Abstract
Previous research suggests that physical fitness moderates the adverse effects of stressful life events. However, the relation between fitness and psychological distress needs to be explored, especially in armed force personnel. The aim of this study was to investigate the association between physical fitness and psychological distress among Brazilian armed force personnel. In this cross-sectional study, we measured physical fitness and psychological distress of 1252 subjects, using, respectively, field tests and the General Health Questionnaire (GHQ-12). After adjusting for confounders, statistically significant direct associations (p < 0.05) between physical fitness and psychological distress were found. Low levels of muscle endurance (OR 1.65; 95% CI 1.2–2.3) and combined cardiorespiratory fitness and muscle endurance (OR 1.91; 95% CI 1.2–3.0) were associated with greater psychological distress in the overall sample. In the operational group, low levels of muscle endurance (OR 1.81; 95% CI 1.2–2.8), cardiorespiratory fitness (OR 2.09; 95% CI 1.2–3.6) and combined cardiorespiratory fitness and muscle endurance (OR 2.70; 95% CI 1.4–5.1) were also associated with greater psychological distress. On the other hand, no significant (p > 0.05) association was found for the non-operational group. Low levels of physical fitness were associated with greater psychological distress among armed force personnel, especially among those with operational status. These findings suggest that physical fitness is not only relevant for military functions but also for mental health.
Similar content being viewed by others
References
Xue C, Ge Y, Tang B, Liu Y, Kang P, Wang M, Zhang L (2015) A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS One 10(3):e0120270. https://doi.org/10.1371/journal.pone.0120270
Zamorski MA, Rusu C, Garber BG (2014) Prevalence and correlates of mental health problems in Canadian Forces personnel who deployed in support of the mission in Afghanistan: findings from postdeployment screenings, 2009–2012. Can J Psychiatry 59:319–326. https://doi.org/10.1177/070674371405900605
Hines LA, Sundin J, Rona RJ, Wessely S, Fear NT (2014) Posttraumatic stress disorder post Iraq and Afghanistan: prevalence among military subgroups. Can J Psychiatry 59:468–479. https://doi.org/10.1177/070674371405900903
Roy SS, Foraker RE, Girton RA, Mansfield AJ (2015) Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans. Am J Public Health 105:757–763. https://doi.org/10.2105/AJPH.2014.302342
Steenkamp MM, Nash WP, Litz BT (2013) Post-traumatic stress disorder: review of the comprehensive soldier fitness program. Am J Prev Med 44:507–512. https://doi.org/10.1016/j.amepre.2013.01.013
Rowan AB, Varga CM, Clayton SP, Martin Zona DM (2014) Career impacts and referral patterns: army mental health treatment in the combat theater. Mil Med 179:973–978. https://doi.org/10.7205/MILMED-D-13-00518
Freeman MD, Woodruff SI (2011) Incidence and predictors of mental health hospitalizations in a cohort of young U.S. Navy women. Mil Med 176(5):524–530
Martins LC, Lopes CS (2012) Military hierarchy, job stress and mental health in peacetime. Occup Med 62:182–187. https://doi.org/10.1093/occmed/kqs006
Smith TC, Zamorski M, Smith B, Riddle JR, Leardmann CA, Wells TS, Engel CC, Hoge CW, Adkins J, Blaze D, Millennium Cohort Study T (2007) The physical and mental health of a large military cohort: baseline functional health status of the Millennium Cohort. BMC Public Health 7:340. https://doi.org/10.1186/1471-2458-7-340
Sassen B, Cornelissen VA, Kiers H, Wittink H, Kok G, Vanhees L (2009) Physical fitness matters more than physical activity in controlling cardiovascular disease risk factors. Eur J Cardiovasc Prev Rehabil 16(6):677–683. https://doi.org/10.1097/HJR.0b013e3283312e94
Jensen MT, Suadicani P, Hein HO, Gyntelberg F (2013) Elevated resting heart rate, physical fitness and all-cause mortality: a 16-year follow-up in the Copenhagen Male Study. Heart 99(12):882–887. https://doi.org/10.1136/heartjnl-2012-303375
van der Kolk NM, van Nimwegen M, Speelman AD, Munneke M, Backx FJ, Donders R, Post B, Overeem S, Bloem BR (2014) A personalized coaching program increases outdoor activities and physical fitness in sedentary Parkinson patients; a post-hoc analysis of the ParkFit trial. Parkinsonism Relat Disord 20:1442–1444. https://doi.org/10.1016/j.parkreldis.2014.10.004
Vancampfort D, Probst M, Scheewe T, De Herdt A, Sweers K, Knapen J, van Winkel R, De Hert M (2013) Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia. Psychiatry Res 207:25–32. https://doi.org/10.1016/j.psychres.2012.09.026
Kettunen O, Kyrolainen H, Santtila M, Vasankari T (2014) Physical fitness and volume of leisure time physical activity relate with low stress and high mental resources in young men. J Sports Med Phys Fit 54:545–551
Richards J, Foster C, Townsend N, Bauman A (2014) Physical fitness and mental health impact of a sport-for-development intervention in a post-conflict setting: randomised controlled trial nested within an observational study of adolescents in Gulu, Uganda. BMC Public Health 14:619. https://doi.org/10.1186/1471-2458-14-619
Sener U, Ucok K, Ulasli AM, Genc A, Karabacak H, Coban NF, Simsek H, Cevik H (2016) Evaluation of health-related physical fitness parameters and association analysis with depression, anxiety, and quality of life in patients with fibromyalgia. Int J Rheum Dis 19:763–772. https://doi.org/10.1111/1756-185X.12237
Willis BL, Leonard D, Barlow CE, Martin SB, DeFina LF, Trivedi MH (2018) Association of midlife cardiorespiratory fitness with incident depression and cardiovascular death after depression in later life. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2018.1467 (Epub ahead of print)
Harvey SB, Sellahewa DA, Wang MJ, Milligan-Saville J, Bryan BT, Henderson M, Hatch SL, Mykletun A (2018) The role of job strain in understanding midlife common mental disorder: a national birth cohort study. Lancet Psychiatry 5:498–506. https://doi.org/10.1016/S2215-0366(18)30137-8
Useche S, Montoro L, Cendales B, Gómez V (2018) Job strain in public transport drivers: data to assess the relationship between demand-control model indicators, traffic accidents and sanctions. Data Brief 19:293–298. https://doi.org/10.1016/j.dib.2018.05.036
Cendales-Ayala B, Useche SA, Gómez-Ortiz V, Bocarejo JP (2018) Bus operators’ responses to job strain: An experimental test of the job demand-control model. J Occup Health Psychol 22(4):518–527. https://doi.org/10.1037/ocp0000040
Crowley SK, Wilkinson LL, Wigfall LT, Reynolds AM, Muraca ST, Glover SH, Wooten NR, Sui X, Beets MW, Durstine JL, Newman-Norlund RD, Youngstedt SD (2015) Physical fitness and depressive symptoms during army basic combat training. Med Sci Sports Exerc 47:151–158. https://doi.org/10.1249/MSS.0000000000000396
Gubata ME, Urban N, Cowan DN, Niebuhr DW (2013) A prospective study of physical fitness, obesity, and the subsequent risk of mental disorders among healthy young adults in army training. J Psychosom Res 75:43–48. https://doi.org/10.1016/j.jpsychores.2013.04.003
Ridner SH (2004) Psychological distress: concept analysis. J Adv Nurs 45:536–545
Mollaoglu H, Ucok K, Kaplan A, Genc A, Mayda H, Guzel HI, Sener U, Uygur E, Ozbulut O (2012) Association analyses of depression, anxiety, and physical fitness parameters in Turkish obese adults. J Back Musculoskelet Rehabil 25:253–260. https://doi.org/10.3233/BMR-2012-0333
Taylor MK, Markham AE, Reis JP, Padilla GA, Potterat EG, Drummond SP, Mujica-Parodi LR (2008) Physical fitness influences stress reactions to extreme military training. Mil Med 173:738–742
Mari JJ, Williams P (1985) A comparison of the validity of two psychiatric screening questionnaires (GHQ-12 and SRQ-20) in Brazil, using Relative Operating Characteristic (ROC) analysis. Psychol Med 15:651–659
Gouveia VV, Barbosa GA, Oliveira AED, Carneiro MB (2010) Factorial validity and reliability of the General Health Questionnaire (GHQ-12) in the Brazilian physician population. Cad Saude Publica 26:1439–1445
Cooper KH (1968) A means of assessing maximal oxygen intake. Correlation between field and treadmill testing. JAMA 203:201–204
Crotti M, Bosio A, Invernizzi PL (2018) Validity and reliability of submaximal fitness tests based on perceptual variables. J Sports Med Phys Fit 58:555–562. https://doi.org/10.23736/S0022-4707.17.07199-7
Fielitz L, Coelho J, Horne T, Brechue W (2016) Inter-rater reliability and intra-rater reliability of assessing the 2-minute push-up test. Mil Med 181(2):167–172. https://doi.org/10.7205/MILMED-D-14-00533
Ortega FB, Brown WJ, Lee DC, Baruth M, Sui X, Blair SN (2011) In fitness and health? A prospective study of changes in marital status and fitness in men and women. Am J Epidemiol 173:337–344. https://doi.org/10.1093/aje/kwq362
Byles JE, Gallienne L, Blyth FM, Banks E (2012) Relationship of age and gender to the prevalence and correlates of psychological distress in later life. Int Psychogeriatr 24:1009–1018. https://doi.org/10.1017/S1041610211002602
Hourani LL, Williams TV, Kress AM (2006) Stress, mental health, and job performance among active duty military personnel: findings from the 2002 Department of Defense Health-Related Behaviors Survey. Mil Med 171:849–856
Hellerstedt WL, Jeffery RW (1997) The association of job strain and health behaviours in men and women. Int J Epidemiol 26:575–583
White RL, Babic MJ, Parker PD, Lubans DR, Astell-Burt T, Lonsdale C (2017) Domain-specific physical activity and mental health: a meta-analysis. Am J Prev Med 52:653–666. https://doi.org/10.1016/j.amepre.2016.12.008
Harvey SB, Hotopf M, Overland S, Mykletun A (2010) Physical activity and common mental disorders. Br J Psychiatry 197:357–364. https://doi.org/10.1192/bjp.bp.109.075176
Hu GC, Chien KL, Hsieh SF, Chen CY, Tsai WH, Su TC (2014) Occupational versus leisure-time physical activity in reducing cardiovascular risks and mortality among ethnic Chinese adults in Taiwan. Asia Pac J Public Health 26:604–613. https://doi.org/10.1177/1010539512471966
Scott D, Happell B (2011) The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs 32:589–597. https://doi.org/10.3109/01612840.2011.569846
Muhsen K, Garty-Sandalon N, Gross R, Green MS (2010) Psychological distress is independently associated with physical inactivity in Israeli adults. Prev Med 50(3):118–122. https://doi.org/10.1016/j.ypmed.2009.12.002
Hausser JA, Schulz-Hardt S, Mojzisch A (2014) The active learning hypothesis of the job-demand-control model: an experimental examination. Ergonomics 57:23–33. https://doi.org/10.1080/00140139.2013.854929
Conway PM, Campanini P, Punzi S, Fichera GP, Camerino D, Francioli L, Neri L, Costa G (2013) Work stress, common mental disorders and Work Ability Index among call center workers of an Italian company. Epidemiol Prev 37:17–28
Soderfeldt B, Soderfeldt M, Muntaner C, O’Campo P, Warg LE, Ohlson CG (1996) Psychosocial work environment in human service organizations: a conceptual analysis and development of the demand-control model. Soc Sci Med 42:1217–1226
Kim K, Shin YJ, Nam JH, Choi BY, Kim MK (2008) A dose-response relationship between types of physical activity and distress. J Korean Med Sci 23:218–225. https://doi.org/10.3346/jkms.2008.23.2.218
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
All participants provided written informed consent after being informed about the protocols and objectives of the present study. This was approved by the research ethics committee of the Rural Federal University of Rio de Janeiro.
Rights and permissions
About this article
Cite this article
Oliveira, A.J., Neto, G.A.M., Barros, O.D. et al. Association between physical fitness and psychological distress among Brazilian armed force personnel. Sport Sci Health 15, 141–147 (2019). https://doi.org/10.1007/s11332-018-0503-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11332-018-0503-9