Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial

Background: Bouldering psychotherapy (BPT) combines psychotherapeutic elements with physical activity (PA). It might be effective for reducing symptoms of depression, but so far, no study has assessed individuals' levels of PA to control for whether positive effects on depression can also be fo...

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Main Authors: Eva-Maria Stelzer, Stephanie Book, Elmar Graessel, Benjamin Hofner, Johannes Kornhuber, Katharina Luttenberger
Format: Article
Language:English
Published: Elsevier 2018-03-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844017317784
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author Eva-Maria Stelzer
Stephanie Book
Elmar Graessel
Benjamin Hofner
Johannes Kornhuber
Katharina Luttenberger
author_facet Eva-Maria Stelzer
Stephanie Book
Elmar Graessel
Benjamin Hofner
Johannes Kornhuber
Katharina Luttenberger
author_sort Eva-Maria Stelzer
collection DOAJ
description Background: Bouldering psychotherapy (BPT) combines psychotherapeutic elements with physical activity (PA). It might be effective for reducing symptoms of depression, but so far, no study has assessed individuals' levels of PA to control for whether positive effects on depression can also be found when adjusting for participants' levels of PA. This is important because PA itself has been proven effective in reducing depression and therefore might be an important variable to account for – especially in therapies using sport as one therapeutic mechanism. Methods: Using a waitlist control group design, outpatients with depression were assessed at baseline and after eight, 16, and 24 weeks. The intervention group took part in an eight-week bouldering psychotherapy which met once a week for three hours. Self-report measures before and after the intervention included the Symptom Checklist-90-R (SCL-90-R), the Beck Depression Inventory (BDI-II), and the questionnaire on resources and self-management skills (FERUS). PA was assessed during the first 16-week period via FitBit Zip accelerometers. Results: Altogether, 47 complete cases (20 men and 27 women) were included in the final analyses. Depression scores dropped by up to 6.74 (CI 2.80–10.67) points on the SCL-90-R depression scale and by up to 8.26 (CI 4.21–12.31) points on the BDI-II during the BPT intervention, the control group remained stable (SCL-90-R Cohen's d = 0.60; BDI-II: Cohen's d = .50). All Participants accrued an average of 6,515 steps per day, which is considered “low-active.” Participants of the BPT intervention were significantly more likely to reduce their depressive symptoms (p = .025) than participants of the control group, even when PA was controlled for in a regression analysis. Limitations: Limitations of the study are the relatively small number of patients and the assessment of outcome scores via self-report. Conclusions: This study provides evidence that short-term BPT can be effective for reducing symptoms of depression even if controlled for other therapeutically active confounders including antidepressant medication, psychotherapy and general level of PA.
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spelling doaj.art-f2d90967938a4e52a351701379ded2502022-12-22T03:04:32ZengElsevierHeliyon2405-84402018-03-0143e00580Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trialEva-Maria Stelzer0Stephanie Book1Elmar Graessel2Benjamin Hofner3Johannes Kornhuber4Katharina Luttenberger5Friedrich-Alexander-Universität Erlangen-Nürnberg Psychiatric and Psychotherapeutic University Clinic Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, Germany; University of Arizona, Department of Psychology, 1503 E University Blvd, Tucson, AZ 85719, USAFriedrich-Alexander-Universität Erlangen-Nürnberg Psychiatric and Psychotherapeutic University Clinic Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, GermanyFriedrich-Alexander-Universität Erlangen-Nürnberg Psychiatric and Psychotherapeutic University Clinic Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, GermanyFriedrich-Alexander-Universität Erlangen-Nürnberg, Department of Medical Informatics, Biometry and Epidemiology, Waldstraße 6, 91054 Erlangen, Germany; Section Biostatistics, Paul-Ehrlich-Institut, Langen, GermanyFriedrich-Alexander-Universität Erlangen-Nürnberg Psychiatric and Psychotherapeutic University Clinic Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, GermanyFriedrich-Alexander-Universität Erlangen-Nürnberg Psychiatric and Psychotherapeutic University Clinic Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, Germany; Corresponding author.Background: Bouldering psychotherapy (BPT) combines psychotherapeutic elements with physical activity (PA). It might be effective for reducing symptoms of depression, but so far, no study has assessed individuals' levels of PA to control for whether positive effects on depression can also be found when adjusting for participants' levels of PA. This is important because PA itself has been proven effective in reducing depression and therefore might be an important variable to account for – especially in therapies using sport as one therapeutic mechanism. Methods: Using a waitlist control group design, outpatients with depression were assessed at baseline and after eight, 16, and 24 weeks. The intervention group took part in an eight-week bouldering psychotherapy which met once a week for three hours. Self-report measures before and after the intervention included the Symptom Checklist-90-R (SCL-90-R), the Beck Depression Inventory (BDI-II), and the questionnaire on resources and self-management skills (FERUS). PA was assessed during the first 16-week period via FitBit Zip accelerometers. Results: Altogether, 47 complete cases (20 men and 27 women) were included in the final analyses. Depression scores dropped by up to 6.74 (CI 2.80–10.67) points on the SCL-90-R depression scale and by up to 8.26 (CI 4.21–12.31) points on the BDI-II during the BPT intervention, the control group remained stable (SCL-90-R Cohen's d = 0.60; BDI-II: Cohen's d = .50). All Participants accrued an average of 6,515 steps per day, which is considered “low-active.” Participants of the BPT intervention were significantly more likely to reduce their depressive symptoms (p = .025) than participants of the control group, even when PA was controlled for in a regression analysis. Limitations: Limitations of the study are the relatively small number of patients and the assessment of outcome scores via self-report. Conclusions: This study provides evidence that short-term BPT can be effective for reducing symptoms of depression even if controlled for other therapeutically active confounders including antidepressant medication, psychotherapy and general level of PA.http://www.sciencedirect.com/science/article/pii/S2405844017317784Clinical psychologyEvidence-based medicinePsychiatryPsychology
spellingShingle Eva-Maria Stelzer
Stephanie Book
Elmar Graessel
Benjamin Hofner
Johannes Kornhuber
Katharina Luttenberger
Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial
Heliyon
Clinical psychology
Evidence-based medicine
Psychiatry
Psychology
title Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial
title_full Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial
title_fullStr Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial
title_full_unstemmed Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial
title_short Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial
title_sort bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for a randomized controlled trial
topic Clinical psychology
Evidence-based medicine
Psychiatry
Psychology
url http://www.sciencedirect.com/science/article/pii/S2405844017317784
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