Physical Activity Psych Exam 2 pt 2

Depression

mood disorder characterized primarily by depressed mood or loss of interest and pleasure

mood disorders

major depressive disorder (mdd)

bipolar disorder

dysthymia

cyclothymia

DSM-V for MDD

have to have either point 1 or 2 and 4 other symptoms to be diagnosed

DSM-V for MDD point 1

depressed mood most of the day, nearly every day

DSM-V for MDD point 2

diminished interest/pleasure in all or most activities

bipolar disorder

one or more episodes of mania or mixed episodes of mania and depressions

`dysthymia`

chronic form of depression, fewer than 5 symptoms required for DSM-V for MDD

dysthymia prevlence

2x more likely in women

dysthymia duration

\~ 2 years in adults and 1 in children

cyclothymia

more mild form of BPD

marked by manic and depressive states

MDD prevalence

2016: 6.7% adults had 1+ major depressive episodes

women 2x more likely than men

MDD comorb. and mortality

cognitive impairment

poor quality of life

MDD and chronic disease

increased risk for: CVD, type 2 diabetes, alcohol and drug abuse, obesity, suicide

suicide

10th leading cause of death in the US

suicide rates

men (4x women)

non-hispanic american indian/ alaska native

85+

what causes depression

complex and varying psychological and physiological etiologies

factors associated with depression

biological differences

neurotransmitters

hormones

genetics

life events

early childhood trauma

brain and depression

prefrontal cortex, hippocampus, and amygdala

depressed brain

prefrontal cortex an hippocampus volume decrease

amygdala volume increasees

depression psychotherapy

regular meetings with licensed professional- finding ways to cope and the issues

depression medication

selective serotonin reuptake inhibitors (SSRIs)

monoamine oxidase inhibitors (MAOs)

other depression treatments

eletctroconvulsive therapy (ECT)

transcranial magnetic stimulation (TMS)

bright light therapy

keto

PA as depression prevention

25-40% lower odds of depressive symptoms in active people

15-25% after adjustments

fitness as depression prevention

risk reduction of 31% men and 44% women with mod CRF

risk reduction of 51% men and 54% women with high CRF

PA as treatment for depression

exercise is associated with reduction of mild-moderate depression

DOSE study

public health dose of PA effective for treating mild-moderate MDD (adults, age 20-45)

SMILE study

aerobic exercise as effective as drug treatment in adults 40+ with MDD

TREAD study

exercise viable treatment for adults with MDD that dont respond to drugs (18-75)

prevention

regular PA protects against onset of depressive symptoms and MDD

treatment

PA programs reduce depressive symptoms in people diagnosed as depressed

psychological mediators

time-out hypothesis

mastery hypothesis

affect regulation hypothesis

social interaction hyopthesis

physiological mediators

endorphin hypothesis

monoamine hypothesis

increase in growth factors

increased hippocampal neurogenesis

decreased cortisol

serious mental illness

one or more mental, behavioral, or emotional disorders resulting in serious functions impairment, which substantially interferes with or limits one or more major life activities

schizophrenia

delusions, hallucinations, disorganized speech and behavior, and other symptoms that cause social or occupational dysfunction

schizophrenia DSM-V criteria part 1

two or more of the following during a 1-month period:

delusions

hallucination

disorganized speech

grossly disorganized or catatonic behavior

negative symptoms

schizophrenia DSM-V criteria part 2

one or more major areas of functioning are markedly below the level achieved prior to onset

schizophrenia DSM-V criteria part 3

duration of at least 6 months- with at least 1 month period of symptoms

schizophrenia prevalence

\~2.4 mil affected

worldwide: \~ 0.5%- 1.0%

genders affected equally

schizophrenia possible predictors- genetics

occurs in 10% of people with first degree relative with schizophrenia

occurs in 40-65% people who have identical twin with disorder

schizophrenia possible predictors- environment

genetics-environment interaction

schizophrenia possible predictors- brain chemistry & structure

imbalance in neurotransmitters

larger ventricles, less grey matter, smaller hippocampal volume, less activity

schizophrenia possible predictors- others

complication of pregnancy & births

underweight during adolescence

older age of father

taking psychoactive of psychotropic drugs in teen years and young adulthood

schizophrenia treatment options

antipsychotic medications:

typical- first generation 1950s

atypical- second generation 1990s

psychosocial treatments

mechanisms of PA and schizophrenia

increase neurotransmitters

change in brain structure

social support

self-efficacy

mastery

distraction

sheewe 2013 premise

increased mortality in schizophrenia caused largely by lifestyle factors and med side-effects

sheewe 2013 study purpose

examine the side effect of exs vs OTsheewe 2013 premise on mental and physical health

sheewe 2013 study design

single blind, randomized controlled

supervised exs vs OT

sheewe 2013 participants

63 people

stable on antipsychotic meds

sheewe 2013 primary measures

mental health: psychiatric symptoms, depression, need of care

physical health: cardiorespiratory fitness, BMI, body fat %, metabolic syndrome

sheewe 2013 exercise intervention

1 hour supervised exercise, 2x week for 6 months

increase in intensity 45% HRR → 65% HRR → 75%HRR

CVS exercise- mostly

sheewe 2013 occupational therapy

1 hour, 2x week for 6 mths

creative and recreational activities

sheewe 2013 MH intention-to-treat

no difference in psychiatric symptoms or need of care

trend level effect on depressive symptoms

sheewe 2013 MH per protocol

sig. decreases in psychiatric symptoms -20.7% vs + 3.3%, depressive symptoms

sig. reduction in need of care

sheewe 2013 PH per protocol

CRF: sig increases in Wpeak and trend-level increases in VO2peak

trend-level improvement in trigly

sheewe 2013 PH intention-to-treat

CRF: sig. increases in Wpeak, VO2peak

no sig effect on secondary measures

cognitive function

the process whereby an individual perceives, recognizes and understands thoughts and ideas

executive functioning

processes that control cognitive functions toward goal-directed behavior

epidemiological studied

sofi et al- 2011

higher PA levels → 38% lower probability of cognitive decline

low to moderate PA levels → 35% lower probability of cognitive decline

school-based studies

CDC (2010): school-based physical activity → greater performance

experimental studies

Kramer et al (1999)

older adults and aerobic exercise program

exercise group: increased CVS fitness, increased performance on cognititve tasks controlled by prefrontal and frontal cortex

selective improvement hypothesis

exercise improves aspects of cognitive function differently

exercise has greatest benefit on executive functioning (goal-directed behaviors)

cardiovascular fitness hypothesis

physical activity → fitness → cognitive function

improved oxygen transport and metabolism

more efficient neurotransmitter function

cerebrovascular reserve hypothesis

enhance cognitive function is mediated by better circulation in the brain

better cerebral blood flow + more blood in brain tissues in resting stated + enhanced ability to respond to stimuli

molecular mechanisms

exercise increases internal growth factors: brain derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1)

cellular mechanisms

exercise increases neuroplasticity = capacity to grow new neurons and strengthen synapses

neurogenesis

birth of new neurons in hippocampus

synaptogenesis

building more synapses and making existing synapses stronger

peripheral (indirect) mechanisms

exercise improves: body composition, blood lipid levels, blood pressure, insulin sensitivity, glucose tolerance, reduces inflammation

normal cog changes with age

slower behvaior

attention, language, thinking and planning processes disrupted

memory processes disrupted

normal anatomical changes with age

frontal and temporal lobes atrophy: loss of dendrites and synapses

brain weight decreases: gray and white matter loss

alzheimer’s disease (AD)

loss of cognitive function and behavioral abilities

mild cognitive impairment (MCI)

usually begin in the 60s

irreversible and progressive neurodegenerative disease

widespread neuronal cell death

hallmarks of AD

beta amyloid plaques

tau neurofibrillay tangles- dead nerve cells tangling

cell death (atrophy)

acetylcholine deficits- production decreases

PA and AD

strong evidence

more PA associated with reduced risk of developing cognitive impairment

cognitive functioning in children

time for brain development and cognitive maturation

cognitive performance and academic performance are important at youth ages

PA and cognition in children

largest effects on executive function, attention, and academic achievement

emotional well-being

greater amount of positive affect than negative affect

emotional well-being and PA

exercise reduced :( emotions

exercise increases :) emotions

exercise also improves cognitive function

emotion

immediate and brief response to a specific stimulus that requires cognitive imput

cause usually ided

more intense and variable than mood

emos can impact mood

mood

affective state influenced by overall disposition and by emotions

cause not always ided

can alter way we process information

affect

more general “valenced” response

reflexive (no cognitive input)

valenced and activation

circumplex model of affect

2 dimensions

4 quadrants

2 dimensions of the CMA

valance anf activation

4 quadrants

pleasant-activation

pleasant-unactivated

unpleasant-unactivation

unpleasant-activated

pleasant-activation

high-activation, pleasant affect

pleasant-unactivated

low-activation, pleasant affect

unpleasant-unactivation

low activation, unpleasant affect

unpleasant-activated

high-activation, unpleasant affect

post moderate exercise

positive affects increases

negative affects is either unchanged or reduced

post high intensity exercise

less fit people: negative affect may increase, positive affect decreases

more fit people: still see increase in positive affect

in-task exercise response

people feel better after exercise, but its how they feel during exercise that may be part of the problem

in-task exercise research

feeling scale ratings negatively related to HR & lactate while running

exs below the ventilatory threshold impreoved mood 20 in and remained elevated

exs at vent thresh worseed mood 10 min in and remained low until recovery

in-task exercise general conclusion

affect gets progressively more negative as exercise intenstiy increases, thus moderate intensity exercise generally results in more positive affective changes

staleness syndrome

increased negative mental health (depression, anxiety, fatigue, reduced energy) and poor performance

primary exercise dependence

exercise is an end in itself

exercise is the end goal

secondary exercise dependence

exercise is used exclusively to control body composition

best exercise for wellbeing

intensity: mod

frequency/ duration: don’t over do it

mode: aerobic

health-related quality of life

reflects on the goodness of those dimensions of life that can be affected by health and by health intervention

dimensions of HRQoL

physical functioning

emotional functioning and well-being

social functioning

cognitive functioning

health status

HRQoL and exercise

treatment effectiveness

important benefit of exercise

prescribing exercise

HRQoL objective measures

made by someone other than the patient

quantitative

measure overall HRQoL or individual components

QALY