Acute exercise effects on worry, state anxiety, and feelings of energy and fatigue among young women with probable Generalized Anxiety Disorder: A pilot study
Introduction
Among young adult women with Generalized Anxiety Disorder (GAD), evidence supports the effects of exercise training on clinical severity (Herring, Jacob, Suveg, Dishman, & O'Connor, 2012), worry, anxiety, and feelings of energy and fatigue, (Herring, Jacob, Suveg, & O'Connor, 2011), dimensions of sleep quality and quantity (Herring, Kline, & O'Connor, 2015), and health-related quality of life (Herring, Johnson, & O'Connor, 2016). Improved signs and symptoms of GAD, including anxiety, worry, and feelings of energy and fatigue, have been reported following as few as two weeks of exercise training involving the collective effects of three bouts of exercise (Herring et al., 2011). However, less is known about the effects of a single bout of exercise among individuals with GAD and, in particular, subclinical levels of GAD (i.e., elevated worry, the hallmark of GAD). Given that individuals who display elevated symptom scores are more likely to develop clinically significant psychopathology (Ruscio et al., 2007, Wolitzky-Taylor et al., 2014), investigating exercise effects on worry and other key outcomes in the symptom profile of GAD, including state anxiety and feelings of energy and fatigue, among individuals with emerging symptoms of GAD may be particularly important. However, the effects of a single bout of exercise among individuals with elevated worry scores indicative of GAD are not yet known.
GAD is more prevalent among women (Bandelow and Michaelis, 2015, Remes et al., 2016), and women have a higher likelihood of reporting GAD symptoms shown to be improved by exercise (i.e., fatigue, irritability, muscle tension, and somatic symptoms) (Herring et al., 2011, Steiner et al., 2005, Vesga-López et al., 2008). The limited available evidence of exercise effects among individuals with GAD has supported positive benefits for young women with GAD. Recent evidence also supported moderate-to-large reductions in feelings of fatigue, total mood disturbance, and state anxiety and increases in feelings of energy following acute exercise in young adult women (McDowell, Campbell, & Herring, 2016). Thus, the authors’ reasoned that females with elevated worry indicative of GAD may be particularly likely to benefit from a single bout of vigorous intensity aerobic exercise.
Additionally, very little is known about potential moderators of response to acute exercise. Identifying predictors/correlates of outcome responses to acute exercise has implications for the future development of both acute and chronic exercise protocols. Thus, the objectives of this study were to: (1) test the effects of acute aerobic exercise compared to quiet rest on worry, state anxiety, and feelings of energy and fatigue, and, (2) explore potential moderators of response among young women with worry scores indicative of GAD. The authors hypothesized that, compared to quiet rest, an acute bout of aerobic exercise would significantly improve worry, state anxiety, and feelings of energy and fatigue among young women with worry indicative of GAD.
Section snippets
Design & participants
The study protocol was approved by the University's Research Ethics Board. Prior to participation, interested potential participants provided written informed consent and completed a medical history screening questionnaire that included the Physical Activity Readiness Questionnaire. Seventeen young adult women, aged 20.8 ± 1.4y, were recruited from the university and surrounding populations as part of ongoing recruitment for a series of acute exercise studies. Of 85 consecutively recruited
Baseline characteristics, associations, and differences based on high trait anxious, depression, and poor sleep status
Baseline participant characteristics are presented in Table 1, and Table 2 presents baseline associations between participant characteristics and outcomes. Significant moderate-to-large, positive associations were found between worry and worry engagement, absence of worry, trait anxiety, depressive symptoms, and sleep quality (all p < 0.05), between worry engagement and depressive symptoms, absence of worry, state anxiety, and sleep quality (all p < 0.05), between absence of worry and
Discussion
The primary findings of this pilot study were that, compared to 30 min of quiet rest, a 30-minute bout of aerobic exercise completed at an average intensity of 73%HRR significantly improved worry engagement, state anxiety, and feelings of energy and fatigue. Statistically nonsignificant improvements were also observed for total PSWQ worry score. The magnitude of improvements ranged from moderate to large, and is consistent with previously reported effects of acute exercise on mood states among
Conclusions
The present findings provide support for the positive effects of acute aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young women with elevated worry indicative of GAD. Future research can benefit from larger sample sizes that compare equal distributions of female and male participants, comparisons of varying degrees of subclinical and clinical GAD severity, and the comparison of multiple exercise modes. The examination of plausible cognitive or biological
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