H Van Coppenolle

Assessment of physical self-perceptions in normal Flemish adults versus depressed psychiatric patients

Abstract The purpose of this research was to investigate the reliability and validity of a Flemish version of the Physical Self-Perception Profile (PSPP). Males ( n =146) and females ( n =154) completed the PSPP and the Rosenberg Self-Esteem Inventory, and their scores were compared to those of 217 Flemish psychiatric patients (83 males, 134 females). Confirmatory factor analysis supported a three-component structure, due to the merging of the original sports competence and physical condition subscales (CFI=0.91 in males; CFI=0.90 in females). Partial correlation analysis supported the hierarchical structure of the PSPP. The new PSPP scales manifested strong internal consistency, and discriminated between normal adults and psychiatric patients (canonical r =0.44 for males, r =0.55 for females). It was concluded that the three-component PSPP can be considered as a reliable and valid instrument for measuring physical self-perceptions in normal Flemish adults and patients with mood disorders.

Relationships between self-perceptions and negative affect in adult Flemish psychiatric in-patients suffering from mood disorders

Abstract Objectives. To compare measures of physical self-perceptions and self-esteem of adult psychiatric patients suffering from mood disorders with norms of non-patients and to investigate the comparative influence of physical self-perceptions and self-esteem on indices of negative affect in these patients. Method. Cross-sectional. Adult psychiatric patients (53 males, 124 females), all with DSM-IV diagnosis of mood disorder and with elevated depression scores, completed the Physical Self-Perception Profile subscales assessing perceived sports competence and condition, body attractiveness, physical strength, and a domain scale of physical self-worth. Also assessed were global self-esteem, using the Rosenberg Self-Esteem Inventory, depression, with the Beck Depression Inventory, and anxiety with the State-Trait Anxiety Inventory. Results. Depressed patients scored significantly lower on physical self-perceptions and global self-esteem than non-patients, consistent with the symptomatology of depression and anxiety. Partial correlation analysis and path analysis indicated that physical self-perceptions explained a significant proportion of variance in negative affects ( R 2 from 0.37 to 0.49). With the exception of trait anxiety in male patients, direct pathways became non-significant when global self-esteem was added to the model. Model fit parameters using structural equation modelling indicated the superior fit of the indirect model with global self-esteem as a mediator. Conclusion. The relationship between physical self-perceptions and negative affect is mainly indirect and mediated by global self-esteem in mood disordered psychiatric patients. The Expanded Exercise and Self-Esteem Model, which includes physical self-perceptions and self-esteem estimates, might be considered as a valuable framework for furthering our understanding of the depression and anxiety reducing potential of exercise and physical activity in clinically depressed individuals.

The Meaning of Movement

The problem of the connection between psychological functioning and somatic process can be approached by studying the content of psychological experiences related to bodily processes. Movement, having

The effect of fitness training on clinically depressed patients: an intra-individual approach

Objectives. To use hierarchical class analysis (HICLAS) in a case study to offer insight into the effect of exercise on aspects of functioning of a depressed patient. Methods. Based on a retrospective interview with a 32-year-old depressed male patient, immediately preceding discharge from the hospital, a HICLAS grid analysis of interactions between relevant situations in the hospital, including different treatment components, and emotional and behavioural reactions is described and explained. Results and conclusions.Although there is no support for a direct antidepressant effect of fitness training, the results reveal that fitness training embedded in a cognitive-behavioural treatment program, is associated with positive changes in other relevant aspects of the patients’ functioning. This includes enhanced coping strategies, sustained efforts to continue activities, and improved awareness of physical well-being. Other therapeutic interventions and pharmacotherapy are associated with a more ambivalent reaction pattern of positive as well as negative emotional and behavioural characteristics. The present findings are discussed in light of the multidisciplinary approach to clinical depression. Furthermore, the application of intraindividual research methodology is highly recommended to complement more traditional research designs to investigate the effect of exercise on depressed patients, not least because new research hypotheses can be generated.  2003 Elsevier Ltd. All rights reserved.

The effectiveness of two psychomotor therapy programmes on physical fitness and physical self-concept in nonpsychotic psychiatric patients: a randomized controlled trial

Objective: To compare the changes in cardiorespiratory and muscular fitness, and the changes in physical self-concept after participation in one of two psychomotor therapy programmes in a sample group of psychiatric patients. To study the relationship between the changes in physical fitness and the changes in physical self-concept. Design: Randomized controlled parallel-group trial with repeated measures. Setting: Three treatment units of a university psychiatric hospital in Belgium. Subjects: One hundred and ninety-nine patients with severe symptoms of depression and/or anxiety, and/or personality disorders. Interventions: A general programme of psychomotor therapy, consisting of different forms of physical exercises and relaxation training, and a personalized psychomotor fitness programme, consisting of aerobic and resistance training. These programmes were followed three times a week for a period of 16 weeks. Outcome measures: The maximum dynamic strength, the strength endurance, physical work capacity at 60% and 80% of the estimated maximal heart rate reserve, and the physical self-concept by means of the Dutch version of the Physical Self-Perception Profile. Results: After eight weeks, both groups exhibited an improvement in muscular fitness (both p-values <0.0001), but only the psychomotor fitness group had improved in cardiorespiratory fitness (p < 0.01). After 16 weeks, the patients in the general programme of psychomotor therapy had not increased in cardiorespiratory fitness. At the end of the 16-week programmes, both groups showed a more positive physical self-concept (p from 0.01 to <0.0001). However, these improvements were not related to the progress in physical fitness. Conclusions: The main difference in the effectiveness of the two programmes was the increase in cardiorespiratory fitness in the psychomotor fitness group. The gains in fitness did not play an essential role in the enhancement of physical self-concept.

Changes in psychological well-being in female patients with clinically diagnosed depression: an exploratory approach in a therapeutic setting

The objective of this exploratory one-group pretest-posttest study was to evaluate the nature of psychological change in inward depressed psychiatric patients attending multi-disciplinary treatment, including physical activity, designed to improve mental well-being. Female depressed psychiatric patients (n = 51) were examined before and after this programme over a period of 3 months. The following psychological parameters were assessed: depression, anxiety, global self-esteem, and physical self-perceptions. Depressed patients demonstrated statistically significant improvements in depression, anxiety, global self-esteem and physical self-worth (t(50) ranging from −3.76 to 4.65, all p < 0.007; ES ranging from 0.53 to −0.65). Changes in depression and anxiety displayed a strong negative correlation with changes in global self-esteem, and those changes are independent of the initial severity of the depressive symptoms ( F(2,48) ranging from 0.03 to 0.70, n.s.). Patients with greater improvement in physical self-perceptions reported greater improvement anxious symptoms then patients who did not improve. Consequently, within the limitations of the research design it can be concluded that the programme appeared successful in improving psychological well-being in female depressed patients. Results also provide preliminary insight into the potential role of the physical self in recovery.

Assessing the additional impact of fitness training in depressed psychiatric patients receiving multifaceted treatment: a replicated single-subject design

Purpose: Exercise has been put forward as a therapeutic means for the treatment of clinical depression. Methods: In this study, 29 patients, all with diagnosed with mood disorder, completed daily measurements of depression and physical well-being during periods ranging from 77 to 436 days (M = 146.5). Fitness training was added to the treatment after a period and changes before (A-phase) and after (B-phase) the implementation of this training were the subject of investigation. Data were analysed by means of randomization tests with an AB-design and time-series analysis. Replication of the findings was investigated using Fishers multiplicative method. Results: Adding fitness training to the treatment of clinical depression does not systematically lead to changes in self-reported feelings of depression on top of benefits that may be due to other treatments. Conclusion: Since the present findings are not in agreement with previous studies, the absence of statistically significant changes in self-reported feelings of depression is discussed within the complexity of the ‘exercise – depression’ relationship in inpatient populations. These included the severity of their depression, the potential ceiling effect of a multifaceted treatment programme and the initial increase in depression due to the confrontational nature of the intervention.

Evaluation of cardio-respiratory fitness and perceived exertion for patients with depressive and anxiety disorders: a study on reliability

Purpose: The implementation of a physical reconditioning programme for patients with depressive and/or anxiety disorders requires a thorough evaluation of the physical fitness and the perceived exertion during exercise. This implies the use of reliable and clinically useful instruments. The present study examined the reliability of the Franz ergocycle test, as measure for cardio-respiratory fitness, and the Borg Category Ratio 10 Scale, as measure for subject-perceived exertion. Method: Sixty-eight hospitalized patients performed test and re-test of the Franz ergocycle test and the Borg CR 10 Scale with a between interval of 1 week. Results: The Physical Work Capacity 130 and the Physical Work Capacity 150, determined by the Franz ergocycle test, had a proper to good test-re-test reliability (r ranged from 0.74 to 0.90). The Borg Category Ratio 10 Scale had a moderate reliability (r ranged from 0.42 to 0.82). Conclusions: The Franz ergocycle test seems to be a reasonable reliable instrument for measuring physical work capacity of these patients. Possible explanations for the simply moderate reliability of the Borg Category Ratio 10 Scale could be the low level of physical activity prior to hospitalization, and the depressive and anxiety symptoms that might influence the perceived exertion.

Psychomotorische therapie en depressie: - een paradox?

De laatste decennia werden meerdere malen de gunstige effecten gerapporteerd van lichamelijke activiteit op psychologische determinanten van gezondheid zoals stemming, psychisch welbevinden en zelfwaardering. Onderzoek (bij een totaal van 2158 patienten) geeft aan dat regelmatige lichamelijke activiteit een bijdrage kan leveren aan de behandeling en de preventie van depressie. Een gebrek aan motivatie tot (lichamelijke) activiteit en een lage competentiebeleving zijn inherent aan de depressieve symptomatologie. Samen met het ontbreken van de nodige succeservaringen en positieve sociale feedback raken mensen daardoor vaak in een vicieuze cirkel van ‘depressie ’ lage competentiebeleving ’ inactiviteit’ (zie figuur 1). De laatste dertig jaar werd psychomotorische therapie geintegreerd in de biopsychosociale behandeling van depressieve patienten. Psychomotorische therapie beoogt onder meer door doelgerichte bewegingsactiviteiten deze vicieuze cirkel te doorbreken om zo het psychisch welbevinden en het gezondheidsgedrag van deze patienten positief te beinvloeden. In deze bijdrage komt de psychomotorische therapie binnen een cognitief-gedragstherapeutische setting aan bod. Vervolgens bespreken we de determinanten van participatie aan bewegingsactiviteiten, enkele algemene richtlijnen omtrent lichamelijke activiteit bij depressie, de interactie van psychomotorische therapie met andere behandelingsvormen en tenslotte de betekenis van lichamelijke activiteit in het kader van nazorg en preventie.