Physical Exercise as the Spice of Life: The Impact of Regular Exercise on Anxiety and the Meaning of Life in Diabetes, Psoriasis, and Heart Disease Patients
The primary scope of the current study was to investigate the effects of physical activity among three types of diseases, that is diabetes, psoriasis and heart disease in well-being and negative emotional states. The sample consisted of 120 Greek adults with a clinical diagnosis of a medical condition, aged between 30 and 50 years. The participants completed four self-report questionnaires (DASS 21, Meaning in Life, Subjective Happiness Scale, Life Satisfaction Scale) and reported their frequency of exercise and their demographic characteristics. A 3 (no, moderate, high exercise) × 3 (diabetes, psoriasis, heart disease) factorial ANOVA was conducted. The results showed that regarding anxiety, symptoms were prospectively associated with lower exercise frequency. The findings suggest the prudence of exercising on psychological prosperity in patients with chronic disease.
References
[1]
Bernstein, G. A., & Borchardt, C. M. (1991). Anxiety Disorders of Childhood and Adolescence: A Critical Review. Journal of the American Academy of Child & Adolescent Psychiatry, 30, 519-532. https://doi.org/10.1097/00004583-199107000-00001
[2]
Cohen, R. A. (2011). Yerkes-Dodson Law. In J. S. Kreutzer, J. DeLuca, & B. Caplan (Eds.), Encyclopedia of Clinical Neuropsychology. New York: Springer. https://doi.org/10.1007/978-0-387-79948-3_1340
[3]
Cohen, S., & Rodriguez, R. (1995). Pathways Linking Affective Disturbances and Physical Disorders. Health Psychology, 15, 374-380. https://doi.org/10.1037/0278-6133.14.5.374
[4]
Cotman, C. W., & Berchtold, N. C. (2002). Exercise: A Behavioral Intervention to Enhance Brain Health and Plasticity. Trends in Neurosciences, 25, 295-301. https://doi.org/10.1016/S0166-2236(02)02143-4
[5]
Cunliffe, W. J., Holubar, K., Millikan, L. E., Parish, L. C., Ring, J., Lipozenèiæ, J. et al. (2003). Topical Procedures, Innovations, and Mistreatments in Dermatovenerology. Acta Dermatovenerologica Croatica, 11, 89.
[6]
De Arruda, L. H. F., & De Moraes, A. P. F. (2001). The Impact of Psoriasis on Quality of Life. British Journal of Dermatology, 144, 33-36. https://doi.org/10.1046/j.1365-2133.2001.144s58033.x
[7]
De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular Exercise, Anxiety, Depression and Personality: A Population-Based Study. Preventive Medicine, 42, 273-279. https://doi.org/10.1016/j.ypmed.2005.12.002
[8]
De Moor, M. H. M., Boomsma, D. I., Stubbe, J. H., Willemsen, G., & de Geus, E. J. C. (2008). Testing Causality in the Association between Regular Exercise and Symptoms of Anxiety and Depression. Archives of General Psychiatry, 65, 897-905. https://doi.org/10.1001/archpsyc.65.8.897
[9]
DeBoer, L. B., Powers, M. B., Utschig, A. C., Otto, M. W., & Smits, J. A. J. (2012). Exploring Exercise as an Avenue for the Treatment of Anxiety Disorders. Expert Review of Neurotherapeutics, 12, 1011-1022. https://doi.org/10.1586/ern.12.73
[10]
Dunn, A. L., Trivedi, M. H., & O’Neal, H. A. (2001). Physical Activity Dose-Response Effects on Outcomes of Depression and Anxiety. Medicine and Science in Sports and Exercise, 33, 587-S597. https://doi.org/10.1097/00005768-200106001-00027
[11]
Epps, F., To, H., Liu, T. T., Karanjit, A., & Warren, G. (2019). Effect of Exercise Training on the Mental and Physical Well-Being of Caregivers for Persons Living with Chronic Illnesses: A Systematic Review and Meta-Analysis. Journal of Applied Gerontology, 0733464819890753. https://doi.org/10.1177/0733464819890753
[12]
Evans, M., Rohan, K. J., Howard, A., Ho, S. Y., Dubbert, P. M., & Stetson, B. A. (2017). Exercise Dimensions and Psychological Well-Being: A Community-Based Exercise Study. Journal of Clinical Sport Psychology, 11, 107-125. https://doi.org/10.1123/jcsp.2017-0027
[13]
Feigal, J. P., Boyle, S. H., Samad, Z., Velazquez, E. J., Wilson, J. L., Becker, R. C., Williams Jr., R. B., Kuhn, C. M., Ortel, T. L., Rogers, J. G., O’Connor, C. M., & Jiang, W. (2017). Associations between Positive Emotional Well-Being and Stress-Induced Myocardial Ischemia: Well-Being Scores Predict Exercise-Induced Ischemia. Psychosomatic Research, 93, 14-18. https://doi.org/10.1016/j.jpsychores.2016.11.012
[14]
Galanakis, M., Lakioti, A., Pezirkianidis, C., Karakasidou, E., & Stalikas, A. (2017). Reliability and Validity of the Satisfaction with Life Scale (SWLS) in a Greek Sample. International Journal of Humanities and Social Studies, 5, 120-127.
[15]
Genuth, S., Alberti, K. G., Bennett P., Buse, J., Defronzo, R., Kahn, R., Kitzmiller, J., Knowler, W. C., Lebovitz, H., Lernmark, A., Nathan, D., Palmer, J., Rizza, R., Saudek, C., Shaw, J., Steffes, M., Stern, M., Tuomilehto, J., & Zimmet, P. (2003). Expert Committee on the Diagnosis and Classification of Diabetes Mellitus 2, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-Up Report on the Diagnosis of Diabetes Mellitus. Diabetes Care, 26, 3160-3167. https://doi.org/10.2337/diacare.26.11.3160
[16]
Giannini, C., Mohn, A., & Chiarelli, F. (2006). Physical Exercise and Diabetes during Childhood. Acta Bio-Medica, 77, 18-25.
[17]
Gordon, B. R., McDowell, C. P., Lyons, M., & Herring, M. P. (2017). The Effects of Resistance Exercise Training on Anxiety: A Meta-Analysis and Meta-Regression Analysis of Randomised Controlled Trials. Sports Medicine, 47, 2521-2532. https://doi.org/10.1007/s40279-017-0769-0
[18]
Hassmén, P., Koivula, N., & Uutela, A. (2000). Physical Exercise and Psychological Well-Being: A Population Study in Finland. Preventive Medicine, 30, 17-25. https://doi.org/10.1006/pmed.1999.0597
[19]
Herring, M. P., O’Connor, P. J., & Dishman, R. K. (2010). The Effect of Exercise Training on Anxiety Symptoms among Patients: A Systematic Review. Archives of Internal Medicine, 170, 321-331. https://doi.org/10.1001/archinternmed.2009.530
[20]
Howell, D. (2013). Fundamental Statistics for the Behavioral Sciences. Boston, MA: Cengage Learning.
[21]
Huebschmann, A. G., Schauer, I. E., Bauer, T. A., Regensteiner, J. G., & Reusch, J. E. (2018). Exercise Performance Impairments and Benefits of Exercise Training in Diabetes. In Diabetes and Exercise (pp. 83-108). Cham: Humana Press. https://doi.org/10.1007/978-3-319-61013-9_6
[22]
International Diabetes Foundation (2020). https://idf.org/our-network/regions-members/europe/members/137-greece.html
[23]
Ivanova, E., Burns, R. J., Deschênes, S. S., Knäuper, B., & Schmitz, N. (2017). A Longitudinal Investigation of Anxiety and Depressive Symptomatology and Exercise Behaviour among Adults with Type 2 Diabetes Mellitus. Canadian Journal of Diabetes, 41, 73-81. https://doi.org/10.1016/j.jcjd.2016.07.006
[24]
Jayakody, K., Gunadasa, S., & Hosker, C. (2014). Exercise for Anxiety Disorders: Systematic Review. British Journal of Sports Medicine, 48, 187-196. https://doi.org/10.1136/bjsports-2012-091287
[25]
Karakasidou, E., Pezirkianidis, C., Stalikas, A., & Galanakis, M. (2016). Standardisation of the Subjective Happiness Scale (SHS) in a Greek Sample. Psychology, 7, 1753-1765. https://doi.org/10.4236/psych.2016.714164
[26]
Liu, T., Chan, A. W., Liu, Y. H., & Taylor-Piliae, R. E. (2018). Effects of Tai Chi-Based Cardiac Rehabilitation on Aerobic Endurance, Psychosocial Well-Being, and Cardiovascular Risk Reduction among Patients with Coronary Heart Disease: A Systematic Review and Meta-Analysis. European Journal of Cardiovascular Nursing, 17, 368-383. https://doi.org/10.1177/1474515117749592
[27]
Lovibond, P. F., & Lovibond, S. H. (1995). The Structure of Negative Emotional States: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335-343. https://doi.org/10.1016/0005-7967(94)00075-U
[28]
Lyubomirsky, S., & Lepper, H. (1999). A Measure of Subjective Happiness: Preliminary Reliability and Construct Validation. Social Indicators Research, 46, 137-155. https://doi.org/10.1023/A:1006824100041
[29]
Mandolesi, L., Polverino, A., Montuori, S., Foti, F., Ferraioli, G., Sorrentino, P., & Sorrentino, G. (2018). Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits. Frontiers in Psychology, 9, 509. https://doi.org/10.3389/fpsyg.2018.00509
[30]
Marquez, D. X., Jerome, G. J., McAuley, E., Snook, E. M., & Canaklisova, S. (2010). Self-Efficacy Manipulation and State Anxiety Responses to Exercise in Low Active Women. Psychology & Health, 17, 783-791. https://doi.org/10.1080/0887044021000054782
[31]
McDonough, E., Ayearst, R., Eder, L., Chandran, V., Rosen, C. F., Thavaneswaran, A., & Gladman, D. D. (2014). Depression and Anxiety in Psoriatic Disease: Prevalence and Associated Factors. The Journal of Rheumatology, 41, 887-896. https://doi.org/10.3899/jrheum.130797
[32]
Michas, G., Karvelas, G., & Trikas, A. (2019). Cardiovascular Disease in Greece; the Latest Evidence on Risk Factors. Hellenic Journal of Cardiology, 60, 271-275. https://doi.org/10.1016/j.hjc.2018.09.006
[33]
Myers, V. H., McVay, M. A., Brashear, M. M., Johannsen, N. M., Swift, D. L., Kramer, K., Harris, M. N., Johnson, W. D., Earnest, C. P., & Church, T. S. (2013). Exercise Training and Quality of Life in Individuals with Type 2 Diabetes. American Diabetes Association, 36, 1884-1890. https://doi.org/10.2337/dc12-1153
[34]
National Psoriasis Foundation (2020). https://www.psoriasis.org/content/statistics
[35]
Penedo, F. J., & Dahn, J. R. (2005). Exercise and Well-Being: A Review of Mental and Physical Health Benefits Associated with Physical Activity. Current Opinion in Psychiatry, 18, 189-193. https://doi.org/10.1097/00001504-200503000-00013
[36]
Pezirkianidis, C., Galanakis, M., Karakasidou, I., & Stalikas, A. (2016). Validation of the Meaning in Life Questionnaire (MLQ) in a Greek Sample. Psychology, 7, 1518-1530. https://doi.org/10.4236/psych.2016.713148
[37]
Pezirkianidis, C., Karakasidou, E., Lakioti, A., Stalikas, A., & Galanakis, M. (2018). Psychometric Properties of the Depression, Anxiety, StressScales-21 (DASS-21) in a Greek Sample. Psychology, 9, 2933-2950. https://doi.org/10.4236/psych.2018.915170
[38]
Reid, R. D., Tulloch, H. E., Sigal, R. J., Kenny, G. P., Fortier, M., McDonnell, L. et al. (2010). Effects of Aerobic Exercise, Resistance Exercise or Both, on Patient-Reported Health Status and Well-Being in Type 2 Diabetes Mellitus: A Randomised Trial. Diabetologia, 53, 632-640. https://doi.org/10.1007/s00125-009-1631-1
[39]
Rogerson, M. C., Murphy, B. M., Bird, S., & Morris, T. (2012). “I Don’t Have the Heart”: A Qualitative Study of Barriers to and Facilitators of Physical Activity for People with coronary Heart Disease and Depressive Symptoms. International Journal of Behavioral Nutrition and Physical Activity, 9, Article No. 140. https://doi.org/10.1186/1479-5868-9-140
[40]
Rogerson, M., Wood, C., Pretty, J., Schoenmakers, P., Bloomfield, D., & Barton, J. (2020). Regular Doses of Nature: The Efficacy of Green Exercise Interventions for Mental Wellbeing. International Journal of Environmental Research and Public Health, 17, 1526. https://doi.org/10.3390/ijerph17051526
[41]
Scully, D., Kremer, J., Meade, M. M., Graham, R., & Dudgeon, K. (1998). Physical Exercise and Psychological Well-Being: A Critical Review. British Journal of Sports Medicine, 32, 111-120. https://doi.org/10.1136/bjsm.32.2.111
[42]
Steger, M. F., Frazier, P., Oishi, S., & Kaler, M., (2006). The Meaning in Life Questionnaire: Assessing the Presence of and Search for Meaning in Life. Journal of Counseling Psychology, 53, 80-93. https://doi.org/10.1037/0022-0167.53.1.80
[43]
Strandberg, R. B., Graue, M., Wentzel-Larsen, T., Peyrot, M., & Rokne, B. (2014). Relationships of Diabetes-Specific Emotional Distress, Depression, Anxiety, and Overall Well-Being with HbA1c in Adult Persons with Type 1 Diabetes. Journal of Psychosomatic Research, 77, 174-179. https://doi.org/10.1016/j.jpsychores.2014.06.015
[44]
Ströhle, A. J. (2009). Physical Activity, Exercise, Depression and Anxiety Disorders. Journal of Neural Transmission, 116, Article No. 777. https://doi.org/10.1007/s00702-008-0092-x
[45]
Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., Salum, G. A., & Schuch, F. B. (2017). An Examination of the Anxiolytic Effects of Exercise for People with Anxiety and Stress-Related Disorders: A Meta-Analysis. Psychiatry Research, 249, 102-108. https://doi.org/10.1016/j.psychres.2016.12.020
[46]
Tang, T. S., Brown, M. B., Funnell, M. M., & Anderson, R. M. (2008). Social Support, Quality of Life, and Self-Care Behaviors among African Americans with Type 2 Diabetes. The Diabetes Educator, 34, 266-276. https://doi.org/10.1177/0145721708315680
[47]
Torres, T., Alexandre, J. M., Mendonça, D., Vasconcelos, C., Silva, B. M., & Selores, M. (2014). Levels of Physical Activity in Patients with Severe Psoriasis: A Cross-Sectional Questionnaire Study. American Journal of Clinical Dermatology, 15, 129-135. https://doi.org/10.1007/s40257-014-0061-0
[48]
van der Mheen, M., van Beynum, I. M., Dulfer, K., van der Ende, J., van Galen, E., Duvekot, J. et al. (2018). The CHIP-Family Study to Improve the Psychosocial Wellbeing of Young Children with Congenital Heart Disease and Their Families: Design of a Randomised Controlled Trial. BMC Pediatrics, 18, Article No. 230. https://doi.org/10.1186/s12887-018-1183-y
[49]
Van Voorhees, A. S., & Fried, R. (2009). Depression and Quality of Life in Psoriasis. Postgraduate Medicine, 121, 154-161. https://doi.org/10.3810/pgm.2009.07.2040
[50]
Weinstein, A., Maayan, G., & Weinstein, Y. (2015). A Study on the Relationship between Compulsive Exercise, Depression and Anxiety. Journal of Behavioral Addictions, 4, 315-318. https://doi.org/10.1556/2006.4.2015.034
[51]
Whooley, M. A., De Jonge, P., Vittinghoff, E., Otte, C., Moos, R., Carney, R. M. et al. (2008). Depressive Symptoms, Health Behaviors, and Risk of Cardiovascular Events in Patients with Coronary Heart Disease. JAMA, 300, 2379-2388. https://doi.org/10.1001/jama.2008.711
