anxiety exercise self efficacy

RELATIONSHIP BETWEEN ANXIETY, EXERCISE, AND SELF-‐EFFICACY 1

The Relationship Between Anxiety, Exercise, and Self-Efficacy

Marlene Garzona

Rutgers, The State University of New Jersey


Abstract

Exercise has many positive far-reaching effects including both physical and psychological ones.

It is often suggested that improvement in an individual’s life satisfaction may be obtained by

increasing their physical activity levels. Similarly studies have documented the benefits of high

self-efficacy and the aversive effects of anxiety. This study examined how an intervention aimed

at increasing exercise behavior affected self-efficacy and anxiety levels in a group of college

students. It attempted to establish a link between increased behavior and increased self-efficacy

and decreased anxiety. The participants consisted of a sample of 18 undergraduate students, who

varied in grade level, gender, and age. Two researcher created self-report measures were used

for obtaining self-efficacy and anxiety levels. The measures were administered twice: first as a

pre-test and then as a post-test. While one self-report researcher created behavioral log was used

to monitor the subject’s exercise intervention for a total of 7 weeks. The data complied was then

compared to see if there was any relationship present between the variables. Results showed

there was no significant change in self-efficacy and anxiety levels as the behavioral activation

exercise intervention progressed. Implications and suggestions for future research are discussed.

Work remains to be done to determine the interplay between exercise, anxiety, and self-efficacy.


The Relationship Between Anxiety, Exercise, and Self-Efficacy

Exercise can play a fundamental role in many aspects of life. Its incorporation into an

individual’s daily routine can help them establish both a healthy mind and body. The physical

effects of increased exercise are widely known, it can help lower the chance of certain diseases

and improve overall well being. The psychological effects of exercise however are not as

known. Exercise can help lower not only anxiety but also raise perceived notions of self-efficacy.

Thus the key to bettering overall life satisfaction may be becoming more active.

Physical activity is among the ways an individual can live both a physically sound and

mentally favorable life. It can take many forms but most typically it has to do with the skeletal

muscles of body and occurs when movement is made resulting in the loss of additional energy

apart from what is needed to maintain homeostasis (Carek et al., 2011). Exercise can be defined

as physical activity that is coordinated, consistent, and done for a reason (Carek et al., 2011).

Decreased exercise behavior can often lead to health issues such as cardiovascular disease along

with lower reported self-esteem scores (Elavsky et al., 2005). While increased exercise behavior

has been shown to provide a wealth of positive benefits among them not only improved general

health and happiness but also improved academic success (Coe et al., 2006). Therefore looking

at an intervention aimed at increasing exercise among individuals may be beneficial.

Studies have well documented the benefits of increased physical activity in the terms of

exercise. One study with a large sample measured the relationship between physical fitness and

academic achievement in children. They did so by comparing scores from a fitness test to that of

an achievement one, finding that there was a positive linear correlation. A gender difference was

also uncovered revealing that females seemed to improve faster than males (Grissom, 2005).

Another study though unable to establish a link between moderate exercise and academic


achievement, was able to find that higher grades were particularly associated with vigorous

physical activity (Coe et al., 2006). The positive influence of exercise has not only been seen in

children but is apparent in all age groups. A comparison study of groups of college students has

suggested that regular exercise may reduce perceived stress on upcoming assignments (Bass et

al., 2002). While one population based study even concluded that regular exercise is associated

with lower levels of anxiety and increased extraversion (De Moor et al., 2006). Exercise has even

been found to improve the quality of life in older adults, as increased physical activity leads to an

increase in self-efficacy contributing to an overall improvement in life satisfaction (Elavsky et

al., 2005). The effects of exercise are far reaching on the well being of individuals and it can

even be used as an alternative treatment for a variety of disorders.

Anxiety is a persistent fear of what the future holds. Anxiety disorders, which are among

the most commonly diagnosed mental disorders, are distinguished by the belief of perceived

apparent danger. Individuals will often incorrectly intensify potential for harm in future

situations (Beck et al., 1987). There is also a high chance that comorbidity exists between

anxiety and other psychological disorders. Many types of anxiety disorders exist though they

usually differ from one another in what is fear provoking, what involves avoidance behaviors,

and the related mentality that is held by individuals experiencing them (American Psychiatric

Association, 2013). They differ from normal fear or nerves by their endurance (usually lasting

more than 6 months, less in children), their tendency to develop in childhood with higher female

to male ratios, and the fact they often have lifetime prevalence (American Psychiatric

Association, 2013). Among the disorders recognized are: separation anxiety disorder, social

anxiety disorder, panic disorder, post-traumatic stress disorder, agoraphobia, generalized anxiety


disorder, and specific phobias. Regardless of the disorder however anxiety oftentimes impairs an

individual from living their life to the fullest extent possible.

Anxiety is negative because it leads to stress and can lead to negative performance in

many aspects of life including academic achievement as well as social relationships. It also has

high comorbidity with depression (American Psychiatric Association, 2013). A longitudinal

study with elementary school students and their parents highlighted the relationship between

anxiety and depression in children. With the use of both self-report measures and parent reports

to ensure various perspectives it was revealed that higher levels of reported anxiety predicted

change in reported depression six months later (Cole et al., 1998). Anxious children are more

prone to depressive emotions as they age. Another study with a large sample of adolescents has

also indicated that gender differences exist between boys and girls. Their results concluded that

girls and boys begin to sway apart from each other at a very early age, so that by age 6 it is more

likely that twice as many girls as boys will be diagnosed with an anxiety disorder (Lewinsohn et

al., 1998). Understanding the role of anxiety in adolescents will aid its treatment and prevention

in adulthood. If anxiety could be decreased in everyday life via non-medical means, individuals

may prosper tremendously from reduced stress and increased confidence.

Self-efficacy is how well an individual thinks they can accomplish something they set out

to do; it is the belief that they have the capability to affect the events that go on in their lives

(Bandura, 2010). In other words this is the self- perceived notion that an individual maintains in

their life about how effectively their desired outcomes can be achieved through their own

actions, thoughts, and feelings. This notion is highly influential in all aspects of life as it

determines the effort put into a task, the way that task is performed, and the overall mentality

maintained throughout the task (Bandura, 2010). If individuals do not believe they can


accomplish their goals independently they will be less likely to try to achieve them and will also

not be able to overcome the obstacles necessarily to do so. Decreased life satisfaction stems from

reduced confidence, therefore attention must be focused on keeping’ self-efficacy in individuals

high.

The way an individual perceives a task has everything to do with how it will be carried

out and ultimately interpreted later on. Self-efficacy is essential to an individual’s well being as

well as their overall success in life. People with higher levels of self-efficacy are better able to

keep their emotions controlled and manage unpleasant occurrences (Bandura, 2010). They are

less likely to be bothered by negative thoughts by employing proper coping techniques such

directing their attention to positive thoughts. Overall they have more self-worth. While

individuals with low levels of self-efficacy are more likely to feel anxious due to those same

thoughts and their belief of their inability to do anything about them, which may even cause

those thoughts to magnified (Bandura, 2010). They also experience more feelings of

worthlessness. The level of distress experienced over a threat is dependent on an individual’s

perception of their control over it. Research has shown that self-efficacy beliefs can be

predictors of positive thinking and happiness. One longitudinal study focused on adolescents as

they the transitioned from childhood to adulthood, finding that self-efficacy beliefs contributed

significantly to their subjective well being (Caprara et al., 2006). Higher levels allowed them to

manage negative thoughts and reflect positively not only on themselves but also their futures,

which influenced their overall happiness accordingly. While another study discovered that

strong self-efficacy beliefs early in life are better long-term predictors of life satisfaction later on,

even more so than academic achievement or peer preference (Vecchio et al., 2007). Self-efficacy


has a variety of implications that can be seen both internally within a person and externally

through their actions.

An individual’s perception of what they can and cannot do influences what they will and

will not do. Self-efficacy contributes to adaptation and selection, which causes it to influence the

way an individual’s life will turn out by their choices. (Bandura, 2010). Previous studies have

also shown the relationship between self-efficacy and career choice among adolescents as well as

college students. One study highlighted that, children’s perceived self-efficacy influenced the

career choices they believed they had the capacity to do and would ultimately affect the ones

they choose. It also reported that girls hold higher self-efficacy in social and educational

services while boys reported higher self-efficacy in science and technology careers explaining

the gender gap often seen (Bandura et al., 2001). Meanwhile another focused on Hispanic

college students, who tend to have higher drop out rates when compared to other groups. It was

found that students with higher self-efficacy had greater persistence rates since they were better

able to adjust to college, experienced less stress, and were more likely to continue in advancing

their education when compared to those with lower rates (Solberg & Viliarreal, 1997). Self-

efficacy findings from multiple lines of research have documented the tremendous role it plays in

the life of individuals. If self-efficacy can be increased via interventions than an individual’s

general outlook on life may be improved as well.

Exercise behavior provides an escape from reality resulting in decreased anxiety and

increased self-efficacy. Individuals who believe in their ability to properly manage problems

(high self-efficacy) are not burdened by constant negative worrisome thoughts and experience

less anxiety over all. Therefore as fitness improves so should self-efficacy as more positive

feedback is obtained (Anderson & Shivakumar, 2013). A study conducted on 30 women with


Generalized Anxiety Disorder compared the effects of resistance exercise training to aerobic

exercise training on worry symptoms. Findings suggest that there were significant reductions in

worry symptoms for both conditions when compared to the control (Herring et al., 2011). The

potential success of exercise inventions has been seen before. Various studies have found that

anxiety sensitivity is greatly reduced with different exercise conditions (Broman-Fulks et al.,

2004 & Smits et al., 2008). Exercise has been shown to be an effective and affordable treatment

intervention alternative for anxiety, which in turns leads to increased self-efficacy (as individuals

can focus on their perceived control of situations instead of their anticipated fear of them).

Behavioral Activation has been widely accepted as an effective intervention method to

depression. A behavioral activation approach helps individuals to modify their behaviors instead

of their thoughts. They are encouraged to reengage in their lives and focus on experiences that

can reward them positively therefore creating a natural protection barrier against depression.

(Jacobson et al., 2001). It revolves around increasing positive reinforcement by increasing an

individual’s activity involvement level to provide benefits such as increased self-efficacy.

(Hopko et al., 2004). Given the high rates of comorbidity and the fact that anxiety and

depression share many similar characteristics, it is perceived to be effective in reducing anxiety

as well. The success of this intervention has already been seen in one case study with a comorbid

individual suffering from both depression and anxiety (Hopko et al.,2004).

In the current study, behavioral activation is focused on an increased exercise behavior

intervention in the form of having participants walk three times a week for twenty minutes. The

relationship between physical activity and anxiety suggests that an intervention aimed at

increased exercise behavior would result in decreased anxiety levels. It is also further likely that


an improvement in exercise behavior might lead to an increase in self-efficacy as a similar

relationship between low exercise behavior levels and poor self-efficacy has been established.


Methods

Participants

The participants consisted of a sample of 18 undergraduate students in a Rutgers

University Abnormal Psychology Laboratory. These students participated in the experiment as

part of the lab curriculum. The study was conducted on a mixed gender class consisting of 7

males (38.9%) and 11 females (61.1%). The age range of the students was 19-25 with a mean of

21 years of age. There were four class years represented in the sample: sophomore, junior,

senior and super senior, with the breakdown being 2 (11.1%) sophomores, 4 (22.2%) juniors, 9

(50%) seniors, and 3 super seniors (16.7%). The data was collected both during as well as out of

the Abnormal Psychology Laboratory class periods using self-report measures.

Materials

In this experiment the measures consisted of two self-reported questionnaires and one

self-report behavioral log. The independent variable was the behavioral log. The two dependent

variables were the researcher created measures for the purpose of this study.

Behavior Log: A behavior log created by the researcher to monitor the subject’s exercise

behavioral activation intervention (an increased exercise behavior intervention in the form of

having participants walk three times a week for twenty minutes). The weekly log featured each

day of the week and could be scored as activated or not activated.

Measure 1 (self-efficacy): A researcher created self-report self-efficacy measure with 15

items, administered pre and post the behavioral activation intervention. Items are scored on a

five- point scale with 1=not at all true, 2=hardly true, 3=sometimes true, 4=mostly true,

5=exactly true. Sample items include ‘I am confident that I could deal efficiently with

unexpected events’ and ‘Most things happen to me because I am lucky’. Item reliability analysis


resulted in the removal of item 12 ‘I feel driven by my personal values’ to improve alpha. The

Cronbach’s alpha for the remaining 14 items of this measure was .92 at Time 1 (pre) and .91 at

Time 2 (post); the test-retest reliability was significant (r=.80, p<.001): a mean score for the 14

items was used in analysis.

Measure 2 (anxiety): A researcher created self-report anxiety measure with 15 items,

administered pre and post the behavioral activation intervention. Items are scored on a 4 point

scale with 1=not at all, 2 =somewhat, 3=moderately so, 4=very much so. Sample items include

‘I am worried’ and ‘I do not feel self confident’. The Cronbach’s apha for this measure at Time

1 (pre) was .95 and .92 at Time 2 (post); the test-retest reliability was non-significant (r=.34,

p=.16): a mean score for the 15 items was used in analysis.

Procedure

The participants were first given the researcher created anxiety and self-efficacy

measures to complete prior to the start of the behavioral activation. The measures were given as

a pre-test in order establish a baseline of the self-reported anxiety and self-efficacy levels in the

participants. Additional questions included in the measures also asked about demographics.

These measures were given in class during a session of Abnormal Lab with the teaching assistant

present. The process of the behavioral activation was then explained to the participants and the

behavior trying to be activated was identified as exercise. Exercise in terms of going for a walk.

Participants were instructed to at least 3 times each week attempt to go for an approximately 20-

minute walk outside for a duration period of 7 weeks. They were further asked to record when

they activated this behavior outside of the classroom using the behavioral log each week. After

the 7 weeks the researcher created anxiety and self-efficacy measures were given in the lab again


as a posttest. The data complied was then compared (pre-test vs. post-test) to see if there was any

relation present between the variables.


Results

Demographics

This study took a group of lab students and compared them on various levels over a eight

week period. The majority of the students who participated in this assesstment were female (11,

61.1%) with a mean age of 21. The demongraphics testing was done using independent sample

t-tests to provide information on the PSM-9 and exercise BA by gender and group.

The impact of gender on stess and exercise revealed that subjects differed significantly in

levels of stress at two time points. Week 5 t (16)=2.54, p=.02 and Week 7 t (16)=2.28, p=.04,

during this time stress was effected by gender and males were more stressed than females.

The impact of group on stress and exercise revealed that there was a significant

difference between groups at one time point. Week 5 t(15), p=.02, during this time stress was

effected by group and group 2 was more stressed than group 1.

Ultimately however gender or group does not significantly impact exercise levels

although males and group 2 exercised less.

Hypothesis Testing

The hypothesis testing was done using paired sample’s t-tests. The comparison of means

in the pre-test (3.54) and post-test of self-efficacy (3.65) revealed that while increase did occur it

was not significant. Similarly the comparison of means in the pre-test (1.68) and post-test of

anxiety (1.57) also revealed that while decrease did occur it was not significant. Looking at the

interplay between exercise, anxiety, and self-efficacy it was found that there were no significant

change in anxiety and self-efficacy levels.


Discussion

This current study sought to establish a relationship between exercise behavior, self-

efficacy, and anxiety; ultimately it was unable to establish a relationship between these variables.

It was predicted that a behavioral activation intervention aimed at increased exercise behavior

would lead to increased self-efficacy levels and decreased anxiety levels in a college sample. It

was found that the intervention produced no significant change in either variable; furthermore no

significant changes were seen in the anxiety or self-efficacy levels. This non-significance may

be attributed to the fact that both the anxiety and self-efficacy measures were given only twice,

first as pre-tests for baselines and then as post-tests. The pre-tests were given early on in the

semester during the month of September after classes had started but before midterms. The post-

tests were then given towards the latter part of the semester during the month of November after

midterms. These periods between exams can be considered “grace periods” where anxiety is

typically stable with only relatively normal everyday stressors. While self-efficacy levels are not

affected due to the lack of major stressors such as the fear of an upcoming exam or poor

academic performance. The results obtained experienced interference since they were conducted

around testing periods. The method of answering might have also contributed to some

discrepancies; self-report gives the individuals the opportunity to answer untruthfully whether

due to the confusion of question wording or simply choice. The hypotheses were not supported

in this study and they are many explanations as to why this was so.

Contrary to previous research and theory, this study found that exercise behavior did not

help individuals escape from reality. Increased exercise behavior was unable to decrease anxiety

or increase self-efficacy. Traditionally, the positive influence of exercise has been seen in

college students. Regular exercise in one study reduced perceived stress on upcoming


assignments (Bass et al.,2002) and was associated with lower levels of anxiety in another (De

Moor et al., 2006). While a third study found that increased physical activity leads to an

increase in self-efficacy contributing to an overall improvement in life satisfaction (Elavsky et

al., 2005). Therefore, we had expected to find, we hypothesized that an intervention aimed at

increasing exercise behavior would positively affect both anxiety and self-efficacy levels. As

was the case in a study conducted by Herring (2011), which found that exercise produced

significant reductions in worry symptoms. However, we found that in this study that the results

were non-significant and thus no relationship could be established between the variables.

There are various limitations that must be acknowledged. This study was conducted over

a relatively short period of time, the course of a semester, which was not enough time to properly

measure the change or affect of the variables on each other. Anxiety and self-efficacy levels were

only assessed twice, ideally these measures would have been done weekly throughout the

semester to fully depict the change that was occurring if any. The study also only tested 18

participants with the majority of them being women and thus the sample size used was not big

enough to provide any significant findings that might have come from larger groups. In fact the

results might have even been skewed because 1 participant was eventually lost and in such a

small sample size one individual makes a huge difference. The population tested was also very

limited and not at all diversified, a group of college students taking a specific lab during a

specific time block, thus excluding younger, older, and non-lab specific college populations.

Threats to internal validity were also present. All the measures used relied on self-report

and all participants were required to complete the assessments without any option to opt out.

Therefore it is very possible that participants could have lied and fabrication could have occurred

in the data collection ultimately influencing the results. It might have been better to use self-


report measures in addition to another one such as third-party reports or observation data. All the

measures also had a very high degree of imprecision since they were researcher-created and did

not have any previous empirical support. These unique conditions and sample make it

impossible to draw any real conclusions, as the results cannot be generalized to any broader

populations.

The next step in studying the relationship between exercise, anxiety, and self-efficacy is

to conduct a longitudinal study. The current study used a small class in which the participants

had no choice but to participate in it over the course of a semester. It would ideal to conduct

future studies in a real world setting with a random sample over a longer period of time. A

longitudinal study with a large non-college sample that consists of an equal amount of women

and men will make it easier to see how these variables interact in different age groups over an

extended period of time. Research with children, high school students, senior citizens, or even

different college groups can provide interesting insights and perhaps even results similar to those

seen in previous research. It might also be beneficial to use empirically supported measures such

as the General Self-Efficacy Scale, Beck Anxiety Inventory, or the State-Trait Anxiety Inventory

to measure the variable levels instead of the researcher created ones. In addition to having

another measure that is not subjective such as observation or a report done by a third party (a

parent, teacher, friend, etc.). Two different measures for each variable, both a user reported

measure and an observation that provides a 2nd viewpoint, which are measuring the same thing

would allow for a higher validity in results. It would also be interesting to see the change in the

variable levels (if students are more anxious, have higher self-efficacy levels, and/or are more

active) and their influence on one another as adjustment occurs between a previous semester and

a new semester.


This study was not able to establish a link a between increased exercise behavior and

decreased anxiety levels or increased self-efficacy levels. It did however note slight changes in

each variable though while not significant could provide some groundwork for future studies.

Considerable work remains to be done to determine how exactly exercise, anxiety, and self-

efficacy interplay with one another but this is a good stepping-stone.


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Figures

Table 1: The Relationship Between Exercise and Stress Between Genders Male Female Exercise

M(SD) PSM-9 M(SD)

Exercise M(SD)

PSM-9 M(SD)

Week 1 3.57 (1.81) 4.48(.59) 3.45(1.04) 3,88(.88) Week 2 3.57(1.90) 3.87(.72) 3.55(1.29) 3.71(1.14) Week 3 3.71 (1.50) 4.10 (.59) 3.27(1.35) 4.0(.99) Week 4 3.14 (2.04) 4.19 (.79) 3.36 (1.03) 3.76(1.10) Week 5 3.14 (2.04) 4.10 (.56) * 3.45 (1.13) 3.58(.95) Week 6 3.0 (2.08) 4.01(.75) 3.18 (.982) 3.70 (.1.03) Week 7 3.29 (2.06) 4.68 (.55) * 3.10 (1.45) 3.64 (.83) Week 8 4.10 (.79) 3.67 (.89) *p<.05, **p<.01, ***p<.001

Table 2: The Relationship Between Exercise and Stress Between Genders Group1 Group 2 Exercise

M(SD) PSM-9 M(SD)

Exercise M(SD)

PSM-9 M(SD)

Week 1 3.87 (1.64) 3.93(.823) 3.33(1.00) 4.14(.773) Week 2 4.25(1.58) 3.50(.720) 3.11(1.27) 3.90(1.17) Week 3 4.0(1.51) 3.83(.799) 3.22(.971) 4.21(.930) Week 4 4.0(1.51) 3.81(.790) 2.78(1.20) 4.11(1.20) Week 5 * 4.13(1.46) 3.32(.711) 2.78(1.30) 4.23(.769) Week 6 3.88(1.55) 3.38(.926) 2.56(1.13) 4.14(.835) Week 7 4.0(1.51) 3.85(1.06) 2.78(1.30) 4.21(.794) Week 8 3.67(.920) 3.91(.855) *p<.05, **p<.01, ***p<.001

Table 3: Change in Self-Efficacy

Pre-test of Self-Efficacy

M(SD)

Post-test of Self-Efficacy

M(SD)

Mean 3.54 (.710) 3.65 (.683)

Table 4: Change in Anxiety Pre-test of Anxiety

M(SD)

Post-test of Anxiety

M(SD)

Mean 1.57 (.588) 1.68 (.594)


Graph 1: Change in Exercise and Stress Over Time Between Genders.

Graph 2: Change in Exercise and Stress Over Time Between Groups.

0 0.5 1

1.5 2

2.5 3

3.5 4

4.5 5

Mean Mean Mean Mean

Exercise PSM-‐9 Exercise PSM-‐9

Male Female

Exercise and Stress Between Genders

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Mean Mean Mean Mean

Exercise PSM-‐9 Exercise PSM-‐9

Group1 Group 2

Excercise and Stress Between Groups

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8


Graph 3: Change in Self-Efficacy at Pre-test and Post-test.

Graph 4: Change in Anxiety at Pre-test and Post-Test.

3.45

3.5

3.55

3.6

3.65

3.54

3.65

Change in Self-‐Ef?icacy

Pre-‐test of Self-‐EfEicacy

Post-‐test of Self-‐EfEicacy

1.5

1.55

1.6

1.65

1.7

1.68

1.57

Change in Anxiety

Pre-‐test of Anxiety

Post-‐test of Anxiety

anxiety exercise self efficacy

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