Category: Health Psychology / Behavioral Medicine - Adult

Symposium

Promoting Exercise and Enhancing Mood Through Brief Behavioral Activation Treatment

Saturday, November 18
8:30 AM - 10:00 AM
Location: Sapphire Ballroom O & P, Level 4, Sapphire Level

Keywords: Exercise | Depression | Behavioral Activation
Presentation Type: Symposium

Although cognitive-behavioral therapy (CBT) and antidepressants are efficacious first-line treatments for outpatients with major depressive disorder (MDD), up to 34% of patients do not respond to these treatments (Fava & Davidson, 1996), demonstrating the need for alternative interventions.  Randomized trials and meta-analytic summaries indicate that exercise is an efficacious intervention for MDD. Exercise has been shown to be effective in combination with CBT for anxiety (Merom et al., 2008) and with behavioral activation (BA) for comorbid MDD and diabetes (Schneider et al., 2016). Brief BA for depression (BATD) offers an ideal format for enhancing adherence to an exercise regimen through activity scheduling, which has been shown to reduce depression symptoms with similar effect sizes to CBT and antidepressants. The current study examined the effects of an exercise augmentation to BATD for maximizing mood enhancement through exercise promotion. 


A total of 31 depressed, sedentary patients (Mean age = 34 ± 13 years, 78% female) were randomized to receive up to 9 sessions of BATD in combination with either an exercise (n = 15) or stretching (n = 16) augmentation. BATD sessions included identifying valued activities, scheduling activities, and problem-solving. The augmentation strategies involved 6 weekly 30-min sessions in which participants planned exercise/stretching for the week and received motivational interventions (Otto & Smits, 2011). 


Results of mixed effects linear regression models indicated that patients significantly improved on all outcome measures (depression, disability, and quality of life) over time regardless of randomized augmentation condition (all p < 0.004). All patients also completed more exercise over time, regardless of augmentation condition (p = 0.008, d = 0.76). Degree of exercise completed was predictive of greater mood improvement (p = 0.006, d = 0.75). Hence, an additional specific exercise prescription may not be necessary when completing BATD as BATD provides a built-in structure for enhancing motivation for exercise. Considerations for future research as well as other clinical implications will be discussed.

Kristin L. Szuhany

Graduate Student
Montefiore Medical Center

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