Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Associations between physical activity and motivation, competence, functioning, and apathy in inhabitants with mental illness from a rural municipality: a cross-sectional study

Authors: Anders Farholm, Marit Sørensen, Hallgeir Halvari, Torfinn Hynnekleiv

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

There is increasing evidence for physical activity (PA) having a positive impact on physical and mental health as well as illness symptoms in individuals with severe mental illness (SMI). However, individuals with SMI experience several barriers that makes it difficult to take advantage of the benefits associated with PA. One barrier consistently reported to impede PA is motivational issues. Thus, the main aim of the present study was to examine associations between PA and motivation for PA, perceived competence for PA, functioning, apathy, and demographic variables among individuals with SMI. This was conducted within a larger study aiming at including all inhabitants with SMI in one particular small, rural municipality.

Method

A total of 106 participants were recruited to the study. Questionnaire-based interviews conducted by two mental health nurses assessed self-reported PA, motivation and competence for PA, functioning, and apathy. Additionally, 71 participants accepted to wear an accelerometer-equipped wristwatch yielding an objective assessment of PA.

Results

The participants engaged in little PA. However, they did not lack motivation, as over 90% stated that they would like to be more active, and participants across PA level displayed high scores of a motivation reflecting that they valued the benefits of PA. Results showed that higher self-reported PA level was associated with higher levels of integrated regulated motivation and perceived competence for PA while it was unrelated to functioning and apathy. In the subpopulation with objectively measured PA, integrated regulated motivation for PA remained significantly associated with PA level, whereas poor scores on functioning lowered the odds ratio for higher PA level.

Conclusion

The results show that PA specific motivation is associated with PA even when controlling for functioning and apathy. This highlight the importance of facilitating context specific motivation (i.e., motivation for PA) and that health care practitioners should emphasise helping people with SMI develop more intrinsic forms of motivation.
Literature
1.
De Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10:52–77.CrossRefPubMedPubMedCentral
2.
Nordentoft M, Wahlbeck K, Hallgren J, Westman J, Osby U, Alinaghizadeh H, et al. Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PLoS One. 2013;8:e55176.CrossRefPubMedPubMedCentral
3.
Nordentoft M, Mortensen PB, Pedersen CB. Absolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry. 2011;68:1058–64.CrossRefPubMed
4.
Crump C, Winkleby MA, Sundquist K, Sundquist J. Comorbidities and mortality in persons with schizophrenia: a Swedish national cohort study. Am J Psychiatry. 2013;170:324–33.CrossRefPubMed
5.
Crump C, Sundquist K, Winkleby MA, Sundquist J. Comorbidities and mortality in bipolar disorder - a Swedish national cohort study. Jama Psychiatry. 2013;70:931–9.CrossRefPubMed
6.
Laursen TM, Wahlbeck K, Hallgren J, Westman J, Osby U, Alinaghizadeh H, et al. Life expectancy and death by diseases of the circulatory system in patients with bipolar disorder or schizophrenia in the Nordic countries. PLoS One. 2013;8:e67133.CrossRefPubMedPubMedCentral
7.
Robson D, Gray R. Serious mental illness and physical health problems: a discussion paper. Int J Nurs Stud. 2007;44:457–66.CrossRefPubMed
8.
Scott D, Happell B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs. 2011;32:589–97.CrossRefPubMed
9.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–34.CrossRefPubMed
10.
Landers DM, Arent SM. Physical activity and mental health. In: Tenebaum G, Eklund RC, editors. Handbook of sport psychology. Hoboken, NJ: John Wiley & Sons, INC; 2007. p. 469–91.
11.
12.
Rosenbaum S, Tiedemann A, Sherrington C, Curtis J, Ward PB. Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry. 2014;75:964–74.CrossRefPubMed
13.
Firth J, Cotter J, Elliott R, French P, Yung ARA. Systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med. 2015;45:1343–61.CrossRefPubMed
14.
Josefsson T, Lindwall M, Archer T. Physical exercise intervention in depressive disorders: meta-analysis and systematic review. Scand J Med Sci Sports. 2014;24:259–72.CrossRefPubMed
15.
Dauwan M, Begemann MJ, Heringa SM, Sommer IE. Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: a systematic review and meta-analysis. Schizophr Bull. 2016;42:588–99.CrossRefPubMed
16.
Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: a meta-analysis. J Affect Disord. 2016;202:67–86.CrossRefPubMed
17.
Nyboe L, Lund H. Low levels of physical activity in patients with severe mental illness. Nord J Psychiatry. 2013;67:43–6.CrossRefPubMed
18.
Janney CA, Fagiolini A, Swartz HA, Jakicic JM, Holleman RG, Richardson CR. Are adults with bipolar disorder active? Objectively measured physical activity and sedentary behavior using accelerometry. J Affect Disord. 2014;152-154:498–504.CrossRefPubMed
19.
Stubbs B, Firth J, Berry A, Schuch FB, Rosenbaum S, Gaughran F, et al. How much physical activity do people with schizophrenia engage in? A systematic review, comparative meta-analysis and meta-regression. Schizophr Res. 2016;176:431–40.CrossRefPubMed
20.
Hodgson MH, McCulloch HP, Fox KR. The experiences of people with severe and enduring mental illness engaged in a physical activity programme integrated into the mental health service. Ment Health Phys Act. 2011;4:23–9.CrossRef
21.
Glover CM, Ferron JC, Whitley R. Barriers to exercise among people with severe mental illnesses. Psychiatr Rehabil J. 2013;36:45–7.CrossRefPubMed
22.
Johnstone R, Nicol K, Donaghy M, Lawrie S. Barriers to uptake of physical activity in community-based patients with schizophrenia. J Ment Health. 2009;18:523–32.CrossRef
23.
Happell B, Platania-Phung C, Scott D. Survey of Australian mental health nurses on physical activity promotion. Int J Men Health Promot. 2013;15:148–61.CrossRef
24.
Soundy A, Stubbs B, Probst M, Hemmings L, Vancampfort D. Barriers to and facilitators of physical activity among persons with schizophrenia: a survey of physical therapists. Psychiatr Serv. 2014;65:693–6.CrossRefPubMed
25.
Fraser SJ, Chapman JJ, Brown WJ, Whiteford HA, Burton NW. Physical activity attitudes and preferences among inpatient adults with mental illness. Int J Ment Health Nurs. 2015;24:413–20.CrossRefPubMed
26.
Farholm A, Sørensen M. Motivation for physical activity and exercise in severe mental illness: a systematic review of intervention studies. Int J Ment Health Nurs. 2016;25:194–205.CrossRefPubMed
27.
28.
Farholm A, Sørensen M. Motivation for physical activity and exercise in severe mental illness: a systematic review of cross-sectional studies. Int J Ment Health Nurs. 2016;25:116–26.CrossRefPubMed
29.
Gard DE, Sanchez AH, Starr J, Cooper S, Fisher M, Rowlands A, et al. Using self-determination theory to understand motivation deficits in schizophrenia: the 'why' of motivated behavior. Schizophr Res. 2014;156:217–22.CrossRefPubMedPubMedCentral
30.
Deci EL, Ryan RM. The "what" and "why" of goal pursuits: human needs and the self-determination of behavior. Psychol Inq. 2000;11:227–68.CrossRef
31.
Ng JYY, Ntoumanis N, Thogersen-Ntoumani C, Deci EL, Ryan RM, Duda JL, et al. Self-determination theory applied to health contexts: a meta-analysis. Perspect Psychol Sci. 2012;7:325–40.CrossRefPubMed
32.
Bandura A. Self-efficacy: the exercise of control. New York. Freeman. 1997;
33.
Nicholls JG. The competitive ethos and democratic education. Cambridge, MA: Harvard University Press; 1989.
34.
Williams GC, McGregor HA, Zeldman A, Freedman ZR, Deci EL. Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychol. 2004;23:58–66.CrossRefPubMed
35.
Williams GC, McGregor HA, Sharp D, Levesque C, Kouides RW, Ryan RM, et al. Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial. Health Psychol. 2006;25:91–101.CrossRefPubMed
36.
Leas L, McCabe M. Health behaviors among individuals with schizophrenia and depression. J Health Psychol. 2007;12:563–79.CrossRefPubMed
37.
Bezyak JL, Berven NL, Chan F. Stages of change and physical activity among individuals with severe mental illness. Rehabil Psychol. 2011;56:182–90.CrossRefPubMed
38.
Beebe LH, Smith K, Burk R, Dessieux O, Velligan D, Tavakoli A, et al. Effect of a motivational group intervention upon exercise self efficacy and outcome expectations for exercise in schizophrenia Spectrum disorders (SSDs). J Am Psychiatr Nurses Assoc. 2010;16:105–13.CrossRefPubMed
39.
Vancampfort D, Probst M, Scheewe T, Knapen J, De Herdt A, De Hert M. The functional exercise capacity is correlated with global functioning in patients with schizophrenia. Acta Psychiatr Scand. 2012;125:382–7.CrossRefPubMed
40.
Vancampfort D, Knapen J, Probst M, Scheewe T, Remans S, De Hert M. A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatr Scand 2012;125:352–362.
41.
Vancampfort D, De Hert M, Stubbs B, Ward PB, Rosenbaum S, Soundy A, et al. Negative symptoms are associated with lower autonomous motivation towards physical activity in people with schizophrenia. Compr Psychiatry. 2015;56:128–32.CrossRefPubMed
42.
Lindamer LA, McKibbin C, Nonnan GJ, Jordan L, Harrison K, Abeyesinhe S, et al. Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophr Res. 2008;104:294–301.CrossRefPubMedPubMedCentral
43.
Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed
44.
Brugniaux JV, Niva A, Pulkkinen I, Laukkanen RM, Richalet JP, Pichon AP. Polar activity watch 200: a new device to accurately assess energy expenditure. Br J Sports Med. 2010;44:245–9.CrossRefPubMed
45.
46.
IPAQ. Guidelines for data processing and analysis of the international physical activity questionnaire (IPAQ) - Short and long forms. 2005. www.​ipaq.​ki.​se. Accessed 2 May 2016.
47.
World Health Organization Global recommendations on physical activity for health. Geneva: world health Organization; 2010.
48.
Levesque CS, Williams CG, Elliot D, Pickering MA, Bodenhamer B, Finley PJ. Validating the theoretical structure of the treatment self-regulation questionnaire (TSRQ) across three different health behaviors. Health Educ Res. 2007;22:691–702.CrossRefPubMed
49.
Williams G, Freedman Z, Deci E. Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care. 1998;21:1644–51.CrossRefPubMed
50.
Wing J, Beevor A, Curtis R, Park S, Hadden S, Burns A. Health of the nation outcome scales (HoNOS). Research and development. Br J Psychiatry. 1998;172:11–8.CrossRefPubMed
51.
Lelliott P. Defenition of severe mental illness. In: Charlwood P, Mason A, Goldacre M, Cleary R, Wilkinson E, editors. Health outcome indicators: severe mental illness. Oxford: National Centre for health outcomes Development; 1999. p. 87–93.
52.
Parabiaghi A, Kortrijk HE, Mulder CL. Defining multiple criteria for meaningful outcome in routine outcome measurement using the health of the nation outcome scales. Soc Psychiatry Psychiatr Epidemiol. 2014;49:291–305.CrossRefPubMed
53.
54.
Faerden A, Nesvag R, Barrett EA, Agartz I, Finset A, Friis S, et al. Assessing apathy: the use of the apathy evaluation scale in first episode psychosis. Eur Psychiatry. 2008;23:33–9.CrossRefPubMed
55.
Faerden A, Friis S, Agartz I, Barrett EA, Nesvag R, Finset A, et al. Apathy and functioning in first-episode psychosis. Psychiatr Serv. 2009;60:1495–503.CrossRefPubMed
56.
Jimenez E, Arias B, Mitjans M, Goikolea JM, Ruiz V, Brat M, et al. Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder. Acta Psychiatr Scand. 2016;133:266–76.CrossRefPubMed
57.
Kline P. The handbook of psychological testing. 2nd ed. Ed. London: Routledge; 1999.
58.
Tabachnick BG, Fidell LS. Using multivariate statistics. Fifth edition ed. Boston, MA: Pearson Education; 2007.
59.
Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. Third ed. New York: Routledge; 2003.
60.
Teixeira PJ, Carraca EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nut Phys Act. 2012;9:78.CrossRef
61.
Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34:1996–2001.CrossRefPubMed
62.
Faulkner G, Cohn T, Remington G. Validation of a physical activity assessment tool for individuals with schizophrenia. Schizophr Res. 2006;82:225–31.CrossRefPubMed
63.
Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010;31:399–418.CrossRefPubMed
64.
Sørensen M. Motivation for physical activity of psychiatric patients when physical activity was offered as part of treatment. Scand J Med Sci Sports. 2006;16:391–8.CrossRefPubMed
65.
Carless D, Douglas K. Narrative, identity and mental health: how men with serious mental illness re-story their lives through sport and exercise. Psychol Sport Exerc. 2008;9:576–94.CrossRef
66.
Carless D. Narrative, identity, and recovery from serious mental illness: a life history of a runner. Qual Res Psychol. 2008;5:233–48.CrossRef
67.
Fortier MS, Hogg W, O'Sullivan TL, Blanchard C, Reid RD, Sigal RJ, et al. The physical activity counselling (PAC) randomized controlled trial: rationale, methods, and interventions. Appl Physiol Nutr Metab. 2007;32:1170–85.CrossRefPubMed
68.
Haase AM, Taylor AH, Fox KR, Thorp H, Lewis G. Rationale and development of the physical activity counselling intervention for a pragmatic TRial of exercise and depression in the UK (TREAD-UK). Ment Health Phys Act. 2010;3:85–91.CrossRef
69.
Ryan RM, Lynch MF, Vansteenkiste M, Deci EL. Motivation and autonomy in counseling, psychotherapy, and behavior change: a look at theory and practice. Couns Psychol. 2011;39:193–260.CrossRef
70.
Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88:879–903.CrossRefPubMed
Metadata
Title
Associations between physical activity and motivation, competence, functioning, and apathy in inhabitants with mental illness from a rural municipality: a cross-sectional study
Authors
Anders Farholm
Marit Sørensen
Hallgeir Halvari
Torfinn Hynnekleiv
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1528-3

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Research article

What is the significance of onconeural antibodies for psychiatric symptomatology? A systematic review

Research article

How effective are interventions to improve social outcomes among offenders with personality disorder: a systematic review

Study protocol

Effectiveness and cost-effectiveness of a guided Internet- and mobile-based intervention for the indicated prevention of major depression in patients with chronic back pain—study protocol of the PROD-BP multicenter pragmatic RCT

Research article

Jump step - a community based participatory approach to physical activity & mental wellness

Research article

Crucial factors preceding compulsory psychiatric admission: a qualitative patient-record study

Research article

Association of body mass index with amnestic and non-amnestic mild cognitive impairment risk in elderly