Stress regulation through sport
The topic of stress regulation and sport can be viewed from two different perspectives. From the point of view of he alth sport, it is primarily about stress regulation through sport. The question arises to what extent physical and sporting activity can be used to cope better with the stresses of everyday life, so that he alth impairments can be avoided or reduced. From the point of view of competitive sport, it is about stress regulation in sport.
Over the past two decades, several models have been developed that summarize the stress-regulating effects of exercise and sport. Fuchs and Klaperski (2018) roughly subdivide stress into stress and stress management. In the process of stress development, a stressor-reducing and resource-boosting effect of exercise and sport can be differentiated (Fig. 25.4, not included in this reading sample). If there is stress, there is also a reaction-reducing effect at the level of stress management, whereby a distinction can be made between cognitive, affective, behavioral and biological effects. In this context, there is also talk of palliative-regenerative stress management. By "palliative" is meant that exercise prevents inappropriately high or prolonged responses to stress. "Regenerative" means that exercise and sport help the affected person to quickly return to the initial state in a reaction parameter. All of these effects can be used to justify the so-called "stress buffer effects" of exercise and sport. This means that they provide possible explanations as to why people with a physically active lifestyle have to accept fewer he alth impairments when faced with high levels of stress (Gerber and Pühse 2009; Klaperski 2018). In addition, a general he alth-enhancing effect is shown in the model. This is intended to express the fact that regular physical activity can have he alth effects, regardless of a person's level of stress.
25.7.1 Are physically active people less stressed or does stress lead to less physical activity?
There are various empirical studies on the connection between physical activity and stress (Klaperski 2018; Stults-Kolehmainen and Sinha 2014). While most cross-sectional studies suggest that high levels of physical activity are associated with lower perceptions of stress (e.g., Aldana et al. 1996; Lovell et al. 2015), no causal conclusions can be drawn from these findings. In other words, it remains unclear whether the statistical relationships are based on the fact that physical activity reduces stress or whether stressed people simply tend to be less physically and athletically active. Longitudinal studies suggest that there is a high probability of a reciprocal relationship between physical activity and stress. On the one hand, prospective studies show that the amount of physical activity recorded at baseline is suitable for predicting reduced stress perception at follow-up (Jonsdottir et al. 2010; Schnohr et al. 2005). On the other hand, several studies show that stress leads to reduced physical activity, regardless of whether an experimental approach is chosen (Roemmich et al. 2003), stress is measured at a daily level (Sonnentag and Jelden 2009) or prolonged stress exposure (Oaten and Cheng 2005).) were raised. Lutz et al. (2010) also found that during periods of stress, people who are physically active are more likely to remain physically active than those who have just started exercising. Finally, in a review of the literature on randomized control group studies, Klaperski (2018) comes to the conclusion that in six of a total of eleven studies available, a significant (stress-reducing) influence of the intervention on stress perception could be demonstrated (study box: Influence of stress on physical activity behavior: A meta-analysis).
Study Box
Influence of stress on physical activity behavior: A meta-analysis
To find out how occupational stress affects people's physical activity behavior, Fransson et al. (2012) presented data from 14 European cohort studies. Baseline data were available for a total of 170,162 people. Of these, 56,735 people could be tracked for between two and nine years. The results of the cross-sectional data suggest that people who are stressed at work are 26% more likely to be physically inactive than those who are not overly stressed at work. The prospective analyzes showed a similar finding, with stressed individuals still having a 21% increased risk of becoming physically inactive during the follow-up period.
25.7.2 Does stressful physical activity protect against he alth impairments?
Science has been discussing for a long time whether exercise and sport are able to protect people from stress-related he alth problems. The first study on this topic was carried out in the early 1980s by Kobasa et al. (1982) published. In the following 35 years, numerous original works were published that cannot be presented in detail here. In their review, Gerber and Pühse (2009) came to the conclusion that the majority of the available studies support the validity of the "stress buffer hypothesis" (at least in part), regardless of the age and sex of the subjects or the chosen study design (cross- vs. longitudinal approach). It should be added that in many of the early studies both physical activity and he alth indicators were collected through self-reporting by the subjects. In more recent studies, this shortcoming has been addressed by measuring these variables using objective methods (e.g.g. accelerometry, fitness tests, physiological risk markers) (Gerber et al. 2017a; Holtermann et al. 2010; Puterman et al. 2010). One of these studies is described in more detail in the following study box (study box: fitness-related stress buffer effects). Likewise, in a recent study, a person-centered approach was chosen to find out whether certain statistical methods can be used to identify stress-resilient people (i.e. people who show no mental symptoms despite high levels of stress). It was shown that stress-resilient people on average report a higher level of physical and sporting activity than people who are exposed to high levels of stress but who also have a high level of symptoms (Gerber et al. 2014b). In the meantime, there are also some experimental studies in which an exercise and sports intervention was implemented with the subjects. O'Dougherty et al. (2012) performed aerobic endurance training with 303 American women for 16 weeks. It was shown that the influence of critical life events on the development of depressive symptoms could be buffered in the endurance group, which was not the case in the control group. Klaperski and Fuchs (2014) came to a similar conclusion in a study with 149 male participants, in which they did not examine critical life events but rather the general perception of stress. For further literature on the triangular relationship between a) stress, b) physical activity and specific he alth indicators such as overweight/obesity, sleep, brain/cognition and heart he alth, see Holmes (2018), Ludyga (2018), Brand (2018) and Deiseroth and Hanssen (2018) (excursus: explanation of stress buffer effects).
Excursion
Explanation of stress buffer effects
stress buffer effects can be attributed to a stressor reducing, a resource strengthening or a reaction reducing effect become (Fig.25.4, not included in this excerpt). The former is the case when exercise and sport contribute to certain stressors not occurring in the first place (e.g. prevention of chronic diseases or social isolation). The second is when exercise and sport help to strengthen certain resources that in turn have a beneficial effect on the stress management process (e.g. building self-confidence and mental toughness, availability of social support when needed; for an overview of the current state of research see Fuchs and Klaperski 2018). The reaction-reducing mode of action means that physiological, psychological or behavioral stress reactions are lower (reduced reactivity) or the initial level can be restored more quickly (improved regeneration).
Study Box
Fitness-Related Stress Buffer Effects
To find out whether a high level of fitness "buffers" the he alth-damaging influence of stress, researchers from Switzerland and Sweden carried out a study with around 200 people employed in the he alth sector. The state of fitness was assessed objectively using a submaximal fitness test ("Åstrand bicycle ergometer test"). Based on age- and gender-specific norms, participants were categorized into three groups of low, moderate, and high fitness. Stress levels were recorded using a questionnaire. Based on this, two groups were formed (high vs. low stress levels). In addition, both mental he alth (depression, burnout) and risk markers for cardiovascular diseases (e.g. blood pressure, BMI, blood lipid levels, blood sugar) were recorded. Overall, the results showed that the three fitness groups with low levels of stress hardly differed from each other in terms of the he alth parameters examined. However, when the stress level was high, the study participants with low fitness showed more he alth impairments than those with medium and high fitness. Examples are in Fig.25.5 presents the findings for depressive symptom burden and low-density lipoprotein (LDL) cholesterol. With regard to LDL cholesterol, values of ≥3.0 mmol/l are the clinical cut-off, which should not be exceeded according to European guidelines (De Backer et al. 2003) (Fig. 25.5, not included in this reading sample).
Reduced stress reactivity in physically active or fit people can be justified physiologically with the so-called "Cross-Stressor-Adaptation-Hypothesis" ("CSA-Hypothesis") (Sothmann 2006). This assumes that a) the physiological reactivity to physical, cognitive and psychosocial stress stimuli equally lead to an activation of the SAM system and the HPN axis and b) repeated experiences with a sufficiently intense and lasting stress stimulus in an organism specific and non-specific cause adaptation processes. In the sense of a specific adaptation, it can be assumed that regular physical activity leads to reduced reactivity, especially in the case of stressors with a body-related stress element, while in the sense of an unspecific adaptation it can be expected that stresses that are not related to sport (e.g. B. in psychosocial stress) result in similar effects. The "CSA hypothesis" is theoretically plausible, since training-related adjustments often lead to overall changes in tissue structures and it can be assumed that changes in a stress-modulating subsystem affect all systems involved in stress regulation (Sothmann 2006).
The validity of the "CSA hypothesis" has been tested in several meta-analyses; however, these have brought partially contradictory findings to light. While the "CSA hypothesis" was supported when the focus was specifically on cardiovascular markers (Crews and Landers 1987; Forcier et al. 2006), this was not the case when other indicators of reactivity were included (Jackson and Dishman 2006). Jackson and Dishman (2006) concluded that fit subjects showed no lower stress reactivity to experimental stress tasks than unfit controls. However, they found that fit people recover from stress faster. It should be noted that the meta-analysis by Jackson and Dishman (2006) mainly included studies in which subjects were confronted with cognitive stressors. In comparison, more recent studies using psychosocial stressors (excursus: psychosocial stress in laboratory studies) mostly conclude that trained individuals have lower stress reactivity, particularly with regard to HHN axis activity (Gerber 2018; Mücke et al. 2018). However, studies also make it clear that the stress-relieving influence of regular physical activity or a high level of fitness depends on other factors. This is how Gerber et al. (2017b) that the protective effect associated with physical activity, which can be determined in the laboratory, is particularly high in people with a generally high level of stress. Similarly, Puterman et al. (2011) found that physical activity is associated with a lower stress reactivity, especially when people have a tendency to brood over problems for a long time. The only intervention study to date indicates that reactivity to experimentally induced stress decreases after a multi-week endurance training program (Klaperski et al. 2014). There is also strong empirical evidence that physical activity immediately prior to exposure to a laboratory stressor leads to reduced reactivity (Hamer et al. 2006). This finding is important because the stress-relieving potential of physical activity does not only become apparent after weeks of training, but people benefit immediately from each individual training episode (Methods: Recording physiological and psychological stress reactions in laboratory studies).
Literature
Aldana, S. G., Sutton, L. D., & Jacobson, B. H. (1996). Relationship between leisure time physical activity and perceived stress. Perceptual and Motor Skills, 82, 315–321.
Brand, S. (2018). Sport activity, stress and sleep. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, p.293–310.
Brouwer, A. M., & Hogervorst, M. A. (2014). A new paradigm to induce mental stress: The Sing-a-Song Stress Test (SSST). Frontiers in Neuroscience, 8, 141–148.
Buske-Kirschbaum, A., Jobst, S., Wustmans, A., Kirschbaum, C., Rauh, W., & Hellhammer, D. (1997). Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. Psychosomatic Medicine, 59, 419-426.
Crews, D. J., & Landers, D. M. (1987). A meta-analytic review of aerobic fitness and reactivity to psychosocial stressors. Medicine and Science in Sports and Exercise, 19, 114-130.
G De Backer, E Amgrosioni, K Borch-Johnsen, C Grotons, R Cifkova, J Dallongeville, et al. (2003). European guidelines on cardiovascular disease prevention in clinical practice. European Journal of Cardiovascular Prevention and Rehabilitation, 2003, S1–S78.
Deiseroth, A., & Hanssen, H. (2018). Physical activity, stress and arterial stiffness. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, pp. 325–342.
Dickerson, S. S., & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130, 355–391.
Forcier, K., Stroud, L. R., Papandonatos, G. D., Hitsman, B., Reiches, M., Krishnamoorthy, J., & Niaura, R. (2006). Links between physical fitness and cardiovascular reactivity and recovery to psychological stressors: A meta-analysis. He alth Psychology, 25, 723–739.
Fransson, E. I., Heikkilä, K., Nyberg, S. T., Zins, M., Westerlund, H., Westerholm, P., et al. (2012). Job strain as a risk factor for leisure-time physical inactivity: An individual-participant meta-analysis of up to 170,000 men and women. American Journal of Epidemiology, 176, 1078–1089.
Fuchs, R., & Klaperski, S. (2018). Stress regulation through sport and exercise. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Berlin: Springer, p.205–226.
Gerber, M. (2018). Physiological mechanisms of action of sport under stress. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, pp. 319–416; 251–276.
Gerber, M., & Pühse, U. (2009). Do exercise and fitness protect against stress-induced he alth complaints? A review of the literature. Scandinavian Journal of Public He alth, 37, 801–819.
Gerber, M., Jonsdottir, I. H., Lindwall, M., & Ahlborg, G. (2014b). Physical activity in employees with differing occupational stress and mental he alth profiles: A latent profile analysis. Psychology of Sport and Exercise, 15, 649-658.
Gerber, M., Endes, K., Herrmann, C., Colledge, F., Brand, S., Donath, L., et al. (2017a). Fitness, stress and body composition in primary school children. Medicine and Science in Sports and Exercise, 49, 581–587.
Gerber, M., Ludyga, S., Mücke, M., Colledge, F., Brand, S., & Pühse, U. (2017b). Low vigorous physical activity is associated with increased adrenocortical reactivity to psychosocial stress in students with high stress perceptions. Psychoneuroendocrinology, 80, 104–113.
Hamer, M., Taylor, A., & Steptoe, A. (2006). The effect of acute exercise on stress related blood pressure responses: A systematic review and meta-analysis. Biological Psychology, 71, 183–190.
Holmes, M. (2018). Physical activity, stress and obesity. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, pp. 311–324.
Holtermann, A., Mortensen, O. S., Burr, H., Søgaard, K., Gyntelberg, F., & Suadicani, P. (2010). Physical demands at work, physical fitness, and 30-year ischemic heart disease and all-cause mortality in the Copenhagen Male Study. Scandinavian Journal of Work and Environmental He alth, 36, 357–365.
Jackson, E. M., & Dishman, R. K. (2006). Cardiorespiratory fitness and laboratory stress: A meta-regression analysis. Psychophysiology, 43, 57–72.
Jonsdottir, I. H., Rödjer, L., Hadzibajramovic, E., Börjesson, M., & Ahlborg, G., Jr. (2010). A prospective study of leisure-time physical activity and mental he alth in Swedish he alth care workers and social insurance officers. Preventive Medicine, 51, 373–377.
Kasten, N., & Fuchs, R. (2018). Methodological aspects of stress research. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, S 179–202.
Klaperski, S. (2018). Exercise, stress and he alth: The stress-buffering effect of exercise. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, pp. 227–250.
Klaperski, S., & Fuchs, R. (2014). Experimental investigation of the stress buffering effect of sport activity. In R Frank, I Nixdorf, F Ehrlenspiel, F Geipel, A Mornell, & J Beckmann (eds.), Performing under pressure. Writings of the German Association for Sports Science (p. 110). Hamburg: Feldhaus.
Klaperski, S., von Dawans, B., Heinrichs, M., & Fuchs, R. (2014). Effects of a 12-week endurance training program on the physiological response to psychosocial stress in men: A randomized controlled trial. Journal of Behavioral Medicine, 37, 1118–1133.
Kobasa, S. C., Maddi, S. R., & Puccetti, M. C. (1982). Personality and exercise as buffers in the stress-illness-relationship. Journal of Behavioral Medicine, 5, 391–404.
Lovell, G. P., Huntsman, A., & Hedley-Ward, J. (2015). Psychological distress, depression, anxiety, stress, and exercise in Australian and New Zealand mothers: A cross-sectional survey. Nursing & He alth Sciences, 17, 42-48.
Ludyga, S. (2018). Sport activity, stress and the brain. In R. Fuchs & M. Gerber (Eds.), Handbook of Stress Regulation and Sport. Heidelberg: Springer, pp. 275–292.
Lutz, R., Stults-Kolehmainen, M., & Bartholomew, J. (2010). Exercise caution when stressed: Stages of change and the stress-exercise participation relationship. Psychology of Sport and Exercise, 11, 560-567.
Mücke, M., Ludyga, S., Colledge, F., & Gerber, M. (2018). Influence of regular physical activity and fitness on stress reactivity as measured with the Trier Social Stress Test protocol: A systematic review. Sports Medicine, 48, 2607-2622.
Oaten, M., & Cheng, K. (2005). Academic examination stress impairs self-control. Journal of Social and Clinical Psychology, 24, 254–279.
O'Dougherty, M., Hearst, M. O., Syed, M., Kurzer, M. S., & Schmitz, K. H. (2012). Life events, perceived stress and depressive symptoms in a physical activity intervention with young adult women. Mental He alth and Physical Activity, 5, 148–154.
Puterman, E., Lin, J., Blackburn, E., O'Donovan, A., Adler, N., & Epel, E. (2010). The power of exercise: Buffering the effect of chronic stress on telomere length. PLoS One, 5, e10837.
Puterman, E., O'Donovan, A., Adler, NE, Tomiyama, A. J., Kemeny, M., Wolkowitz, O. M., & Epel, E. (2011). Physical activity moderates effects of stressor-induced rumination on cortisol reactivity. Psychosomatic Medicine, 73, 604-611.
Roemmich, J. N., Gurgol, C. M., & Epstein, L. H. (2003). Influence of an interpersonal laboratory stressor on youths' choice to be physically active. Obesity Research, 11, 1080-1087.
Schnohr, P., Kristensen, T. S., Prescott, E., & Scharling, H. (2005). Stress and life dissatisfaction are inversely associated with jogging and other types of physical activity in leisure time - The Copenhagen City Heart Study. Scandinavian Journal of Medicine and Science in Sports, 15, 107-112.
Sunday, S., & Jelden, S. (2009). Job stressors and the pursuit of sport activities: A day-level perspective. Journal of Occupational He alth Psychology, 14, 165–181.
Sothmann, M. S. (2006). The cross-stressor adaptation hypothesis and exercise training. In E. O. Acevedo & P. Ekkekakis (eds.), Psychobiology of physical activity (pp. 149-160). Champaign: Human Kinetics.
Stults-Kolehmainen, M. A., & Sinha, R. (2014). The effects of stress on physical activity and exercise. Sports Medicine, 44, 81–121.
von Dawans, B., Kirschbaum, C., & Heinrichs, M. (2011). The Trier Social Stress Test for Groups (TSST-G): A new research tool for controlled simultaneous social stress exposure in a group format. Psychoneuroendocrinology, 36, 514–522.
