Chapter 12
Putting Positive Psychology Into Motion Through Physical Activity

GUY FAULKNER, KATE HEFFERON AND NANETTE MUTRIE

Seligman (2002) suggested that the goal of positive psychology is to “learn how to build the qualities that help individuals and communities not just endure and survive but also flourish” (p. 8). We believe that physical activity is one behavior that will help both individuals and communities survive and flourish. At an individual level, we will show that physical activity has the capacity to prevent mental illness, to foster positive emotions, to buffer individuals against the stresses of life, and to facilitate thriving after adversity. At a community level, we suggest that a community in which physical activity is seen as the social norm may be healthier and have greater social capital. Indeed, we would argue that physical activity is a “stellar” positive psychological intervention (PPI; Hefferon & Mutrie, 2012) as it helps to produce positive emotions, engagement, and accomplishment, as well as preventing and reducing more negative experiences and states (e.g., stress, depression).

We use physical activity (PA) as a term that refers to any movement of the body that results in energy expenditure above that of resting level (Caspersen, Powell, & Christenson, 1985). Exercise is often (incorrectly) used interchangeably with PA, but this term refers to a subset of PA in which the activity is structured, often supervised, and undertaken with the aim of maintaining or improving physical fitness or health. Examples of exercise include going to the gym, jogging, taking an aerobics class, or taking part in recreational sport for fitness.

In the field of physical activity for health, a landmark moment occurred in 2010 with the launch of The Toronto Charter for Physical Activity by the Global Advocacy Council for Physical Activity (see www.globalpa.org.uk). This document is a call for action and an advocacy tool; its aim is to create sustainable opportunities for physically active lifestyles for everyone. This advocacy resulted in the World Health Organization (2010) issuing global recommendations on physical activity for health based on a consensus process and using the most up to date epidemiological data. These recommendations include the guidance that children aged 5 to 17 years should accumulate 60 minutes of moderate- to vigorous-intensity activity on a daily basis. For adults, the guidance suggests that a minimum of 150 minutes of moderate intensity activity should be accumulated over the course of the week in bouts of no less than 10 minutes. Adults are also encouraged to take part in activities that promote muscle strengthening at least twice per week. Adults over age 65 were recommended to undertake the same level and types of activity as younger adults but it was also noted that balance training might be beneficial for some and that older adults should be as active as their own abilities allow. These guidelines are consistent with most national guidelines for physical activity.

Unfortunately, the majority of children, youth, and adults are not meeting such guidelines (Hallal et al., 2012). If we take an evolutionary look at our beginnings, we see a life in which high levels of physical activity were required for survival. As recently as one century ago, most people needed to be physically active to work, to travel, and to take care of homes and families. Our modern world has engineered such activity out of our lives. There are fewer manual jobs, we do not need to travel on foot, we do not need to hunt and harvest for our food, and many domestic chores have been mechanized. Although these changes have created many benefits for our longevity and quality of life as the centuries have passed, they have also created many problems. It has recently been estimated that across the globe, physical inactivity causes 6% of the burden of disease from coronary heart disease, 7% of type 2 diabetes, and 10% of breast cancer and colon cancer (Lee et al., 2012). Table 12.1 shows the long (and growing) list of conditions for which there is good evidence that increased physical activity can have a beneficial effect.

Table 12.1 Health Benefits of Physical Activity

Strong evidence of reduced rates of Strong evidence of
All-cause mortality
Coronary heart disease
High blood pressure
Metabolic syndrome
Type 2 diabetes
Breast cancer
Colon cancer
Depression
Falling		 Increased cardiorespiratory and muscular fitness
Healthier body mass and composition
Improved bone health
Increased functional health
Improved cognitive function

Source: Adapted from data in Lee et al. (2012).

We cannot and would not want to return to the lifestyles of our ancestors, but we do need to take a positive approach to creating lifestyles that include physical activity. The aim of this chapter is to provide an overview of what is known about the effects of physical activity on psychological function and to raise awareness of this knowledge among psychologists. This chapter develops the principle that the body is important to how we think, feel, and behave. The principles of psychosomatic medicine have clearly established the idea that how we think and feel will affect the functioning of the body. However, our task in this chapter is to show that the reverse is also true—that there is a somatopsychic principle (Harris, 1973), which is very much in line with the principles of positive psychology. The somatopsychic principle is neatly displayed in the well-known phrase “mens sana in corpore sano” (“a healthy mind in a healthy body”) (see Hefferon, 2013).

Seligman (2002) talks of building strength as one of the key principles of positive psychology. If we examine physical strength as part of this concept, we can begin to see the somatopsychic principles working. Gaining physical strength or capacity allows us to feel more confident in our ability to do everyday tasks, perhaps provides us with a more positive perception of our physical selves, and thus can influence our self-esteem. Seligman (2002) further argues that building strength should be at the forefront of treating mental illness, and we will show that this building of physical strength has a somatopsychic impact on those people who are suffering from poor mental health. Although the tides may be turning from positive psychology's predominantly cognitive approach to a more embodied approach to well-being (Hefferon, 2013; Hefferon, Chapter 45, this volume), the discipline retains somewhat of a “neck-up” focus on flourishing (Peterson, 2013; Seligman, 2011). Ultimately, we will present the evidence that shows the positive link between psychological well-being and regular physical activity, moving toward a more holistic discipline in its scope and applications.

Physical Activity and Mental Health

In the past 10 years there has been tremendous growth in the study of physical activity and mental health. A new journal, Mental Health and Physical Activity, is devoted to the topic, and there have been numerous textbooks examining the relationship (e.g., Carless & Douglas, 2010; Clow & Edmunds, 2013; Faulkner & Taylor, 2005; Leith, 2010). Recently, the most comprehensive edited collection to date was published (see Ekkekakis, 2013). The result of this cumulative research is that we now have a convincing evidence base that supports the existence of a strong relationship between physical activity and a number of dimensions of psychological well-being. This relationship may be critical. The literature indicates that mental health outcomes motivate people to persist in physical activity while also having the potentially positive impact on well-being (Biddle & Mutrie, 2008). Without regular participation, both mental and physical benefits will not accrue.

The existing evidence can be broadly categorized in terms of four main functions of physical activity for impacting mental health. First, physical activity may prevent mental health problems. Second, exercise has been examined as a treatment or therapy for existing mental illness. Third, physical activity may improve the quality of life for people with chronic physical and mental health problems. The final function concerns the role of physical activity in improving the psychological well-being of the general public. All four of these functions have elements of positive psychology in that there is a clear preventative function; a clear function for enhancing positive emotions, mood, and affect, even for those with existing mental illness; and a clear role in a positive approach to treating mental illness. We now briefly examine each of these functions.

The Preventative Function

In terms of preventing poor mental health, the strongest evidence supporting the role of physical activity comes in the area of depression. In a recent systematic review, Mammen and Faulkner (2013) reviewed studies with a prospective-based, longitudinal design examining relations between physical activity and depression over at least two time intervals. A total of 25 of the 30 studies found a significant, inverse relationship between baseline physical activity and follow-up depression, suggesting that physical activity is preventative in the onset of depression. Given the heterogeneity in physical measurement in the reviewed studies, a clear dose–response relationship between physical activity and reduced depression was not readily apparent. However, there is promising evidence that any level of physical activity, including low levels, can prevent future depression.

Such studies involve large numbers of people and measure physical activity status prior to the incidence of depression. In one of the most well-cited examples, Camacho, Roberts, Lazarus, Kaplan, and Cohen (1991) found an association between inactivity and incidence of depression in a large population from Alameda County in California who provided baseline data in 1965 and were followed up in 1974 and 1983. Physical activity was categorized as low, medium, or high. In the first wave of follow-up (1974) the odds ratios (OR) of developing depression were significantly greater for both men and women who were low active in 1965 (OR = 1.8 for men, 1.7 for women) compared to those who were high active (see Figure 12.1).

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Figure 12.1 The odds ratios for developing depression at follow-up (1974) from different levels of baseline physical activity (1965).

Source: Adapted from “Physical Activity and Depression: Evidence from the Alameda County Study,” by T. C. Camacho, R. E. Roberts, N. B. Lazarus, G. Kaplan, and R. D. Cohen, 1991, American Journal of Epidemiology, 134, pp. 220–231.

There could be alternative explanations of the positive findings such as bias, confounding factors, or chance. Bias is unlikely in these former large studies, and careful checks of nonrespondents are made to ensure they do not differ from the responders. All of the positive studies take account of a wide range of possible confounding factors, such as disability, body mass index, smoking, alcohol, and social status; and in the statistical modeling, the relationship between physical activity and a decreased risk of depression remains. Despite consistency in the literature regarding a protective function of physical activity, some caution is required given that there may be a number of covariates, such as genetic variations (De Moor, Boomsma, Stubbe, Willemsen, & De Geus, 2008), that predict both physical activity and depression and may not have been fully accounted for in the reviewed studies.

The evidence for a preventative role for physical activity in other mental illnesses is not convincing at this point. If we accept that one of the key principles in positive psychology is to identify preventative strategies, then, at least for depression, enabling individuals to be physically active is a central target.

The Therapy Function

The possibility that physical activity could be used as a treatment in mental illness has long been recognized, but it was not well-researched until more recent times. For example, physical activity was seen as a popular and effective treatment for alcoholism as far back as the 19th century, as the following quotation from Cowles (1898) illustrates:

The benefits accruing to the patients from the well-directed use of exercise and baths is indicated by the following observed symptoms: increase in weight, greater firmness of muscles, better colour of skin, larger lung capacity, more regular and stronger action of the heart, clearer action of the mind, brighter and more expressive eye, improved carriage, quicker responses of nerves, and through them of muscle and limb to stimuli. All this has become so evident to them that only a very few are unwilling to attend the classes and many speak freely of the great benefits derived. (p. 108)

As with the preventative function, the most compelling evidence comes from studies in the area of clinical depression. The most recent review on the topic of exercise as a treatment for depression was published by The Cochrane Library and was conducted by Cooney and colleagues (2013), who found 39 studies that met their inclusion criteria. Reviews published in The Cochrane Library must have followed the standards of systematic reviewing that have been established by the Cochrane Collaboration, and so we can be confident in the manner in which this review was conducted. The meta-analysis showed a moderate effect size of –0.62 (95% confidence interval [CI] –0.81 to –0.42), for exercise versus no-treatment control conditions. For the six trials considered to be at low risk of bias (adequate allocation concealment, intention-to-treat analyses, and blinded outcome assessment), a further analysis showed a small clinical effect in favor of exercise that did not reach statistical significance. Finally, the authors compared the exercise effects to those of cognitive-behavioral therapy for the seven trials that had these comparisons and found no significant difference. Similarly, four trials compared exercise with antidepressant medication and no significant difference was found.

This suggests that exercise has a similar effect size to other recognized therapies for depression, including medication. One large study has shown that exercise equaled the effect found from a standard antidepressant drug after 16 weeks (Blumenthal et al., 1999), and after 6 months there were some indications that those who had continued to exercise had additional benefits in comparison (Babyak et al., 2000; see Figure 12.2). Cooney and colleagues (2013) concluded that exercise appears to be no more effective than psychological or pharmacological therapies. A more appropriate interpretation might be that exercise may be as beneficial as other common treatments—not necessarily better. Compared to earlier meta-analyses examining exercise and depression, we are tending to see reduced effect sizes because exercise is being compared to other active treatments such as psychotherapy and medication.

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Figure 12.2 BDI scores pre- and post- 16 weeks of treatment.

Source: Adapted from Blumenthal et al., 1999 (pretreatment) and Babyak et al., 2000 (6-month follow-up).

There are many unanswered questions, such as the exact dosage and mode of activity that might work best. One team of systematic reviewers has examined the physical activity mode of walking (Robertson, Robertson, Jepson, & Maxwell, 2012). They found eight trials that met their inclusion criteria and an effect size of 0.86 (CI = 1.12, –0.61). The authors concluded that “Walking has a statistically significant, large effect on the symptoms of depression in some populations but the current evidence base from randomized, controlled trials is limited” (p. 73). In terms of policy and practice, the National Institute for Health and Clinical Excellence (2009) reviewed the evidence and recommended structured, supervised exercise programs three times a week (45 minutes to 1 hour) over 10 to 14 weeks as an intervention for mild to moderate depression.

The Quality of Life Function

For people with chronic mental and/or physical health problems, improvement in quality of life tends to enhance the individual's ability to cope with and manage his or her disorder. Preliminary evidence suggests that regular physical activity can improve positive aspects of mental health (such as psychological quality of life and emotional well-being) in people with mental disorders and those coping with a chronic disease.

For example, improved quality of life is particularly important for individuals with severe and enduring mental health problems, such as schizophrenia, when complete remission may be unrealistic (Faulkner & Sparkes, 1999). A Cochrane review of the evidence concerning schizophrenia reported that exercise programs are possible in this population and that they can have modest effects on both the physical and mental health and well-being of individuals with schizophrenia (Gorczynski & Faulkner, 2010). An emerging evidence base concerns physical activity and quality of life among individuals with multiple sclerosis. Meta-analytic evidence suggests that exercise training is associated with a small improvement in quality of life (Motl & Gosney, 2008). Larger randomized studies are required in both cases before any definitive conclusions can be drawn.

The “Feel Good” Function

Often when we ask someone why they exercise, they respond that it makes them “feel good.” Current consensus clearly supports an association between physical activity and numerous domains of psychological well-being in the general population. This has largely been addressed through studies assessing the impact of physical activity on many variables such as quality of life, self-esteem and self-perceptions, and cognitive functioning (see Ekkekakis, 2013). We briefly review research looking at affect, stress, and anxiety, and a more recent body of work looking at physical activity and posttraumatic growth.

Affect

Feeling good during and/or after physical activity is motivational, serves as an important health outcome in itself, and contributes to quality of life. To a certain extent, the acute effects of physical activity have received increasing attention given its presumed motivational properties. It is certainly now reliably established that moderate levels of exercise intensity below the ventilatory threshold (the point at which relatively more carbon dioxide is produced than the oxygen that is consumed) is associated with “feeling better” (see Ekkekakis, Parfitt, & Petruzello, 2011, for a comprehensive overview of this field of research). At this level of activity you can easily talk to someone beside you. Beyond the ventilatory threshold, it becomes more difficult to do so.

Positive activated affect is described as a subjective mental state of positive energy and engagement. In two well-cited meta-analyses, both acute (Reed & Ones, 2006) and regular aerobic physical activity (Reed & Buck, 2009) increase self-reported positive activated affect by approximately one half a standard deviation in experimental participants compared to control. Alternatively, these findings suggest that “a randomly selected person who just completed aerobic activity would be about 65 to 70 per cent more likely to report higher positive activated affect than a randomly selected sedentary person” (Reed, 2013, p. 417). Simply, exercise can help people feel good, and this induction of positive emotions is a vital component for overall flourishing (Seligman, 2011).

Coping With Stress

Stress is a common feature of life for many of us. Often of a subclinical nature, it can have a negative impact on quality of life and health and is a major source of sickness-related absence from work. Stress can manifest itself in emotional states, such as anxiety, that reflect negative cognitive appraisal and physiological responses such as increased blood pressure.

Cross-sectional and prospective surveys in the United States and Canada (Iwasaki, Zuzanek, & Mannell, 2001; Stephens, 1988), Finland (Hassmen, Koivula, & Uutela, 2000), and the United Kingdom (Steptoe & Butler, 1996) indicate that more active individuals self-report fewer symptoms of anxiety or emotional distress. Several meta-analyses demonstrate medium effect sizes for physical activity interventions in the reduction of anxiety (Conn, 2010; Wipfli, Rethorst, & Landers, 2008).

Another focus for research concerns the effectiveness of fitness and/or regular physical activity on the mental and physical ability to cope with stress. Taylor (2000) reviewed 14 experimental studies and concluded that single sessions of moderate exercise can reduce short-term physiological reactivity to and enhance recovery from brief psychosocial stressors. An earlier meta-analysis found an overall effect size of 0.48 for reduced reactivity to stressors (Crews & Landers, 1987). Specifically, reduced reactivity to stressors (e.g., systolic and diastolic blood pressure, skin conductivity, muscle tension, self-reported psychological symptoms) or a faster recovery following a stressor were generally found for those who were fitter or improved their fitness with training, or who had undertaken a single exercise session, compared with baseline measures or a control group. Overall, exercise may act as a buffer or coping strategy for stress.

Physical Activity: Beyond Building Resilience

Researchers have linked participation in sports and group-based structured exercise programs, following trauma, with the facilitation of posttraumatic growth (PTG; Hefferon, Grealy, & Mutrie, 2008, 2010). PTG is the phenomenon in which, following adversity, individuals surpass previous levels of functioning than those that existed before the event occurred. Hefferon et al. (2008, 2010) found that women who had undergone a 3-month structured physical activity intervention during breast cancer treatment utilized the activity to facilitate PTG as well as considered this engagement with exercise as a positive outcome in itself. More specifically, the women perceived the exercise classes to be a “safe environment,” offering a positive support system and the opportunity to transfer new learned skills (e.g., confidence) to their everyday lives. Furthermore, the women reported a heightened awareness of their health and an increase in positive health behaviors (e.g., change in diet, increased exercise) and the cessation of detrimental health behaviors (e.g., smoking). A 5-year follow-up study with the same population (Mutrie et al., 2012) reported serendipitous accounts of PTG (24%) (Hefferon, 2012), 70% of whom were part of the original intervention group. Thus, these findings suggest that there may be opportune time points during the cancer process (e.g., immediately after diagnosis and through treatment) in which engagement in physical activity can help reconnect cancer patients to their bodies, thereby helping them to grow, as well as perceiving the engagement as a positive from the trauma in itself.

Several other clinical populations have also utilized physical activity for the facilitation of PTG and considered the heightened awareness of health and engagement in activity as a positive outcome following their trauma (Hefferon, Grealy, & Mutrie, 2009). For example, Hefferon, Mallery, Gay, and Elliott (2012) found that engagement in a 6-week Boxercise class for individuals with mental health difficulties facilitated elements of PTG, including enhanced psychological well-being, sense of personal strength, and increased self-regulation over emotions and physical self. Furthermore, the participants demonstrated a progressive somatopsychic experience, attributing the sense of feeling stronger in the body (via the exercise) to becoming stronger in the mind. In summary, although the current research into the links between physical activity and growth are qualitative and exploratory, there appears to be an interesting dynamic between the utilization of exercise during trauma and PTG. Future mixed-methods research is needed to understand the complex relation between the two areas because, to date, activity and PTG research has only been studied within group environments.

Mechanisms: A Process Orientation

There is considerable agreement that the underlying mechanisms that relate to the positive effects from exercise on mental health are not yet known. Several possible mechanisms, including biochemical changes as a result of exercise, such as increased levels of neurotransmitters (such as endorphins or serotonin; see Dishman & O'Connor, 2009), physiological changes such as improved cardiovascular function or thermogenesis, and psychological changes such as an increased sense of mastery, have been proposed. From a positive psychology perspective, physical activity may foster the six main elements of Ryff and Singer's (1996, 2006) model: enhancing self-acceptance (e.g., self-esteem), offering autonomy (e.g., choice of program), gaining environmental mastery (e.g., learning a new and transferable skill), fostering positive relationships (e.g., group-based interventions), giving new purpose in life (e.g., increased importance of health), and overall personal growth for both normal and clinical populations (Hefferon & Mutrie, 2012).

This model reflects a process orientation for understanding the benefits of physical activity. In acknowledging the huge diversity of potential triggers (such as exercise type, environment, social context) and individual circumstances (such as state of mental health, needs, preferences, and personal background), Fox (1999) suggests that several mechanisms most likely operate in concert, with the precise combination being highly individual-specific. Studying the process of mental health change as a result of physical activity participation must therefore allow for the diverse range of factors that influence an individual's sense of psychological well-being. The isolation of a specific mechanism cannot realistically address the large number of potential psychological influences that may be experienced through physical activity. It is more realistic for a process-oriented approach to allow for the broad range of potential influences and therefore provide a more complete explanation of the causes of psychological change (Faulkner & Carless, 2006).

For example, Deci and Ryan (1985) have proposed that the basic needs for competence, autonomy, and relatedness must be satisfied across the life span for an individual to experience an ongoing sense of integrity and well-being (see also Ryan & Deci, 2000; Brown & Ryan, Chapter 9, this volume). These three basic needs are commonly reported outcomes of physical activity interventions. Existing research suggests that physical competence and self-perceptions can be improved through physical activity and that this can have a positive mental health effect (Fox, 1997). Exercise self-efficacy can be increased through interventions and is associated with positive exercise emotion (Biddle & Mutrie, 2008). Autonomy, or perceptions of personal control, is reported to be frequently lacking among people with depression, where feelings of powerlessness and helplessness are common (Seligman, 1975). Physical activity offers a potential avenue through which meaningful control can be gradually taken as the individual assumes responsibility for the organization of his or her exercise schedule or feels in control of how his or her body looks or performs. When we make progress in our physical capacity, it is hard for even the most pessimistic to attribute this progress to anything but their own efforts and abilities. It might be that autonomy gained through exercise generalizes to other areas of life through feelings of empowerment (Fox, 1997). Finally, the provision of physical activity in a supportive group environment represents one approach to providing opportunity for positive social interaction that may be valuable.

No single theory is likely to adequately explain the mental health benefits of physical activity. Process theories, such as self-determination theory (Deci & Ryan, 1985), allow for a broader theoretical stance in understanding the mechanisms underpinning the physical activity and psychological well-being relation and also suggest how motivation to be active can be facilitated (Faulkner & Carless, 2006). Specifically, we would argue that structuring the physical activity experience to support feelings of autonomy, competence, and social relatedness is a good basis for promoting adherence to exercise and enhancing psychological well-being.

How Can People Get More Active?

A sedentary lifestyle is now the normal lifestyle of many of the populations in developed countries, and inactivity is a growing population health concern in developing countries. It has been estimated that over 30% of the world's population is inactive, with the percentage ranging from low levels of inactivity in Southeast Asia (17%) to high levels of inactivity in the Americas and eastern Mediterranean (43%). There is a global trend for inactivity to increase with age and for women to be less active than men. Across the world, only 20% of 13- to 15-year-olds meet the recommendation of being active for 60 minutes each day (Hallal et al., 2012). Major reported barriers to exercise participation include: psychological barriers (e.g., lack of motivation, perceived lack of time); physical barriers (e.g., weight, injury); and contextual and environmental barriers (e.g., employment, proximity/access to facilities, seasonal weather) (Hefferon, Murphy, McLeod, Mutrie, & Campbell, 2013).

Leading academics and practitioners from around the world reviewed evidence for interventions that were effective in increasing physical activity levels. This review led to the production of a companion document to the Toronto charter, which includes “Seven Best Investments for Physical Activity” (http://www.globalpa.org.uk/investments). These seven approaches are:

  1. School programs in which children are encouraged to be active on the journey to and from school, during school break times, after school, and via quality physical education programs at all ages.
  2. Transport policies and systems that prioritize walking, cycling, and public transport.
  3. Urban design regulations and infrastructure that provide for equitable and safe access to recreational physical activity, and recreational and transport-related walking and cycling across the life course.
  4. Physical activity and noncommunicable disease prevention integrated into primary health care systems.
  5. Public education, including mass media to raise awareness and change social norms on physical activity.
  6. Community-wide programs involving multiple settings and sectors and that mobilize and integrate community engagement and resources.
  7. Sports systems and programs that promote “sport for all” and encourage participation across the life span.

Psychologists reading this list can see that their role may be one of advocacy in ensuring local opportunities exist for children and adults to be active. But in more individual settings, counseling people to be more active for health and well-being now has some established guidelines. An example is provided by Kirk, Barnett, and Mutrie (2007). Although originally developed for people with type 2 diabetes, these guidelines are applicable to many different populations.

Is There an Exercise Dosage for Psychological Well-Being?

Identifying a dose–response relationship between physical activity and mental health is still not possible. Effects are likely to be highly individualized and depend on preferences, experiences, and setting, and vary in terms of the dimensions of well-being, interest, and whether we are interested in the acute or long-term effects of physical activity. In the absence of a single definitive dosage for psychological well-being, standard adult physical activity guidelines of accumulating 150 minutes of moderate to vigorous physical activity each week should apply equally to mental health promotion. In terms of acute effects, short bouts (10–15 minutes) of moderate walking have been shown to induce significant affective changes in experimental studies (Ekkekakis, Hall, VanLanduyt, & Petruzzello, 2000). The most effective dose is likely the one that individuals enjoy and can sustain. Critically, a range of exercise modes and intensities should be recommended based on the participant's previous exercise experiences, personal preferences, strengths, and goals.

The challenge of research is to establish an evidence base that demonstrates the efficacy of a dose of physical activity that can be translated into interventions acceptable to participants and feasible to deliver. An example can be seen in the work examining the role of short bouts of physical activity, such as walking at a brisk pace for 10 minutes, in alleviating cigarette cravings and withdrawal symptoms in abstinent smokers (Haasova et al., 2013).

An emerging focus for research is the impact of sedentary behavior on mental health. Sedentary behavior can be defined as any waking behavior characterized by a low energy expenditure (i.e., ≤ 1.5 resting metabolic equivalents) while in a sitting or reclining posture (see the Sedentary Behaviour Research Network website: http://www.sedentarybehaviour.org/what-is-sedentary-behaviour/). Although this field is still in its infancy, research demonstrates emerging evidence of at least an association between time engaged in sedentary behavior and mental health (Faulkner & Biddle, 2013). In the future, intervention doses may consist of shorter bouts of low to moderate intensity physical activity to break up sedentary time in contrast to, or complementing, traditional doses of exercise.

Active Communities

Although definitions vary, social capital is fundamentally about how people interact with one another (Dekker & Uslaner, 2001). Evidence consistently suggests that communities with high levels of physical activity participation also have high levels of social capital. Studies using social trust as an indicator of social capital have shown that high compared to low levels of trust are associated with a reduction in the risk of physical inactivity. In a large cross-sectional study using data from the 2003 Health Survey for England, Poortinga (2006) found that individuals who experience some lack or a severe lack of social support were 20% and 24% less likely to do at least one walk of 30 minutes per week. A high level of trust, a medium level of civic participation, and a high level of civic participation increased the likelihood of doing at least one walk of 30 minutes per week by 20%, 14%, and 53%, respectively. Similarly, a large Canadian cross-sectional study showed that individuals who did not participate in any formal groups or associations were more likely to be physically inactive compared to those with high participation (Legh-Jones & Moore, 2012).

Much research has also focused on the physical aspects of social capital in terms of the built environment. For example, systematic reviews have shown that mixed land use, increased housing density, compact development patterns, and levels of open space are associated with increased levels of physical activity, primarily walking (Durand, Andalib, Dunton, Wolch, & Pentz, 2011). Such characteristics are likely to reflect greater walkability—the extent to which a particular built environment is friendly to the presence of people living, shopping, visiting, enjoying, or spending time in an area (Coyle, 2011).

Neighborhood crime and safety have also been found to be negatively associated with physical activity. Data from a population-based survey of adults in the United Kingdom found that people who felt safe in their neighborhood were more likely to be physically active (Harrison, Gemmell, & Heller, 2007). Such associations also have implications for children. Children are more physically active when they have greater independent mobility (a child's freedom to travel around their own neighborhood or to public places without adult supervision) (Mitra, Faulkner, Buliung, & Stone, in press). In a study in Toronto, Canada, Mitra et al. (in press) found that children had significantly less independent mobility when their parents were worried about strangers or thought their neighborhood was unsafe. Attractiveness of neighborhood streets and the presence of other people “talking and doing things together” were also associated with greater independent mobility among children.

Most of the evidence concerning physical activity and aspects of social capital is cross-sectional in nature. Accordingly, causality cannot be inferred. Future research should examine these relationships experimentally and explore the impact of physical activity interventions on such social outcomes, and on whether enhancing such outcomes has an impact on physical activity. At the least, we can say that where one lives is associated with how physically active one is. Urban planning and public health initiatives should focus on interventions that enable the production and maintenance of social capital among neighbors, address safety concerns, and create communities where being physically active is the easiest option.

Conclusion

In conclusion, there is compelling evidence as to the positive relation between physical activity and mental health in clinical and nonclinical populations. Although methodological concerns do exist, we would contend that the potential of psychological benefits accruing through exercise far outweighs the potential risk that no effect will occur. Because physical activity is an effective method for improving important aspects of physical health, such as obesity, cardiovascular fitness, and hypertension (see Lee et al., 2012), the promotion of physical activity for psychological well-being can be seen as a “win-win” situation with both mental and physical health benefits accruing (Mutrie & Faulkner, 2003).

Summary Points

  • There is a convincing evidence base that supports the existence of a strong relationship between physical activity and a number of dimensions of psychological well-being.
  • The promotion of physical activity for psychological well-being can be seen as a “win-win” situation with both mental and physical health benefits accruing.
  • Existing evidence suggests physical activity may perform a preventative function, a treatment function, and a clear function for enhancing positive emotions, mood, and affect, even for those with existing mental or physical illness.
  • The challenge remains how to help people initiate physical activity and maintain participation. Professional psychologists have an important role to play in legitimizing physical activity as positive psychology in motion and in helping individuals develop the self-regulatory skills to initiate and maintain physical activity (e.g., self-monitoring, goal-setting, action planning).
  • The most effective dose of physical activity is likely the one that individuals enjoy and find pleasant. A range of physical activity modes and intensities should be recommended based on the participant's previous experiences, preferences, strengths, and goals.
  • Future research should examine why physical activity enhances well-being in some people but not others, adopt a process approach in exploring potential mechanisms explaining the psychological benefits of physical activity, and develop a new agenda exploring sedentary behavior and psychological well-being.

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