Physical Activity Participation, Quality of Life, and Behavioral Health Disorders for Veterans with PTSD
DOI:
https://doi.org/10.18666/TRJ-2024-V58-I1-12055Keywords:
Behavioral health disorders, Posttraumatic stress disorder, Physical activity, health related quality of life, Recreational Therapy, Substance use disorder, VeteranAbstract
The growing prevalence of behavioral health disorders in veterans has triggered a wide-spread effort to identify and provide complementary interventions. This study investigated physical activity as a complementary treatment option for veterans with posttraumatic stress disorder (PTSD) for recreational therapy (RT) programs. A correlational survey research design was used to examine relationships between participation in three types of physical activity (traditional indoor fitness, outdoor adventure activity, and mind-body practices) and four psychosocial measures for veterans with PTSD (depression, anxiety, health-related quality of life [HRQoL], and substance use). A total of 102 participants completed the online survey. Results indicated that the frequency and duration of traditional indoor fitness activities and outdoor adventure activities were significantly associated with higher HRQoL, lower reoccurrence of substance use risk, substance use, and depression. Implications for the use of physical activity in recreational therapy for veterans with behavioral health disorders and future research studies were presented.
References
Acosta, J., Becker, A., Cerully, J. L., Fisher, M. P., Martin, L. T., Vardavas, R., Schell, T. L. (2014). Mental health stigma in the military. Research Reports (p. 330). Retrieved from http://www.rand.org/pubs/research_reports/RR426.html
Acosta, J., Becker, A., Cerully, J. L., Fisher, M. P., Martin, L. T., Vardavas, R., Schell, T. L. (2016). Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma. —BRIEFING
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Fifth ed. Arlington, VA: American Psychiatric Association; 2013.
Babson, K. A., Heinz, A. J., Ramirez, G., Puckett, M., Irons, J. G., Bonn-miller, M. O., & Woodward, S. H. (2015). The interactive role of exercise and sleep on veteran recovery from symptoms of PTSD. Mental Health and Physical Activity, 8, 15–20. http://doi.org/10.1016/j.mhpa.2014.12.002
Bennett, J. L., Craig, P., Aytur, S., Thompson, T., Roscoe, H. S., & Gravink, J. (2022). Community-based recreational therapy for veterans with behavioral health disorders: Impacts on quality of life, participation, and happiness. Community Mental Health Journal, https://doi.org/10.1007/s10597-022-00962-6.
Bennett, J. L., Piatt, J. A., & Van Puymbroeck, M. (2017). Outcomes of a therapeutic fly-fishing program for veterans with combat-related disabilities: A community-based rehabilitation initiative. Community Mental Health Journal, 53(7), 756-765. doi:10.1007/s10597-017-0124-9
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res, 52(2), 69-77.
Caddick, N., & Smith, B. (2014). The impact of sport and physical activity on the well-being of combat veterans: A systematic review. Psychology of Sport and Exercise. 15, 9-18. https://doi.org/10.1016/j.psychsport.2013.09.011
Ekkekakis, P. (2015). Honey, I shrunk the pooled SMD! Guide to critical appraisal of systematic reviews and meta-analyses using the Cochrane review on exercise for depression as an example. Mental Health and Physical Activity, 8, DOI10.1016/j.mhpa.2014.12.001
Fisher, M., & Baum, F. (2010). The social determinants of mental health: implications for research and health promotion. The Australian and New Zealand Journal of Psychiatry, 44(January), 1057–1063. https://doi.org/10.3109/00048674.2010.509311
Gelkopf, M., Hasson-Ohayon, I., Bikman, M., & Kravetz, S. (2013). Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: A randomized control trial. Psychiatry Research, 209(3), 485–493. https://doi.org/10.1016/j.psychres.2013.01.026
Hawkins, B. L., Townsend, J. A., & Garst, B. A. (2016). Nature-based recreational therapy for military service members: A strengths approach. Therapeutic Recreation Journal, 50(1), 55–74. https://doi.org/10.18666/TRJ-2016-V50-I1-6793
Hooker, T., Townsend, J., & Hawkins, B.L. (2022). Examining importance and performance of a military specific equine therapy program. American Journal of Recreation Therapy, 21(1). DOI: https://doi.org/10.5055/ajrt.2022.0253.
Kazis L. E., Miller, D.R., Skinner, K. M., Lee, A., Ren, X.S., Clark, J.A., Rogers, W. H., Spiro, A., Selim, A., Linzer, M., Payne, S.M., Mansell, D., & Fincke, B.G (2006). Applications of Methodologies of the Veterans Health Study in the VA Health Care System: Conclusions and Summary. J Ambulatory Care Management, 29:2. 182-188.
Landale, Sarah. (2012). Trajectories, transitions, and turning points: Sports, substance misuse, and desistance. Doctoral dissertation. Retrieved from http://etheses.dur.ac.uk/3623/
Lundberg, N. R., Bennett, J. L., & Smith, S. (2011). Outcomes of adaptive sports and recreation participation among veterans returning from combat with acquired disability. Therapeutic Recreation Journal, 45(2), 105-120.
Misra-Hebert, A. D., Santurri, L., DeChant, R., Watts, B., Rothberg, M., Sehgal, A. R., & Aron, D. C. (2015). Understanding the health needs and barriers to seeking health care of veteran students in the community. Southern Medical Journal, 108(8), 488–493. https://doi.org/10.14423/SMJ.0000000000000326.
Mowatt, R. A., & Bennett, J. L. (2011). War narratives: Veteran stories, PTSD effects and therapeutic fly-fishing. Therapeutic Recreation Journal, 45(4), 286-308.
Murphy, J.L., McKellar, J.D., Raffa, S.D., Clark, M.E., Kerns, R.D., & Karlin, B.E. Cognitive behavioral therapy for chronic pain among veterans: Therapist manual. Washington, DC: U.S. Department of Veterans Affairs.
National Center of Complementary and Integrative Health (2017). Complementary, alternative, or integrative health: What's in a name?. Retrieved from https://nccih.nih.gov/health/integrative-health
Olenick, M., Flowers, M., & Diaz, V. (2015). US veterans and their unique issues: enhancing health care professional awareness. Advances in Medical Education and Practice, 635. https://doi.org/10.2147/AMEP.S89479
Rauch, S. A. M., Favorite, T., Giardino, N., Porcari, C., Defever, E., & Liberzon, I. (2010). Relationship between anxiety, depression, and health satisfaction among veterans with PTSD. Journal of Affective Disorders, 121(1–2), 165–168. https://doi.org/10.1016/j.jad.2009.05.026
Sharp, M. L., Fear, N. T., Rona, R. J., Wessely, S., Greenberg, N., Jones, N., & Goodwin, L. (2015). Stigma as a barrier to seeking health care among military personnel with mental health problems. Epidemiologic Reviews, 37(1), 144–162. https://doi.org/10.1093/epirev/mxu012
Smith, M. A., & Lynch, W. J. (2012). Exercise as a potential treatment for drug abuse: Evidence from preclinical studies. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2011.00082
Stern, A. (2014). Questionnaire review: the hospital anxiety and depression scale. Occupational Medicine, 64, 393-394. doi:10.1093/occmed/kqu024
Substance Abuse and Mental Health Services Administration (2008). National consensus statement on mental health recovery. Retrieved from http://www.cibhs.org/sites/main/files/file-attachments/10_fundamental_components_of_recovery.pdf
Sylvia, L., Bernstein, E., Hubbard, J., Keating, L., & Anderson, E. (2014). A Practical Guide for Measuring Physical Activity. J. Acad Nutr Diet. 114(2): 199-208. https://doi.org/10.1016/j.jand.2013.09.018
Tull, M. T., Lee, A. A., Geers, A. L., & Gratz, K. L. (2018). Exploring the role of sedentary behavior and physical activity in depression and anxiety symptom severity among patients with substance use disorders. Mental Health and Physical Activity, 14, 98-102. https://doi.org/10.1016/j.mhpa.2018.03.001
U.S. Department of Health and Human Services Physical Activity Guidelines Advisory Committee (2018) Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC:, 2018.
U.S. Department of Veterans Affairs (2016). The returning veteran of the Iraq War: background issues and assessment guidelines. Retrieved from https://www.ptsd.va.gov/professional/treatment/vets/vets-iraq-war-guidelines.asp
U.S. Department of Veterans Affairs (2021). VA Research on Mental Health. Retrieved from https://www.research.va.gov/topics/mental_health.cfm#:~:text=According%20to%20the%20National%20Institute,mental%20health%20services%20to%20Veterans
U.S. Department of Veterans Affairs (2023). PTSD: National center for PTSD. Retrieved from https://www.ptsd.va.gov/understand/related/substance_abuse_vet.asp
Walker, J. & Pacik, D. (2017). Controlled rhythmic yogic breathing as complementary treatment for post-traumatic stress disorder in military veterans: A case series. Medical Acupuncture, 29(4), 232–238. https://doi.org/http://dx.doi.org/10.1089/acu.2017.1215
Wang, D., Wang, Y., Wang, Y. Li, R., & Zhou, C. (2014). Impact of physical exercise on substance use disorders: A meta-analysis. PLOS One 9(10). https://doi.org/10.1371/journal.pone.0110728
Weathers, F.W., Litz, B.T., Herman, D.S., Huska, J.A. and Keane, T.M. (1993). The PTSD Checklist (PCL): Reliability, Validity, and Diagnostic Utility. Annual Convention of the International Society for Traumatic Stress Studies, San Antonio.
Wheeler, M., Cooper, N., Andrews, L., Hacker, J., Juanchich, R., Rakow, T., Orbell., S. (2020). Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial. PLoS One, 15(11): e0241763. https://doi.org/10.1371/journal. pone.0241763.
Whitworth, J. W., & Ciccolo, J. T. (2016). Exercise and post-traumatic stress disorder in military veterans: A systematic review. Military Medicine, 181(9), 953–960. https://doi.org/10.7205/MILMED-D-15-00488
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Zschucke, E., Gaudlitz, K., & Ströhle, A. (2013). Exercise and Physical Activity in Mental Disorders: Clinical and Experimental Evidence. Journal of Preventive Medicine & Public Health S12 J Prev Med Public Health, 46, 12–21. https://doi.org/10.3961/jpmph.2013.46.S.S12
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