Exercise-Based Interventions for Mental Illness: Physical Activity as Part of Clinical Treatment

Description

Exercise-Based Interventions for People with Mental Illness: A Clinical Guide to Physical Activity as Part of Treatment provides clinicians with detailed, practical strategies for developing, implementing and evaluating physical activity-based interventions for people with mental illness. The book covers exercise strategies specifically tailored for common mental illnesses, such as depression, schizophrenia, bipolar disorder, and more. Each chapter presents an overview of the basic psychopathology of each illness, a justification and rationale for using a physical activity intervention, an overview of the evidence base, and clear and concise instructions on practical implementation. In addition, the book covers the use of mobile technology to increase physical activity in people with mental illness, discusses exercise programming for inpatients, and presents behavioral and psychological approaches to maximize exercise interventions. Final sections provide practical strategies to both implement and evaluate physical activity interventions. Covers interventions for anxiety, depression, eating disorders, alcohol use disorder, and more Provides the evidence base for exercise as an effective treatment for mental illness Demonstrates how to use mobile technology to increase physical activity in people with mental illness Features practical strategies for implementation and assessment Covers treatment approaches for patients of all ages. Exercise-Based Interventions for Mental Illness: Physical Activity as Part of Clinical Treatment Copyright List of Contributors Dedication Foreword Introduction Why Mental Health? Mental Illness and Mental Health Integrating Mind and Body: Mental and Physical Ill-Health Mental Illness Is All of Our Business References 1. Exercise for the Prevention and Treatment of Depression Introduction Relationship Between Physical Activity and Depression Physical Activity and the Prevalence of Depression Physical Activity and the Incidence of Depression Exercise as a Treatment for MDD Evidence From Meta-Analyses Exercise for Symptom Management Exercise Training for Depression: Historical Development and Potential Prescriptions Potential Mechanisms Barriers/Facilitators Summary and Future Directions References 2. Exercise for the Management of Anxiety and Stress-Related Disorders Anxiety: What Is It and Why Do We Care? Definition and Conceptualizations Etiology and Development Anxiety and Stress-Related Disorders Traditional Treatment of Anxiety and Stress-Related Disorders Measurement of Anxiety Symptoms and Anxiety and Stress-Related Disorders Diagnostic Interviews Diagnostic Screeners Measures of Anxiety Symptoms Disorder-Specific Symptom Inventories Exercise Effects in Anxiety and Stress-Related Disorders Exercise Effects on Anxiety and Among Patients With Anxiety and Stress-Related Disorders Exercise Effects on Anxiety Exercise Effects Among Patients With Anxiety and Stress-Related Disorders Early Studies Studies of Mixed Samples of SAD, GAD, and PD Patients Specific Phobias SAD Patients GAD Patients OCD Patients PTSD Patients PD Patients Plausible Mechanisms of the Anxiolytic Effects of Exercise Self-Concept/Self-Esteem Exposure Expectation/Placebo Effect Adaptations in the GABA Neurotransmitter System Adaptations in the Norepinephrine Neurotransmitter System Adaptations in the Serotonin Neurotransmitter System Exercise Prescription, Dose, and Compliance Summary References 3. Bipolar Disorder and Physical Activity Introduction Clinical Features Epidemiology, Burden, and Risk Factors Physical Health of People With Bipolar Disorder Current Treatments for Bipolar Disorder Physical Activity and Bipolar Disorder Examples of Trials Including a Physical Activity Component in People With Bipolar Disorder Future Directions Conclusions References 4. Schizophrenia and Exercise INTRODUCTION CLINICAL FEATURES Positive Symptoms Negative Symptoms Cognitive Impairment EPIDEMIOLOGY AND RISK FACTORS CURRENT TREATMENT STRATEGIES FOR SCHIZOPHRENIA PHYSICAL HEALTH OF PEOPLE WITH SCHIZOPHRENIA PHYSICAL ACTIVITY AND SCHIZOPHRENIA Factors Influencing Physical Activity Participation Benefits of Physical Activity for People with Schizophrenia EXAMPLES OF PA INTERVENTION STUDIES Keeping the Body in Mind FUTURE DIRECTION—SUSTAINABLE IMPLEMENTATION CONCLUSION References 5. Exercise for Alcohol Use Disorders Alcohol Use Disorders: Definition, Prevalence, and Societal Impact Help-Seeking Is Poor and Treatment Response Limited Comorbid Health Problems Are Common in AUDs Psychiatric Comorbidity and Cognitive Deficits Current Treatment Options for AUDs Brief Interventions and Internet-Based Support Evidence of the Benefits of Exercise From Intervention Studies Reviews of the Evidence—Positive Effects on Health, Depression, and Physical Fitness Dropout and Treatment Adherence Safety and Adverse Effects Mechanisms of Action: Mood States, Inflammation, and Cognition Alcohol Consumption and Physical Activity in the General Population Conclusions and Clinical Implications References 6. Sedentary Behavior and Mental Health Sedentary Behavior Sedentary Behavior and Mental Health in Adults Depression and Anxiety Bipolar Disorder Schizophrenia Sedentary Behavior and Mental Health in Children and Adolescents General Limitations of Current Research Strategies to Reduce Sedentary Behavior in Those With Mental Health Disorders Summary References 7. Exercise for Older People With Mental Illness Introduction Benefits of Physical Activity and Exercise Methods Search Strategy Selection Criteria Data Extraction and Appraisal Results Effects of Exercise on Severity of Depression Effects of Exercise on the Cognitive Function of Older Adults With Dementia Discussion Main Findings Recommendations for Clinical Practice Implications for Research Conclusions References 8. Exercise for Adolescents and Young People With Mental Illness EXERCISE FOR ADOLESCENTS AND YOUNG PEOPLE WITH MENTAL ILLNESS YOUNG PEOPLE AND MENTAL ILL HEALTH EXERCISE FOR DEPRESSION IN YOUNG PEOPLE: THE EVIDENCE EXERCISE FOR ANXIETY IN YOUNG PEOPLE: THE EVIDENCE EXERCISE FOR BIPOLAR AFFECTIVE DISORDER IN YOUNG PEOPLE: THE EVIDENCE EXERCISE FOR EARLY PSYCHOSIS IN YOUNG PEOPLE: THE EVIDENCE EXERCISE FOR SUBSTANCE USE/ABUSE: THE EVIDENCE SUMMARY OF THE EVIDENCE BASE FOR EXERCISE INTERVENTIONS IN YOUTH MENTAL HEALTH APPLICATION IN CLINICAL PRACTICE CONCLUSIONS References 9. Eating Disorders and Exercise—A Challenge Introduction Eating Disorders: Diagnostic Characteristics Exercise in the Diagnostic Criteria of Eating Disorders The Meaning of Exercise and Eating Disorders in Clinical Practice Prevalence of High Levels of Exercise in Eating Disorders How Should the Level of Activity in Patients With Eating Disorders Be Measured? Different Questionnaires Assessing the Context of Physical Activity Are Available How Much Exercise Is Too Much and When Does Physical Activity Become Unhealthy and/or Harmful in Patients With Eating Disor ... References 10. Behavioral and Psychological Approaches in Exercise-Based Interventions in Severe Mental Illness Barriers and Obstacles to PA Motivational Correlates of PA in Mental Disorders Social-Cognitive Theories and PA BCTs as a Practical Component to Implement PA Interventions PA Preferences May Be the Next Step to Maximize Long-Term Adherence A Framework for Exercise Interventions for Adults With severe mental illness (SMI) Initiation: To Fill the Gym Exercise Collective Endorsement of Exercise as Treatment by Care Providers Behavior Change Techniques Initial Interview Implementation Intentions Development: Let's Talk About Pleasure in Exercise Exercise A Self-Paced Intensity During First Sessions Behavior Change Techniques Adherence: I Feel Confident in My Ability to Come Back to the Next Session Exercise Delivery Style of Behavioral Support Behavior Change Techniques Maintenance: From Gym to Green (Football, Park, Garden) Exercise The Exercise Professional as a Counselor Behavior Change Techniques References 11. Exercise Interventions in Secure and Forensic Services Secure and Forensic Services Physical Health of Secure Forensic Service Users The Potential and Importance of Exercise in Secure Care Developing Physical Activity Programs for People With Mental Illness in Secure Care Conclusion References 12. mHealth and Physical Activity Interventions Among People With Mental Illness Introduction What Is mHealth? mHealth Technologies Smartphone Devices Internet-Delivered Education Smartphone “Apps” Wearable Technology mHealth for Physical Health Care Summary What Can mHealth Be Used for? mHealth for Mental Health Care mHealth Uses for People With SMI Ownership and Endorsement of mHealth Technologies for People With SMI Questions Ownership Endorsement Barriers for People With SMI mHealth Interventions in Mental Health Settings Smartphone Apps for SMI Symptom Monitoring Intervention Delivery Other Uses Summary Mobile Technology for Mental Health How can mHealth Increase Physical Activity in People With SMI? Why Is It Important to Increase Physical Activity in People With SMI? Current Physical Activity Interventions in SMI Using mHealth to Increase Physical Activity Previous Research Using mHealth to Increase Physical Activity in People With SMI Smartphone Apps Wearable Devices Other Technological Approaches to Increase Physical Activity in People With SMI Summary Increasing Physical Activity in People With SMI Conclusions and Future Directions Recommendations Conclusions References Further Reading 13. Integration of the Exercise Professional Within the Mental Health Multidisciplinary Team Introduction Meeting Needs and Role Delineation What Is an Exercise Professional? Why the Need for an Exercise Professional? Clinicians Beliefs of Exercise in Mental Health What Are Important Attributes of Exercise Professionals? Examples of Integration The Keeping the Body in Mind Example The Secure Extended Care Facility Example The Forensic Secure Facility Example The Inpatient Example Community Linkage Example A Common Theme Practice Considerations Future Steps References 14. Integrating Physical Activity Into Routine Medical Care: The Physician's Perspective Introduction Research Evidence Physician Counselling Evidence-Based Lifestyle Interventions “Exercise Is Medicine” Barriers: Patient Factors Overcoming Barriers Assess Advise Agree Assist Arrange Evidence-Based Lifestyle Interventions Optimizing Pharmacotherapy for Psychosis Addressing Social Determinants of Health Barriers: Provider Factors Training and Education Current Graduate and Postgraduate Training Programs Curricular Content Barriers: Systems Factors Conclusion/Summary References 15. Overview of Mechanisms of Action of Exercise in Psychiatric Disorders and Future Directions for Research Effects of Exercise on the Serotonin System Exercise Effects on the Dopaminergic System Effects of Exercise on Hypothalamic-Pituitary-Adrenal Axis Endocannabinoids and Exercise BDNF and Exercise Informing Clinical Treatment Decisions Using Biological Mechanisms References 16. Research and Evaluation in Exercise and Mental Health Introduction Designing an Evaluation Framework: Beyond the Randomized Controlled Trial What to Measure? Selecting Appropriate Outcomes Objective Versus Subjective Assessments Measuring Physical Activity Participation and Sedentary Behavior International Physical Activity Questionnaire Physical Activity as a Vital Sign The Simple Physical Activity Questionnaire Cardiorespiratory Fitness and Exercise Capacity Quality of Life Sleep Behavior Putting It All Together: Planning for and Conducting an Evaluation Asking the Right Question Ensuring the Method Matches the Aim Choosing the Right Outcome Measure Developing a Protocol and Submitting for Ethical Review Data Collection, Analysis, and Dissemination References 17. Research to Practice: Case Studies* Exercise Counselling for People Living With a Diagnosis of Schizophrenia: A Case Study Session 1: Build Rapport and Gather Knowledge Session 2: Goal Setting Sessions 3 and 4: Evaluate, Revise, Inform Maximal Strength Training in Recovery of Eating Disorders Including Exercise in Early Intervention for Young People With a First-Episode Psychosis: A Case Study Prescreening Session 2 Session 3 Session 4: Motivational Interviewing Outcome Lifestyle Changes and Cardiovascular Health in a Woman With Bipolar Disorder: A Case Study of the PsychoActive Project Results Discussion References Index A B C D E F G H I K L M N O P Q R S T U V W Y