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IU Health & Wellness

Research and insights from Indiana University

Jan. 14, 2009

IU Health and Wellness for January discusses the following topics:

Physical activity, mood and serious mental illness
Emotional toll of athletic injuries
Prenatal exposure to nicotine and behavior problems

Physical activity, mood and serious mental illness. A new study from Indiana University suggests that even meager levels of physical activity can improve the mood of people with serious mental illnesses (SMI) such as bipolar disorder, major depression and schizophrenia. The study, published in the November issue of the International Journal of Social Psychiatry, both reinforces earlier findings that people with SMI demonstrate low levels of physical activity and supports the consideration of physical activity as a regular part of psychiatric rehabilitation. "We found a positive association between physical activity level and positive mood when low to moderate levels of physical activity are considered," said study author Bryan McCormick, associate professor in IU's Department of Recreation, Park and Tourism Studies. "Physical activity interventions that require lower levels of exertion might be more conducive to improving transitory mood, or the ups and downs people with SMI experience throughout the day." McCormick said physical activity often is advocated in addition to psychiatric treatment for people with SMI because of the significant health concerns common to this population. The low levels of physical activity also common to this population poses a major hurdle, however. For this study, physical activity is considered most forms of sustained movement, such as house cleaning, gardening, walking for transportation or formal exercise. "The challenge is how to use naturally motivating activities that people have in their everyday lives to get them out and engaged," McCormick said.

About the study:

  • For seven consecutive days, researchers randomly paged study participants, who then filled out questionnaires about their mood and recent activities. The responses were matched with data collected during the previous 10 minutes using small light-weight accelerometers worn by the study participants. The equipment measured activity levels and duration. McCormick said this is the first time these research methods were combined, allowing researchers to look at study participants' daily ups and downs as they occur rather than trying to average the experiences.
  • The study involved 11 people from the U.S. and 12 people from Serbia. Central Europe is experiencing a shift from institutional care to community care for its citizens with SMI, similar to the shift seen in the U.S. in the 1970s. McCormick's research has been examining this, too, in comparison to U.S. populations. The findings were surprising in this particular study. "I was expecting a higher level of physical activity within the population of Eastern Europeans," he said. "We didn't see any differences."
  • The average physical activity level for both groups was comparable to that of sedentary adults, less than that of adults with a developmental disability and considerably less than that of active adults, according to earlier research by study co-author Georgia Frey, associate professor in IU's Department of Kinesiology.
  • The least active experiences captured in this study correlated with less positive moods.

The study notes that walking is one of the most frequently advocated forms of physical activity in psychiatric rehabilitation programs. Such programs, according to the study, would appear to afford both physiological and psychological benefits.

Co-authors include Frey; Chien-Tsung Lee, IU Department of Kinesiology, School of Health, Physical Education and Recreation; Sanghee Chun, IU School of HPER's Department of Recreation, Park and Tourism Studies; Jim Sibthorp, University of Utah, Salt Lake City; Tomislav Gajic, M.D., Branka Stamatovic-Gajic, M.D., and Milena Maksimovich, Department of Psychiatry, Health Centre Valjevo, Valjevo, Serbia.

McCormick can be reached at 812-855-3482 and Top

Journal citation: "Predicting Transitory Mood From Physical Activity Level Among People With Severe Mental Illness in Two Cultures," International Journal of Social Psychiatry. 2008, 54: 527-538.

Douglas McKeag

Douglas McKeag

Print-Quality Photo

Recovery rage? When athletes become injured -- particularly competitive athletes -- they often experience a range of emotions that can prolong their recovery and cloud their judgment. Depression, anger and denial are emotions athletes can find themselves dealing with as they work to rejoin their teams or return to top competitive form. "Whenever something is taken from you and you don't really have control over that process -- most humans don't respond well to this," said Douglas McKeag, M.D., director of the Center for Sports Medicine at the Indiana University School of Medicine. "It's a modified version of the grief process." Often, for example, patients will arrive at appointments angry and unwilling to accept that they are making good progress. Sometimes athletes deny that they are experiencing pain and as a result run or practice through it -- delaying their recovery and increasing the possibility of reinjury. McKeag said he enjoys practicing sports medicine in large part because of the motivation his patients have for returning to their competitive form. "This motivation can be positive, but it could become negative as well," he said.

McKeag offers these considerations:

  • Recognize the role emotions can play in recovery and work with a physician or health care provider on a reasonable recovery plan.
  • Determine the cause of an injury. This can be challenging, particularly with back injuries, but it's important. If the pain has subsided simply because of rest, athletes are at risk of reinjury when they return to normal activity, because the cause of the injury might not have not been addressed.
  • Most reinjuries occur because the cause of the injury was not determined and the athlete returned to normal activity prematurely.

McKeag also is chair of the Department of Family Medicine. He can be reached at the IU Center for Sports Medicine at 317-278-0317 or at Top


The influence of prenatal exposure to nicotine on kids' behavior problems less than thought. For years, research has shown that there is a connection between prenatal exposure to nicotine and behavior problems in children, but an Indiana University study suggests that these problems are caused by environmental factors that increase the probability of both maternal smoking during pregnancy and offspring problems, not the specific effects of prenatal exposures. The study, published in the journal Development and Psychopathology, investigated the association between mothers who smoke during pregnancy and the occurrence of attention deficit hyperactivity problems, oppositional-defiant problems, and conduct problems in their offspring. Sampling data from a national survey of women and their children, the study found that when siblings differed in levels of exposure to prenatal nicotine, the offspring did not differ in conduct or oppositional-defiant problems. Brian D'Onofrio, assistant professor in IU Bloomington's Department of Psychological and Brain Sciences, said the study suggests that family factors not observed in previous research are responsible for some of the problems in children previously thought to be caused by smoking during pregnancy. The study, "Smoking During Pregnancy and Offspring Externalizing Problems: An Exploration of Genetic and Environmental Confounds," did find a connection between smoking during pregnancy and attention deficit hyperactivity problems, but much smaller than previously thought.

Co-authors include Carol A. Van Hulle, University of Chicago; Irwin D. Waldman, Emory University; Joseph Lee Rodgers, University of Oklahoma; K. Paige Harden, University of Virginia; Paul J. Rathouz and Benjamin B. Lahey, University of Chicago.

D'Onofrio can be reached at 812-856-0843 and The Department of Psychological and Brain Sciences is in the College of Arts and Sciences at IU Bloomington. For a copy of the study, contact Tracy James at 812-855-0084 or Top

Journal citation: "Smoking during pregnancy and offspring externalizing problems: An exploration of genetic and environmental confounds," Development and Psychopathology. 2008, 20: 139-164.

For additional assistance with these tips, contact Tracy James, University Communications, at 812-855-0084 and