Browsing by Author "Mason, Julia Elizabeth"

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Open Access
Can Cognitive Behavioural Techniques Reduce Exercise Anxiety and Improve Adherence to a Resistance Training Program for People with Anxiety-Related Disorders?
(Faculty of Graduate Studies and Research, University of Regina, 2021-04) Mason, Julia Elizabeth; Asmundson, Gordon J.G.; Hadjistavropoulos, Heather; Wright, Kristi; Neary, Patrick; Stewart, Sherry
Anxiety-related disorders (ARDs) are highly prevalent and associated with substantial functional impairment, including poor health outcomes and economic burden. Exercise is a cost-efficient alternative to other treatments for ARDs (e.g., psychotherapy, pharmaceutical) that is also associated with health benefits. Several exercise modalities, including resistance training (RT), have demonstrated efficacy at reducing symptoms of ARDs; however, there are challenges associated with effectively implementing such protocols, most notably, exercise avoidance or early discontinuation. Researchers have identified exercise anxiety (i.e., exercise-related worries, fear of exercise-related physical sensations, and anxiety-driven exercise-related behaviours) as a contributor to exercise avoidance for people with ARDs. Consequently, exercise-based interventions for people with ARDs may need to include strategies for helping these individuals cope with exercise anxiety to facilitate long-term exercise engagement. Cognitive-behavioural techniques (CBT), such as cognitive restructuring and exposure, can alter maladaptive thinking and behavioural patterns associated with ARDs. Teaching people how to apply CBT techniques to manage their exercise anxiety could improve both the efficacy and effectiveness of exercise-based interventions; however, research has not been conducted to test this hypothesis. The primary purpose of this randomized controlled trial (RCT) was to examine the effects of combining select modules from a transdiagnostic iteration of CBT with a RT program for people with ARDs. Primary outcomes included changes in exercise anxiety, disorder-specific anxiety-symptoms, exercise behaviour, physical activity, and general psychological distress. This RCT also evaluated potential predictors of exercise frequency. A total of 59 physically inactive (i.e., not meeting Canada’s Physical Activity Guidelines) participants who met Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria for at least one anxiety disorder, obsessivecompulsive disorder, or posttraumatic stress disorder were recruited. Participants were randomized into either RT + CBT, RT, or waitlist (WL). Each condition consisted of a month-long active phase and a three-month-long follow-up phase. During the active phase, participants in both RT groups received and followed a program supported by a certified personal trainer. This program consisted of three weekly RT sessions. During the active phase, participants in the RT + CBT group also met weekly with a clinical psychology doctoral student to learn CBT techniques. Primary measures were assessed at baseline, weekly during active phase, and at 1-week, 1-month, and 3-month follow-ups. Multilevel modelling was used for all analyses. Findings showed that as compared to both WL and RT, RT + CBT was associated with significantly greater reductions in disorderspecific symptoms, increased exercise behaviour and vigorous physical activity, and improved exercise self-efficacy. Comparable improvements in exercise anxiety and exercise motivation were noted for both RT and RT + CBT participants. In addition, exercise anxiety was identified as the best predictor of exercise frequency. This RCT is the first to evaluate strategies for helping people with ARDs exercise. Findings indicate both RT and RT + CBT can reduce exercise anxiety; however, the addition of CBT techniques may help facilitate improvements in exercise self-efficacy, reductions in disorder-specific anxiety, and increases in long-term exercise behaviour and vigorous physical activity. These techniques may be useful for researchers and clinicians alike in supporting individuals with ARDs interested in using exercise to cope with anxiety. Keywords: randomized controlled trial, anxiety-related disorders, resistance training, cognitive behavioural techniques, Unified Protocol, exercise adherence, physical activity.
Open Access
A Single Bout of Sprint Interval Training or Continuous Moderate Intensity Training for Reducing Anxiety Sensitivity: A Randomized Controlled Trial
(Faculty of Graduate Studies and Research, University of Regina, 2017-08) Mason, Julia Elizabeth; Asmundson, Gordon J.G.; Hadjistavropoulos, Heather; Wright, Kristi; Sabourin, Brigette
Anxiety sensitivity (AS) is the fear of arousal related sensations based on the belief that these sensations may have harmful or negative consequences, such as death, insanity, or social rejection (Reiss & McNally, 1985). Significant reductions in AS have been observed following as little as one session of moderate intensity exercise (Broman-Fulks et al., 2015); however, the effect of high intensity exercise on AS has not yet been investigated. Reductions in AS are associated with successful treatment outcomes in clinical populations, as well as a decreased risk of developing mental disorders in nonclinical populations (Schmidt, Keough, Timpano, & Richey, 2008). Treatments capable of reducing AS may have broad and important implications for the prevention and treatment of a range of mental disorders, especially the anxiety and mood disorders. This randomized controlled trial was designed to examine the effect of different levels of exercise intensity (i.e., moderate and high) on reductions in AS following a single session of exercise. A total of 56 participants attending an in-lab session were randomized into either a 10-minute sprint interval training group (SIT), a 50-minute moderate intensity continuous training group (MICT), or a waitlist control group. All participants completed self-report psychological measures, including a measure of AS, prior to and following completion of their assigned exercise session. Follow up measures were administered at 3 and 7 days after the in-lab session. Hierarchical linear modeling was used to evaluate whether the two exercise protocols were efficacious at reducing AS, symptoms of depression, intolerance of uncertainty, and distress intolerance, and if so, whether one protocol was more efficacious than the other. The results of this study show that although both protocols significantly reduced AS, effects were attributable to significant reductions across the different dimensions of AS. Specifically, for the SIT group, significant reductions in AS were observed only on the Physical Concerns subscale, but not on the Social or Cognitive Concerns subscales. Conversely, for the MICT group, significant reductions were only observed on the Social and Cognitive Concerns subscales, but not on the Physical Concerns subscale. Significant reductions in symptoms of depression, intolerance of uncertainty, and distress intolerance were not observed following either exercise protocol. The current trial is the first to present evidence regarding the effect of SIT on features of psychological wellbeing. Findings that SIT and MICT target different dimensions of AS could allow for increased flexibility when tailoring specific exercise recommendations to individuals. Additionally, given that lack of time is frequently reported as a barrier to exercising regularly (Trost, Owen, Bauman, Sallis, & Brown, 2002), findings that SIT reduces overall AS to a similar extent as MICT in a fraction of the time, could also assist the refinement of exercise strategies for improving psychological wellbeing and increasing overall exercise adherence. Keywords: randomized controlled trial, anxiety sensitivity, sprint interval training, moderate intensity continuous training, high intensity interval training