Direct and indirect effects of exercise on posttraumatic stress disorder symptoms: a longitudinal study
Abstract
Objective Emerging evidence suggests that exercise may have beneficial effects on posttraumatic stress disorder (PTSD), and that this relationship may be indirectly affected by sleep, pain, and alcohol/substance use. The present study examined the longitudinal direct and indirect effects of exercise on PTSD symptoms.Method A national sample of 182 individuals, screening positive for PTSD, completed online assessments of PTSD symptoms, exercise behavior, psychological distress, sleep quality, and alcohol/substance use at baseline and three-month follow-up.Results There were direct effects of strenuous intensity exercise on avoidance/numbing (b=-2.18, SE=1.12, p=0.05) and hyperarousal symptoms (b=-1.87, SE=0.82, p=0.03); and direct effects of total exercise on avoidance/numbing symptoms (b=-1.76, SE=0.94, p=0.05). Strenuous intensity exercise was indirectly associated with total PTSD symptoms (ab=-2.53, 95% CI: -5.72 to -0.38), avoidance/numbing (ab=-0.99, 95% CI: -2.43 to -0.05), and hyperarousal symptoms (ab=-0.78, 95% CI: -1.88 to -0.07) through sleep, while total exercise was indirectly associated with total PTSD symptoms through alcohol use (ab=0.32, 95% CI: 0.18-1.42).Conclusion Findings suggest that exercise has a complex, longitudinal, and beneficial association with PTSD symptoms. Future studies should continue to examine this relationship and any direct and indirect effects exercise may have on PTSD and its related conditions.
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In the same longitudinal study, vigorous-intensity exercise was associated with fewer hyperarousal symptoms at 3 month follow-up.
“those who reported engaging in vigorous-intensity exercise (vigorous running or cycling) but not moderate intensity exercise (non-exhaustive sports) on the Godin Leisure-Time Questionnaire (GLTEQ) had fewer avoidance/numbing (β = −2.18, p = 0.05) and hyperarousal (β = −1.87, p = 0.03) symptoms at follow-up”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [49]
For participants reporting both moderate- and vigorous-intensity exercise, the longitudinal association between total exercise and PTSD was observed only for avoidance/numbing symptoms.
“For those participants reporting both moderate- and vigorous-intensity exercise, the longitudinal association between total exercise and PTSD was observed only for avoidance/numbing symptoms (β = −1.76, p = 0.05).”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [49]
In a longitudinal study of 182 community-recruited adults with PTSD, those who reported engaging in vigorous-intensity exercise, but not moderate intensity exercise, had fewer avoidance/numbing symptoms at 3 month follow-up.
“those who reported engaging in vigorous-intensity exercise (vigorous running or cycling) but not moderate intensity exercise (non-exhaustive sports) on the Godin Leisure-Time Questionnaire (GLTEQ) had fewer avoidance/numbing (β = −2.18, p = 0.05) and hyperarousal (β = −1.87, p = 0.03) symptoms at follow-up”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [49]
The possibility that exercise could result in desensitization to physiological arousal cues in a clinical PTSD sample is consistent with findings that those who engage in vigorous-intensity exercise have fewer hyperarousal symptoms of PTSD.
“Nevertheless, the possibility that exercise could result in desensitization to physiological arousal cues in a clinical PTSD sample is consistent with the findings reviewed that suggest that those who engage in vigorous-intensity exercise have fewer hyperarousal symptoms of PTSD”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [49]
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References 44 · Cited by 51
- Authors
- Whitworth, J. W., Craft, L. L., Dunsiger, S. I., & Ciccolo, J. T.
- Affiliations
- Columbia University (US)
- American College of Sports Medicine (US)
- Brown University (US)
- Corresponding author
- Ciccolo, Joseph T.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 49
- Pages
- 56-62
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2630677231
- Cited by
- 51
- References
- 44
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 12 · 2022: 5 · 2021: 6 · 2020: 5 · 2019: 7 · 2017: 1
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- physical activity, post-traumatic stress disorder, posttraumatic stress symptoms, sleep quality, alcohol consumption, substance use, hyperarousal symptoms, psychological distress
- MeSH terms
- Adult, Alcohol Drinking, Female, Humans, Longitudinal Studies, Male, Middle Aged, Sleep Wake Disorders, Stress Disorders, Post-Traumatic, Exercise, Young Adult
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