Symposia
Transdiagnostic
Kristin L. Szuhany, Ph.D.
NYU School of Medicine
New York, New York
Margot H. Steinberg, PhD
Research Data Associate
NYU Langone Medical Center
New York, New York
Nicole McLaughlin, PhD
Assistant Professor of Psychiatry and Human Behavior
Alpert Warren Medical School of Brown University, Butler Hospital
Providence, Rhode Island
Maria Mancebo, PhD
Assistant Professor of Psychiatry and Human Behavior, Clinician Educator
Alpert Medical School – Brown University
Providence, Rhode Island
Richard Brown, PhD
Research Professor
The University of Texas at Austin
Austin, Texas
Benjamin Greenberg, MD, PhD
Professor of Psychiatry and Human Behavior
Alpert Medical School – Brown University
Providence, Rhode Island
Naomi Simon, MD
Professor
NYU Langone Health, New York University School of Medicine
New York, NY
Ana Abrantes, Ph.D.
Professor
Alpert Medical School of Brown University
Providence, RI
Most US adults, even more so those with psychiatric conditions, do not engage in recommended physical activity (PA) levels, despite intentions to be active. Therefore, it is essential to identify mechanisms that drive long-term PA engagement so they can be targeted. Aligned with the NIH Science of Behavior Change (SOBC) framework, the current study aimed to examine possible mechanisms that may promote long-term PA in a secondary analysis of individuals with obsessive compulsive disorder (OCD).
56 low-active patients (Mean age=38.8±13.0, 64% women) with a primary diagnosis of OCD and a Yale-Brown Obsessive-Compulsive Scale ≥16 (clinically significant symptoms despite treatment) were randomized to 12 weeks of moderate intensity aerobic exercise (n=28) or health education (n=28). PA engagement was measured by self-reported time exercising per week over the past 3 months. Predictors of PA engagement (possible mechanisms) included baseline PA, behavioral activation (Behavioral Activation for Depression Scale; BADS), affect (PANAS), physical activity enjoyment (PACES), and intervention condition. Assessments were completed at baseline, post-intervention, and 3, 6, and 12-month follow-up.
At baseline, mean PA was 78.4 (182.4) minutes per week. More baseline PA (Estimate=0.29, 95%CI= [0.09, 4.90], p=.005) and higher baseline PA enjoyment significantly predicted PA engagement (Estimate=1.09, 95%CI= [0.30, 1.89], p=.008). In separate follow-up regressions, higher levels of both baseline PA and PA enjoyment predicted greater PA engagement at post-intervention (baseline PA: β=.35, p=.01; PACES: β=.30, p=.03), 3-month (baseline PA: β=.31, p=.03; PACES: β=.43, p=.003) and 6-month follow-ups (baseline PA: β=.35, p=.02; PACES: β=.29, p=.04) but not 12-month follow-up (baseline PA: β=-.15, p=.37; PACES: β=.16, p=.32). Other hypothesized predictors (BADS, PANAS, intervention) did not significantly predict PA (all p >.10).
Higher levels of pre-intervention PA and PA enjoyment predicted greater PA up to 6-months post-treatment suggesting it may be an important modifiable target mechanism even prior to formal PA intervention. Neither were predictive of continued engagement through 12-month follow-up suggesting booster sessions may be necessary for PA maintenance. Next steps aligned with the SOBC framework include examining intervention strategies to target PA enjoyment, particularly among individuals with OCD or other psychiatric conditions, who may benefit most from long-term exercise’s effects on physical and mental health.