A brief intervention to improve exercising in patients with schizophrenia: a controlled pilot study with mental contrasting and implementation intentions (MCII)

BMC Psychiatry

Michael Odenwald¹  Franz Volk¹  Daniel Nischk¹  Steffen Stoewer³  Karl Pröpster¹  Frank Wieber²  Pascal Sailer² 

[1] Center for Psychiatry, Feursteinstrasse 55, Reichenau, 78479, Germany;Department of Psychology, University of Konstanz, Universitätsstrasse 10, Konstanz, 78464, Germany;Thurgau Psychiatric Services, Seeblickstrasse 3, Münsterlingen, 8596, Switzerland

关键词: Self-regulation;    Schizophrenia;    Physical activity;    Mental contrasting;    Implementation intentions;    Exercise;   

Others  :  1229595
DOI  :  10.1186/s12888-015-0513-y

 received in 2013-11-25, accepted in 2015-05-29,  发布年份 2015

【 摘 要 】

Background

Regular exercise can have positive effects on both the physical and mental health of individuals with schizophrenia. However, deficits in cognition, perception, affect, and volition make it especially difficult for people with schizophrenia to plan and follow through with their exercising intentions, as indicated by poor attendance and high drop-out rates in prior studies. Mental Contrasting and Implementation Intentions (MCII) is a well-established strategy to support the enactment of intended actions. This pilot study tests whether MCII helps people with schizophrenia in highly structured or autonomy-focused clinical hospital settings to translate their exercising intentions into action.

Methods

Thirty-six inpatients (eleven women) with a mean age of 30.89 years (SD = 11.41) diagnosed with schizophrenia spectrum disorders from specialized highly structured or autonomy-focused wards were randomly assigned to two intervention groups. In the equal contact goal intention control condition, patients read an informative text about physical activity; they then set and wrote down the goal to attend jogging sessions. In the MCII experimental condition, patients read the same informative text and then worked through the MCII strategy. We hypothesized that MCII would increase attendance and persistence relative to the control condition over the course of four weeks and this will be especially be the case when applied in an autonomy-focused setting compared to when applied in a highly structured setting.

Results

When applied in autonomy-focused settings, MCII increased attendance and persistence in jogging group sessions relative to the control condition. In the highly structured setting, no differences between conditions were found, most likely due to a ceiling effect. These results remained even when adjusting for group differences in the pre-intervention scores for the control variables depression (BDI), physical activity (IPAQ), weight (BMI), age, and education. Whereas commitment and physical activity apart from the jogging sessions remained stable over the course of the treatment, depression and negative symptoms were reduced. There were no differences in pre-post treatment changes between intervention groups.

Conclusions

The intervention in the present study provides initial support for the hypothesis that MCII helps patients to translate their exercising intentions into real-life behavior even in autonomously-focused settings without social control.

Trial registration

ClinicalTrials.gov ID; URL: NCT01547026 Registered 3 March 2012.

【 授权许可】

   
2015 Sailer et al.

【 图 表 】

Fig. 1.

Fig. 2.

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