Psychology of Physical Activity

Determinants, Well-Being and Interventions

Stuart Biddle, Nanette Mutrie, Trish Gorely, Guy Faulkner, Stuart J. H. Biddle

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000367553
• Edition: 4
• Topic: Psychology
• Subtopic: Pediatric Medicine
• Index: Psychology

The positive benefits of physical activity for physical and mental health are now widely acknowledged, yet levels of physical inactivity continue to be a major concern throughout the world. Understanding the psychology of physical activity has therefore become an important issue for scientists, health professionals and policy-makers alike as they address the challenge of behaviour change. Psychology of Physical Activity provides comprehensive and in-depth coverage of the fundamentals of exercise psychology, from mental health, to theories of motivation and adherence, and to the design of successful interventions for increasing participation.

Now publishing in a fully revised, updated and expanded fourth edition, Psychology of Physical Activity is still the only textbook to offer a full survey of the evidence base for theory and practice in exercise psychology, and the only textbook that explains how to interpret the quality of the research evidence. As the field continues to grow rapidly, the new edition expands the behavioural science content of numerous important topics, including physical activity and cognitive functioning, automatic and affective frameworks for understanding physical activity involvement, new interventions designed to increase physical activity (including use of new technologies), and sedentary behaviour.

A full companion website offers useful features to help students and lecturers get the most out of the book during their course, including multiple-choice revision questions, PowerPoint slides and a test bank of additional learning activities.

Psychology of Physical Activity is the most authoritative, engaging and up-to-date book on exercise psychology currently available. It is essential reading for all students working in behavioural medicine, as well as the exercise and health sciences.

Section II
Physical Activity and Mental Health

2 Physical Activity and Psychological Well-Being

A fundamental question in the psychology of physical activity is: ‘Does physical activity make you feel good?’ This topic is often reflected in the phrase ‘a healthy mind in a healthy body’ – a translation of the Latin phrase mens sana in corpore sano,attributed to theRoman poet Juvenal in the 1st and 2nd second century ad. The phrase has several interpretations, but the link between body and mind is a common one: the belief is that staying ‘fit and active’ will enable better mental health.

This chapter reviews the evidence on the relationship between participation in physical activity and psychological well-being (PWB) in a broad sense. Specifically, we review the areas of health-related quality of life, mood and affect, enjoyment, and sleep, as well as psychological well-being for women. Specifically, in this chapter we aim to:

• introduce the concept of health-related quality of life and how it is typically measured;
• review the evidence linking physical activity with measures of mood and affect, with an emphasis on effects from single bouts of exercise;
• highlight the construct of physical activity enjoyment and present three approaches to understanding this construct;
• highlight results on the effect of physical activity on sleep;
• discuss physical activity and psychological well-being for women.

A case is made in Chapter 1 for the diverse health benefits of a physically active lifestyle. However, although there is plenty of anecdotal support for the view that physical activity has positive effects on psychological well-being, the emphasis is often placed more firmly on the physical outcomes. For example, in the development of physical activity guidelines in the Netherlands, Weggemans et al. (2018) listed 12 physical chronic health conditions, 13 physical health/disease outcomes, but only 3 mental health-related conditions of interest for the appraisal of evidence.

Evidence on psychological well-being, however, is far from just anecdotal; there is a great deal of research linking physical activity to many elements of mental health (see Ekkekakis, 2013b). One example of growth is that there is now an academic journal – Mental Health and Physical Activity – devoted solely to this topic (see www.journals.elsevier.com/mental-health-and-physical-activity).

Historically, the publication of health-related documents in England by the government in the 1990s marked an important change in approach to health care and promotion and placed greater emphasis on aspects of well-being (Department of Health, 1993). For example, in the overall aims of the government’s Health of the Nation initiative was not only ‘adding years to life’ – reducing premature mortality and improving life expectancy – but also adding life to years, that is, improving quality of life. Similarly, the seminal Surgeon General’s Report on physical activity and health in the United States recognised the importance of physical activity for well-being as well as disease prevention (US Department of Health and Human Services, 1996). Later, a report by the four Chief Medical Officers of the UK on physical activity and health recognised the positive effects that physical activity can have on various elements of psychological well-being (Department of Health, 2011). More recently, in a summary of the health benefits of physical activity supporting the 2018 US guidelines for physical activity, 2 of the 6 key health-related benefits for young people, and 6 of 20 for adults and older adults, are psychological (Piercy et al., 2018).

The promotion of health through physical activity, therefore, now incorporates the recognition of the importance of psychological well-being. This recognition is important. The psychological benefits of physical activity may also serve as motivation for continued participation, necessary for physical health benefits to accrue. This chapter reviews the evidence on the links between physical activity and psychological well-being. A clear focus is on more generalised affective states or perceptions, with an emphasis on mood and ‘core’ affect from acute bouts of physical activity. More discrete forms of mental health – such as depression and self-esteem, and from longer-term (‘chronic’) involvement in physical activity – are dealt with elsewhere in the book (see Chapter 3, Chapter 4, Chapter 5 and Chapter 6). Specifically, in this chapter we review evidence concerning:

• health-related quality of life
• affective outcomes
• mood
• enjoyment
• sleep.

Health-Related Quality of Life

Perceived quality of life is a generic measure of well-being, including physical and psychological well-being. It is similar to the concept of ‘life satisfaction’. At this generic level it can include perceptions of health, well-being, personal circumstances, happiness, and even where you live (e.g., ‘liveability’). In most physical activity studies where quality of life has been measured it has usually been assessed as ‘health-related quality of life’ (HRQoL) (Focht, 2012), including ‘subjective well-being’.

Some have suggested a simple division of HRQoL into functional measures and those assessing perceptions of quality of life (Muldoon et al., 1998). The assessment of quality of life has become increasingly important because health economists use it to quantify the benefits of different approaches to treatment. The unit ‘quality adjusted life year’ (QALY) is used to estimate how much it would cost to improve someone’s quality of life or extend that person’s life with a new treatment.

Given the emphasis in HRQoL measures on functional status, it is not surprising that when this is included in physical activity studies, it has been in the context of special populations. These have included older adults (Elavsky & McAuley, 2013), those with a disability (dos Santos Delabary et al., 2018) or those with chronic conditions, including cancer and cardiovascular disease (e.g., Vallance et al., 2013). Focht (2012) concludes that findings “clearly demonstrate that exercise consistently results in … clinically meaningful improvements in a variety of quality-of-life outcomes” (p. 110). There is considerably less evidence concerning young people (e.g., Page et al., 2009) than adults (Marker et al., 2018). Rejeski et al. (1996) outline six types of HRQoL measure:

• global indices of HRQoL: these might include general life satisfaction, or self-esteem
• physical function: perceptions of function, physical self-perceptions, health-related perceptions
• physical symptoms: fatigue, energy, sleep
• emotional function: depression, anxiety, mood, affect
• social function: social dependency, family/work roles
• cognitive function: memory, attention, problem-solving.

Key Point: Health-related quality of life is a complex but important multifaceted outcome to be assessed in physical activity studies.

Key HRQoL measures include the SF-36 and the EQ-5D (Buxton et al., 1990, 1992; see also www.euroqol.org). The well-known SF-36 measure (also known as the SF-36 Health Survey and the RAND 36-item Health Survey) is a 36-item questionnaire designed to assess eight health dimensions covering functional status, well-being and overall evaluation of health (Dixon et al., 1994). It has a version for use in the UK as well as a short form (SF-12). The SF-36 assesses eight health concepts: general health perception; physical functioning; social functioning; role limitations due to physical problems; bodily pain; mental health; role limitations due to emotional problems; and vitality. It also has one item assessing perceptions of recent changes in health (Bowling, 1997).

The EQ-5D is used for quality of life and economic appraisal. It consists of two parts:

1. a 15-item instrument assessing self-description of perceived mobility (e.g., ‘I have some problems walking about’), self-care (e.g., ‘I have some problems washing and dressing myself’), usual activities (e.g., ‘I am unable to perform my usual activities’), pain/discomfort (e.g., ‘I have no pain or discomfort’) and anxiety/depression (e.g., ‘I am extremely anxious and depressed’);
2. a visual analogue scale ranging from ‘worst imaginable health state’ (score = 0) to ‘best imaginable health state’ (score = 100).

One global dimension of HRQoL is perception of life satisfaction. This might be particularly important for older adults if they experience physical and mental decline. Extensive research has been conducted on HRQoL outcomes in older adults involved in physical activity interventions. For example, in a five-year follow-up study, Elavsky et al. (2005) showed that positive self-efficacy, physical self-worth and affect resulting from enhanced levels of physical activity predicted life satisfaction after one year. Moreover, self-efficacy, physical self-worth and affect showed good stability over four years, and again predicted life satisfaction. The authors concluded that enhanced life satisfaction associated with physical activity is mediated by enhanced feelings of self-efficacy, physical self-worth and affect.

A systematic review by Bize et al. (2007) showed consistent positive associations between physical activity and HRQoL for cross-sectional studies. However, longitudinal, cohort and randomised controlled trial (RCT) designs were limited, and thus not allowing for a meaningful research synthesis. Focht’s (2012) review of exercise and HRQoL concluded that findings “clearly demonstrate that exercise consistently results in statistically significant, clinically meaningful improvements in a variety of quality-of-life outcomes” (p. 110). However, it was also noted that the field is highly complex, partly because of the many different conceptualisations of HRQoL and, subsequently, the diversity of measurement instruments used. Moreover, Focht has argued that we should not infer changes in HRQoL beyond the specific construct assessed. He concluded that “the effects of exercise on HRQoL are not consistent across all outcomes. Consequently, change in one particular index of HRQoL cannot be used to infer change in separate measures of HRQoL” (p. 112).

Affective Outcomes of Physical Activity

The affective reactions associated with physical activity have a potentially important role in physi...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of Figures
• List of Tables
• Preface
• Glossary
• Section I Introduction
• Section II Physical Activity and Mental Health
• Section III Physical Activity Correlates and Theories
• Section IV Physical Activity Behaviour Change
• Section V Sedentary Behaviour
• Section VI Conclusions
• Author Index
• Subject Index