervention features. People with more frequent depressive symptoms had lower perceived behavioral control of physical activity (β = −0.19), were more likely to report that goal-setting intervention tools (β = 0.10) and personally-relevant information (β = 0.09) would be helpful, and were less likely to report intervention features portraying information about how similar people are being regularly active as helpful (β = −0.10) than those with less frequent symptoms. These findings highlight key components for designing web-based physical activity intervention content for people with depressive symptoms.     

Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers

BackgroundOlder adults' function level can be used as a predictor of future detrimental events, such as disability, reliance on others, risk of institutionalization and likelihood of death. The assessment of function at the primary health care centers using self-reported and/or performance based measures is of prime importance.ObjectiveTo determine whether personal factors, pain, depression and physical activity are associated with self-reported and performance based disability for older adults aged ≥60 years attending primary health care centers, as measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and Short Physical Performance Battery (SPPB), respectively.MethodsParticipants (196 females and 55 males; mean age ± SD = 70.87 ± 7.76) had their pain, self-reported disability, performance, physical activity levels and depressive symptoms assessed. Regression analyses were performed with self-reported and performance-based disability as the dependent variable and age, sex, education, chronic conditions, depression, physical activity and pain characteristics as dependent variables.ResultsMean (SD) results for SPPB were 8.45 (2.86) and 20.06 (8.21) for WHODAS. Pain intensity, depression, pain frequency, number of chronic conditions and level of physical activity explained 44% of the self-reported disability variance. Pain intensity, age, level of physical activity, years of formal education and chronic conditions explained 37% of the performance variance. Pain intensity alone explained 27% and 18% of the self-reported and performance based disability, respectively.ConclusionFindings indicate that primary health care interventions should target pain intensity, depressive symptoms and physical activity as a means to preventing or decreasing both self-reported and performance based disability.     

Associations between daily step count trajectories and clinical outcomes among adults with comorbid obesity and depression

PurposeTo examine the relationship between features of daily measured step count trajectories and clinical outcomes among people with comorbid obesity and depression in the ENGAGE-2 Trial.MethodsThis post hoc analysis used data from the ENGAGE-2 trial where adults (n = 106) with comorbid obesity (BMI ≥30.0 or 27.0 if Asian) and depressive symptoms (Patient Health Questionnaire-9 score ≥10) were randomized (2:1) to receive the experimental intervention or usual care. Daily step count trajectories over the first 60 days (Fitbit Alta HR) were characterized using functional principal component analyses. 7-day and 30-day trajectories were also explored. Functional principal component scores that described features of step count trajectories were entered into linear mixed models to predict weight (kg), depression (Symptom Checklist-20), and anxiety (Generalized Anxiety Disorder Questionnaire-7) at 2-months (2M) and 6-months (6M).ResultsFeatures of 60-day step count trajectories were interpreted as overall sustained high, continuous decline, and disrupted decline. Overall sustained high step count was associated with low anxiety (2M, β = −0.78, p < .05; 6M, β = −0.80, p < .05) and low depressive symptoms (6M, β = −0.15, p < .05). Continuous decline in step count was associated with high weight (2M, β = 0.58, p < .05). Disrupted decline was not associated with clinical outcomes at 2M or 6M. Features of 30-day step count trajectories were also associated with weight (2M, 6M), depression (6M), and anxiety (2M, 6M); Features of 7-day step count trajectories were not associated with weight, depression, or anxiety at 2M or 6M.ConclusionsFeatures of step count trajectories identified using functional principal component analysis were associated with depression, anxiety, and weight outcomes among adults with comorbid obesity and depression. Functional principal component analysis may be a useful analytic method that leverages daily measured physical activity levels to allow for precise tailoring of future behavioral interventions.     

Self-reported physical activity and aerobic fitness are differently related to mental health

BackgroundA relevant, but overlooked question is if self-reported physical activity and aerobic fitness are differently related to mental health.PurposeTo examine the relation between mental health and level of self-reported physical activity (SRPA) and aerobic fitness (AF), and whether AF mediates the relation between SRPA and mental health.MethodsParticipating in the study were 177 voluntary subjects (49% men, 51% women) with a mean age of 39 years. Symptoms of depression and anxiety were measured through the Hospital Anxiety and Depression (HAD) scale, and the Shirom-Melamed Burnout Questionnaire (SMBQ) was used to evaluate self-reported symptoms of burnout. Leisure time SRPA during the last three months were measured using a single item. AF was measured by using the Åstrand bicycle test.ResultsSelf-reported physical activity, but not AF, was significantly related to self-reported symptoms of depression, anxiety, and burnout. Light to moderate physical activity that is performed regularly seems to be associated with more favorable mental health pattern compared with physical inactivity. No support was found for the mediating effect of AF of the physical activity–mental health relationship.ConclusionsSelf-reported behavior of regular physical activity seems to be more important to monitor than measures of AF when considering the potential preventive effects of physical activity on mental health.     

Family history and perceived risk of diabetes,cardiovascular disease,cancer, and depression

BackgroundFamily history is a useful and inexpensive tool to assess risks of multifactorial diseases. Family history enables individualized disease prevention, but its effects on perceived risks of various diseases need to be understood in more detail. We examined how family history relates to perceived risk of diabetes mellitus, cardiovascular disease (CVD), cancer, and depression, and whether these associations are independent of or moderated by sociodemographic factors, health behavior/weight status (smoking, alcohol consumption, physical activity, BMI [kg/m²]), or depressive symptoms.MethodsParticipants were Finnish 25–74-year-olds (N = 6258) from a population-based FINRISK 2007 study. Perceived absolute lifetime risks (Brewer et al., 2004; Becker, 1974; Weinstein and Nicolich, 1993; Guttmacher et al., 2004; Yoon et al., 2002) and first-degree family history of CVD, diabetes, cancer and depression, and health behaviors were self-reported. Weight and height were measured in a health examination.ResultsFamily history was most prevalent for cancer (36.7%), least for depression (19.6%). Perceived risk mean was highest for CVD (2.8), lowest for depression (2.0). Association between family history and perceived risk was strongest for diabetes (β = 0.34, P < 0.001), weakest for depression (β = 0.19, P < 0.001). Adjusting for sociodemographics, health behavior, and depressive symptoms did not change these associations. The association between family history and perceived risk tended to be stronger among younger than among older adults, but similar regardless of health behaviors or depressive symptoms.DiscussionAssociation between family history and perceived risk varies across diseases. People's current understandings on heritability need to be acknowledged in risk communication practices. Future research should seek to identify effective strategies to combine familial and genetic risk communication in disease prevention.     

The physical activity profiles of patients with persecutory delusions

BackgroundSevere paranoia is likely to limit engagement in physical activities. In this study we set out to examine for the first time the activity profiles of patients with current persecutory delusions and the associations with psychiatric symptoms.MethodSeventy-five patients with persecutory delusions in the context of non-affective psychosis wore a pedometer for seven days. Participants completed measures of meaningful activity, mobility, and psychiatric symptoms. Latent class analysis was used to identify physical activity profiles.ResultsThree distinct activity profiles emerged: a mobile but inactive group (n = 47, 63%) (mean daily step count = 6453, SD = 3348), an immobile and inactive group (n = 20, 27%) (mean daily step count = 4205, SD = 2442), and a mobile and active group (n = 8, 11%) (mean daily stepcount = 18396, SD = 5715). The groups did not significantly differ in their levels of paranoia, anhedonia, psychological wellbeing, insomnia, beliefs about self or others, or safety-seeking behaviours. There were significant group differences in depression and number of physical health appointments, with the immobile and inactive group showing higher levels of both. There were indications of group differences in body mass index, hours worked, hallucinations, and worry.ConclusionThere are likely to be different physical activity profiles for patients with current psychotic experiences. The majority of people with persecutory delusions are physically inactive, but a small minority are highly active. In those patients who have low activity levels, there is a potentially important distinction in self-reported mobility, which warrants further investigation. Treatments designed to improve physical activity levels may need to tailor by activity profile.     

One Meaning for Two Persons: An Actor-Partner Interdependence Model Analysis of Meaning in Life,Anxiety, and Depression Among Rehabilitation Patients and Caregivers

ObjectivePatients and caregivers in the inpatient physical rehabilitation setting are presented with life-changing medical conditions, and their meaning in life can change dramatically. Meaning in life is associated with fewer depressive and anxiety symptoms, but little is known about how they are related interdependently among patients and caregivers. In the current study, we aim to explore their dyadic relationships.DesignActor-partner interdependence model through structural equation modeling for dyadic analyses.Setting and ParticipantsA total of 160 pairs of patients and caregivers recruited from 6 inpatient rehabilitation hospitals in China.MethodsCross-sectional surveys were conducted among pairs of rehabilitation patients and caregivers. The presence of and search for meaning were measured with the Meaning in Life Questionnaire.ResultsIn 2 separate models, we found that patients' presence of meaning was negatively associated with their own depression (β = −0.61, P < .001) and anxiety (β = −0.55, P < .001), as well as their caregivers' depression (β = −0.32, P < .001) and anxiety (β = −0.31, P < .001). However, the caregivers’ presence of meaning was only negatively associated with their own depression (β = −0.25, P < .05) and anxiety (β = −0.21, P < .05). A search for meaning was not significantly associated with depression or anxiety.Conclusions and ImplicationsThe results indicate that the anxiety and depressive symptoms of rehabilitation inpatients and caregivers are associated with their own level of presence of meaning. Caregivers' depression and anxiety are interdependently associated with patients' presence of meaning. Clinicians should take dyadic interdependence into consideration when providing psychological services to rehabilitate patients and their caregivers. Meaning-centered interventions can be helpful for the dyads’ meaning-making and mental health.     

Physical activity and depression: A multiple mediation analysis

ObjectivesPhysical activity is associated with reduced symptoms among people with depression, but the factors that may mediate this relationship are poorly understood. We conducted multiple mediation analyses to assess whether positive affect (PA), negative affect (NA), physical activity self-efficacy, coping self-efficacy and exercise-induced feelings cross-sectionally mediated the association and the relative importance of each of these. We also examined whether leisure-time, non-leisure time or total physical activity were more strongly associated with depression.MethodParticipants (N = 164) experiencing depression or low mood completed a one-off postal questionnaire containing measures of physical activity, depression, the potential mediators and covariate variables. Data were analysed using correlations and multiple mediation analyses, controlling for the covariates.ResultsHigher levels of leisure-time and total, but not non-leisure time, physical activity were significantly associated with lower depression. Improvement in PA, pleasant feeling states, NA and levels of physical exhaustion significantly mediated the association between leisure-time and total, but not non-leisure time, physical activity and depression. Post-hoc analyses showed that improvements in physical activity self-efficacy mediated the leisure-time physical activity and depression relationship through improved PA. Coping self-efficacy was not a statistically significant mediator.ConclusionsLeisure-time physical activity may be more beneficial for depression than non-leisure time physical activity, as it increases PA and pleasant feelings and reduces NA and physical exhaustion. PA responses may be partly dependent on improvement in physical activity self-efficacy. People's psychosocial experiences of physical activity may be more important predictors of their depression response than total energy expenditure.     

Stressful life events and habitual physical activity in older adults: 1-year accelerometer data from the Nakanojo Study

ObjectivesStressful life events may have an indirect effect on health by reducing a person's habitual physical activity. The literature supports a negative association between stressful life events and the self-reported physical activity of younger adults, but further evidence is needed for older individuals, using objective measurements of physical activity. We have therefore investigated this issue in a healthy sample of seniors.MethodsThe subjects were 83 men and 101 women, aged 65–85 years. An accelerometer measured their step counts and the intensity of physical activity in metabolic equivalents (METs) on a 24-h basis for an entire year. At the year's end, subjects reported stressful life events that had occurred during the year. Pearson's partial correlation coefficients between these events and physical activity were calculated after controlling for inter-individual differences in age.ResultsThe age-adjusted number of events was negatively correlated with both average daily step count and average daily duration of activity > 3 METs in males (r = ?0.27, p = 0.02; r = ?0.37, p = 0.001, respectively). The self-reported age-adjusted total severity of events showed significant negative correlations with both step count and duration of activity > 3 METs, both in males (r = ?0.29, p = 0.01; r = ?0.37, p = 0.001, respectively) and in females (r = ?0.21, p = 0.03; r = ?0.25, p = 0.01, respectively).ConclusionStressful life events in the elderly are associated with a low level of habitual physical activity (particularly in men who take little exercise of moderate intensity).     

Maltreatment Clusters Among Youth in Outpatient Substance Abuse Treatment: Co-Occurring Patterns of Psychiatric Symptoms and Sexual Risk Behaviors

The purpose of the current study was to describe the use of a brief maltreatment assessment instrument to classify adolescents receiving alcohol or other drug (AOD) treatment services based on the extensiveness and severity of prior maltreatment. This goal is significant because maltreatment reduces the effectiveness of AOD treatment and is associated significantly with co-occurring patterns of psychiatric symptoms and sexual risk behaviors. Structured interviews were administered to 300 adolescent treatment clients (202 males, 98 females; M = 16.22 years; SD = 1.13 years) to assess childhood maltreatment experiences, past year psychiatric symptoms, and sexual risk behaviors during the past 180 days. Cluster analysis classified adolescents into unique groups via self-reported sexual abuse, physical punishment, and parental neglect/negative home environment. Significant between-cluster differences in psychiatric symptoms and sexual risk behaviors were documented using MANOVA and chi-square analyses. More severe maltreatment profiles were associated with higher scores for psychiatric symptoms and unprotected intercourse. Significant heterogeneity and distinct types within this treatment sample of adolescents supports the adaptation of selected prevention efforts to promote HIV/STI risk reduction.