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      Association between regular physical exercise and depressive symptoms mediated through social support and resilience in Japanese company workers: a cross-sectional study

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          Abstract

          Background

          Regular physical exercise has been reported to reduce depressive symptoms. Several lines of evidence suggest that physical exercise may prevent depression by promoting social support or resilience, which is the ability to adapt to challenging life conditions. The aim of this study was to compare depressive symptoms, social support, and resilience between Japanese company workers who engaged in regular physical exercise and workers who did not exercise regularly. We also investigated whether regular physical exercise has an indirect association with depressive symptoms through social support and resilience.

          Methods

          Participants were 715 Japanese employees at six worksites. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression (CES-D) scale, social support with the short version of the Social Support Questionnaire (SSQ), and resilience with the 14-item Resilience Scale (RS-14). A self-report questionnaire, which was extracted from the Japanese version of the Health-Promoting Lifestyle Profile, was used to assess whether participants engage in regular physical exercise, defined as more than 20 min, three or more times per week. The group differences in CES-D, SSQ, and RS-14 scores were investigated by using analysis of covariance (ANCOVA). Mediation analysis was conducted by using Preacher and Hayes’ bootstrap script to assess whether regular physical exercise is associated with depressive symptoms indirectly through resilience and social support.

          Results

          The SSQ Number score ( F = 4.82, p = 0.03), SSQ Satisfaction score ( F = 6.68, p = 0.01), and RS-14 score ( F = 6.01, p = 0.01) were significantly higher in the group with regular physical exercise ( n = 83) than in the group without regular physical exercise ( n = 632) after adjusting for age, education, marital status, and job status. The difference in CES-D score was not significant ( F = 2.90, p = 0.09). Bootstrapping revealed significant negative indirect associations between physical exercise and CES-D score through the SSQ Number score (bias-corrected and accelerated confidence interval (BCACI) = −0.61 to −0.035; 95 % confidence interval (CI)), SSQ Satisfaction score (BCACI = −0.92 to −0.18; 95 % CI), and RS-14 score (BCACI = −1.89 to −0.094; 95 % CI).

          Conclusion

          Although we did not find a significant direct association between exercise and depressive symptoms, exercise may be indirectly associated with depressive symptoms through social support and resilience. Further investigation is warranted.

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          Most cited references38

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          Assessing social support: The Social Support Questionnaire.

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            A review of instruments measuring resilience.

            The objectives of the study were to evaluate the psychometric properties and appropriateness of instruments for the study of resilience in adolescents. A search was completed using the terms resilience and instruments or scales using the EBSCO database (CINAHL, PreCINAHL, and Academic Search Premier), MEDLINE, PsychINFO and PsychARTICLES, and the Internet. After instruments were identified, a second search was performed for studies reporting the psychometric development of these instruments. Using inclusion and exclusion criteria, six psychometric development of instrument studies were selected for a full review. A data extraction table was used to compare the six instruments. Two of the six instruments (Baruth Protective Factors Inventory [BPFI] and Brief-Resilient Coping Scale) lacked evidence that they were appropriate for administration with the adolescent population due to lack of research applications. Three instruments (Adolescent Resilience Scale [ARS], Connor-Davidson Resilience Scale, and Resilience Scale for Adults) had acceptable credibility but needed further study in adolescents. One instrument (Resilience Scale [RS]) was determined to be the best instrument to study resilience in the adolescent population due to psychometric properties of the instrument and applications in a variety of age groups, including adolescence. Findings of this review indicate that the RS is the most appropriate instrument to study resilience in the adolescent population. While other instruments have potential (e.g., ARS, BPFI) as they were tested in the adolescent and young adult populations, they lack evidence for their use at this time. An evaluation of the review and recommendations are discussed.
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              Variation and homogeneity in affective responses to physical activity of varying intensities: an alternative perspective on dose-response based on evolutionary considerations.

              A model for systematic changes in patterns of inter-individual variation in affective responses to physical activity of varying intensities is presented, as a conceptual alternative to the search for a global dose-response curve. It is theorized that trends towards universality will emerge in response to activities that are either generally adaptive, such as moderate walking, or generally maladaptive, such as strenuous running that requires anaerobic metabolism and precludes the maintenance of a physiological steady state. At the former intensity the dominant response will be pleasure, whereas at the latter intensity the dominant response will be displeasure. In contrast, affective responses will be highly variable, involving pleasure or displeasure, when the intensity of physical activity approximates the transition from aerobic to anaerobic metabolism, since activity performed at this intensity entails a trade-off between benefits and risks. Preliminary evidence in support of this model is presented, based on a reanalysis of data from a series of studies.
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                Author and article information

                Contributors
                e-yoshi@nms.ac.jp
                +81-42-341-2711 , d-nishi@umin.ac.jp
                yumatsuo@ncc.go.jp
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                12 July 2016
                12 July 2016
                2016
                : 16
                : 553
                Affiliations
                [ ]Department of Neuropsychiatry, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama Tama City, Tokyo, 206-8512 Japan
                [ ]Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8602 Japan
                [ ]Department of Psychiatry, National Disaster Medical Center, 3256 Midoricho, Tachikawa, Tokyo, 190-0014 Japan
                [ ]Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo, 187-8553 Japan
                [ ]Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
                Article
                3251
                10.1186/s12889-016-3251-2
                4942984
                27405459
                957b30de-6b48-450c-bc51-587018c9d5bf
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 December 2015
                : 29 June 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                depressive symptoms,social support,resilience,physical exercise
                Public health
                depressive symptoms, social support, resilience, physical exercise

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