Exercise and mental health in the pediatric population.

Although the generally accepted belief in the psychological benefits of exercise for children has very little documentation by well controlled studies, the risk:benefit ratio nonetheless tends to favor exercise when competition is sensibly controlled. The field is a fertile one for longitudinal and developmental investigations employing more sophisticated psychological measures and appropriate physiological assessment. Studies using self-concept measures in very young children may find less change after exercise than those using a more age-specific developmental scale, such as the Vineland Social Maturity Scale or human figure drawings. Exercise programs for childhood research may be more informative when natural exercise patterns are observed than when artificial regimens are imposed. The mechanism through which exercise effects psychological change remains unidentified; the beta-endorphin theory suggested by Carr was not documented when Markoff, Ryan, and Young discovered that naloxone, an endorphin antagonist, failed to reverse the mood elevation associated with running. The important effects of exercise on the immune system recently reported in adults have not been investigated in children. The possible implications of my recent finding of a significantly reduced level of absolute lymphocytes among a large group of hospitalized depressed adults remain to be assessed but suggest directions for research. Having treated a 10-year-old Little League player with a generalized anxiety disorder; a 7-year-old Pony League outfielder terrified over the possibility of being hit in the head with a baseball; and a 9-year-old with peptic ulcer associated with a Little League all-star selection, I plead for the encouragement of sports for pleasure rather than glory, while at the same time recommending regular and age-appropriate exercise for children. Using our research findings, we have developed a profile of psychosomatic fitness, an optimal state of health in which there is an accurate balancing process involving mind, body, and spirit through attention to how we live and regard others. No one may possess all the characteristics of this profile, but it is an ideal. The extent to which one may achieve psychosomatic fitness may vary from time to time, depending on one's unique circumstances, but its attainment seems to be related to will power, motivation, and respect for the dire consequences of failure.