Extensive research has demonstrated that exercise has benefits that
extend beyond physical health to mental health. Thus, several
reviews have concluded that physical activity improves mood and reduces
symptoms of depression while other research has suggested that exercise
may be comparable to antidepressant medication in the treatment of
depression. Although the bulk of this research has been conducted
with adults, there is also evidence suggesting participation in sports
and exercise may have benefits for emotional functioning in children,
including reduced negative affect, increased self-esteem, and elevated
feelings of well-being.
Because anxiety and depressed mood tends to be higher in children with
ADHD compared to peers, it would be interesting to study whether
exercise and sports participation might help address these symptoms,
particularly since these symptoms are not those typically targeted by
ADHD treatments. One possible physiological basis for
anticipating such benefits is that physical activity influences the
activity in several neurotransmitter systems, i.e., dopaminerginc,
noradrenergic, and serotonegic systems, and research has suggested that
children with ADHD have some dysfunction in dopaminergic activity.
The current study [Kiluk, Weden, & Culotta (2009). Sports
participation and anxiety in children with ADHD.
Journal of Attention
Disorders, 12, pp. 499-506.] provides an initial exploration of
whether sports
participation may help manage anxiety symptoms in children with
ADHD. Participants were 65 6 to 14-year old children
diagnosed with pure ADHD, i.e., no other diagnosed conditions, and 32
similarly aged children diagnosed with a learning disability
(LD). Each group contained a good representation of females (38%
in the ADHD group and 50% in the LD group.
As part of each child's evaluation, parents completed the Child
Behavior Checklist, a standardized behavior rating scale that inquires
about participation in sports and about symptoms of
anxiety/depression. The authors simply examined whether symptoms
of anxiety/depression were lower among children with ADHD and children
with LD groups based on how many sports they had participated in during
the prior year. (Although it would have been interesting to
examine the association between sports participation and core ADHD
symptoms, this was not possible because all children in the ADHD group
met criteria for an ADHD diagnosis, and there was thus limited
variability in core symptoms.)
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Results
-
For both boys and girls in the ADHD group, there was a significant and
moderately strong negative correlation between the number of sports
they participated in and parent ratings of anxious/depressed symptoms,
-.531 for boys and -.492 for girls. This means that children with
greater sports involvement displayed fewer anxious/depressed symptoms
according to parents. For children in the LD group, no such
association was found.
The authors also divided children into high vs. low sports
participation groups, i.e., 2 or fewer sports vs. 3 or more sports, and
compared the average scores on the Anxious/Depressed scale for these
groups. For children with ADHD, boys and girls in the high sports
group had significantly lower anxious/depressed scores than children in
the low participation group. The magnitude of this affect would
be considered large as the groups differed by more than a full standard
deviation. Furthermore, this difference remained significant even
when controlling for parents' ratings of children's social functioning
and more general functioning at school. Once again, no such
differences were found among children with a learning disability.
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Summary and
Implications -
Results from this study provide preliminary evidence that sports
participation may have unique benefits for children with ADHD in terms
of reducing anxious/depressed symptoms that frequently accompany the
condition. Based on the data collected here, these benefits
appear to be equivalent for males and females. Thus, physical
activity and sports participation may serve as an important complement
to traditional ADHD treatments that don't typically directly target
symptoms of emotional distress.
It is noteworthy that sports participation was only associated with
reduced anxious/depressed symptoms in children with ADHD and not
children with LD. The authors suggest that physical activity may
be particularly helpful in reducing anxious/depressed symptoms in
children with ADHD "...because of the dysfunction in the
neurotransmission associated with this disorder." This is an
interesting hypothesis, but it is important to recognize that it is
highly speculative. The fact that benefits remained even after
controlling for social and school functioning suggests that sports
participation may have benefits above and beyond the socialization
opportunities that are provided.
While this is an intriguing study that yielded encouraging initial
findings, it should be clear that this is truly an exploratory
investigation and the authors recognize several important limitations
that prevent firm conclusions from being drawn. These include the
absence of any direct measure of children's physical activity, using a
purely correlational design rather than examining how sports
participation influence anxious/depressed symptoms over time, and the
inability to control for differences in family circumstances between
high and low sports participation groups that may have contributed to
the findings. The authors are appropriately cautious in
emphasizing these limitations and correctly note that additional
research in this area is required.
Despite these important limitations, this study opens a potentially
significant new avenue for addressing some of the emotional
difficulties that accompany ADHD for many children. In addition,
sports participation is unlikely to have adverse consequences so this
would appear to be a relatively 'low risk' approach that may be
associated with meaningful benefits. One hopes that additional
studies examining whether and how physical activity and participating
in sports benefits children with ADHD will be forthcoming.