Satisfaction with physical activity is known to be an important factor in physical activity maintenance, but the factors that influence satisfaction are not well understood. The purpose of this study was to elucidate how ongoing experiences with recently initiated physical activity are associated with satisfaction. Participants (n = 116) included insufficiently active volunteers who initiated a self-directed physical activity regimen and completed daily diaries about their experiences for 28 days. We used multilevel models to examine the associations between experiences with physical activity and satisfaction. Significant between-person effects demonstrated that people reporting higher average levels of positive experiences and lower levels of thinking about the negative aspects of exercise were more likely to report higher levels of satisfaction (ps < .05). Positive experiences and perceived progress toward goals had significant within-person effects (ps < .01), suggesting that day-to-day fluctuations in these experiences were associated with changes in satisfaction. These findings elucidate a process through which people may determine their satisfaction with physical activity.
Although cross-sectional and retrospective, this study provides support that greater cognitive ability, specifically verbal learning, along with self-reflectiveness, may confer elevated risk for more severe suicidal ideation and behavior in an independent fashion. Interestingly, poorer problem-solving was associated with aborted suicide attempts.
Objective
The aims were to predict cognitive therapy (CT) noncompletion and to determine, relative to other putative predictors, the extent to which the patient skills in CT for recurrent major depressive disorder predicted response in a large, two-site trial.
Method
Among 523 outpatients aged 18-70, exposed to 12-14 weeks of CT, 21.6% dropped out. Of the 410 completers, 26.1% did not respond. To predict these outcomes, we conducted logistic regression analyses of demographics, pre-treatment illness characteristics and psychosocial measures, and mid-treatment therapeutic alliance.
Results
The 17-item Hamilton Rating Scale for Depression (HRSD17) scores at entry predicted drop-out and nonresponse. Patients working for pay, of non-Hispanic white race, who were older, or had more education were significantly more likely to complete. Controlling for HRSD17, significant predictors of nonresponse included: lower scores on the Skills of Cognitive Therapy-Observer Version (SoCT-O), not working for pay, history of only two depressive episodes, greater pre-treatment social impairment. Mid-phase symptom reduction was a strong predictor of final outcome.
Conclusions
These prognostic indicators forecast which patients tend to be optimal candidates for standard CT, as well as which patients may benefit from changes in therapy, its focus, or from alternate modalities of treatment. Pending replication, the findings underscore the importance of promoting patients’ understanding and use of CT skills, as well as reducing depressive symptoms early. Future research may determine the extent to which these findings generalize to other therapies, providers who vary in competency, and patients with other depressive subtypes or disorders.
Objective
People with depressive symptoms typically report lower levels of exercise self-efficacy and are more likely to discontinue regular exercise than others, but it is unclear how depressive symptoms affect people’s exercise self-efficacy. Among potential sources of self-efficacy, engaging in the relevant behavior is the strongest (Bandura, 1997). Thus, we sought to clarify how depressive symptoms affect the same-day relation between engaging in exercise and self-efficacy during the initiation of regular exercise.
Methods
Participants (N=116) were physically inactive adults (35% reported clinically significant depressive symptoms at baseline) who initiated regular exercise and completed daily assessments of exercise minutes and self-efficacy for four weeks. We tested whether (a) self-efficacy differed on days when exercise did and did not occur, and (b) the difference was moderated by depressive symptoms. Mixed linear models were used to examine these relations.
Results
An interaction between exercise occurrence and depressive symptoms (p<.001) indicated that self-efficacy was lower on days when no exercise occurred, but this difference was significantly larger for people with high depressive symptoms. People with high depressive symptoms had lower self-efficacy than those with low depressive symptoms on days when no exercise occurred (p=.03), but self-efficacy did not differ on days when exercise occurred (p=.34).
Conclusions
During the critical period of initiating regular exercise, daily self-efficacy for people with high depressive symptoms is more sensitive to whether they exercised than for people with low depressive symptoms. This may partially explain why people with depression tend to have difficulty maintaining regular exercise.
Physical activity (PA) interventions have a clear role in promoting mental health. Current PA guidelines directed toward specific PA intensities may have negative effects on affective response to exercise, and affective response is an important determinant of PA adherence. In this randomized trial of 67 previously inactive adults, we compared the effects of a PA prescription emphasizing the maintenance of positive affect to one emphasizing a target heart rate, and tested the extent to which the effect of the affect-guided prescription on PA is moderated by cardiorespiratory fitness (CRF). We found the effect of an affect-guided prescription was significantly moderated by CRF. At one week, for participants with lower CRF (i.e. poor conditioning), the affect-guided prescription resulted in significantly greater change in PA minutes (M = 240.8) than the heart rate-guided prescription (M = 165.7), reflecting a moderate-sized effect (d = .55). For those with higher CRF (i.e. good conditioning), the means were in the opposite direction but not significantly different. At one month, the same pattern emerged but the interaction was not significant. We discuss the implications of these findings for the type of PA prescriptions offered to individuals in need.
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