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

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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