(PS9-A15) Physical Activity and Self-efficacy in Emotion Management in Anxiety Disorder Treatment: Ecological Momentary Assessment in CBT for Anxiety Disorders

Background

            Anxiety-related disorders are associated with difficulty managing emotional distress and maintaining social connection and physical health. Although CBT is associated with improvements in affect and ability to manage distressing emotions, it is not clear whether physical activity can also impact affect and emotion management. We hypothesized that in patients receiving treatment for anxiety-related disorders, increased physical activity (steps taken per day) would be associated with improved next-day affect (reduced anxiety and depression symptoms), social health (reduced social isolation), physical health (sleep function, physical functioning, and global physical health), and positive psychological function (self-efficacy in emotion management). We also expected that improved affect, emotion management, and physical and social health would be predictive of increased next-day physical activity.

Methods

We evaluated changes in psychological and physical health outcomes using technology-based assessments in a naturalistic sample of adult patients receiving CBT for anxiety disorders (N = 40). Participants were provided with a wearable device (Fitbit) that they were encouraged to wear as much as possible and were sent daily ecological momentary assessments (EMA) throughout the duration of their CBT, or for up to 20 weeks. Fitbits monitored participants’ daily physical activity and sleep. EMA questions measured participants’ self-reported experiences in 7 domains – anxiety, depression, sleep, social isolation, self-efficacy in emotion management, global physical health, and physical function – alternating each day of study participation.  

Results

            We observed that increased physical activity significantly predicted next-day improved self-efficacy in emotion management (t = 2.41, p = .02), but did not significantly predict improvements in next-day EMA-assessed anxiety (t = -0.89, p = .37), depression (t = -0.06, p = .96), social isolation (t = -0.08, p = .93), sleep (t = -.11, p = .91), global physical health (t = 1.16, p = .25), or physical functioning (t = .78, p = .44). EMA-assessed self-efficacy in emotion management (t = .95, p = .35), anxiety (t = 0.49, p = .63), depression (t = -0.84, p = .40), social isolation (t = -1.59, p = .12), sleep (t = -0.80, p = .42), global physical health (t = .72, p = .47), and physical functioning (t = 1.47, p = .14) were not significantly associated with next-day physical activity.

Conclusions

These results indicate that EMA assessments may be useful during CBT for highlighting the association between increasing physical activity and improving self-efficacy in emotion management for patients with anxiety-related disorders. While we hypothesized that physical activity would predict both affect and self-efficacy in emotion management, these findings indicate that we may be able to differentially predict one domain and not the other.

Keywords: anxiety, CBT, ecological momentary assessment, technology/mobile health