The Efficacy of Aerobic Exercise and Resistance Training for Anxiety-Related Disorders and Constructs: A Randomized Controlled Trial

Abstract

Anxiety-related disorders are highly prevalent and comorbid, affecting nearly one third of individuals over their lifetime. Evidence suggests that anxiety-related disorders share common etiology, latent structure, higher-order dimensions, and response to treatment. These similarities have fostered the development of transdiagnostic treatments that can effectively target a relatively wide array of anxiety-related psychopathological concerns and can also be widely and efficiently disseminated to individuals in need treatment. There is empirical evidence to support the use of physical activity, primarily aerobic exercise, as an effective intervention to treat a variety of mental health concerns; however, what effect exercise has on anxiety-related disorders and constructs (e.g., anxiety sensitivity) using an integrative, transdiagnostic approach is unknown. Therefore, the purposes of the current trial were: (1) to quantify the effects of aerobic exercise and resistance training on symptoms of anxiety-related disorders and constructs, (2) to evaluate whether both modalities of exercise were equally efficacious in reducing such symptoms, and (3) to determine whether exercise enjoyment and pre-intervention physical fitness were associated with symptom reduction. A total of 48 individuals with anxiety-related disorders were randomized to one of three conditions: aerobic exercise, resistance training, or a waitlist control. Symptoms of anxiety-related disorders, related constructs (i.e., general psychological distress, depression, anxiety, stress, anxiety sensitivity, distress tolerance, intolerance of uncertainty), and exercise enjoyment were assessed at pre-intervention and weekly during the 4-week intervention. Participants were further assessed 1-week and 1-month post-exercise. Both aerobic exercise and resistance training were efficacious in improving disorder status. Additionally, aerobic ii exercise was efficacious in improving general psychological distress and anxiety, while resistance training was efficacious in improving disorder-specific symptoms, anxiety sensitivity, distress tolerance, and intolerance of uncertainty. For both types of exercise, lower pre-intervention physical fitness was associated with greater reductions in general psychological distress. For aerobic exercise, lower physical fitness was also associated with greater reductions in stress. Scores at follow-up were generally not significantly different when compared to post-intervention. Results highlight the efficacy of aerobic exercise and resistance training in uniquely addressing anxiety-related disorder symptoms and constructs. Keywords: randomized controlled trial; transdiagnostic; anxiety disorders; aerobic exercise; resistance training