McCausland Hannah C, Hagerman Charlotte J, Ehmann Marny M, Butryn Meghan L
Department of Psychological and Brain Sciences and Center for Weight Eating and Lifestyle Science (WELL Center) Drexel University Philadelphia Pennsylvania USA.
Obes Sci Pract. 2023 Jan 17;9(4):364-375. doi: 10.1002/osp4.661. eCollection 2023 Aug.
Many adults with overweight or obesity experience subclinical symptoms of depression, but little is known about how such symptoms are associated with physical activity (PA) or the experience of PA during behavioral weight loss (BWL) treatment.
In the current study, adults recruited from the community (N = 320) received 18 months of group-based BWL treatment and wore accelerometers at months 0, 6, and 18 to objectively measure PA. Participants with a mood disorder that was not well controlled were not eligible for the study and were referred for individual treatment. Depressive symptoms, PA barriers, discomfort avoidance, and self-control were self-reported with validated measures.
At baseline, the majority of participants indicated some depressive symptoms, mostly at subclinical levels. Results of multilevel models suggest that depressive symptoms were not significantly associated with concurrent measures of PA engagement (minutes/week) or sedentary behavior (minutes/week) at a given time point (i.e., baseline, 6 months, or 18 months). Results of cross-level interactions suggest that baseline depressive symptoms did not moderate the change in PA or sedentary behavior across time. Concurrent depressive symptoms and PA barriers were significantly and positively associated at a given time point (i.e., baseline, 6 months, or 18 months); however, baseline depressive symptoms did not moderate the improvement in perceived PA barriers across time. At baseline, higher discomfort avoidance and lower self-control each independently and partially mediated the relationship between depressive symptoms and PA barriers.
Results suggest that, among BWL samples in which most participants do not have clinically significant depressive symptoms, the likelihood of adopting and sustaining PA does not depend on the extent of depressive symptoms, but those with elevated symptoms may benefit from approaches that address their perception that engaging in PA is especially challenging.
许多超重或肥胖的成年人存在抑郁症的亚临床症状，但对于这些症状如何与身体活动（PA）相关联，或在行为减肥（BWL）治疗期间的PA体验，人们知之甚少。
在本研究中，从社区招募的成年人（N = 320）接受了为期18个月的基于小组的BWL治疗，并在第0、6和18个月佩戴加速度计以客观测量PA。患有未得到良好控制的情绪障碍的参与者无资格参加本研究，并被转介接受个体治疗。通过经过验证的测量方法自我报告抑郁症状、PA障碍、不适回避和自我控制情况。
在基线时，大多数参与者表示有一些抑郁症状，大多处于亚临床水平。多层次模型的结果表明，在给定时间点（即基线、6个月或18个月），抑郁症状与PA参与度（分钟/周）或久坐行为（分钟/周）的同时测量结果无显著关联。跨层次交互作用的结果表明，基线抑郁症状并未调节PA或久坐行为随时间的变化。在给定时间点（即基线、6个月或18个月），同时存在的抑郁症状与PA障碍显著正相关；然而，基线抑郁症状并未调节随时间推移感知到的PA障碍的改善情况。在基线时，较高的不适回避和较低的自我控制各自独立且部分介导了抑郁症状与PA障碍之间的关系。
结果表明，在大多数参与者没有临床上显著抑郁症状的BWL样本中，采用和维持PA的可能性并不取决于抑郁症状的程度，但症状较高的人可能会从解决他们认为参与PA特别具有挑战性这一观念的方法中受益。
