Physical Activity as a Treatment for Social Anxiety in Clinical and Non-clinical Populations: A Systematic Review and Three Meta-Analyses for Different Study Designs
Open accessAbstract
The fear of being in the focus of attention in social situations can develop into a social anxiety disorder (SAD). The classical treatment for SAD is cognitive behavioral therapy, which is in many cases accompanied by drug treatments. A promising alternative treatment is physical activity (PA) interventions, because regular PA has been shown to be suitable for reducing anxiety in general. We conducted a pre-registered systematic review and meta-analysis (PROSPERO registration no. CRD42020191181) as well as two additional searches. Our aim was to investigate whether PA interventions are a suitable treatment for SAD and whether PA is suitable for reducing social anxiety (SA) in general. For studies with randomized controlled trial designs, a not statistically significant effect of medium size toward lower general SA symptomatology was found in the PA group in comparison with the control group ( d = −0.24, p = 0.377). For studies with longitudinal designs, significantly lower SA symptoms were found after PA treatments ( d = −0.22, p = 0.001). The effect of PA on SA was stronger for adults than for children and adolescents ( p = 0.003). For cross-sectional studies, a small negative association between SA symptoms and the amount of PA was found, i.e., lower SA was found for people who were more physically active ( r = −0.12, p = 0.003). We conclude that PA is a promising means for the (additional) treatment of SAD or to reduce SA in general in non-clinical samples, but more research in which high-quality studies with randomized controlled trial designs are used is needed. Furthermore, open questions with respect to moderating variables (e.g., age, sex, BMI, type of intervention, stress, amount of regular PA before the intervention, and comorbidities) remain still open.
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Previous meta-analyses demonstrated little to no benefits of exercise interventions for anxiety disorder.
“Previous meta-analyses also demonstrated little to no benefits in exercise interventions for anxiety disorder [170, 171].”
From Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis (2022) · cites this paper as [171]
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“Social anxiety disorder often occurs comorbidly with other psychiatric disorders, such as depression and substance dependency (Ruscio et al., 2008; Ohayon and Schatzberg, 2010; Stein et al., 2017; Prior et al., 2019; Rozen and Aderka, 2020).”
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Socio-ecological Lens Towards Health Behaviours
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- Authors
- Zika, M. A., & Becker, L.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Corresponding author
- Becker, Linda
- ORCID
- Becker, Linda
- Venue
- Frontiers in Human Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2021-06-11
- Volume
- 15
- Pages
- 653108-653108
- ISSN
- 1662-5161 (ISSN-L)
- PMC
- PMC8230570
- OpenAlex
- W3166047122
- Cited by
- 39
- References
- 122
- Citations by year
- 2026: 20 · 2025: 7 · 2024: 7 · 2023: 4 · 2022: 1
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Human Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- OPUS FAU (Kooperativer Bibliotheksverbund Berlin-Brandenburg (KOBV), on behalf of the Universitätsbibliothek Erlangen-Nürnberg) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Friedrich-Alexander-Universität Erlangen-Nürnberg
- Deutsche Forschungsgemeinschaft
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- physical activity, social anxiety disorder, social anxiety, exercise intervention, anxiety reduction, non-clinical population, children and adolescents, age differences, physical activity level
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