What prevents youth at clinical high risk for psychosis from engaging in physical activity? An examination of the barriers to physical activity

Newberry, Raeana E.; Dean, Derek J.; Sayyah, Madison D.; Mittal, Vijay A.

doi:10.1016/j.schres.2018.06.011

Cited by 22 publications

(30 citation statements)

References 44 publications

(54 reference statements)

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“…Consistent with these reports, findings indicate individuals with schizophrenia tend to have highly sedentary lifestyle characterized by low aerobic fitness which was highly correlated with poor cognitive functioning and symptoms (287). These findings parallel reports among individuals at clinical high risk for psychosis indicating lower levels of fitness, less physical activity, as well as more barriers to exercise (288)(289)(290)(291)(292)). Yet, a pilot AE RCT indicated engagement in AE led to 11.0% increase aerobic fitness (293) as well as BDNF vs. a 1.9% in the TAU subjects (294) (reviewed in 295).…”

Section: Aerobic Exercise: a Potentially Protective Factorsupporting

confidence: 73%

Considering the Microbiome in Stress-Related and Neurodevelopmental Trajectories to Schizophrenia

et al. 2020

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Early life adversity and prenatal stress are consistently associated with an increased risk for schizophrenia, although the exact pathogenic mechanisms linking the exposures with the disease remain elusive. Our previous view of the HPA stress axis as an elegant but simple negative feedback loop, orchestrating adaptation to stressors among the hypothalamus, pituitary, and adrenal glands, needs to be updated. Research in the last two decades shows that important bidirectional signaling between the HPA axis and intestinal mucosa modulates brain function and neurochemistry, including effects on glucocorticoid hormones and brain-derived neurotrophic factor (BDNF). The intestinal microbiome in earliest life, which is seeded by the vaginal microbiome during delivery, programs the development of the HPA axis in a critical developmental window, determining stress sensitivity and HPA function as well as immune system development. The crosstalk between the HPA and the Microbiome Gut Brain Axis (MGBA) is particularly high in the hippocampus, the most consistently disrupted neural region in persons with schizophrenia. Animal models suggest that the MGBA remains influential on behavior and physiology across developmental stages, including the perinatal window, early childhood, adolescence, and young adulthood. Understanding the role of the microbiome on critical risk related stressors may enhance or transform of understanding of the origins of schizophrenia and offer new approaches to increase resilience against stress effects for preventing and treating schizophrenia.

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Section: Aerobic Exercise: a Potentially Protective Factorsupporting

confidence: 73%

Considering the Microbiome in Stress-Related and Neurodevelopmental Trajectories to Schizophrenia

et al. 2020

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“…It is notable that older age should be related to reduced, not increased, indices of fitness, and so it is possible that the effect is larger than what is reported in the current paper. Finally, the current study was of a similar size to comparable extant literature; 1,9,10,25 however, the field would benefit from an increased sample size to examine additional variables that may affect fitness, e.g. sex and ethnicity.…”

Section: Discussionmentioning

confidence: 99%

“…of items from a number of validated measures [33][34][35][36] and subscales of this self-report have been previously reported in assessing physical activity in CHR individuals. 10,12 The items selected for the current study include: perceived fitness, frequency of exercise, time spent exercising, and intensity of exercise. Perceived fitness was rated by participants on a Likert-type scale that ranged from 0 (Poor) to 3 (Excellent).…”

Section: Self-reported Fitness Scale Chr Participants Completed a Sementioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] Despite the benefits of this new area of intervention, substantially less work has examined unique factors of the CHR population that would have bearing on tailoring an effective, early intervention (i.e., understanding characteristic health and starting fitness levels). 7,[9][10][11] Extant research, however, has relied solely on self-report measures of physical activity to assess fitness, 9,10,[12][13][14] with few exceptions. 9,14 However, such reports are vulnerable to the influence of episodic memory difficulties, emotional states at the time of the assessment, as well as cognitive biases/reframing.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, CHR individuals consistently self-report lower levels of fitness, less physical activity, and more barriers to exercise. [10][11][12][13][14] Clarifying the nature and extent of fitness deficits in early risk for psychosis would provide critical insight to developing and refining targeting of exercise interventions in these populations. 6,7,22,27 These inconsistencies may be driven by methodological issues surrounding assessments of fitness.…”

Section: Introductionmentioning

confidence: 99%

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Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

Damme¹,

Sloan

Bartels

et al. 2020

Preprint

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Introduction:Exercise is a promising intervention for clinical high-risk for psychosis (CHR) populations, who have attenuated positive symptoms, but evidence suggests that these youth may require tailored exercise interventions. Presently, the scope of the problem is unknown, as these youth may not be reliable reporters on fitness. This issue is compounded by the fact that there have been no investigations that utilized a formal fitness assessment in this critical population.The present study aims to determine the level of fitness in CHR youth with lab-based measures, test how effectively self-report measures characterize objective fitness indices, and explore clinical factors that may be interrupting reliable self-report-an important tool if these interventions are to be taken to scale.Methods: Forty CHR individuals completed an exercise survey and lab-based indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed lab indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness.Results: CHR youth showed greater BMI and lower VO2max compared to healthy volunteers. In the CHR group, abstract self-report items (perceived fitness) did not reflect lab indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with laboratory-based fitness measurements. Exploratory analyses suggested that positive symptoms involving grandiosity, and negative symptoms such as avolition, correlated with discrepancy between self-perception and laboratory findings of fitness. Discussion:Results suggest that CHR individuals are less objectively fit than matched controls, and that it will be important to consider unique population characteristics when weighing selfreport data.

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The impact of inflammation on neurocognition and risk for psychosis: a critical review

Kogan

Ospina

Mittal

et al. 2019

Eur Arch Psychiatry Clin Neurosci

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Neurocognitive difficulties are highly prevalent among people with schizophrenia and have been linked to increased inflammation, as well as dysfunction and disability. Poor neurocognitive functioning has also been documented in individuals at clinical high risk for psychosis (CHR) and a burgeoning literature point to alterations in inflammation markers in this population. However, there is limited information regarding the putative link between inflammation and neurocognition in CHR individuals, and the potential role of inflammation in the development of cognitive difficulties and psychosis. As previous reports indicate that early treatment in schizophrenia is associated with better outcomes, there is an urgent need to identify neurobiological mechanisms underlying cognitive deterioration and psychosis in CHR individuals to provide them with care prior to significant cognitive and functional declines. To address this gap in the literature, we review and summarize the relevant literatures on inflammation and neurocognitive dysfunction in schizophrenia and CHR individuals, point to remaining gaps, and suggest directions for future research.

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What prevents youth at clinical high risk for psychosis from engaging in physical activity? An examination of the barriers to physical activity

Abstract: The results of the current study support the notion that sedentary behavior is common in CHR youth, and more broadly, provide an impetus to target motivation through supervised exercise and fitness tracking to promote the health and well-being of CHR individuals.

Cited by 22 publications

References 44 publications

Considering the Microbiome in Stress-Related and Neurodevelopmental Trajectories to Schizophrenia

Considering the Microbiome in Stress-Related and Neurodevelopmental Trajectories to Schizophrenia

Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

The impact of inflammation on neurocognition and risk for psychosis: a critical review

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