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Exercise Psych - exam Flashcards

1
Q

Define affect

A

Expression of value given to a feeling state
Positive or negative

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2
Q

Define emotions

A

Brief responses of negative or positive feelings evoked by particular situations
Can contribute to mood

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3
Q

Define mood

A

Host of transient fluctuating affective states that can be positive or negative

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4
Q

Types of Factor that can affect mood

A

Exogenous- transient conditions in the environment
Endogenous rhythms- innate biological processes eg menstrual cycle
Traits and temperament -general tendency people have in experiencing affect
Characteristic variability- individual differences in the magnitude of mood fluctuations

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5
Q

Other things that affect mood

A

Repeated intense emotions
Physiological changes - sleep, drugs, exercise

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6
Q

How does exercising affect mood

A

Hormones - endorphins, serotonin, noradrenaline, adrenaline, dopamine (runners high)
Self - esteem + self efficacy
Previous experience exercising

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7
Q

Task variables that affect mood

A

Intensity - Inc intensity inc arousal, effects depends on participants response to arousal
Duration
Mode

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8
Q

Situational variables affecting exercise and mood

A

Physical environment
Social environment
Interact with personal and task variables to influence mood

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9
Q

Describe the mastery hypothesis

A

Improved emotional stability, self sufficiency + conscientiousness from persistent involvement in meaningful activity

Inc sense of global wellbeing, euphoric highs, sense of accomplishment
Improved concentration
Experience vivid physical sensations

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10
Q

Describe the distraction hypothesis

A

Decreased awareness of feelings of fear, tension and irritability
Distraction from worry and rejection
Countering effect on inertia, fatigue + depression

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11
Q

Theories on psychosocial benefits of exercise that enhance mood

A

Mastery theory
Distraction theory

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12
Q

How do you measure affect

A

Self report - likert scale or circumplex model of affect

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13
Q

Describe likert scale

A

Measures response to each adjective on a scale typicallly 1-5
Can be done on how you feel in the moment or over 4 weeks

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14
Q

Describe circumplex model of affect

A

Can be used for single terms

Rate each term by feeling -5 to +5 and arousal 1-6
These are mapped onto plot

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15
Q

Consideration for self report of affect

A

Single items may be better - less likely to change variable being measured through act of measurement

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16
Q

Other ways to measure affect

A

Skin conductance
EMG
EEG
Neuroimaging

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17
Q

Describe hedonic principle

A

Humans seek pleasure and avoid displeasure so positive reinforcement + feeling good encourages participation

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18
Q

Describe the affective-reflective theory

A

Dual process depending on affect and automatic response

An exercise related stimulus causes an automatic association (type 1 process)
This causes automatic effect valuation + encoded effect + cognition
Automatic effect valuation causes action impulse + allows reflective valuation
Reflective valuation (type 2 process) allows action plans
Action impulse + action plans lead to behaviour

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19
Q

Exercise intensity + motivation to exercise

A

Intensity Inc above ventilatory threshold- feels unpleasant may put people off BUT often get affective rebound at end (due to sense of accomplishment etc)
Exercise below threshold feels more pleasant

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20
Q

When do people have most positive affect

A

Self - selected physical activity below threshold
As
Perception of control and ability
Exercise outcomes

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21
Q

Describe attention restoration theory

A

People have limited capacity to direct attention to something that’s not interesting- directed attentional fatigue

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22
Q

How to counter direct attentional fatigue

A

Fascination - different/ novel objects/environments
Being away - from noise/busyness/normal environments
Extent of connectedness - doing it with others
Compatibility

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23
Q

What is natural environment

A

Characterised by variety of different + novel objects of interest that replenish depleted energy and attention

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24
Q

Why is exercise in the natural environment better

A

Less noise / over crowding which can overwhelm ability to direct attention + cause further negative emotions
It promotes positive emotions and affect due to aestically pleasing factors that use effortless attention or fascination

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25
Q

Who gets the biggest effects from being in natural environment

A

Extremely stressed/fatigued individuals
Get more positive mood changes and perform better on stress tasks

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26
Q

Effect of sitting on mood and affect

A

Negatively influences situational negative affect, tiredness and energy levels

Restoration still occurs when sitting in a natural environment but to a lesser extent

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27
Q

Effect of exercise duration on mood

A

Favourable effect on various mood profiles regardless of duration

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28
Q

Define mental health

A

Whole state can be flourishing and good or bad.

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29
Q

Who is more likely to have mental health problems

A

Smokers
Poor social-economic background

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30
Q

Potential consequences of poor mental health

A

Likely to die earlier

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31
Q

NHS 5 steps to mental well-being

A

Connect, be active, take notice, learn new skills, give to others

Exercising can tick off most of these

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32
Q

Impact of physical activity on mental illness

A

Decreased risk + helps mx of major depressive disorder, anxiety + psychosis
Improved sleep quality (+ cardiorespiratory fitness)
But the more severe the mental illness less impact PA has

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33
Q

What mental health Sx / problems can PA help

A

Illness duration
Dec suicide attempts (but not ideation)
Global functioning
QoL
Normalising
Dec antipsychotic prescriptions
Social inclusion
Memory

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34
Q

Type of PA best for mental health

A

Sport- most favourable mental health outcomes, positive social development, dec social exclusion
Leisure time PA - more enjoyable, Inc participation + motivation
Work time PA - has no association with mental illness

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35
Q

Facilitators for participating in community mental health exercise programs

A

Good, easily accessible facilities
Education + training
Flexibility
Peer support - buddy system
Consistent communication
1ST SESSION V IMPORTANT

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36
Q

What is the moving for mental health report

A

Used to help inform govt policy + promote benefits of community based PA

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37
Q

Why was the moving for mental health report needed?

A

Covid had significant impact on mental health + accelerated inequalities
PA is beneficial but only under right conditions - need to identify + promote these
PA decreased in Covid 1.2 million more inactive adults
Much of the sector stopped + never recovered from covid

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38
Q

Moving for mental health outcomes

A
  1. Develop cross-govt strategy promoting movement for mental health
  2. Office for health improvement + disparities responsible for this - should work with other departments to create more opportunities
  3. Prioritise cross sector partnerships and role of experts by lived experience
  4. Professionals + volunteers should receive standardised training + professional development
  5. Prioritise + fund more consistent + accessible evaluations to identify improvements
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39
Q

Depression prevalence

A

1in 6 adults worldwide
Affects 150 million worldwide

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40
Q

Define depression

A

Concurrent presence of at leat 5/10Sx which occur most of the day, nearly everyday for 2 weeks. 1sx must be low mood, anhedoinia, or low energy (core Sx of depression)

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41
Q

Depression Sx

A

Core - low mood, low energy, anhedoina
Others - difficulty concentrating, psychosis, sleep changes, appetite changes, feeling worthless, inappropriate guilt, fatigue, psychomotor agitation

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42
Q

Depression Mx

A

Mindfulness, exercise, SSRI, CBT, ECT

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43
Q

Impact of exercise on depression

A

Regularly active 15% less likely to get depression in future
150 mins exercise per week dec risk depression 30%

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44
Q

Psychological benefits of PA for depressed

A

Dec anxiety + depression sx
Dec psychological distress
Improved mood, sleep, energy + concentration levels
Improved self esteem, confidence and connectedness

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45
Q

What exercise has the biggest benefits for depression

A

Moderate intensity, aerobic exercise with supervision by exercise professionals

But exercise at any intensity likely to help prevent subsequent depression
Team sport = fewer Sx anxiety + depression

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46
Q

Motivation regulation spectrum

A

Ranges from
Autonomous motivation (I love doing it)
To controlled motivation (I have to do it)
Autonomous better in LT

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47
Q

What is needed for people to attend PA sessions

A

Focus on fun + enjoyment
Provide info on PA and well-being
Accepting of participants behaviours and beliefs
Acknowledge negative feelings, demonstrate trust
Show understanding + care
Advice on overcoming barriers

48
Q

Define GAD

A

Excessive worry, difficult to control for >= 6 months on most days with >=3 sx causing distress or functional impairment

49
Q

GAD SX

A

Restlessness, insomnia, fatigue, concentration problems, irritability, muscle tension,

50
Q

Describe panic disorder

A

Recurrent panic attacks with fear of consequences and or avoidance behaviour >= 1 month

51
Q

Panic disorder Sx

A

Palpitations, sweating, shaking, choking sensation, SoB, chest pain, nausea, dizziness, depersonalisation, fear of dying

52
Q

Panic disorder Mx

A

Exposure therapy- exposure to feared sx can help reattribute to a recognisable cause
Eg exercise can also cause sweating + SoB

53
Q

Exercise + anxiety

A

Exercise decrease anxiety but not as much as antidepressants
Use as adjunct
Not clear what h type of exercise is best

54
Q

Anxiety + mindful exercise

A

Yoga dec anxiety
Larger effect in participants with previous yoga experience
Larger effect with no exercise control
Some evidence for Tai Chi

55
Q

What is sleep?

A

A natural Re-occurring reversible state of suspended awareness and inhibition of voluntary muscles and sensory activity

56
Q

What Does sleep enable

A

Body And brain recovery muscular repair, hormone release, protein synthesis tissue growth, CNS clearance

57
Q

Describe Sleep regulation

A

Driven By circadian rhythm and homeostatic pressure

58
Q

Describe Homeostatic pressure of sleep

A

Adenosine Builds up in brain making you feel sleepy, then dissipates when you sleep

59
Q

Symptoms Of acute sleep loss

A

Fatigue, Drowsiness irritability, low mood, anxiety, hormone, dysregulation, impaired attention increased errors, perceptual disturbance, Paranoia hallucinations

60
Q

Chronic Sleep loss symptoms

A

Increased stress reaction, HTM, dyslipidaemia, insulin resistance, increased risk of cardiovascular, disease, cancer, dementia, mental illness

61
Q

Effect of sleep on exercise

A

Poor Sleep quality is associated with lower levels of physical activity
Shorter sleep duration is associated with less vigourous activity
Lack of sleep results in more sedentary time, higher fatigue and lower alertness

62
Q

Effect of sleep on exercise performance

A

Short term sleep loss has a limited impact on single bouts of muscular or aerobic exercise
Negative Impact on fine motor skills such as darts and on cognitive and mood parameters such as reaction times

63
Q

Does Exercise predict sleep

A

426 adults reported her sleep and exercise for two years physical activity didn’t predict subsequent sleep quality

Vigourous Activity was associated with shorter asleep duration at night

64
Q

Meta analysis Of Effects of exercise on sleep

A

Overall Improvement in sleep, quality with exercise
Supervised facility based programs were more effective

65
Q

Sleep Hygiene methods

A

Maintain Regular bed and wake times
Bedroom Dark, cool, quiet and comfortable with bed reserved for intimacy and sleep
Minimise Bright light and avoid screens for two hours before bed
Exercise In the day, avoid 4 hours before bed
Increase Exposure to natural light in the morning

66
Q

Does Exercise, timing effect sleep

A

Morning Exercise is significantly beneficial
Evening exercise doesn’t appear detrimental other than vigourous exercise, very close to bed

67
Q

Define Pain

A

Unpleasant, sensory and emotional experience associated with actual or potential tissue damage

68
Q

Describe The pain pathway

A

Harm is detected by nociceptors
Messages Sent through the nervous system via spinal cord to brain
B-Endorphins released via opioid receptors in brain, provide a natural painkiller

69
Q

Describe Chronic pain

A

Pain that persists or occurs over three months
Can Be primary or secondary
Often Linked to hypersensitivity of the CMS
Strong Psychological components

70
Q

Vicious cycle of chronic pain

A

Pain
Distress/ anger
Catastrophising
Fear
Hypervigilance
Activity avoidance
Disuse disability

71
Q

What Increases chance of recovery in chronic pain

A

Ability To confront and accept the pain

72
Q

None Pharmacological management of chronic pain

A

Acceptance And commitment therapy ACT
CBT
Supervised, exercise programs considering specific needs preferences and abilities

73
Q

Effect of exercise on chronic pain

A

A. Meta analysis showed small to moderate improvements, following exercise for pain, physical function, and quality of life

74
Q

Effect of combined approach for chronic pain

A

Combines exercise and psychological therapy
Reduction in pain is not significantly different to exercise alone
Higher pain self-efficacy , safe and lower pain catastrophising and fear of movement

75
Q

Exercise Analgesia methods

A

Tissue healing, increased blood flow and inflammation
Cardiometabolic - Inc aerobic fitness, body composition
Neuromuscular- flexibility, postural stability,
Psychological- fear avoidance, catastrophising

76
Q

Is Exercise a placebo for chronic pain

A

Exercise Was more effective compared to no treatment
No Difference in pain reduction between exercise and placebo

77
Q

Placebo biology

A

If You are expecting an end, result, your body sometimes releases what is required to get the result expectedly.
Release of endorphins- reduce pain
Release of dopamine - reduce tremor
Sham O2 - dec prostaglandin levels + HR

78
Q

Define Dependent use of a substance

A

Habitual and compulsive use, despite adverse consequences

79
Q

Substance Use disorder criteria Pharmacological

A

Developing Tolerance?
Withdrawal

80
Q

Substance Use disorder criteria, risky behaviour

A

Repeated Use in risky situations
Continued Use, despite it causing health problems

81
Q

Substance Use disorder criteria impaired control

A

Consuming More than intended
Failing To control use
Spending A lot of time gaining or using substance

82
Q

Substance Use disorder criteria, social impairment

A

Failure to fulfil role obligations
Continued Use despite relationship damage
Giving up or reducing activities due to substance use

83
Q

Amount Of alcohol consumed by population

A

None = 20%
</14 units = 57% population
Excess (>35 f or 50 m units) = 4 %

84
Q

How To assess for alcohol dependence

A

AUDIT - Alcohol, use disorders identification test
CAGE questionnaire

85
Q

Relationship between exercise +alcohol

A

Higher level’s exercise = higher levels drinking
People drink more on days that they exercise

86
Q

Why is exercise associated with higher alcohol intake

A

Age - young drink more and exercise more
Health status - poor health - less likely to drink or exercise
Alcohol is a reward for exercise
Exercise compensates for alcohol calories
Exercise relieves guilt of drinking
Personality- extroverts more likely to exercise + drink
Social

87
Q

Brain circuitry of exercise + alcohol

A

Both represent rewarding stimuli- activate brains mesocorticolimbic pathway

88
Q

Exercise as a treatment for alcohol dependence

A

As a substitute it decreases cravings + intake
Animal studies suggest exercise may ameliorate alcohol related neural damage
No difference between exercise + the standard tx in reducing alcohol intake but exercise superior for fitness + depression

89
Q

Exercise as an adjunct for alcohol dependence tx

A

Superior for drinking volume + aerobic fitness
No difference in binge drinking

90
Q

What are cravings

A

Strong desires, urges or compulsion to drink
Triggered by a conditioned response to cues associated with drinking
Lead to alcohol seeking behaviour + associated with relapse

91
Q

Exercise and cravings

A

Exercise may provide a distraction + alleviate negative mood states that can precipitate drinking

Study comparing exercise, active control eg colouring + passive control
Cravings significantly lower than in passive control
Mood Inc after exercise + active control

92
Q

WHO mental health definition

A

A state of wellbeing in which the individual regocnices their abilities, can cope with normal Stresses of life, work productively + fruitfully + is available to make a contribution to their community

93
Q

NHS Stepped care model

A

Step 5 - crisis inpatient
Step 4 - Specialist, high intensity intervention
Step 3 - High intensity, intervention, evidence-based formal therapy
Step 2 - Low intensity interventions, such as facilitatedself-help, Psycho-education, and CBT
Step 1 - Recognition of a common mental health problem by GP or self

94
Q
  1. Elements to diagnose severe mental illness
A

Diagnosis - Psychosis, bipolar, personality disorders
Disability - Disorder causes significant disability
Duration - At least two years

95
Q

Mental Illness, incidence

A

1 in 5 adults experience mental illness
1 in 24 SMI
1 in 12 substance misuse

96
Q

Aetiology of mental health difficulties

A

Indicator Of psychological distress
Adverse Childhood experiences and trauma
Societal Contributers to inequality, poverty, racism, discrimination
Genetic + environmental vulnerabilities

97
Q

Physical health inequalities in severe mental illness

A

15 - 20yrs earlier death
Multi morbidity common
Deprived areas Increased physical and mental health problems

98
Q

Antipsychotic side-effects

A

Weight gain
High BP
high cholesterol
High blood sugar
Sedation
Agitation
Dec sleep

99
Q

What Should interventions to improve physical health in SMI include

A

Integrated care and joined up systems
Address Multiple risk behaviours at once

100
Q

Difficulties In SMI. Interventions to improve physical health.

A

Often Have poor self management
None compliance
Difficulty accessing treatment

101
Q

Benefits Of physical activity in SMI

A

Tend to engage in less physical activity from the general population
Improvements In weight cardiovascular fitness and BMI
Improved Quality of life and social functioning
Decrease In depressive and psychotic symptoms

102
Q

European psychiatry, research guidelines

A

Focus On implementation and culture in clinical practice
Examine Effects of interventions to decrease sedentary behaviour and increase physical activity
Undertake Long-term and cost effectiveness analysis of physical activity interventions

103
Q

European psychiatry, practice guidelines

A

Use physical activity as a treatment for mild to moderate depression and to improve physical fitness
Use as an adjunct for schizophrenia spectrum disorders to improve symptoms, cognition and quality of life
Use To improve physical health
Screen For physical activity, habits in primary and secondary care

104
Q

Barriers in SMI

A

Low mood
Stress
Lack support.
Lack energy
Poor physical health
Low motivation

105
Q

Reasons to exercise in SMI

A

lose/maintain weight + fitness
Mx mood
Dec stress
Inc physical health
Inc sleep
Overall mental health Mx

106
Q

Motivations to exercise is SMI

A

Used self determination theory
People with affective disorders had higher levels of introjected regulations compared to people with schizophrenia
No difference for other motivational regulations

Suggests autonomous motivation may be important for adoption + maintenance of health behaviours

107
Q

Trauma informed PA

A

85% people on secure wards experienced trauma - important to recognise complexity

Need to feel safe emotionally + physically
Good communication
Modifications and adaptations
Instructor training and qualifications

108
Q

Sedentary behaviour + mental illness

A

Secure wards are very sedentary

Interruptions to sitting time have positive physical health benefits but little research into mental health benefits

109
Q

Are there downsides to exercise in SMI

A

mania some types exercise may make symptoms worse - eg football

110
Q

SMI + PA in secure services

A

Average length stay 18-24 months
Little PA average 775.54 mins stationary

111
Q

Why is there so little physical activity on secure ward

A

Individual- Sx, med S.E, lack motivation
Social - no one else exercising, staff risk adverse
Physical environment- may not have facilities
Organisational - no routine, appointments etc can be at any time

112
Q

Measuring PA in secure ward

A

Accelerometry- accurate but limited access + expensive
Self report - issues accentuated in SMI
SIMple physical activity questionnaire

113
Q

Describe MULTI study for PA in secure hospitals

A

Intervention includes multiple components- diet, PA, psycho education
Used qualified professional + required culture change for Mx
Study 1 18 months with inpatients>1yr,
Improved total activity , BMI, Waist circumference, HDL cholesterol

114
Q

MULTI study barriers

A

Programme complexity
Lack of time

115
Q

MULTI study facilitators

A

Positive attitudes of staff + patients
Strong commitment
Ownership towards multi

116
Q

What is the ‘move it ‘ toolkit

A

Mandatory staff training module for psych ward staff, to improve knowledge of PA on mental health
Result of a paper commissioned by MRC for development of complex interventions

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