The Stress-Exercise Relationship

Current society has changed our world into a highly competitive place to live. Raley, Mattingly, and Bianchi (2006) did a comparative study using data collected from dual income families complied during 1970 to 2001. The researchers noted a change from 9% in 1970 to 24% in 2001 in wives who contributed income equally with husbands (2006). This finding points to a realization that more families had to become dual-income families to meet the ever changing needs of the modern family. With intense competition comes stress and controlling and managing that stress then becomes imperative. The purpose of this paper was to investigate the use of exercise as a viable way to manage stress. The stress that accompanies daily life requires a real need to be acknowledged, managed, and dealt with so that an individual may lead a healthy life.

Several tools are available currently to help individuals deal with and manage stress. One such tool, and the focus of this paper, is exercise and/or physical activity. It has been a long standing principle that exercise provided a positive impact on the management of stress (Johnson-Kozlow, Sallis, & Calfas, 2004) and was able to lessen the psychological and physiological effects of that stress. Exercise provides an extensive variety of health benefits both physical and psychological in nature. Research has revealed that regular participation in exercise boosts the immune system, boosts energy, improves muscle tone, relieves depression, and manages stress (2004). However, even in light of all the positive benefits associated with exercise or physical activity participation, access to proper exercise or physical activity outlets have been a source of much concern.

One such study concluded that coping resources, which exercise was one, were not evenly distributed between the socio-economic classes and that lower socio-economic classes suffered more from mental health issues than higher socio-economical classes (Thoits, 2006). What this finding revealed was that specific areas, such as the underprivileged inner cities or remote rural areas, were at a higher risk of poorer mental health than rich metropolitan or upper scale suburbia. Individuals that were living in these a-risk type areas were not being afforded all of the possible coping resources available and as a result suffered more under the strain of stress management than those individuals who had complete access to all available coping resources. One cause for persons not having access to all available coping strategies could be economic based.

Research has demonstrated that economic status may not directly impact overall health in a particular class of individuals but that it was a good indicator of which direction, positive or negative, the overall health of that particular class of individuals will go (Wilkinson, 2006). The vast majority of research, roughly 78% of research that has been conducted, has shown strong statistical support for the effects of economic equality on population health (2006). This conclusion is a clear indicator that one way to improve or at least potentially improve the mental health of any given class is to improve and stabilize that class's current economic situation. A research finding such as these also raises the question as to what can be done to not only make exercise more accessible but more enticing to all individuals. To obtain a better understanding of how to make exercise or physical activity participation more tantalizing to individuals, an investigation into the theories and cognitive aspects of exercise and stress management is necessary.

A variety of theories and techniques have been developed and utilized to explain and inspire courses of action by individuals to better deal with stress. Two of the main theories currently in utilization are Rational-Emotive Therapy, developed by Albert Ellis, and the Reversal Theory, developed by Michael Apter. Each of these theories and their

impact on the stress management-exercise relationship will be discussed in greater detail later in the paper. From the abstract to the concrete, theories must have a set of tools and techniques that can be employed as a way to "test" the validity of the theory. Two of the tools currently used by the reversal theory and rational-emotive therapy include mindfulness-based stress management programs and cognitive-behavioral based programs. First background information concerning the cognitive-behavioral therapy program will be discussed.

Cognitive-behavioral therapy (CBT) has been defined as "a form of therapy that focuses on changing one's cognitions (beliefs, thoughts, assumptions, etc.) and behaviors" (Monat, Lazarus, & Reevy, 2007b, p. 567). Cognitive-behavioral therapy accomplishes this task by identifying an individual's negative beliefs or pessimisms and then producing a different way to interpret the event that precipitated the negative thinking towards a more realistic and positive view (2007b). For example, a situation has arisen where an adult has lost her car keys and as a result has begun to chide herself for being so stupid. Under CBT, a therapist would identify the negative belief, being stupid, and point out that in reality many people misplace their car keys and a systematic and thoughtful search would produce the keys. Thus realigning the thought process of the individual to a more realistic and positive train of thought. The use of cognitive behavioral stress management programs have been demonstrated to be very effective in dropping depression levels, fatigue levels, and cortisol levels, while at the same time increasing physical and psychological recovery times in individuals (Perna, Antoni, Baum, Gordon, & Schneiderman, 2003). Although exercise as a tool can be firmly placed into the physiological based camp based on its physical benefits to the body, exercise can also be a tool used to bring about changes in one's mental health as well. An investigation into mindful-based stress management programs is now in order.

Mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR) both rely on the beneficial effects that exercise produces on the human body and mind. Mindfulness-based stress reduction program has been defined as "a clinical program originally developed to facilitate adaptation to medical illness, that provides systematic training in mindfulness meditation as a self regulation approach to stress reduction and emotion management" (Bishop, 2007; as cited by Monat, Lazarus, & Reevy, 2007, p. 475). Currently in North America and Europe there were over 240 MSBR programs in use with more being developed yearly (Kabat-Zinn, Massion, Herbert, & Rosenbaum, 1998; as cited by Bishop, 2007, as cited by Monat, Lazarus, & Reevy, 2007 ). The main purpose of MSBR programs is to foster meditation techniques in people so that they may experience totally mindfulness quality (Bishop, 2007; as cited by Monat, Lazarus, & Reevy, 2007). To understand fully what mindfulness-based stress reduction truly means, one must break MBSR down even further. To start with, a closer examination of the term mindfulness was carried out.

The term mindfulness has been widely described as being "highly aware and focused on the reality of the present moment, accepting and acknowledging it, without getting caught up in the thoughts that are about the situation or in emotional reactions to the situation" (Kabat-Zinn, 1982, 1990; cited by Bishop, 2007; as cited by Monat, Lazarus, & Reevy, 2007, p. 475). This means that the program instructs an individual faced with a stressful event or situation how to "step away" from the event calmly and not engage in any negative thoughts or feelings (Bishop, 2007; as cited by Monat, Lazarus, & Reevy, 2007). There has been a dense amount of research that has demonstrated that mindfulness-based stress reduction can help lessen several mental issues such as anxiety, stress, and dysphoria (Shapiro, Schwartz, & Bonner, 1992, 1998; as cited by Bishop 2007; as cited by Man, Lazarus, Reevy, 2007). What about cognitive-behavioral therapy or CBT? Next cognitive-behavioral therapy shall be discussed.

An individual's cognition takes on a core role in stress reduction because it is that cognition that permits that individual to classify a particular stressor or stress and, subsequently, how to handle and manage that stress or stressor (Everly Jr. & Lating, 2007; as cited by Monat, Lazarus, & Reevy, 2007). Cognitive-behavioral therapy was originally developed by Meichenbaum during the 1970's (Everly Jr. & Lating, 2007; as cited by Monat, Lazarus, & Reevy, 2007). The original impetus of CBT was to develop a highly specialized form of therapy that focused on using one's own cognition to deal with excessive stress (2007). CBT actively targets negative explanations and/or explanations for external events and by instructing an individual on proper coping skills, relaxation or assertiveness for example, moves to eliminate the original negative thoughts (Gillham & Reich, 2007; as cited by Monat, Lazarus, & Reevy, 2007). Smith, Shelley, Dalen, Wiggins, Tooley, and Bernard (2008) concluded that both MBSR and CBSR were effective in lowering perceived stress and depression in individuals. Both MBSR and CBSR use yoga, exercise, and meditation among other techniques as part of their stress management regime (2008). The following sections further this current investigation by defining stress, the general benefits, both psychological and physiological, of exercise, and lastly the role of exercise as a stress management device. STRESS DEFINED

The importance of having a viable and well defined definition is crucial in conducting specific research. The term stress has been used interchangeably with a variety of other terms and meanings for decades, thus muddying the research waters. Most lines of thinking agree that there are generally three types of stress. Those stresses are physiological, psychological, and sociocultural (Monat, Lazarus, & Reevy, 2007).

Physiological stress is primarily concerned with a potentially harmful reaction to external events by the body (2007). Psychological stress is primarily concerned with the emotional factors that guides threat appraisal (2007). Finally sociocultural stress refers to the conflicts that disrupt social systems (2007). With three different classifications of stress, natural problems arose when discussing stress because the term stress had become to represent a variety of different human conditions. For example, in the past the term stress has been used to describe external events or stressors (2007). At the same time, stress has also been used to describe the response pattern of an organism to a stimulus (2007). Clearly a more comprehensive and definitive definition of stress was needed.

Currently the American Psychological Association (APA) defines stress as "the pattern of specific and nonspecific responses an organism makes to stimulus events that disturb its equilibrium and tax or exceed its ability to cope" (APA, 2008, p.S). The APA goes on to define stressors as "an internal or external event or stimulus that induces stress" (APA, 2008, p. S). Finally, the APA defines the term Stress moderator variables as "variables that change the impact of a stressor on a given type of stress reaction" (APA, 2008, p.S). It is the APA's definition of stress that defined the remainder of this paper. GENERAL BENEFITS OF EXERCISE

Exercise should be an important and consistent part of the daily routine for all individuals, young and old alike. Over the decades, a mountainous amount of research has been dedicated to the benefits, both psychological and physiological, that exercise produces for the human body. For example, the leading cause of death in both sexes in the United States is coronary heart disease or CHD (Daubenmier, Weider, Sumner, Mendell, Merritt-Worden, Studley, & Ornish, 2007). Many factors contribute to the onset of CHD including high fat diets and lack of exercise (2007). The Daubenmier et al. study concluded that along with a sensible diet, exercise was crucial to preventing and recovering from CHD (2007). Other studies such as Balde, Alseny, Figueras, Hawkings, and Miller (2003) concluded that regular exercise positively impacts a wide variety of health concerns including pain management and depression. A meta-analysis covering 134 studies concluded that consistent participation in a regular exercise regime improves both physical and mental fitness (Etneir, Salazar, Landers, Petruzzello, Han, & Nowell, 1997).

Interestingly enough, the need for daily physical activity has been engrained into our evolutionary history. For example, physical activity plays an important role in the development and maturation of the human child (Hills, King, & Armstrong, 2007). The Hills et al. study (2007) pointed out that even though development and maturation will occur as a child or adolescent grows, physical activity and proper nutrition are highly influential in the growth and development of body tissues, including bones, body fat, and muscles.

Even when presented with all of the raw data on the benefits of exercise, a consideration must be made in the psychological reasoning as to why one may choose to or not participate in exercise activities. A study conducted in 2005 by Seth Brown concluded that cognitive variables must be considered when investigating exercise participation. Brown stressed that perceived benefits and perceived barriers were critical in determined physical activity levels (2005). As defined in that study, perceived benefits were the potential benefits acquired by participating in certain activities as evaluated by the individual (2005). For example, if an individual determined that participating in an aerobic class would provide an avenue to losing weight and increasing fitness, then participation in this activity would be beneficial and subsequently more likely. The second cognitive factor was perceived barriers, which was defined as the potential obstacles as determined by an individual that would prevent him from partaking in a physical activity (2005). For example, if an individual felt pressed for time, they might chose not to attend an aerobics class but rather work on a paper due for a psychology class. EFFECTS OF EXERCISE ON STRESS MANAGEMENT

There has been an enormous amount of research conducted in the realm of the function of exercise or physical activity as a useful stress management tool. Many different lines of research have been investigated looking into this complex relationship from a variety of different angles. For example one study followed a line of investigation of how a group of tennis players (serious players and leisurely players) felt before and after playing a tennis match (Kerr, Fujiyama, & Campano, 2002). The researchers were interested in studying each group, the serious or telic players and the leisurely or paratelic players, for a reduction in external stress (2002). The study concluded that with this group of tennis players, regardless of the reason they played tennis, for fun or competitively, the results were basically the same, a positive therapeutic effect in reducing external stress (2002).

In a study with coronary patients, it was concluded that a wide variety of rehabilitation techniques were beneficial in improving recovery from a major cardiac event (Sundin, Lisspers, Hofman-Bang, Nygren, Rydén, & Öhman, 2003). The researchers concluded that using a variety of behavioral and lifestyle changes, included exercise and stress management techniques, recovering cardiac patients had increased sense of personal control, improved diets, and decreased anxiety and depression (2003).

The workplace has seen an interest in boosting employee production and satisfaction, while reducing employee absenteeism and illness. By adding and promoting healthy lifestyle changes, businesses have seen an increase in employee satisfaction and production (Loyd & Foster, 2006). The addition of on-site exercise programs, such as yoga and gyms, has demonstrated an ability to improve the health of employees and to reduce stress levels (2006).

Unfortunately, the concrete effects of exercise must be grounded in sound theoretical constructs to have any type of meaningful impact on an individual. Two main theories have risen to the forefront in this field and they are the Reversal Theory and Rational-Emotive Therapy.

Albert Ellis first developed Rational-Emotive Therapy (RET) by hypothesizing that individuals create their own personal turmoil by thinking in self-defeating, illogical, and/or unrealistic ways (Ellis, 1987). He also went onto describe that subtle or tricky irrational beliefs created more turmoil within individuals and were less likely to be acknowledge by said individual (1987). For this reason, Ellis hypothesized that it would virtually impossible for a person to maintain a consistent state of good mental health (1987). RET has been applied to a wide variety of scenarios from sports performance, to phobia extinction, and stress management.

Ellis (1976) went so far as to describe how RET can eliminate the human ego. Ellis described legitimate conditions to the human ego such as remaining alive and healthy and enjoying one's self (1976). This point is relevant to the discussion at hand because it describes an existence of happiness and little pain (1976). Part of managing stress is minimizing or eliminating "pain" in one's life. As discussed earlier, exercise or physical activity participation can be an excellent way to eliminate stress accumulation from the body. To manage stress effectively then it stands to reason that one must correct asses the stress and then formulate an appropriate response to that stress.

In the light of RET, an example would be sitting at a desk for 8 hours in a small cubicle which causes stiffness and irritability in an office worker. Making the correct assessment that the stress of stiffness and irritability has been caused by the work environment, the office worker can then plan a suitable response to relieve that stress. That response may include going to the local gym to swim or taking a yoga class. In this case the physical response to the stress provides relief to the body in the form of burning calories, providing energy to the body, and improving muscle function and recovery. In this simple example, it was shown how correctly assessing a source of stress lead to the development of a plan to relieve that stress by using a exercise.

A second theory that has gained prominence as of late is the Reversal Theory first proposed by Michael Apter in the 1970's. Simply stated, reversal theory attempts to examine the subjective experiences and behaviors of humans through a motivational framework (Sit & Linder, 2006). The beauty about the reversal theory is that it may offer a more robust framework to describe changes in health behaviors and research (Finfgeld, Wongvatunyu, Conn, Grando, & Russell, 2003). To illustrate the robust application of reversal theory, a paper in 2002 used the theory to answer some unresolved questions during a violent outburst during a European soccer match.

Kerr and de Kock (2002) investigated the aggressive and violent behavior exhibited during a 1997 soccer match. Violence erupted in the crowd and resulted in the death of a Dutch spectator (2002). The reasoning behind using the reversal theory to explain these horrible actions was because of inherent to the reversal theory is its ability to recognize the complexity and inconsistency of any given individual's behavior and their distinctive perception and understanding of events (2002). CONCLUSIONS

This paper has provided the reader with a wealth of research studies and their findings. It can be reaffirmed that exercise and physical activity provides numerous positive benefits for the human body on both the physiological and psychological scale. For example, studies such as the one conducted by Balde, Alseny, Figueras, Hawkings, and Miller (2003) concluded that regular exercise positively impacts a wide variety of health concerns including pain management and depression and the meta-analysis study covering 134 studies concluded that consistent participation in a regular exercise regime improves both physical and mental fitness (Etneir, Salazar, Landers, Petruzzello, Han, & Nowell, 1997).

It was also concluded that exercise or physical activity was a viable technique for stress management. The Smith, Shelley, Dalen, Wiggins, Tooley, and Bernard study (2008) concluded that both Mindfulness-Based Stress Reduction and Cognitive-Based Stress Reduction were effective in lowering perceived stress and depression in individuals. Based on findings such as these, it would be prudent for individuals to partake in some type of physical fitness regiment to not only reduce daily stress levels but to improve over physical and mental wellness. To aid in the understanding of the relationship between exercise and stress management key theories and constructs were discussed.

Two constructs of frameworks were used to explain the how and why exercise or physical activity was a successful stress management technique; they were rational-emotive therapy and the reversal theory. Rational-Emotive Therapy (RET) and the Reversal Theory both provided a viable working framework to explain health behaviors. Rational-Emotive Therapy hypothesized that individuals create their own personal turmoil by thinking in self-defeating, illogical, and/or unrealistic ways (Ellis, 1987). An example in the stress-exercise relationship could be described as feeling unfit and unworthy at a health club caused by comparing one's self to others in the gym. This irrational line of thinking then causes the individual to stop going to the health club because of feeling unworthy. The reversal theory makes use of a robust framework to describe changes in health behaviors (Finfgeld, Wongvatunyu, Conn, Grando, & Russell, 2003). Overall, this paper concurs with previous research studies in the assessment that exercise is a viable and important element to any stress management program. Every individual whether living in a high stress or low stress environment can enjoy the many benefits of regular exercise or physical activity. It is important for health practitioners and educators to continue to spread the word about the benefits of living a healthy lifestyle and to continue work on developing and refining theories and programs that are designed to assist people in maintaining those healthy lifestyles.

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