Supplementary Material 
Supplementary Table S1 
Narrative description of findings of the 47 cross-sectional studies.  
 
 
Author 
 
Narrative description of findings 
1 
Wilson 
(1980) 
comparing the 
mood states of 
marathon 
runners, regular 
joggers and 
non-exercisers 
A Canadian cross sectional study by Wilson et al. (1980) used 30 male participants 
ranging from age 20-45 from the same socioeconomic area to compare the mood 
states of marathon runners (n=10), regular joggers (n=10) and non-exercisers (n=10) 
using the Profile of Mood States as measurement. The marathoners and joggers 
reported less depression (F(2,28) =7.51, p<0.003), less anger (F=10.11, p<0.001), less 
confusion (F=12.41,p<0.001) and more vigor (F=103.21,p<0.001) than the non-
exercisers. The marathoners also reported less fatigue (F=10.26, p<.001) and less 
tension (F=7.51, p<0.003) than the non-exercisers. The marathoners and joggers did 
not significantly differ on reported fatigue and tension, however marathoners had 
significantly less depression, less anger, less confusion and more vigor than the joggers. 
Overall results found that the joggers reported better mood states than the non-
exercisers, and the marathon runners reported even more positive mood states than 
the joggers1.  
2 
Joesting 
(1981) 
investigating 
the relationship 
between 
running and 
depression 
An American controlled cross sectional questionnaire by Joesting (1981) used 100 
runners (21 women, mean age 16.53) and 79 men (mean age 18.36) to investigate the 
relationship between running and depression using the Depression Adjective Checklist 
as measurement. The only significant sex difference between male and female runners 
was their age (t=2.85, p<.01). Results found that using the t test, runners of both sexes 
were significantly (p< .01) less depressed than Lubin's data for non-psychiatric sample 
of patients. Female runners mean score on the Depression Adjective Check List was 
4.33, while the normative non-psychiatric patient normative sample mean was 7.32. 
Male runners mean depression score was 4.59 while the normative non-psychiatric 
male sample mean was 8.02. Overall results suggest that running decreased depression 
measurements in both males and females2. 
3 
Jorgenson 
(1981) 
investigating 
the relationship 
between 
emotional 
wellbeing and 
running 
An American study by Jorgenson et al. (1981) used 454 regular runners (390 males and 
64 females) of whom 9.9% were under 20, 25% were age 21-29, 37% were age 30-39, 
23% were 40 and over, 4.8 did not respond about age. The study used a structured 
questionnaire consisting of 55 items designed by the author to investigate the 
relationship between emotional wellbeing and running. The majority of runners (92.3%, 
n=419) indicated an increase in emotional wellbeing (p<0.01), while 5.7% runners 
reported no effect and 1.8% reported a reduction in emotional wellbeing. Results did 
not report the scale of improvement. More than half the runners (54.8%, n=249) 
indicated an increase in general tolerance of others (p<.01), while 33.7% of runners 
indicated no effect and 6.8% had reduced tolerance of others. Results found that age 
and emotional well-being were significantly correlated (gamma value of 0.42, p<0.001), 
that is the older the runner, the greater the perception of emotional well-being 
resulting from running. The inverse relationship between average hours per week 
running and emotional wellbeing was highly significant (gamma value = -0.43, p<.001). 
Overall, results suggest that running increases emotional wellbeing3.  
4 
Valliant 
(1981) 
compare self-
sufficiency and 
personality 
profiles in 
marathon 
runners vs 
recreational 
joggers 
A Canadian cross sectional study by Valliant et al. (1981) used 68 male participants to 
compare self-sufficiency and personality profiles in marathon runners (n=30, mean age 
34.4) vs recreational joggers (n=38, mean age 20.6) using a one hour ‘Sixteen 
Personality Factor Questionnaire’ as measurement. Marathoners were on average 
more reserved (F=17.07, df=1,66, p<0.001), intelligent (F = 12.69, df=1,66, p<0.001), 
tender-minded (F = 11.79, df = 1,66, p<0.001), imaginative (F=11.09, df=1,66, p<0.005), 
and self-sufficient (F = 19.84, df=1,66, p<0.001) than joggers. Conversely, joggers were 
more happy-go-lucky (F = 10.05, df = 1,66, p<0.005), apprehensive (F = 10.51, df=1,66, 
p<0.005) and controlled (F=7.09, df=1,66, p<0.01). Marathoners were on average 
significantly older (F=99.45, df=1,66, p<0.001), ran more miles per week (F=167.6, 
df=1,66, p<0.001) and trained for more years (F=20.55, df=1,66, p<0.001) than the 
joggers. Overall results found that marathon runners had a more self-sufficient 
personality as compared to joggers who were less assertive, more conscientious and 
controlled personality types4.  
5 
Francis 
(1982) 
Comparing 
anxiety, 
depression and 
hostility in 
various groups 
of runners vs 
sedentary 
controls 
An American cross sectional study by Francis et al. (1982) used 44 male participants 
with a mean age of 32 to compare anxiety, depression and hostility in various groups of 
runners vs sedentary controls using the State-Trait Anxiety Inventory (STAI) and the 
Multiple Affect Adjective Check List (MAACL) as measurements. Participants were 
separated into 4 groups based on the number of miles jogged per week: non-running 
controls who ran 0 miles weekly (n=16), 20 miles (n=10), 30-40 miles (n=8) and 50-60 
miles (n=10). There were no significant differences in psychological variables when 
jogging groups (ie. Miles jogged per week) were compared to each other. Spearman 
correlations for the psychological parameters were as follows: MAACL anxiety= -0.08, 
MAACL depression= -0.15, MAACL hostility= 0.11, STAI anxiety= -0.12, none of which 
were significant. Runners had significantly lower (p<0.01) anxiety, hostility and 
depression than their sedentary counterparts. Combined joggers scores vs sedentary 
control scores for MAACL anxiety were 4.2 vs 7.2, respectively, for MAACL hostility 
were 4.8 vs 6.8, for MAACL depression were 8.6 vs 12.3, and for STAI anxiety were 30.8 
vs 42.8. Combined trait scores revealed that anxiety, hostility, and depression as 
measured by the MAACL in joggers were respectively 27%, 23% and 14% lower than 
normative scores (reported in other papers) and anxiety as measured by the STAI was 
19% lower in joggers when compared to the reported norms. Overall results suggest 
that running lowers depression and anxiety measures5. 
6 
Hailey 
(1982) 
investigate the 
relationship 
between 
running and 
negative 
addiction 
An American cross sectional questionnaire by Hailey et al. (1982) used 60 male runners 
aged between 13 and 60 years old to investigate the relationship between running and 
negative addiction using the negative addiction scale as measurement. The subjects 
were split into three groups: those who had run for less than 1 year (n=12), those who 
had ran for 1-4 years (n=32) and those who had ran for over 4 years (n=16).  Overall, 
the sample mean for negative addiction scores was 5.39 on a scale of 1 to 14. There 
was significant difference in negative addiction between the groups (F(2,58)= 3.48, 
p<.05), with length of running history associated with increasing negative addiction 
scores. Runners with a running history of less than 1 year scored a mean of 3.84, those 
running for 1-4 years scored 5.63, and those running for over 4 years scored 6.38. 
Addiction scores for runners of over 4 years was greater than the addiction score for 
runners of under one year (t(59)=2.72, p<.005). Likewise, the addiction score for 
runners of between one and four years was greater than the score for runners under 
one year (t(59)=2.52, p<.01). However the difference in addiction scores between the 
1-4 year group and the 4+ year group was not statistically significant, which may 
suggest that negative addiction reaches a plateau with running and does not increase 
at the same rate in later stages as it does in the beginning of the development of 
running behaviour with significant differences between the groups. Overall, results 
suggest that the more years a male has been running, the greater the risk of developing 
negative addiction6. 
7 
Callen 
(1983) 
Investigating 
mental and 
emotional 
aspects 
associated with 
long-distance 
running in non-
professional 
runners, 
including 
depression, 
tension, mood, 
happiness, self-
confidence and 
self-image.   
An American cross sectional study by Callen (1983) used 424 non-professional runners 
(303 men and 121 women) with a mean age of 34 years old and who ran on average 
more than 28.8 miles per week to investigate the mental and emotional aspects 
associated with long-distance running, including depression, tension, mood, happiness, 
self-confidence and self-image. A questionnaire designed by the author was used as 
measurement. 96% of the subjects noticed mental or emotional benefits from running, 
however no details were reported of the size of these mental and emotional benefits. 
Benefits included relief of tension (86% of all respondents, 88% of men and 82% of 
women, ns for all three); improved self-image (77% of all runners, 74% of men and 82% 
of women, ns for all three); better mood (66% of all participants, 62% of men (p<0.05) 
and 82% of women(p<0.05)), improved self-confidence (64% of all participants, 63% of 
men and 65% of women, ns for all three), relieved depression (56% of all participants, 
52% of men (p< 0.05) and 69% of women (p < 0.05)) and improved happiness (58% of 
all participants, 56% of men and 64% of women). However, 25% state that they had 
experienced emotional problems associated with running, in which almost every 
instance the problem is one of depression, anger, or frustration associated with not 
being able to run due to an injury. No further details were reported on this. 69% of 
runners experienced an emotional "high" associated with running7. 
8 
Galle (1983) 
Comparing 
psychologic 
profiles 
including 
anxiety and 
depression in 
runners, 
infertility 
patients, fertile 
An American controlled cross sectional questionnaire by Galle et al. (1983) used 391 
female subjects to compare psychologic profiles including anxiety and depression in 
runners (n=102), infertility patients (n=103), fertile subjects (n=139) and Clomid study 
patients whose only infertility abnormality was ovulation dysfunction (n= 47), using the 
Hopkins Symptom Checklist-90 (SCL-90) as measurement. The runners were aged 15 to 
50 years, 15% had amenorrhea, 70% had regular cycles, and 15% had irregular cycles. 
The SCL data showed that the mean scores in all groups-runners, Clomid study patients, 
infertility patients, and fertile control subjects were in the normal range for all factors. 
Mean total scores for SCL did not vary significantly amongst the 4 groups (F=1.19, ns), 
subjects and 
Clomid study 
patients whose 
only infertility 
abnormality 
was ovulation 
dysfunction 
however, there was a significant difference for the depression subscale (F=3.42, 
p<0.025): the depression scores of runners (were nearly identical to those of fertile 
control subjects but were significantly lower than the depression scores of the Clomid 
study patients or the infertility patients. The only significant difference between 
runners and fertile control subjects was that control subjects had higher hostility 
(p<0.05). Significant differences were noted with the factors of obsessive-compulsive 
behaviour (p< 0.01) and psychoticism (p<0.005). The women running more than 30 
miles per week had higher mean scores for all factors, with significant differences in 
somatization (P<0.05) and anxiety (P<0.005). Regarding just runners, there was 
significant differences in depression between amenorrhoeic (n=15) and regular cycling 
runners (n=87), with amenorrhoeic runners scoring higher in the depression factor than 
regular cycling runners (F=3.0, p<0.10). Overall the emotional distress scores of runners 
were not significantly different from fertile control subjects, but both groups of 
infertility patients showed greater distress on items in the depression factor than the 
runners and fertile control subjects. Emotional distress factors were associated with the 
development of amenorrhea in these runners8. 
9 
Lobstein 
(1983)  
Impact of a 
treadmill run 
with increasing 
gradient on 
depression 
An American pre-post controlled between subject design by Lobstein et al. (1983) used 
22 medically healthy men aged 40-60, to compare depression in physically active men 
(n=11) to sedentary men (n=11) using the Minnesota Multiphasic Personality Inventory 
(MMPI) as measurement. The MMPI indicated that sedentary men were more 
depressed (mean 61.36) than the physically active men (mean 50.73) with p < 0.01 and 
standardized canonical coefficients of 0.929. However, both groups of men were within 
clinical limits for normal, mentally healthy, middle aged men9. 
10 
Rudy (1983) 
investigating 
how levels of 
anxiety and 
self-esteem 
related to 
intensity of 
jogging 
An American cross sectional questionnaire by Rudy et al. (1983) used 319 female 
regular runners between the ages of 16 and 60 to investigate how levels of anxiety and 
self-esteem related to intensity of jogging using the Rosenberg Self-esteem Scale and 
Zuckerman's Anxiety Adjective Checklist as measurements. Results found that female 
runners jogging with great intensity demonstrated significantly less anxiety (x 2 = 22.83; 
p<.001). In addition 14% of women listed decreased tension as a result of jogging they 
felt others should know about. No significant relationship was drawn between self-
esteem score and intensity of jogging, however the majority (89%) of women scored in 
the range designated as high self-esteem, and there was evidence that jogging 
influenced self-esteem in the open-ended answers with 29% of responses stating they 
feel better about themselves, 12% stating they have increased self-confidence and 6% 
stating they had a sense of accomplishment. Hence this paper does show evidence that 
jogging influences self-esteem, just not significant evidence10.  
11 
Goldfarb 
(1984) 
Investigating 
anorexia 
nervosa traits 
within distance 
runners 
An American cross sectional study by Goldfarb et al. (1984) used 200 distance runners 
(136 men and 64 women) to investigate anorexia nervosa traits within distance runners 
using the Goldfarb Fear of Fat scale and Activity Vector Analysis to measure personality 
characteristics. The study does not give details on the demographics of the participants. 
Results do not support a connection between running and fear of fat, a central 
component of anorexia nervosa, with only 29 (14.5%) participants reporting a high fear 
of fat score (i.e. between 6 and 10 on the scale). Overall, the mean fear of fat score for 
these runners was 2.91, indicating a low-normal fear of fat. Fear of fat scores did not 
correlate significantly with any of the measures of running zealousness including miles 
run per week (r=-.04), number of workouts per week (r=.09), number of road races 
(r=.05), or marathons completed (r=-.05), and degree of importance placed on running 
(r=-.03). The runners who demonstrated the greatest zealousness demonstrated AVA 
profiles that closely clustered around one particular profile (r=.64, p< .05) consisting of 
high ipsative scores on aggressiveness and dependence and low ipsative scores on 
sociability and emotional stability… indicating that these individuals are assertive, 
obsessive, perfectionistic, and anxious. Overall, results do not support a correlation 
between running and fear of fat. However, the runners most closely resembling 
"obligatory runners" exhibited traits characteristic of anorexia nervosa patients11.  
12 
Guyot 
(1984) 
comparing 
death anxiety in 
runners vs non-
runners 
An American controlled cross sectional study by Guyot et al. (1984) used 126 
participants to compare death anxiety in runners (44 males and 20 females) vs non-
runners (37 males and 25 females) using the Death Concern Scale as measurement. The 
study did not give details on the demographics of the participants. Runners scored 
significantly higher (mean= 19.5) than nonrunners (mean= 17.6) on the death thoughts 
subscale within the Death Concern Scale (F(1,122) =4.49, p<.05), meaning that runners 
reported thinking more about death than nonrunners. However, nonrunners scored 
significantly higher (mean =12.5) than runners (mean =10.8) on the death anxiety 
subscale (F(1,122)=6.35, p<.05), indicating that nonrunners had more anxiety about death 
than runners. Sex of the subject was not significant in either analysis and there were no 
significant interactions. The number of years running, which averaged 5.5 years for 
male runners and 4.9 years for female runners did not significantly correlate with either 
death thoughts subtotal (r=-.04) or death anxiety subtotal (r=-.04). Overall results found 
runners experienced more death thoughts but less death anxiety than nonrunners12. 
13 
Rape (1987) 
Comparing 
depression 
scores in 
runners vs non-
exercisers 
An American controlled cross sectional study with a matched two-group design by Rape 
(1987) used 42 male participants between the ages of 18 and 25 to compare depression 
scores in 21 runners (ran 15 or more miles weekly) vs 21 non-exercisers using the Beck 
Depression Inventory as measurement. Results found that the runners were 
significantly less depressed [M=4.38, SD = 3.88] than the non-exercisers [M=9.55, SD = 
5.40]; (t40= 3.55, p<0.001). Overall results suggest that running reduces depression13.  
14 
Weight 
(1987) 
comparing 
eating attitudes 
and disorders in 
marathon 
runners vs cross 
country runners 
vs non-running 
controls 
A South African cross sectional controlled study by Weight et al. (1987) used 135 
female participants between ages 18-56 to compare eating attitudes and disorders in 
marathon runners (n=85) vs cross country runners (n=25) vs non-running controls 
(n=25) using the Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI) as 
measurements. One way ANOVA of the different groups showed no significant 
difference between any group on any of the EAT sub-scores (P<0.05), with mean EAT 
scores for the marathoners, cross country runners and non-running control at 8.4, 14.3 
and 11.8, respectively. The EDI scores did not follow a definite pattern, with all groups 
showing a gradual, if erratic downward trend. Mean EDI scores for the marathoners, 
cross country runners and non-running controls were 24.8, 27.1 and 32.0, respectively. 
All subjects with high EAT scores (>20) also had high EDI scores (>30) but there was no 
relationship between high EDI scores and the EAT scores. Overall results found that 
abnormal eating attitudes and the incidence of anorexia was no more common among 
competitive female runners than it is among the general population, with a low 
incidence of anorexia in the total group (2 out of 135 participants)14.  
15 
Chan (1988) 
Comparing 
depression, self 
esteem and 
mood in 
prevented 
runners vs 
continuing 
runners  
An American cross sectional questionnaire by Chan et al. (1988) used 60 runners (32 
women and 28 men) aged between 15 & 50 who had ran consistently (at least 3x per 
week) for a minimum of a year and more than 20 miles per week when not injured. The 
study compared depression, self-esteem and mood in 30 prevented runners (unable to 
run for 4 weeks due to a running-related injury) to 30 continuing runners (ran without 
interruption) using the Zung depression Scale, Rosenberg Self-esteem Scale and Profile 
of Mood States as measurement. Prevented runners reported significantly greater 
over-all psychological distress than the continuing runners group (Wilks's =0.63, p<.01: 
X92 = 24.38, p<.01). Regarding Zung Depression Scale scores, the prevented runners 
were significantly more depressed than the continuing runners (F(1,58)= 11.57, p<0.01). 
Based on POMS total score, prevented runners reported a significantly greater over-all 
mood disturbance than the continuing runners group (F(1,58) =11.03, p<.01). vs 42.60). 
On the Rosenberg Self-esteem scale, the prevented runners reported significantly lower 
self-esteem than the continuing runners (F(1,58) =3.17, p<.05). Prevented runners 
reported that they were less satisfied with the way their bodies presently look 
(F(1,58)=4.17, p<.05) and had a greater desire to change something about the way their 
bodies presently look (F(1,58) =4.54, p<.05) compared to continuing runners. Overall, 
results suggest that preventing running in regular runners increases depression, overall 
mood disturbance, as well as decreasing self-esteem and body confidence15. 
16 
Frazier 
(1988) 
Investigating  
the relationship 
between 
running and 
mood in regular 
distance 
runners 
An American post only, non-randomised, long term observational study that is unlikely 
to have made any controls for confounding, by Frazier (1988) used 86 regular, distance 
runners who had all completed a marathon (68 males with mean age of 33.7 and 18 
females with a mean age of 32.2) to investigate the relationship between running and 
mood using the Profile of Mood States as measurement. The running subjects had 
lower mean scores on tension, depression, anger, fatigue and confusion, and a higher 
mean of vigor compared to scores for test norms, however statistical significance 
between the runners and the norm values was not reported. female subjects recorded 
higher mean scores on all sex states (tension, depression, anger, vigor, fatigue, 
confusion), however, only a significant difference was noted on confusion between 
females (mean =7.8) and males (5.5) (F(1,84) = 5.33, p<.05). Overall results suggest that 
regular, distance running improves mood in both males and females16. 
17 
Lobstein, 
Ismail 
(1989) 
Comparing 
anxiety and 
depression 
levels in 
runners vs 
sedentary 
controls 
An American controlled cross sectional study by Lobstein, Ismail et al. (1989) used 36 
male participants aged between 40 & 60 years old to compare anxiety and depression 
levels in runners (n=21) vs sedentary controls (n=15) using the Minnesota Multiphasic 
Personality Inventory (MMPI) and Eysenck Personality Inventory as measurements. In 
MMPI scores, both groups appeared to be within psychologically normal limits, 
however, physically active men exhibited significantly less anxiety than sedentary men 
(mean = 48.95 vs 61.48 respectively, p<0.05, standardised canonical coefficient = -1.07) 
and less depression compared to the sedentary men (mean = 50.76 vs 57.93, 
respectively, p<0.05, standardised canonical coefficient = 0.00). Discriminant function 
analysis showed that anxiety index was the most powerful discriminator between the 
physically active and sedentary men (standardised canonical coefficient =-1.07). 
Neurotocism score (Eysenck) was not significant between the physically active group 
and the sedentary group (4.95 vs 6.20) (standardised canonical coefficient = -0.72). 
High physical fitness scores were correlated with low depression (r=-0.40, p<0.05). 
Overall results indicate that running reduces anxiety and depression compared to being 
sedentary17.  
18 
Lobstein, 
Rasmussen 
(1989) 
Comparing 
depression and 
stress in 
sedentary men 
to physically 
active joggers 
An American cross sectional study by Lobstein, Rasmussen et al. (1989) used 20 
psychologically normal, medically healthy men, aged between 40 & 60, to compare 
depression and stress in sedentary men (n=10) compared to physically active joggers 
who had been running about 20 miles per week for at least 3 years (n=10) using the 
Eysenck Personality Inventory (EPI) and Minnesota Multiphasic Personality Inventory 
(MMPI) as measurements. EPI scores demonstrated that the joggers (mean=2.80) 
exhibited significantly more emotional stability than the sedentary group (mean=7.10) 
(t=-2.84, p<0.01). Regarding the MMPI profile, both physically active and sedentary 
group profiles were within clinical limits for psychologically normal middle-aged men. 
The MMPI subscales of depression and Wiggins depression were both significantly 
lower in the joggers (t=3.70,p<0.01; t=2.40, p< 0.05; respectively) indicating that the 
physically active men were less depressed than the sedentary me. The magnitude and 
direction of the canonical coefficients (0.98) indicated that the subjective depression 
subscale appeared to be the most powerful discriminator between the two groups. 
Overall the findings suggest that regular jogging decreases subjective depression and 
increases emotional stability18. 
19 
Nouri (1989) 
investigating 
the relationship 
between 
various levels of 
jogging vs non-
exercising on 
anxiety and 
addiction/ 
commitment 
An American cross sectional study by Nouri et al. (1989) used 100 male participants 
aged between 18 and 62 to investigate the relationship between various levels of 
jogging vs non-exercising on anxiety and addiction/commitment using the Commitment 
to Running Scale, The Buss-Dutkee Inventory measuring hostility and aggression and 
the Spielberger State-Trait Anxiety Inventory as measurements. Participants were 
divided into 5 groups: non-exercisers (n=28), drop-out joggers (n=21), beginning joggers 
(n=15), intermediate joggers (n=16), 20 advanced joggers (n=20). Commitment to 
Running gave a main effect for level of jogging (F(4,89) = 14.30, p<.01). Advanced, 
Intermediate and Begging joggers all scored higher than drop-outs or non-exercisers on 
the Commitment to Running Scale. However, there was no statistically significant 
difference between non-exercisers and drop-out joggers or among the other jogging 
groups. ANOCA for trait anxiety scores was significant (F(4,89) = 4.43, p<.01). Non-
exercisers had higher mean scores on trait anxiety than advanced, intermediate, bigger 
and drop-out joggers (2.00, 1.42, 1.69, 1.77 and 1.68, respectively). Advanced joggers 
had the lowest mean trait-anxiety score (1.42) and were significantly lower than the 
other groups p<.01). Overall results suggest that running reduces anxiety levels 
compared to physical inactivity, with advanced joggers having even less anxiety than 
beginner and intermediate joggers19.  
20 
Chan (1990) 
Investigating a 
relationship 
between 
running and 
depression, 
stress, tension 
and personality 
profiles  
A Hong Kong based cross sectional study by Chan et al. (1990) used 44 male, Chinese 
runners with a mean age of 27.8, who all except 1 belonged to a single track club, who 
ran for a mean of 4.66 years and ran a mean of 57.2km per week. The study 
investigated a relationship between running and depression, stress, tension and 
personality profiles, using a Chinese version of the Personality Research Form and a 
questionnaire designed by the authors to assess running history and experience. 36.4% 
of participants reported ‘improving mental health’ as a reason to starting running. 
Emotional benefits from running reported were: more self-confident (59.1% of 
respondents), happier (56.8%), better mood (50.0%), relieved tension (45.5%), better 
self-image (36.4%), relieved depression (36.4%), more aggression (36.4%), improved 
outlook (34.1%), more content (31.8%) and better family relationship (15.9%). 
However, when participants stopped running 38.6% experienced low mood and 25.0% 
experienced anxiousness. Significance was largely not reported on throughout the 
results. Results inferred that the typical male runner was more controlled and less 
oriented intellectually and aesthetically. More experienced runners, compared to less 
experienced runners, were less aggressive or easily angered (t=2.92, df=42, p<0.01), 
less guarded or defensive (t=2.13, df=42, p<0.005), and more likely to present 
themselves favourably (t=2.68, df=35, p<0.05). Overall, results suggested that running 
increased mood, happiness and outlook, while relieving depression, aggression and 
anger, however there was no reporting of the size of these changes or their 
significance20. 
21 
Chapman 
(1990) 
investigating 
the relationship 
between 
running 
addiction, 
psychological 
An American cross sectional study by Chapman et al. (1990) used 47 runners (32 males 
aged 34-57, and 15 females aged 35 to 59) to investigate the relationship between 
running addiction, psychological characteristics and running using the Running 
Addiction Scale (RAS), Commitment to Running Scale (CR), Symptom Checklist (SCL-90-
R) and Levenson's Locus of Control Scale as measurements. RAS correlated for both 
sexes of runners strongly with self-rated addiction (p<0.05) and moderately with 
discomfort (p<.05). However, CR did not significantly correlate with self-rated addiction 
characteristics 
and running 
in females (.246, ns) while the RAS did (.753, p<.05) (z=2.00, p<.05). Running addiction 
(RAS) was found to be associated with high frequency of running (p<.05) and longer 
duration of running (males=p<.05; females= ns). The CR score correlated significantly 
with run frequency for the male (.59, p<0.05) but not the female runners (.14, ns), 
while CR and run duration did not correlate significantly for either sex (males=.16, 
females=.28, ns for both). Male runners were above the norm for obsessive compulsive 
tendencies (SCL-90 score) and significantly higher than female runners (p<.05). The 
female runners were above the norm in hostility (p<.05) and interpersonal sensitivity 
(p<.05) and significantly higher than males (p<.05). For males, correlations indicated a 
significant relationship between positive personality characteristics and addiction, high 
frequency and long duration running and psychological health (p<0.05). There were no 
significant correlations with personality traits for females. Overall, results indicates that 
for female runners commitment to running can occur without addiction and that there 
is a sex difference in the relationship between addiction and commitment. Running 
addiction was found to be associated with male positive personality characteristics but 
not with mood enhancement. While the duration of running was found to be 
associated with mood enhancement implying that the benefits of running to mood may 
be obtained without addiction21. 
22 
Guyot 
(1991) 
Investigating  
the relationship 
between 
addiction and 
death anxiety 
between pain 
runners and 
non-pain 
runners 
An American cross-sectional questionnaire by Guyot (1991) used 370 runners to 
investigate the relationship between addiction and death anxiety between pain runners 
and non-pain runners using the Dickstein Death Concern Scale and author created 
questionnaires for pain running, running motives, risk taking and medical symptoms as 
measurements. Participants consisted of 78% males, who had a mean age of 38, ran 
33.3 miles per week and had been running for an average of 7.9 years, and 22% 
females, who had a mean age was 35, ran 21.3miles per week and had been running for 
an average of 6.3 years. 56% of the 370 runners pushed themselves during running 
until they felt pain: 60% of the males and 43% of female runners were classified as pain 
runners. This difference between genders was significant (p=0.008). Compared to non-
pain runners, pain runners were more likely to be male, taller (F(1,366) =11.45, p<0.05), 
heavier (F(1,366) =9.19, p<0.05), and younger (F(1,366) =5.75, p<0.05). Pain runners were 
more likely to be running for competition (58% of PR vs 42% of NPR) and less likely for 
improved health (75% of PR vs 84% of NPR) (p<0.05 for both). Pain runners were 
significantly higher on 17 of 23 (74%) medical symptoms than non-pain runners 
(p<0.05). Pain runners reported significantly more death thoughts Dickstein Death 
Concern Scale (Mean = 16.77) than non-pain runners (Mean = 15.78) F(1,364)= 5.04, 
p<0.05, as well significantly more death anxiety (Mean = 10.95) than non-pain runners 
(Mean = 9.66), F(1,364)= 8.86, p<0.05. Overall, results suggest that runners classified as 
pain runners were experienced significantly more death thoughts and death anxiety 
than non-pain runners22. 
23 
Maresh 
(1991) 
Investigating 
psychological 
characteristics 
including 
anxiety, 
depression and 
stress in 
distance 
runners 
An American cross sectional study by Maresh et al. (1991) used 29 male, distance 
runners with a mean age of 40.1 who had been running for an average length of 11.8 
years prior to the study, to investigate psychological characteristics including anxiety, 
depression and stress using the Myers-Briggs Type Indicator Form to determine 
personality characteristics and the Multidimensional Anger-Inventory as 
measurements. Results suggested that long term involvement in running is associated 
with low levels of self-reported anxiety (m=2.5 on a 6 point scale), depression (M=1.8) 
and stress (m=2.5). 82% of the male runners reported suffering from withdrawal 
symptoms when forced to be inactive, with the level of self-reported addiction average 
4.4 ('moderately' to 'very') on a 6 point scale. Withdrawal symptoms were experienced 
5.0+/-6.2 days after exercise ceased. A majority (55%) of those experiencing withdrawal 
did so within 3 days. Compared to a normative sample of male control students, the 
runners were less angry overall and were less frequently angry across fewer situations. 
Runners also reported very low scores on hostile outlook, however there were no 
differences between the two samples on brooding, guilt over anger, or tendencies to 
turn anger inward against the self. The subjects personality profiles differed markedly 
from the normative sample, with men in the general population tending to be more 
extraverted (75%) than introverted (25%), more sensate (57% than intuitive (25%), 
more thinking (60%) than feeling (40%), and equally split between judging (50%) and 
perception (50%). Overall results suggest that running is associated with a positive 
sense of self; reduced anxiety, depression and stress; and more introverted 
personalities. However, many runners experienced withdrawal symptoms if forced to 
be inactive23. 
24 
Gleaves 
(1992) 
Comparing 
depression, 
body image 
disturbance and 
An American controlled cross sectional study by Gleaves et al. (1992) used 60 female 
participants to compare depression, body image disturbance and bulimia nervosa 
symptomology in runners (n=20), bulimia patients (n=20) and a non-exercising, non-
dieting control group (n=20) using the Beck's depression inventory (BDI) Automatic 
bulimia nervosa 
symptomology 
in runners, 
bulimia patients 
and a non-
exercising, non-
dieting control 
group  
thoughts Questionnaire (ATQ),  subscales from the Eating Disorder Inventory (EDI) 
(Ineffectiveness scale, Drive for Thinness scale, Bulimia scale, and Body dissatisfaction 
scale), a Bulimia test, Body Image Assessment Procedure, and a dieting/weight loss 
questionnaire as measurements. For depression scores the overall MANOVA was 
significant, F(6110.25) = 14.76, P < 0.0001. Bulimics scored significantly higher for BDI 
depression than the runners and controls (20.65, 3.30 and 4.80 respectively, F=56.95, 
p<0.0001), but runners and controls did not differ from each other. The same pattern 
of results was found for the ATQ and the EDII with bulimics differing from the two other 
groups and no significant difference between runners and controls: ATQ (F=45.87, 
p<0.0001), means for runners =41.10, controls=41.50, bulimics = 85.40; EDII (F=34.95, 
p<0.0001), means for runners =0.80, controls=1.60, bulimics = 12.80. There were 
significant group effects on all four dependent variables of bulimia (p<0.001), with 
bulimics scoring higher compared to the other groups who did not differ among 
themselves. There were significant group effects for all three variables of body image 
(p<0.01), again, bulimics differed from runners and controls. Overall, results did not 
indicate that running leads to development of disordered eating or problems with body 
image, but instead that runners are generally indistinguishable from control subjects 
with no differences found between runners and controls throughout the study. 
Bulimics were significantly more disturbed than runners or controls24. 
25 
Coen (1993) 
investigate the 
relationship 
between 
obligatory 
running vs non-
obligatory 
running on 
anxiety, 
anorexia and 
self-identity 
An American cross sectional study by Coen et al. (1993) used 142 male marathon 
runners with a mean age of 44.07 to investigate the relationship between obligatory 
running (n=65) vs non-obligatory running (n=77) on anxiety, anorexia and self-identity 
using the Obligatory Exercise Questionnaire (OEQ), State-Trait Personality Inventory 
and The Ego Identity Scale (EIS) as measurements. The obligatory runners had a mean 
total OEQ score of 56.64; the non-obligatory group had a mean score of 47.60. There 
was a statistical difference between (OEQ) scores of the obligatory and the non-
obligatory runners (t(140) = 13.19, p <0.001), with the obligatory group running more 
miles per week and spending more time running each week. The obligatory group had 
significantly higher (p<0.01) mean levels of anxiety than the non-obligatory group 
(18.85 vs 6.45, respectively), indicating that obligatory runners appear to be more 
perfectionistic and to have higher levels of trait anxiety than non-obligatory runners. 
Although the non-obligatory runners had an average Ego Identity Scale score that was 
higher than the obligatory group (means 8.68 vs 8.34, respectively), the difference was 
not statistically significant (p>0.05) indicating that neither group showed a higher 
developed sense of identity. Overall results suggest that running represents a 
successful coping mechanism to reduce anxiety and becomes problematic only when 
the obligatory individual is unable to run because of injury or other circumstances25.  
26 
Furst (1993) 
Comparing 
negative 
addiction in 
runners vs gym 
exercisers 
An American controlled cross sectional study by Furst et al. (1993) used 188 subjects to 
compare negative addiction in runners (72 male & 26 female runners, 82% white, 42% 
were aged between 20-29 y/o, 36% between 30 and 39 y/o) to gym exercisers (60 male 
& 30 female, 95% were white, 42% were aged between 20 & 29, 36% between 30 & 39) 
using the Negative Addiction Scale as measurements. Subjects were divided into 6 
groups by years of participation and a significant difference was found between years 
of physical activity and addiction scores (F(5,182) = 6.39, p<0.01) indicating that longer 
involvement in physical activity was associated with higher addiction scores. When 
runners were compared with gym exercisers, there were no significant differences in 
mean addiction scores. Only 5 people scored 9 or above on the negative addiction scale 
(ranges from 0 to 14), indicating that none of the 188 participants were extremely 
addicted to the activity. Overall results suggest that the longer people had been 
exercising, both runners and gym goers, the more addicted they were to exercise 26. 
27 
Masters 
(1993) 
Investigating 
self-esteem and 
psychological 
coping of 
marathon 
runners 
An American cross sectional study by Masters et al. (1993) used 712 participants in a 
marathon (601 men and 111 women) all aged between 16 and 79 to assess self-esteem 
and psychological coping of runners using the Motivation of Marathoners Scales 
(MOMS), Sport Orientation Questionnaire, Marlowe-Crowne Social Desirability Scale, 
Attentional Focusing Questionnaire (AFQ) and 3 body satisfaction and composition 
questions. There were significant positive correlations between the AFQ dissociation 
and the MOMS psychological coping [r(66)=.54, p<.001], self-esteem [r(66)=.31, p<.01] 
and life meaning scales [r(66)=.36, p<.01]. Marathon runners reporting higher anxiety 
levels were more likely to endorse psychological motives for marathon running, 
indicating that their running helps them avoid or dampen negative emotional 
experiences: psychological coping, [r(62)= .38, p<.01] and self-esteem, [r(62)=.36, 
p<.01]. A t-test comparing average rating on the weight concern scale for the two 
genders was calculated. Women had a higher mean score than men, and women more 
strongly endorsed weight concern as a reason for involvement in marathons [t(588)= -
3.52, p<.001]. No significant relationship was found indicating that social desirability 
played a major role in subjects responses to the MOMS. Personal goal achievement and 
competition were both positively related to training miles per week [r(575)=.22, p<.001 
and r(576) =.30, p<.001, respectively]. Overall, results suggest that participation in 
marathon running and training was used as a way of problem solving, providing self-
distraction and improving mood and self-esteem27.  
28 
Pierce 
(1993) 
Comparing 
exercise 
dependence in 
recreational 
(non-
competitive) 
runners vs 5km 
runners vs 
marathoner 
runners 
An American cross sectional questionnaire by Pierce et al. (1993) used 89 male runners 
to compare exercise dependence in recreational (non-competitive) runners (n=33) vs 
5km runners (n=24) vs marathoner runners (n=32) using the negative addiction scale as 
measurement. Marathoners showed significantly higher (p<0.05) mean exercise 
dependence scores (3.78) compared to 5K (2.9) and recreational runners (2.16). There 
was no significant difference in exercise dependence scores found between 
recreational and 5K runners. Comparisons between competitive groups and variables of 
exercise addiction and miles per week yielded correlational coefficients of +0.68 and 
+0.81, respectively. Overall results show that training mileage was significantly 
correlated with exercise dependence and competitive orientation28.  
29 
Klock (1995) 
Comparing 
depression, 
anorexia 
nervosa, 
excessive 
exercise and 
eating disorders 
in 
amenorrhoeic 
runners, 
eumenorrheic 
runners and 
eumenorrheic 
sedentary 
women as 
controls 
An American controlled cross sectional study by Klock et al. (1995) used 22 females 
who were not currently pregnant or taking oral contraceptives to compare depression, 
anorexia nervosa, excessive exercise and eating disorders in amenorrhoeic runners 
(n=7, mean age 28.0), eumenorrheic runners (n = 9, mean age 32.1) and eumenorrheic 
sedentary women as controls (n=6, mean age = 27.5) using the modified Body Image 
Questionnaire (BIQ), the Beck Depression Inventory (BDI), the Symptom Checklist-90 
(SCL-90) and the Eating Disorders Inventory (EDI) as measurements. All 3 groups had 
overall satisfaction with general body appearance and there were no significant 
differences regarding body satisfaction. No differences were found among groups on 
the BDI, however the amenorrhoeic runners' mean score was double that of the 
eumenorrheic runners and sedentary controls (8.3 versus 3.8 and 3.0, respectively) but 
it was below 11 which is the lowest score indicative of mild depression. No significant 
differences found between groups on the SCL-90 scores or total EDI scores, although 
the amenorrhoeic runners' mean EDI score was at the level indicative of a clinically 
significant eating disorder. 3 of the 9 amenorrhoeic runners scored in the clinically 
depressed range on the BDI, indicating that they were mild to moderately depressed, 
and also had the highest scores in their group on the SCL-90 and the EDI. Overall results 
found no significant differences between amenorrhoeic runners, eumenorrheic 
runners, and eumenorrheic sedentary controls on any of the psychological measures, 
hence these results do not suggest that there are psychological similarities between 
obligatory runners and anorexics. However, there was a subgroup of amenorrhoeic 
runners who scored in the extreme range on the depression and eating disorder 
measures29.  
30 
Thornton 
(1995) 
Investigating a 
relationship 
between 
habitual 
running and 
addiction 
A UK based cross sectional questionnaire by Thornton et al. (1995) used 40 long-
standing, habitual male runners with a mean age of 38 and who ran on average 4 times 
a week with a weekly mileage of 42.5miles, to investigate a relationship between 
habitual running and addiction using the Rudy and Estok Running Addiction Scale 
(RE/RAS), the Hailey and Bailey Running Addiction Scale (HB/RAS) and the Personal 
Incentives for Exercise questionnaire (PIE) as measurements. The majority (77%) of 
subjects were committed to levels of running which would be classified as moderately 
(scores 13-20) or highly 'addictive' (scores +20) (55% and 22%, respectively). The 
correlation between the two addiction scales revealed a strong positive relationship (rs 
= 0.81; p<0.001). The primary motivation for running was mastery (mean PIE score of 
4.2) followed by competition (3.93), weight regulation (3.9), health benefits (3.89), 
fitness (3.87) and social recognition (3.01). For RE/RAS scores, only two variables, 
mastery (F(1,38) = 12.1, p < 0.001) and social recognition (F(2,37) = 9.4, p < 0.001) 
contributed to the predictive equation. In a second regression analysis for the HB/RAS 
scores, mastery was again entered as the first step (F(1,38) = 16.5,p < 0.001), with both 
social recognition (F(2,37) = 11.8, p< 0.001) and distance (F(3,36) = 11.6, p < 0.001) 
providing significant contributions. A final regression analysis was performed to predict 
'distance run' according to both addiction scales and PIE subscale scores. The model 
entered two variables with the HB/RAS addition scores as the initial variable (F(1,38) = 
8.1, p< 0.01; R2 = 0.18), and social recognition in the second step (F(2,37) = 11.3, p< 0.01; 
R2=0.06). There was no relationship between years of running and either of the 
addiction scales. This contrasts with the significant correlations between both the RE/ 
RAS and the frequency of running (rs = 0.38; p < 0.05) and the HB/RAS scale and the 
number of runs per week (rs = 0.55; p < 0.01). The effect of mileage run was related 
only to the HB/RAS (rs =0.39; p <0.05). Overall results found a high level of commitment 
in the sample of runners, but there was no relationship between years of running and 
addiction measured by the regression analysis30.  
31 
Powers 
(1998) 
Comparing 
psychological 
An American controlled cross sectional study by Powers et al. (1998) used 57 
participants to compare psychological profiles of habitual male runners (n=20), habitual 
profiles of 
habitual male 
runners, 
habitual female 
runners and 
female anorexia 
nervosa 
patients 
female runners (n=20) and female anorexia nervosa patients (n=17) using the 
Minnesota Multiphasic Personality Inventory (MMPI), Leyton Obsessional Inventory, 
Obligate Running Questionnaire, Becks Depression Inventory and three body image 
tests (open door test, body parts satisfaction test and colour-a-person body 
dissatisfaction) as measurements. In the open door test there were significant 
differences between the groups (F=7.969, p<.001) but no significant differences 
between the female groups. On the Body Parts Satisfaction Questionnaire, male 
runners were significantly more satisfied with their bodies than female runners, who 
were significantly more satisfied than anorexics. In the ORQ item “I worry almost 
constantly that I will get fat" anorexics were more likely to answer true, male runners 
more likely to answer false and female runners answered true as often as they 
answered false (p=0.001). In the MMPI subscale scores anorexics scored significantly 
higher than either group of runners (p<.001) for the nine subscales except scale 9 
(p=.0001). Mean T scores were above 70 (considered clinically significant) for subscales 
of depression, hysteria and psychopathic deviate in the anorexic group, while none of 
the mean scores for either set of runners were considered clinically significant. There 
were significant differences in depression scores (F=68,645, p=.0001) with anorexics 
scoring significantly higher (p<.0001) than both male and female runners (mean scores 
were 23, 2.4 and 3.45, respectively) but there was no significant differences between 
the runners. While there were suggestive similarities between female runners and 
anorexics on body image, the overall results found few psychological similarities 
between anorexia patients and habitual runners with evidence of significant 
psychopathology on all psychological measures in the anorexia group, while both 
groups of runners were consistently in the normal range31.  
32 
Slay (1998) 
Comparing 
eating 
pathology traits 
between 
obligatory and 
non-obligatory 
runners 
An American cross sectional questionnaire by Slay et al. (1998) used 324 regular 
runners (240 males and 84 females) between the ages of 15 and 71 to compare eating 
pathology traits between obligatory and non-obligatory runners using the Eat Attitudes 
Test (EAT) and Obligatory Running and Motivations for Running Questionnaire as 
measurements. 21 women (25%) and 63 men (26.2%) were classified as obligatory 
runners. There was a significant effect for miles run per week [F(1,164) =8.31, p<0.001], 
with men running more than women [p<0.05] and obligatory runners with higher 
mileage than non-obligatory runners [p<0.001]. Obligatory runners scored significantly 
higher on the EAT test, with female obligatory runners having the highest mean EAT 
score. A partial correlation, controlling for miles run per week, between the EAT and 
obligatory running scores for men was slightly weaker (r=.28, p<.0001) than for women 
(r=.40, p<.0002), showing a stronger relationship of obligatory running with eating 
pathology in women than in men. Results found women and men scored similarly on 
the EAT with no significant differences at low levels of obligatory running [F(1,164) =2.78, 
p>.05]; however at higher levels women demonstrated significantly higher EAT scores 
than did men [F(1,164) =29.50, p<.001]. Independent of miles run per week, there was 
still significant overall effect on EAT scores, [F(1,164) =9.65, p<.0001] and a sex/obligatory 
running interaction, [F(1,164) =8.02, p<.05]. Overall results suggest that obligatory 
runners, particularly females are most at risk of eating pathophysiology32.  
33 
Ryujin 
(1999) 
Comparing 
eating disorder 
symptomology 
in collegiate 
distance 
runners to non-
running 
undergraduate 
student 
controls 
An American controlled cross-sectional study by Ryujin et al. (1999) used 55 female 
participants to compare eating disorder symptomology in collegiate distance runners 
(n=20) to non-running undergraduate student controls (n=35) using the Eating 
Disorders Inventory 2 as measurement. Differences were significant in the following 
subscales: Drive for Thinness (t(107) = 3.34, p < .005), Bulimia (t(107) = 2.48, p < .05) 
and Body Dissatisfaction (t(107) = 4.23, p < .001). Significance was approached for 
Interpersonal Distrust (t(107) = 1.70, p < .10) and Impulse Regulation (t(107) = 1.65, p = 
.10). Results found that distance runners showed no enhanced symptomatology of 
eating disorders, instead the female distance runners exhibited fewer symptoms of 
eating disorders on all subscales of the EDI-2 except Perfectionism33. 
34 
Leedy 
(2000) 
Comparing 
depression and 
anxiety in 
runners to non-
runners 
An American controlled cross sectional study by Leedy (2000) used 276 participants to 
compare depression and anxiety in runners with an average of 11.5 years of running 
experience (n=239, 56.1% men, mean age 37.9) to non-runners (n=37, 62% women, 
mean age 40.5) using an author created questionnaire designed to measure anxiety 
and depression based on the Diagnostic and Statistical Manual -IV, and an author 
adapted scaled based on the Running Addiction Scale as measurement.  16.2% of non-
runners and 4.6% of runners indicated that they had been diagnosed with an anxiety 
disorder or prescribed an anxiolytic medication at some point in their life. These 
participants had significantly higher anxiety trait scores than those without a diagnosis, 
F(1,274)= 18.87, p<.0001. 27% of non-runners and 11.8% of runners reported a diagnosis 
of depression or being prescribed an antidepressant. These participants had 
significantly higher measures of depression traits: F(1,274)=22.46, p<.0001. Runners who 
were classified as highly committed (n=31) had significantly lower anxiety (F(2,113)= 5.73, 
p<.01) and depression scores (F(2,113)= 8.00, p<.001) than those classified as recreational 
runners (n=46) and non-runners (n=39). Women's Stress Relief scores were significantly 
higher than the men's (F(1,229)= 20.51, p<.001). Stress relief scores also varied across 
race length, F(2,229) = 6.47, p<.005, indicating that the runners entered in the 5K - 10K 
runs had lower scores than those running the half or full marathon. Overall, the 
strongest motivator for running was Health/Fitness, (F(2,229)=135.3, p<.001), for both 
men and women, and for all three race distances. The Committed Runners had 
significantly higher scores across motivation factor scores compared to the 
Recreational Runners, (F(1,156)= 7.00, p<.01), with again, the most strongly endorsed 
motivation factor being Health/Fitness (F(2,156)=39.13, p<.001). Overall, results indicate 
that highly committed runners had significantly lower anxiety and depression than 
recreational runners and non-runners34.  
35 
Edwards 
(2005) 
Comparing 
psychological 
wellbeing and 
physical self-
perception in 
hockey players, 
runners and 
health club gym 
members vs a 
control group of 
non-exercisers 
A South African cross sectional study by Edwards et al. (2005) used 277 participants 
(183 women and 94  men) with a mean age of 25.2 to compare psychological wellbeing 
and physical self-perception in regular exercisers including hockey players (n=60), 
runners (n=40) and health club gym members (n=69) vs a control group of non-
exercisers (n=108), using Ryff's Short Standardized 18 item scale of Objective 
Psychological Wellbeing and Fox's Physical Self-Perception Profile (PSPP) and the 
Physical Self-Perception Profile as measurements. Regular exercisers scored 
significantly higher (p<0.01) than controls on 11 out of the 15 dimensions of 
psychological-well-being and physical self-perception: autonomy (F=11.3), personal 
growth (F=35.4), environmental mastery (F=9.6), purpose in life (F=149.2), positive 
relations with others (F=81.6), self-acceptance (F=50.4), sport competence (F=41.3), 
conditioning (F=28.1), sport importance (F=11.7), conditioning importance (F=28.1), 
body importance (F=31.0). Runners scored significantly higher than controls on 
autonomy, personal growth, environmental mastery, purpose in life, positive relations, 
self-acceptance, sport competence, conditioning, sport importance and conditioning 
importance. However, results don’t give details of significance. Runners had the lowest 
physical self-worth average score out all groups. Hockey players reported more positive 
relations with others and sport competence compared to health club members or 
runners, but no report of significance for either. Men scored higher on sport (F=27.2, 
p<0.01), conditioning (F=20.1, p<0.01), body (F=13.3, p<0.01), sport importance (F=7.2, 
p<0.01) and conditioning importance (F=6.3, p<0.01). No significant influences of age or 
language, but gender was related to body attractiveness (F=13.5, p<0.01). Overall 
results show that all three forms of physical activity were associated with higher scores 
on the psychological well-being and physical self-perception scales compared to the 
control group35.  
36 
Schnohr 
(2005) 
Comparing 
stress levels 
between 
jogging and 
various levels of 
physical 
(in)/activity in 
leisure time 
A large Danish observational cohort study by Schnohr et al. (2005) used 12,028 
participants (5479 men and 6549 women) aged 20-79 to compare stress levels between 
jogging and various levels of physical (in)/activity in leisure time using an author 
created questionnaire as measurement. In both males and females, those who were 
vigorously physically active (joggers) had the lowest level of stress compared to those 
with low activity levels (males 3.1% vs 12.8%, respectively; females= 3.3% vs 19.3%, 
respectively). With increasing physical activity in leisure time, there was a decrease in 
high level of stress, between sedentary persons and joggers (OR= 0.30). With increasing 
physical activity there was also a decrease in life dissatisfaction, between sedentary 
persons and joggers (OR= 0.30). Highest levels of stress and dissatisfaction was seen in 
the sedentary persons who remained inactive at follow-up. In contrast, the group that 
changed from sedentary to active had an adjusted OR of <0.50. The physically active 
who remained active through follow-up reported the lowest level of both stress and 
dissatisfaction. Associations between physical activity and stress/life dissatisfaction 
were similar in men and women, showing that if either gender changed from sedentary 
to more physical activity in leisure time, the was decreased stress and lower life 
dissatisfaction. In contrast if they become sedentary, the opposite is true. Overall 
results showed a clear trend of higher level of stress and of life dissatisfaction in the 
sedentary group compared with the more active running groups36.  
37 
Strachan 
(2005) 
Investigating 
the relationship 
between 
running and 
self-efficacy and 
self-identity 
A Canadian prospective longitudinal study by Strachan et al. (2005) used 67 regular 
runners with an average age of 40.6 (52% were female and had been running on 
average for 8.69 years) to investigate the relationship between running and self-
efficacy and self-identity using author created measures of task self-efficacy, self-
regulatory efficacy and a 10-item, validated athletic identity measurement scale. 
Participants filled out a questionnaire and four weeks following this initial assessment, 
were contacted over the phone in order to obtain a measure of their running behaviour 
over the last week. There was significant comparisons between extreme self-identity 
groups (high vs low) on social cognitive and behavioural variables (F(5,37)=4.72, p<.002). 
Results found that those higher in self-identity showed significantly higher scores on 
task self-efficacy (p<.001), scheduling self-efficacy (p<.03), ran more frequently (p<.001) 
and for longer durations (p<.005), than those who scored lowest on self-identity. Both 
scheduling self-efficacy (R2change =.16, p< .001) and barriers self-efficacy (R2change = 
.22, p<.001), were significantly correlated with self-identity to prospectively predict 
running frequency (F(2,64) =9.98, p< .001; F(2, 63) = 12.89, p<.001, respectively). Both task 
self-efficacy (R2change=.06, p< .05) and self-identity (R2change =.06, p< .04) were 
significant predictors of maintenance duration. Overall both types of self-regulatory 
efficacy were related to prospectively were predictive of maintenance running 
frequency37.  
38 
Galper 
(2006) 
Assessing 
retrospectively 
if level of 
walking/running 
impacted 
depression and 
emotional 
wellbeing 
An American retrospective cross sectional study by Galper et al. (2006) used 6728 
participants (5451 men with a mean age of 49.5, and 1277 women with a mean age of 
48.1) to assess retrospectively if level of walking/running impacted depression and 
emotional wellbeing using the Center for Epidemiological Studies Scale for Depression 
and the General Well-Being Schedule as measurements.  
The participants were classified into four categories: inactive (walking/jogging/running 
<1 mile per week); insufficiently active (1–10 miles per week); sufficiently active (11–19 
miles per week); (highly active (>20 miles per week). 27% (n=1454) of the men were 
classified as inactive, 35% (n=1892) as insufficiently active, 26% (n=1396) as sufficiently 
active, and 13% (n=709) as highly active. Likewise, 33% (n=422) of the women were 
classified as inactive, 35% (n=443) as insufficiently active, 22% (n=283) as sufficiently 
active, and 10% (n=129) as highly active. Results found that among men and women in 
the study, relative increases in habitual physical activity are cross-sectionally associated 
with significantly lower depressive symptomatology (P < 0.0001) and greater emotional 
well-being (P< 0.0001). This peaked at 11–19 miles per week. There was an inverse 
association between physical activity and estimated mean depression scores for both 
men (F(6, 5306)=20.93, P<0.0001) and women (F(6, 1247) = 11.80, P<  0.0001). Inactive men 
had greater depressive symptom severity than insufficiently active men (P < 0.0001) 
and highly active men (P<0.0001). Inactive women had greater depressive symptom 
severity than insufficiently active women (P<0.0001), sufficiently active women (P< 
0.0001) and highly active women (P<0.0001). ANCOVA demonstrated a positive 
association between physical activity and estimated mean wellbeing scores in men (F(6, 
5306) = 78.65, P<0.0001) and women (F(6, 1247) = 24.82, P<0.0001). Inactive men had lower 
emotional wellbeing than insufficiently active men (P<0.0001), sufficiently active men 
(P<0.0001), highly active men (P<0.0001). Inactive women had lower emotional well-
being than insufficiently active women (P<0.0001), sufficiently active women (P 
<0.0001), and highly active women (P<0.0001). Overall results suggest that increased 
habitual physical activity reduces depression and increases emotional wellbeing38.  
39 
Luszcynska 
(2007) 
Investigate the 
relationship 
between self-
efficacy and 
running 
behaviour 
A UK based longitudinal prospective cohort study by Luszcynska et al. (2007) used 139 
runners (111 men and 29 women) with a mean age of 29.5 to investigate the 
relationship between self-efficacy and running behaviour using an author created 
questionnaire as measurement to collect data twice with a time gap of 2 years. 
Participants were divided into subgroups with strong (n=72) and weak (n=66) 
maintenance self-efficacy, into strong (n=72) and weak (n= 61) recovery self-efficacy, 
and into strong (n=87) and weak (n=45) intentions. Participants reduced the number of 
running or jogging sessions over the 2 years, regardless of their strong, or weak 
intentions at baseline (F(1,130)=34.55, p<.001). Again, participants declined in frequency 
of running/jogging over 2 years, regardless of their strong or weak baseline 
maintenance self-efficacy (F(1,130)= 42.12, p<.001). Overall, all participants reduced the 
number of jogging or running sessions over two years (F(1,131)=43.43, p<.001), however, 
those with strong baseline recovery self-efficacy ran/jogged more often at 2 year 
measurement than those who had weak recovery self-efficacy at baseline (F(1,131)=6.12, 
p<.05). Recovery self-efficacy and intention jointly predicted running/jogging behaviour 
2 years later ([F(1,131)= 43.43, p<.001] and [F(1,130) =34.55, p<.001], respectively), whereas 
running/jogging behaviour did not predict recovery self-efficacy and intention. No 
effects of maintenance self-efficacy were found. Recovery self-efficacy at T1 predicted 
recovery self-efficacy (p<.05), maintenance self-efficacy (p<.05) and jogging or running 
behaviour (p<.05) assessed 2yr later. Overall, social–cognitive variables predicted 
behaviour, whereas behaviour did not predict social–cognitive variables. The majority 
of participants (n =120) experienced at least one 2-week period of decline in running or 
jogging behaviour. Among those who experienced lapses, recovery self-efficacy 
remained the only significant social-cognitive predictor of behaviour, accounting for 
30% of the variance of behaviour measured 2 years later (B=.19, p<.05). Overall, results 
found that participants decreased the frequency of running sessions after 2 years, 
regardless of baseline intensions or self-efficacy, however those with stronger recovery 
self-efficacy jogged more than those with weaker recovery self-efficacy 2 years later39.  
40 
Smith 
(2010) 
Comparing 
exercise 
dependence, 
running 
addiction and 
social physique 
anxiety in male 
vs female 
runners 
A UK based cross sectional questionnaire by Smith et al. (2010) used 93 non-
competitive, regular runners with a mean age of 28.05 to compare exercise 
dependence, running addiction and social physique anxiety in male (n=47) vs female 
(n=46) runners using the Exercise Dependence Scale, Running Addiction Scale and 
Social Physique Anxiety Scale as measurements. Results found that a significant 
proportion of runners displayed symptoms of exercise dependence, however there 
were no significant differences were found between the males and females (p>.05 in all 
cases). There was no significant difference between males and females for running 
addiction scale (22.64 and 20.91, respectively), social physique anxiety scale (22.30 and 
22.61, respectively) or total exercise dependence scale scores (72.56 and 66.86, 
respectively). Overall results did not find that exercise dependence was linked to social 
physique anxiety (F(3.179) = 1.21, p>.05), nor that there was a difference between men 
and women40.  
41 
Gapin 
(2011) 
Comparing 
disordered 
eating in 
obligatory and 
non-obligatory 
runners 
An American cross sectional study by Gapin et al. (2011) used 179 regular runners (88 
male and 91 female) with a mean age of 36.0 to compare disordered eating in 
obligatory (91) and non- obligatory runners (n=82) using the Eating Disorder Inventory 
(EDI), Athletic Identity Measurement Scale (AIMS) and Obligatory Exercise 
Questionnaire (OEQ) as measurements. Obligatory runners scored significantly higher 
(P<0.002) on all of the EDI eating attitudes/disorder measures: (Obligatory mean = 8.07, 
non-obligatory mean =4.42), F(1,166)=9.75, P=0.002; Drive for Thinness: (Obligatory 
mean = 6.42, non-obligatory mean =3.01), F(1,166) =28.91, P<0.001; Perfectionism: 
(Obligatory mean = 6.77, non-obligatory mean =3.73), F(1,166) = 21.59, P<0.001; 
Bulimia (Obligatory mean =1.37, non-obligatory mean =0.17), F(1,166) =10.43, P= 
0.001. Obligatory runners also scored significantly higher on the AIMS (Hotelling’s T2= 
0.440, F(8,161) = 8.85, P<0.001). Results from the OEQ indicated that runners in the 
obligatory group demonstrated greater concern with dieting, preoccupation with 
weight, and pursuit of thinness. Overall the findings suggest that obligated running 
(exercising to maintain identification with the running role) may be associated with 
pathological eating and training practices41. 
42 
Wadas 
(2014) 
Investigating 
any relationship 
between male 
runners with 
disordered 
eating 
behaviours and 
eating attitudes 
An American cross sectional study by Wadas (2014) used 68 male high school cross 
country runners with a mean age of 15.9 (70.6% white race) to investigate any 
relationship between male runners with disordered eating behaviours and eating 
attitudes using a questionnaire consisting of The Exercise Motivation Inventory 2, the 
Eating Attitudes Test 26 and the ATHLETE questionnaire as measurements. Factors that 
had a significant relationship with disordered eating are weight management (r =.31, p 
=.011), drive for thinness and performance (r = 0.36: p < 0.05), and the Feelings about 
Performance subscale (or Performance Perfectionism) (r = 0.26: p < 0.05). No significant 
relationships were found between disordered eating behaviors in male cross country 
athletes and personal body feelings (r =.19, p = .109), feelings about eating (r =.18, p 
=.137), and feelings about being an athlete (r =.12, p =.345). The mean EAT-26 score for 
all participants was 6.0, with 4.41% (n=3) male high school cross country runners 
scoring 20 or higher on the EAT-26, indicating at risk for disordered eating and displays 
symptoms. An additional 13.2% (n = 9) met the cut-off score of 14 for disordered eating 
behaviours, one standard deviation above the mean for population norms. Overall 
results found that risk factors associated with eating disorders existed within high 
school male cross country runners42.  
43 
Samson 
(2015) 
Investigating 
the relationship 
between self-
esteem and 
psychological 
coping with 
marathon 
running 
An American cross sectional questionnaire by Samson et al. (2015) used 308 marathon 
runners (117 males and 191 females) with a mean age of 41 to investigate the 
relationship between self-esteem and psychological coping with marathon running, 
using the Motivation for Marathons Scale, The Perceived control questionnaire and The 
Sport Mental Toughness Questionnaire as measurements. Self-esteem was positively 
associated with perceived control (r=.40) (x27= 47.08, p<.001, CFI=.85; RMSEA=.14), but 
negatively associated with mental toughness. There was also a positive relationship 
between perceived control and psychological coping (r=.42) (x28 =45.65, p<.001; 
CFI=.85; RMSEA=.12), suggesting that runners who ran for those reasons also reported 
higher levels of perceived control regarding the outcome of the race, however, it was 
not directly related to perceptions of mental toughness. The mean MOMS scores for 
psychological coping and self-esteem suggested than females were more likely to run 
for these reasons than males: 4.8 & 4.42 respectively for psychological coping, and 5.22 
& 4.62 for self-esteem. Overall results suggest that females were motivated to run to 
improve self-esteem and psychological coping than men43.  
44 
Lucidi 
(2016) 
Investigating 
the relationship 
between 
running and 
stress in 
An Italian cross sectional prospective field study by Lucidi et al. (2016) used 669 runners 
training for a marathon (85% male) with a mean age of 42.07 to investigate the 
relationship between running and stress using the Perceived Stress Scale, the Passion 
Scale and The Italian version of the Locomotion and Assessment Scales as 
measurements. Runners filled out the survey 15 days prior to the marathon to evaluate 
runners training 
for a marathon 
stress. Running positively predicted harmonious passion (β = 0.37; P < 0.001), which in 
turn reduced athletes’ experience of stress, whereas assessment positively predicted 
obsessive passion (β = 0.26; P < 0.001). Harmonious passion negatively predicted 
athletes’ experience of anticipatory stress (β = −0.28; P< 0.001), whereas obsessive 
passion positively predicted it (β = 0.45; P< 0.001). These effects were estimated 
controlling for athletes’ training frequency, which was not significantly related to 
athletes’ stress. The indirect effect of running on anticipatory stress perception through 
harmonious passion was statistically significant (αβ = −0.10; 95% confidence interval: 
from −0.15 to −0.05). Similarly, the indirect effect of assessment on stress through 
obsessive passion was statistically significant (αβ = 0.12; 95% confidence interval: from 
0.07 to 0.17). Results also indicated a significant direct effect of assessment on the 
athletes’ experience of stress (β = 0.22; P < 0.001). The direct effect of running on stress 
was not significant (β = −0.01; P = 0.75). Overall results suggest that running does not 
directly impact stress, however running increases harmonious passion which improves 
stress44.  
45 
Batmyagmar 
(2019) 
Comparing self-
reported health 
& wellbeing 
& quality of life 
over 4 years in 
elderly 
marathon 
runners to non-
exercising 
controls 
An Austrian prospective longitudinal study by Batmyagmar et al. (2019) used 99 
participants to compare self-reported health and wellbeing and quality of life over 4 
years in elderly marathon runners (n=50, mean age of 66, 46 men and 4 women) to 
non-exercising controls (n=49, mean age of 66, 44 men and 5 women) using the Short 
Form Health Survey (SF-36) as measurement. SF-35 scores in all domains remained 
stable over time and, in nearly all of them, marathon runners showed higher self-
reported health than non-athlete controls. Athletes evaluated their health as better 
than non-athletes in the following categories: general health perceptions (mean 
control= 81 vs athletes=81; between subjects F= 14.21, p<0.001); vitality (mean 
control= 69 vs athlete= 80; between subjects F= 13.37, p<0.001); social functioning 
(mean control= 87 vs athlete=97; between subjects F= 11.30, p<0.001); emotional role 
functioning (mean control= 84 vs athlete=98; between subjects F=1.42, p<0.002); 
mental health (mean control= 78 vs athletes=84; between subjects F=6.07, p<0.0016). 
Overall, findings suggest that extensive high intensity endurance exercise is associated 
with improved subjective health and wellbeing in elderly persons45.  
46 
Cleland 
(2019) 
Investigating 
enjoyment, self-
efficacy and 
factors of 
participation in 
Parkrun event 
participants 
An Australian cross sectional study by Cleland et al. (2019) used 372 participants of 
‘Parkrun’ events with a mean age of 43.8 to investigate enjoyment, self-efficacy and 
factors of participation using author-created questionnaires to assess 
psychological/cognitive measures, social support and environmental level factors. 
These Parkrun subjects were divided into three groups: regular walker/runner (n=175, 
55% female, mean age 45.0), occasional walker/runner (n=142, 57.8% female, mean 
age 42.5) and non-walker/runner (n=54, 68.5% female, mean age 43.3). Results were 
often reduced when adjusted for length of time since registration, ie. absolute parkrun 
participation (total number of parkrun events) compared to adjusted parkrun 
participation (absolute park-run participation adjusted for the number of weeks 
registered). Perceived benefits of parkrun including enjoyment (absolute participation: 
B coefficients= 0.32; and adjusted participation: B coefficients = 0.22) and social factors 
(absolute: B= 0.70; and adjusted: B= 0.35) were positively associated with participation 
as was overall enjoyment (absolute: B=0.30; and adjusted: B= 0.30), self-efficacy for 
parkrun (absolute: B=0.46; and adjusted: B= 0.33), social support for parkrun from 
family (absolute: B =0.05; and adjusted: B =0.03) and social support from friends 
(absolute: B= 0.04; and adjusted: B= 0.02) related to parkrun. Perceived social benefits 
(absolute: B= 0.43; and adjusted: B= 0.17) and self-efficacy for parkrun (absolute: B= 
0.18; and adjusted: B= 0.13) were positively associated with absolute and adjusted 
parkrun participation. Overall results suggested that higher participation levels of park-
run events correlated with greater self-efficacy and perceived social benefits46.  
47 
Lukacs 
(2019) 
Investigating 
the prevalence 
of exercise 
addiction and 
psychological 
features in 
amateur 
runners, 
including; 
perceived 
health, life 
satisfaction, 
loneliness, 
stress, anxiety, 
depression, 
A Hungarian cross sectional questionnaire study by Lukacs et al. (2019) used 257 
amateur runners (126 females and 131 males) with a mean age of 40.49 and at least 2 
years of running experience. The study investigated the prevalence of exercise 
addiction and psychological features including; perceived health, life satisfaction, 
loneliness, stress, anxiety, depression, body shape and eating disorders; using the 
Exercise Dependence Scale, a Cantril ladder for Overall life satisfaction, SCOFF eating 
disorder questionnaire, the UCLA 3-item Loneliness Scale, Body Image Subscale from 
the Body Investment scale and the ‘Depression, Anxiety and Stress Scale-21’. About 
53.6% (n=137) of respondents were characterized as non-dependent symptomatic,  
37.8% (n=97) as non-dependent asymptomatic and 8.6% (n=23) were at risk of exercise 
addiction. The logistic regression model indicated that five variables significantly 
predicted the risk of exercise addiction: weekly time spent running [B=1.42, 95% CI for 
odds ratio=4.17, p<.001], childhood physical activity [B=2.06, 95% CI for odds 
ratio=7.86, p=.008], lower educational attainment [B=1.97, 95% CI for odds ratio=7.17, 
p=.006], anxiety [B=0.47, 95% CI for odds ratio=1.61, p=.023], and loneliness [B=0.79, 
body shape and 
eating disorders 
95% CI for odds ratio=2.21, p=.004]). Subscale results of the exercise dependence scale 
suggested that to deal with both anxiety and loneliness, as runners from all groups 
found it important to spend a significant amount of time engaging in exercise [Time 
subscale (3.09, SD = 1.11, 95% CI = 2.96–3.23]) and continually increase exercise 
intensity, frequency, and duration [Tolerance subscale (3.71, SD = 1.28, 95% CI = 3.55–
3.87)] to achieve joyfulness and happiness. The at risk group for exercise addiction 
scored higher on the Lack of Control subscale (4.90, SD = 0.76, 95% CI = 4.57–5.23) and 
therefore these runners were less able to control the urge to exercise or to stop 
exercising for a significant time. All investigated groups showed fewer problems on the 
Intention subscale (exercising longer than intended, expected, or planned; (2.39, SD = 
1.10, 95% CI = 2.25–2.52) and the Reduction in Other Activities subscale (choosing or 
thinking about exercise rather than spending time with family, friends, or concentrating 
on school or work; (1.90, SD = 0.82, 95% CI = 1.80–2.00).  ANOVA post hoc test results 
showed that all three groups significantly differed from each other in all subscales (all 
p<.001): tolerance (F=63.053, np2 = .365), Time (F=68.147, np2 = .371), Continuance 
(F=41.578, np2=.304), Lack of control (F= 171.509, np2 = .587), Withdrawal (F=32.757, np2 
= .222), Intention Effect (F= 61.963, np2 = .360), Reduction (F=65.249, np2 = .386). The 
study results did not comment on the other psychological features (perceived health, 
life satisfaction, stress, depression, body shape and eating disorders)47.  
 
 
 
Supplementary Table S2 
Narrative description of findings of the 23 studies with a single bout of running.  
 
 
Author 
 
Narrative description of findings 
1 
Nowlis (1979)  
Impact of a 
12.5 mile jog 
on mood and 
anxiety  
A Canadian pre-post non-controlled study by Nowlis et al. (1979) used 18 experienced 
joggers (5 females and 13 males) who ranged in age from 17 to 55, to investigate how a 
12.5 mile jog impacted mood and anxiety using the Mood Adjective Checklist and State 
Trait Anxiety Inventory as measurements. Following the 12.5 mile run there was 
significant improvement from pre- to post- measures of pleasantness (2.00 to 2.67;p< 
0.01) and a significant decrease in Trait anxiety (34.81 to 33.31; p<0.10). There was an 
increase in activation, a reduction in state-anxiety, and a reduction of sadness, anxiety, 
depression and relaxation subscales… but no significance was reached in any of these 48.  
2 
Wilson (1981)  
Impact of a 
solo indoor 
track run on 
anxiety  
A Canadian pre-post controlled study by Wilson et al. (1981) used 42 participants 
consisting of 20 runners, 12 participants of a 40 minute aerobic exercise class and  
10 lunchers, all aged between 21 and 28 (23 women and 19 men) to compare the 
impact of solo indoor track running (n=20), an aerobics class (n=12) and lunching (n=10) 
on anxiety using the State-Trait Anxiety Inventory as measurement. Each group showed 
significant decreases in anxiety after the activity (F(1,39)=15.63, p<0.003) but no 
differences between groups (F2,39= 1.27, p > 0.05) and no interaction (F2,39 = 1.57, p > 
0.005) were observed. Results suggest that frequency of runs per week is the most 
important factor for decrements in anxiety during running sessions (r = -0.58, p < 0.01) 
and that initial level of anxiety was positively related to decreased anxiety following 
activity (r = .63, p < .005) for both men and women49.  
3 
Markoff 
(1982) 
Impact of a 1 
hour run on 
mood 
A Hawaiian pre-post non-controlled study by Markoff et al. (1982) used 15 participants 
(11 men & 4 women) aged 23-45 who had all ran at least 1 marathon to examine the 
impact of 1 hour of running on mood using the Profile of Mood States as measurement. 
There was a significant reduction of anxiety pre- to post-run (5.2 to 3.27 in men and 
3.08 to 2.15 in women). The t-test for anxiety was 2.72 and thus p<0.01. For 
depression, there was a non-significant decrease in scores pre- to post- run (4.93 to 
1.73 in men and 7.39 to 1.83 in women). The t-test for depression was 1.80 which was 
not significant50.  
4 
Thaxton 
(1982)  
Impact of 30 
minutes 
outdoor 
running on 
mood 
An American non-randomised controlled trial by Thaxton et al. (1982) used 33 regular 
runners with a mean age of 36 (24 males and 9 females) who were divided into 4 
groups to compare pre-test 30 minute outdoor running test (n=6), pre-test no running 
test (n=9) no pre-test 30 minute running test (n=11) and no pre-test no running test 
(n=7) on mood using the Profile of Mood States as measurement. Significant 
differences in the depression scores between the running and abstaining (non-
pretested) groups, F(1,29) = 4.8,p<.05, however no significant differences between 
anxiety, vigour, and fatigue scores51.  
5 
McGowan 
(1991) 
Impact of 75 
minutes of 
jogging on an 
outdoor track 
on mood  
An American non-randomised controlled trial by McGowan et al. (1991) used 72 college 
students to compare the effect of 75 minutes of jogging on an outdoor track (n=25) vs 
75 minutes of karate (n=11), weight training (n=26) and a stationary science lecture 
class (n=10) on mood using the Profile of Mood States as measurement. The running 
group exhibited significant changes in total mood disturbance from pre-(35.68) to post 
(24.16) test… t24 = 2.84, p<0.009. The weight lifting group had changes of F6,20 = 2.60, p 
= 0.05, but there were no significant changes observed for the karate group or 
control52. 
6 
Goode (1993) 
 
 
Impact of own 
training run 
on mood 
An American pre-post non-controlled study by Goode et al. (1993) used 150 regular 
runners with a mean age of 31.7 (69% male, 31% female) to investigate mood states 
before and after subjects own training run using the Profile of Mood States as 
measurement. All but one (vigor)  of the POMS scales showed significant (p<0.1) 
changes following the run. Tension/anxiety (mean change of -3.1, p<0.1), depression 
(mean change of -1.5, p<0.1), confusion (mean change of -1.1, p<0.1) and anger mean 
change of -1.8, p<0.1) all reduced significantly post run, while fatigue significantly 
increased post run (mean change of +1.8, p<0.1)53.  
7 
Morris (1994)  
 
Impact of a 3 
mile ‘fun-run’ 
on mood 
A British pre-post non-controlled study by Morris et al. (1994) used 165 members of a 
road runners club (98 males and 67 females) with a mean age of 34 to examine how a 3 
mile ‘fun-run’ impacted mood using an author devised adjective checklist based on 
POMS as measurement. Positive mood was increased after running (F( 1,163)=68.18, 
p<0.001), negative mood decreased after running (F(1.163) = 47.62, p<0.001) and 
improvements in mood were greater in women than men but was not significant 
(p>0.1)54.  
8 
Rudolph 
(1996)  
Impact of 
various 
timings of 
treadmill 
running on 
self-efficacy 
(10, 15 and 20 
minutes) 
An American randomised non-controlled trial by Rudolph et al. (1996) used 36 
moderately-active female university students with a mean age of 20.6 to compare the 
impact of 10 (n=12), 15 (n=12) and 20 (n=12) minutes of treadmill running on self-
efficacy using the Exercise-Efficacy Scale as measurement. Mean scores of self-efficacy 
increased significantly in all 3 groups, from pre to post exercise (F(1, 33)= 74.57, p< .001): 
the 10 minute (43.2 to 55.6), 15 minute (34.7 to 45.6) and 20 minute (37.3 to 53.4) 
exercise conditions. The within-group effect sizes for self-efficacy were calculated. 
Although the largest effect size (ES) occurred in the 20 minute condition (ES= .68), the 
effect sizes in the 15 (ES= .36) and 10 (ES= .49) minute conditions are also moderate in 
magnitude55.   
9 
Cox (2001)  
Impact of 30 
minutes of 
treadmill 
jogging at 
either 50% or 
75% predicted 
VO2 max on 
psychological 
affect and 
wellbeing 
An American randomised controlled trial by Cox et al. (2001) used 24 physically active 
male university students with a mean age of 28.3 to compare the impact of 30 minutes 
of treadmill jogging at either 50% or 75% predicted VO2 max vs a stationary stepper on 
psychological affect and wellbeing using the Subjective Exercise Experiences Scale.    
Results showed that following an acute bout of aerobic exercise a significant linear 
trend for time was observed for psychological distress (p=0.001, η2p=0.17) and a 
significant linear trend for time for positive well-being (p=0.037, η2p =0.07) but there 
was no significant difference between the wellbeing for the stepper vs the treadmill 
running group56. 
10 
O’Halloran 
(2002)  
Impact of a 60 
minute 
treadmill run 
on mood  
An Australian pre-post non-controlled study by O’Halloran et al. (2002) used 50 regular 
runners (25 men and 25 women) with a mean age of 26.6 to examine how a 60 minute 
treadmill run impacted mood using the Profile of Mood States and Beliefs Concerning 
Mood Improvements Associated With Running Scale as measurements. The pre vs post 
exercise scores from POMS was as follows: Agreeable-Hostile = 27.3 to 27.58; 
Composed-Anxious = 25.6 to 29.12; Clearheaded-Confused = 27.20 to 28.62; Confident-
Unsure = 25.22 to 25.10; Elated-Depressed = 24.56 to 27.10; Energetic-Tired = 22.42 to 
23.48. There were significant reductions in anxiety (p<0.05), depression (p<0.01) and 
confusion (p<0.05, however there was not a significant change of confidence. The 
largest correlation (r =.44) was between the beliefs scale and changes on the Elated-
Depressed subscale (p<0.01)57.   
11 
Szabo (2003)  
Impact of 20 
minutes of 
track running 
on anxiety 
and feelings 
A UK based pre-post non-controlled time series quasi-experimental study by Szabo et 
al. (2003) used 39 sports science university students (22 male and 17 female) aged 
between 20 and 23 who all had a British-Caucasian cultural background to compare the 
impact of 20 minutes of track running, a comedy video and a nature documentary on 
anxiety, positive wellbeing and psychological distress using the Spielberger State 
Anxiety Inventory and Exercise induced Feeling Inventory as measurements. Both 
exercise and humour had an equally positive effect on psychological distress and 
positive wellbeing. State anxiety significantly reduced with exercise (F(1.5, 58.3) = 5.32, 
p<0.01), however, exercise had a statistically lower reduction on anxiety than humour 
(t(38) = 3.36, p<0.002)58.  
12 
O’Halloran 
(2004)  
Impact of a 60 
minute 
treadmill run 
on mood  
An Australian randomised controlled study by O’Halloran et al. (2004) used 160 regular 
runners (80 males and 80 females) between age 18 and 40 to compare how a 60 
minute treadmill run (n=80) vs no running (n=80) impacted mood using the Profile of 
Mood States and Beliefs Concerning Mood Improvements Associated With Running 
Scale as measurements. There were improvements in composure, energy, elation and 
mental clarity during the run relative to the control condition and pre-exercise 
assessment. Other than the Energetic-tired subscale where improvements were 
evident at 25 minutes (F(1,156) =10.09, p=.002), most subscales didn’t have mood 
improvements until the 40 minute assessment during the run. Runners became more 
composed (less anxious) F(1,156) =9.47, p=.002), more clear headed (less confused) 
(F(1,156) =5.57, p=.02) and more elated (less depressed) (F(1,156) =10.18, p=0.002) by 40 
minutes into a 60 minute treadmill run. Although there was a trend for differences on 
the beliefs concerning mood improvements after running scale, mean scores on the 
beliefs concerning mood during running scale were strikingly similar for the running 
(3.69) and the control groups (3.67)59.  
13 
Robbins 
(2004)  
Impact of 20 
minute 
treadmill run 
on self-
efficacy in 
children and 
adolescents 
An American pre-post non-controlled study by Robbins et al. (2004) used 168 inactive 
African American and European American children & adolescents with a mean age of 
12.6 (49% female) to investigate how 20 minutes of treadmill exercise impacted self-
esteem using the Walking Efficacy Scale as measurement. There was an increase in self-
efficacy post-exercise F(1, 158) = 84.31, p < .001, however girls reported significantly 
lower pre-activity self-efficacy (M = 41.02, SD = 24.37) than boys (M = 52.46, SD= 23.99) 
with t(166) = 3.07, p < .01, and subsequently reported greater perceived exertion. African 
American girls reported significantly lower pre-activity self-efficacy than the other 
three race-gender groups F(3,164) = 5.55, p < .0160.           
14 
Pretty (2005)  
Impact of a 20 
minute 
treadmill run 
with rural vs 
urban stimuli 
on mood and 
self-esteem 
A UK based randomised controlled trial by Pretty et al. (2005) used 100 participants (55 
female and 45 male) with a mean age of 24.6 to investigate how pleasant and 
unpleasant urban vs rural stimuli whilst running on a treadmill for 20 minutes impacted 
mood and self-esteem, using the Profile of Mood States and Rosenberg Self-Esteem 
Questionnaire as measurements. There were 20 participants in each of the 5 different 
stimuli groups: rural pleasant, rural unpleasant, urban pleasant, urban unpleasant and 
the control group who exercised with blank white screens. There was a significant 
increase in self-esteem (from 19.4 (+/-0.4) to 18.1 (+/-0.4), p < 0.001) following 
exercise, however both rural and urban pleasant scenes produced a significantly 
greater positive effect on self-esteem than exercise alone, while both rural and urban 
unpleasant scenes reduced the positive effects of exercise on self-esteem. There were 
significant reductions in confusion, p < 0.01; and tension-anxiety, p < 0.001, while a 
significant improvement vigour, p < 0.001) following exercise61.  
15 
Hoffman 
(2008) 
Impact of a 30 
minute 
treadmill run 
on mood 
An American pre-post pre-experimental study by Hoffman et al. (2008) used POMS to 
examine how a 30 minute treadmill run altered mood using 32 subjects (16 regular 
exercisers and 16 non exercisers, consisting of 8 women and 8 men in each group). Post 
exercise total mood disturbance was decreased 16 +/- 10 (95% CI, 7–24) among the 
moderate exercisers, and  9+/- 13 points (95% CI, 1–18) among the non-exercisers. 
TMD improves post-exercise in both the exercisers and non-exercisers, but the 
exercisers experience almost double the effect. A “nearly significant group-by-time 
interaction” (P.08) is suggestive of a trend toward less of an effect among the non-
exercisers than the other groups62.  
16 
Kwan (2010) 
Impact of a 30 
minute 
treadmill run 
on general 
affective 
response 
An American pre-post non-controlled study by Kwan et al. (2010) used 129 participants 
(67 women and 62 men, 80% white ethnicity) with a mean age of 22 to show the 
positive impact of a 30 minute treadmill run on general affective response using the 
Physical Activity Affect scale (PAAS) as measurement at 6 time points before, during 
and after the exercise. There was a positive effect during exercise (b = .52, SE = .09, p < 
.0001) and between baseline and 15 minutes post-exercise (b= .73, CI.95 = .56, .89, 
t(126)= 8.63, p < .0001)63. 
17 
Weinstein 
(2010)  
Impact of 25 
minutes of 
increasing 
graded 
treadmill 
running on 
mood and 
depression 
An American pre-post controlled study by Weinstein et al. (2010) used 30 participants 
with a mean age of 39.8 (50% women); 14 of whom were diagnosed with minor (n=2) 
or major (n=12) depressive disorder and 16 of whom were controls; to examine how 25 
minutes of increasing graded treadmill exercise impacts mood and depression using the 
Becks depression Inventory scale and Profile of Mood States as measurements. 
Immediately following exercise, depressed individuals displayed improvements in 
depressed mood from baseline (p=0.02) but subsequently exhibited increased 
depressed mood from baseline at 30 mins post exercise F interaction(1,27)= 3.98; p=0.05; 
ηp2 =0.13. The severity of depression (as assessed by BDI-II) was significantly related to 
increases in depressed mood (r = 0.60; p = 0.001) at 30 min post-exercise64.   
18 
Anderson 
(2011) 
Impact of a 
light 10 
minute 
outdoor jog 
on mood 
A British randomised controlled trial 2x2 mixed design by Anderson et al (2011) used 40 
participants aged 18-25 from various sports clubs to compare the impact of a light 10 
minute jog outside on a grass playing field vs a 10 minute cognitive task on mood using 
the ‘Incredibly Short Profile of Mood States’ as measurement. The between persons 
design found a significant mood enhancement (F(1,38) = 24.18, p <.001, n2p = .39) 
within the exercise group, compared with the non-exercise control group65. 
19 
Kane (2013) 
Impact of the 
running pacer 
challenge 
(20m sprints 
within 
increasing 
pace inside a 
gymnasium) 
on self-
efficacy in 
children 
An American pre-post non-controlled study by Kane et al. (2013) used 34 school 
children aged 11 to 14 (18 female and 16 male) to examine how the PACER challenge 
(20m sprints within increasing pace inside a gymnasium) effected self-efficacy using the 
self-efficacy questionnaire adapted for children. The study found a decrease in self-
efficacy following participation in the PACER (mean score decreased from 2.7 to 2.3 
following exercise, t=4.6, p<.001, large effect size of d = 0.79), however there was a 
positive correlation between PACER laps and pre- and post- measures of exercise self-
efficacy (mean score increased from .58 to .70 following exercise)66. 
20 
Szabo (2013) 
 
 
Impact of a 
5km self-
paced run 
along a public 
running path 
on states of 
affect 
A Hungarian pre-post non-controlled study by Szabo et al. (2013) used 50 recreational 
runners (37 males and 13 females) with a mean age of 29.02 to investigate how a 5km 
self-paced run on a public running path impacted states of affect using the Exercise 
Induced Feeling Inventory as measurement. Significant positive changes were seen in 
all 4 measures of affect following the run: revitalisation (F(1,48) = 145.93, p < .001, partial 
n2 = .75 with an effect size of 2.0), positive engagement (F(1,48) = 97.11, p< .001, partial = 
n2 =.67 with an effect size of 1.6), tranquillity (F(1,48) = 85.02, p < .001, partial n2 = .64 
with an effect size of 1.5) and exhaustion (F(1,48) = 32.25, p < .001, partial n2 = .40 with 
an effect size of 1.0)67.         
21 
McDowell 
(2016) 
Impact of a 30 
minute 
treadmill run 
on mood and 
anxiety 
An Irish randomised controlled trial by McDowell et al. (2016) used 53 participants (27 
males and 26 females) with a mean age of 21.2 to compare the effects of 30 minutes of 
vigorous treadmill running vs 30 minutes of seated quiet rest on mood and anxiety 
using the State-Trait Anxiety Inventory and Profile of Mood States as measurements. 
Compared with the control, 30 minutes of acute aerobic exercise significantly improved 
state anxiety (F1,92 = 12.52, P < 0.001), feelings of depression (F1,86 = 5.05, P < 0.027), 
and total mood disturbance F = 36.91, P < 0.00168. 
22 
Rogerson 
(2016)  
 
Impact of a 
5km park run 
on 
psychological 
wellbeing 
A British pre-post non-controlled mixed between-within study by Rogerson et al. (2016) 
used 331 Park Run attendees (180 males and 151 females) with a mean age of 40.8 to 
investigate how a 5km Park Run impacted affective outcomes of psychological 
wellbeing using a questionnaire containing parts of the Profile of Mood States, 
Rosenberg Self-esteem scale and Perceived Stress Scale as measurement. There were 
significant (p<.001) improvements from pre- to post-run for self-esteem (7.7% 
improvement; F(1, 324) = 100.58, η2 = .24), stress (18.4% improvement; F(1, 315) =50.78, η2 
p = .139) and total mood disturbance (14.2% improvement; F(1, 278) =22.15, η2p = .07)69.   
23 
Edwards 
(2017) 
Impact of a 15 
minute 
treadmill jog 
on stress and 
anxiety  
An American randomised controlled trial by Edwards et al. (2017) used 27 participants 
aged between 18 and 35 to compare the effects of a 15 minute treadmill jog (n = 8) to 
the equivalent amount of time walking (n = 9) or stretching (n=10) on stress and anxiety 
after exposure to a film clip which was intended to elicit a negative emotional response 
using the Exercise Induced Feeling Inventory and Affective Circumplex Scale and the 
Strait-Trait Anxiety Inventory as measurements. It found a protective emotional effect 
from jogging, with reduced anxiousness (28.8 vs 13.1, p = 0.06) and stress (11.3 vs 9.4, 
p = 0.11) within the runners after being shown the emotive film. When comparing 
anxiousness scores from baseline to post-film clip, the p-values for the stretching, 
walking, and jogging groups were .21, .21, and .06, respectively, suggesting that 
anxiousness was more significantly different between baseline and post-film clip in the 
jogging group versus the walking or stretching groups. Unlike the walking (p = .11) and 
jogging (11.3 to 9.4, p = .19) groups, only the stretching group (1.2 to 26.0, p = .048) 
had an increased anger score from baseline to post-film clip70.  
 
 
 
 
Supplementary Table S3 
Narrative description of findings of the 9 studies with a double bout of running.  
 
 
Author 
 
Narrative description of findings 
1 
Krotee 
(1980) 
Impact of 50m 
group vs solo 
run on anxiety 
A pre-post pre-experimental non-controlled design by Krotee (1980) in the 
USA used 78 children (31 females and 47 males) between the ages of 7 and 
12 to compare how a 50 metre run in individual vs small group settings 
impacted anxiety using the State-Trait Inventory for Children as 
measurement. In the individual setting, the level of pre initial (31.56) to pre 
termination (31.07) anxiety levels decreased while in the small group setting 
a slight but not significant gain in pre initial (30.54)to pre termination (31.40) 
anxiety level was realised. In the individual setting, the level of post initial 
anxiety (31.56) was higher at post termination (32.72)> This also happened in 
the small group setting, the level of post initial anxiety (30.67) increased at 
post termination level (31.83). There was Significant pre to pre (individual r = 
.9050 and small group r = .8667) and post to post (individual r=.8684 and 
small group r=.7335) correlations concerning the A-State level exists at the 
0.001 level of confidence. It appears that there is relative stability between 
the various measures of pre and post A-State anxiety level and perhaps the 
physical activity and sport situational setting does not create as much anxiety 
for the participant as popularly purported. Results indicate that the children 
did not significantly increase in anxiety level (A-STATE) when participating in 
various physical activity and sport situational settings (ie. individual or 
group), however females) exhibited a significantly higher competitive anxiety 
level (A-TRAIT) than males prior to participation in the physical activity and 
sport situational setting (20.90 & 18.40, respectively)71. 
2 
Wildmann 
(1986) 
Impact of 2 
identical 10km 
runs (1 week 
apart) on 
feelings of 
pleasantness & 
change of mood 
  
A German based pre-post non-controlled study by Wildmann et al. (1986) 
used 21 male long-distance runners with a mean age of 29.8 to investigate 
how two 10km runs (1 week apart) under equal conditions on a 400m 
running track impacted ‘feelings of pleasantness’ and ‘changes of mood’ 
using the Eigenschaftsworterliste scale (an adjective check list) as 
measurement. Following running bouts there was a change in mood with 
good mood scoring higher after running. The mood elevation had 
considerable individual variability but there was a significant correlation in 
the mean values of the 2 runs between ratings in feelings of pleasantness. 
General feeling of pleasantness, which combines items of the EWL checklist 
related to self-confidence and elevated mood, scored higher post-run as 
compared to pre-run. The mean increase of the two runs for all subjects 
tested was 2.79 + 5.54 from a total of 19 items. However, again considerable 
individual differences were striking, therefore the increase did not reach 
significance72.  
3 
O'Connor 
(1991) 
Impact of 5 mile 
outdoor group 
vs solo run on 
anxiety 
An American pre-post non-controlled study by O'Connor et al. (1991) used 17 
members of local running clubs (10 males and 7 females) with a mean age of 
25, to compare how a group vs solo 5 mile outdoor run impacted anxiety and 
body awareness using the State-Trait Anxiety Inventory and Body Awareness 
Scale as measurements. Both cognitive (STAI) and somatic (BAS) anxiety were 
reduced following intense running, performed either in the absence or in the 
presence of interpersonal competition, and that the magnitude of these 
anxiety reductions were equal in the two conditions. When interpersonal 
competition was present, post-exercise state anxiety levels (m=27.5) were 
significantly (p <0.05) below the pre-exercise (m=42.5) and the baseline 
(m=34) anxiety levels. When interpersonal competition was absent, post-
exercise state anxiety levels (m=30) were also significantly below (p<0.05) 
pre-exercise (m=40) and baseline (m=34) anxiety levels. While body 
awareness levels were significantly (p <0.05) below both the pre-exercise but 
not reduced below the baseline value. When interpersonal competition was 
present, post-exercise body awareness (m=27.5) were lower than pre-
exercise (32.5), but not below baseline levels (m=24). When interpersonal 
competition was absent, post-exercise body awareness (m=26) were again, 
below pre-exercise levels (m=31), but not below baseline (m=24). No 
significant effect for gender was found73. 
4 
Nabetani 
(2001) 
Impact of a 10 
minute vs a 15 
minute 
treadmill run on 
mood 
A Japan based pre-post non-controlled study by Nabetani et al. (2001) used 
15 healthy, moderately active male graduate students with a mean age of 
23.4 to compare how two self-selected intensity runs on a treadmill (one for 
10 minutes vs the other for 15 minutes) impacted mood using the Mood 
Checklist Short-form 1 containing three subscales: pleasantness, relaxation 
and anxiety as measurement. The results found that exercise of 10 and 15 
minutes produced similar psychological benefits. Following the 10 minute 
trial: anxiety (ES = 0.61) significantly decreased (p<0.01), whilst there was no 
significant difference of pleasantness (ES = 0.86) and relaxation (ES = 0.33). 
Following the 15 minute trial, anxiety (ES = 0.51) and pleasantness (ES = 0.62) 
significantly decreased (p<0.01), but relaxation (ES = 0.07) had no significant 
pre-post difference74.  
5 
Bodin 
(2003) 
Impact of 1 
hour park vs 
urban run on 
depression and 
anxiety 
A Swedish pre-post non-controlled within-subjects study by Bodin et al. 
(2003) used 12 regular runners (6 female and 6 males) with a mean age of 
39.7 to compare how a 1 hour run in a park vs a 1 hour run in an urban 
environment impacted emotional restoration (depression/ anxiety) using the 
Exercise-Induced Feeling Inventory and the Negative Mood Scale as 
measurements. In both men and women, in park and urban settings, running 
caused a significant decline in anxiety/depression between pre- and post-test 
measures with F(1,10) = 16.2, p <0.002, r=0.78 and a moderate effect size of rs 
= 0.30. The runners preferred the park to the urban environment in a global 
sense (F(1, 10) = 133.07; punadjusted < 0.0001; padjusted < 0.002) and perceived it as 
more psychologically restorative, however, results did not indicate any 
greater emotional benefit from running in the park versus the urban 
environment, nor that men and women differed75. 
6 
Butryn 
(2003) 
Impact of 4 mile 
park vs urban 
run on mood 
An American pre-post non-controlled within-subjects study by Butryn et al. 
(2003) used 30 non-elite female distance runners with a mean age of 31 to 
compare how a 4 mile run in a natural setting vs a 4 mile run in an urban 
setting impacted mood, feeling states and cognition states using the Profile 
of Mood States, Exercise Induced Feeling Inventory and Thoughts During 
Running Scale as measurements. Despite 93% of participants preferring 
running in the park setting, following a 4-mile run regardless of whether the 
run was completed in a park or urban setting there was a decrease in 
negative mood and increase in positive mood. Following the park run, total 
mood disturbance scores decreased 8.97 (p < 0.001), while positive 
engagement, revitalisation and tranquillity all significantly increased (p < 
0.05, p < 0.001 and p < 0.01 respectively). A similar effect was found 
following the urban run: total mood disturbance scores decreased 9.13 (p < 
0.001), whilst positive engagement and revitalisation significantly increased 
(p < 0.05 and p < 0.01 respectively), and tranquillity increased but not 
significantly76. 
7 
Kerr (2006) 
Impact of 
indoor vs 
outdoor 5km 
run on stress 
and emotions 
A Japanese pre-post non-controlled study by Kerr et al. (2006) used 22 
recreational runners with a mean age of 22.7 years to compare how a 5km 
indoor run on a treadmill vs a 5km outdoor run in a natural environment 
impacted stress and emotions using the Tension and Effort Stress Inventory 
as measurement. There were significant pre/post effects for total pleasant 
somatic emotions [F(1, 21) = 16.35, p< 0.01], and total unpleasant somatic 
emotions [F(1, 21) =7.08, p <0.05]. Post hoc tests indicated that total pleasant 
somatic emotions increased from pre- (M=12.55), to post-running (M= 
14.66), while total unpleasant somatic emotions decreased from pre 
(M=9.39), to post-session (M=7.77), while irrespective of running condition. 
There were significant pre/post effects, irrespective of running condition, for 
relaxation [F(1, 21) =5.60, p< 0.05], anxiety [F(1, 21) =9.90, p< 0.01], and 
excitement [F(1, 21) =24.65, p< 0.001]. Relaxation and excitement increased, 
and anxiety decreased from pre- (M=4.30; M=2.50; M=3.14 respectively), to 
post-session (M=4.86; M=3.77; M=2.36 respectively)77. 
8 
Rose (2012) Impact of self-
paced vs 
prescribed pace 
30 minute 
treadmill run on 
self-efficacy 
A New Zealand based pre-post controlled study by Rose et al. (2012) used 32 
females (17 sedentary and 15 active) with a mean age of 45, to compare how 
a 30 minute self-paced bout of treadmill exercise vs a 30 minute prescribed-
paced bout of treadmill exercise (1 week apart) impacted self-efficacy using 
the Self-Efficacy for Exercise Scale as measurement. There was a significant 
main effect for group (F 1,28 = 4.74; P = 0.038; n2 = 0.14), with significantly 
higher self-efficacy in the active women (M=70.9) than the sedentary women 
(M=57.7). There was also a significant main effect for condition (F1,28 = 5.81; 
P<0.023; n2 = 0.17), with higher self-efficacy before the prescribed condition 
(M=66.1) compared with the self-selected condition (M=62.6). There was 
also a significant condition by order interaction (F1, 28 = 18.8; P <0.001; n2 = 
0.39) that showed when the prescribed session was completed first, self-
efficacy was equal for the self-selected (M=65.7) and prescribed (M=63.1) 
conditions, however, when the self-selected condition was completed first, 
self-efficacy was greater for the prescribed (M=69.0) compared with the self-
selected (M=59.4) condition78. 
9 
Reed 
(2013) 
Impact of rural 
vs urban 1.5 
mile run on self-
esteem 
A UK based pre-post non-controlled study by Reed et al. (2013) used 75 
children aged 11 & 12 to compare how a 1.5 mile run in an urban vs a rural 
environment impacted self-esteem using the Rosenberg Self Esteem Scale as 
measurement. Following exercise there was a significant increase in self-
esteem (F(1,74), = 12.2, p <0.001), however there was no significant difference 
between the urban or green exercise condition (F(1,74) =0.13, p = 0.72), or any 
significant difference between boys and girls79. 
 
 
 
 
Supplementary Table S4 
Narrative description of findings of the 3 studies with a triple bout of running.  
 
 
Author 
 
Narrative description of findings 
1 
Harte (1995) 
Impact of 12km 
outdoor run vs 
indoor treadmill 
run with 
external vs 
indoor treadmill 
run with internal 
stimuli on mood 
An Australian pre-post non randomised controlled-repeated measure 
design by Harte et al. (1995) used 10 male amateur triathletes or marathon 
runners with a mean age of 27.1 to investigate how an outdoor 12km run, 
1 indoor treadmill run with external stimuli, an indoor run with internal 
stimuli vs a sedentary control impacted mood using the Profile of Mood 
States as measurement. Following the outdoor run, subjects felt less 
anxious F(3,35) = 14.12 (p <0.005); less depressed F(3,35) = 4.16 (p <0.01); less 
hostile F(3,35) = 13.13 (p < 0.005); less fatigued F(3,35) = 15.09 (p < 0.005); and 
more invigorated F(3,35) = 13.01 (p < 0.005) than at pre-test; while the two 
indoor runs had less positive effects on mood80.  
2 
Berger, 
Owen + Motl 
(1998) 
Impact of three 
15 minute runs 
of varying 
intensities (50, 
65 or 80% age-
adjusted HR 
max) on mood 
Berger, Owen + Motl (1998)81 
 
Study 1 …. A pre-post non controlled study by Berger, Owen + Motl (1998) 
used 71 USA college students (32 male and 39 female) with a mean age of 
21.39 to investigate how three 15 minute runs at intensities of 50, 65 or 
80% age-adjusted HR max impacted mood using the Profile of Mood States 
as measurement. There were significant overall mood benefits for women 
(p<0.001) and for men (p<0.03) post-exercise, with all subscales except 
vigor and fatigue showing significant pre-post changes. No results were 
provided differentiating the three different intensities of running81. 
 
Study 2 ….. A pre-post non controlled study by Berger, Owen + Motl (1998) 
used 68 USA college students (28 male and 40 female) with a mean age of 
22.22 to investigate how three 15 minute runs at intensities of 50, 65 or 
80% age-adjusted HR max impacted mood using the Profile of Mood States 
as measurement. There was significant mood benefits following exercise 
(F(6.57) = 6.43, p< 0.0001) and all POMS subscales, apart from fatigue, had 
significant pre-post improvements reported following running (p<0.05). 
Again, there were no results provided comparing the three different 
intensities of running81.  
3 
Markowitz 
(2010) 
Impact of three 20 
minute treadmill 
runs of varying 
intensities (5% 
below, 5% above 
and directly at 
lactate threshold) 
on anxiety 
An American pre-post controlled trial by Markowitz et al. (2010) used 28 college-
aged students with a mean age of 21, to compare anxiety using the State-Trait 
Anxiety Inventory in 14 active vs 14 sedentary college students following 20 
minutes of treadmill exercise at 5% below, 5% above and directly at their lactate 
threshold. State anxiety improved post-exercise at 5% below (F(1,21) = 22.781, p< 
0.001 and effect size -0.38) and at lactate threshold (F(1, 21) = 16.223, p < 0.001 
and effect size -0.20) but increased at 5% above lactate threshold (F(1)= 10.891, p = 
0.003 and effect size = +0.1382. 
 
 
 
 
 
Supplementary Table S5 
Narrative description of findings of the 34 studies with longer term intervention of running.  
 
 
Author 
 
Narrative description of findings 
1 
Lion (1978) 
Impact of 
running a mile 3 
times per week 
for 2 months on 
anxiety and body 
image in chronic 
psychiatric 
patients  
An American randomised controlled trial by Lion (1978) used 6 middle aged, chronic 
psychiatric patients (4 females, 2 male) to compare how running a mile 3 times per 
week for 2 months (n=3) vs a control group (n=3), impacted anxiety and body image 
using the State-Trait Anxiety Inventory (STAI) and Rorschach Inkblot Test for body-
boundary image as measurements. Post-test anxiety scores on the STAI were 
significantly reduced in the jogging group compared to the control group (t=3.2, df 
= 4, p<0.05), with the joggers showing an average drop of 9 points on the STAI (39.3 
to 30.3) between pre and post-test, while the control group showed an average rise 
of 4 points (32.6 to 36.6, SD=12). However there was no statistical difference found 
between the groups for post-test body image scores on the Inkblot test for barrier 
(t=0.81, df=4. p<0.05) or penetration responses (t=0.23, df = 4, p<0.05)83.  
2 
Blue (1979) 
Impact of 3 runs 
per week for 9 
weeks on 
depression 
An American pre-post non-controlled study by Blue (1979) used 2 former in-
patients of a psychiatric hospital (1 male aged 37 and 1 female aged 32) to examine 
how 3 runs per week for 9 weeks impacted depression using the Zung depression 
scale as measurement. Following the running intervention, both patients’ 
depression scores reduced from the category of "moderately depressed" to "mildly 
depressed", with the male patient reducing his score by 18 points, while the female 
patient reduced her score by 15 points84.  
3 
Young (1979) 
Impact of a 10 
week walking/ 
jogging 
programme 
consisting of 1 
hour 3x per 
week on anxiety 
and depression 
An American pre-post non-controlled intervention study by Young (1979) used 32 
adult participants separated into 4 groups by age and sex: young males (n=8, mean 
age 30.13), middle aged males (n=8, mean age 53.00), young females (n=8, mean 
age 28.25) and middle aged females (n=8, mean age 50.25). The study investigated 
how a walking/jogging programme consisting of one hour 3x per week for 10 
weeks, impacted anxiety and depression using the Multiple Affect Adjective 
Checklist as measurement. Results showed significant reductions in pre- to post-
test  anxiety scores within subject (ANOVA =6.01, p<0.05) and also a significant age 
difference on anxiety in favour of older subjects (ANOVA = 5.37, p<0.05, d.f.(1,28)). 
Results for depression also showed significant age differences  in favour of older 
subjects (ANOVA =5.21, p<0.05, d.f.(1,28)), however there was no significant 
improvement within subject depression scores (ANOVA = 0.25, n.s.) 85.  
4 
Blumenthal 
(1982) 
Impact of 3 
times weekly 
walking-jogging 
programme for 
10 weeks vs 10 
weeks of 
sedentary 
controls on 
anxiety and 
mood 
An American non-randomised controlled cohort study by Blumenthal et al. (1982) 
used 16 healthy adults (11 women and 5 men) with a mean age of 45.1 to compare 
how a 3-times weekly walking-jogging programme for 10 weeks vs 10 weeks of 
sedentary controls, impacts anxiety and mood using the Profile of Mood States and 
the State-Trait Anxiety Inventory as measurements. Results did not detail the 
number of participants in each group.  There were no differences between the 
exercise and control groups POMS scores at pretesting, but after 10 weeks of 
training the exercise group exhibited less tension (F(1,30) = 4.49, p <0.04), less 
depression (F(1,15) = 4.82, p <0.04), less fatigue (F(1,30)= 3.88, p <0.05), less confusion 
(F(1,15) = 4.40, p <0.05) and more vigor (F(1,15)= 3.28, p <0.09) than the sedentary 
controls. There was no change for either group on the POMS anger subscale. 
Similarly for State-trait anxiety: there was no difference between the two groups at 
the time of pretesting, but after the 10 week programme exercisers also exhibited 
less state anxiety (F(1,26) = 4.15, p <0.05), and less trait anxiety (F(1,26) = 6.05, p 
<0.02)86.  
5 
Trujillo (1983) 
Impact of a 16 
week running 
programme vs 
weight training 
vs a control on 
self-esteem 
An American randomised controlled trial by Trujillo (1983) used 35 female college 
students to compare the impact of a 16 week programme of weight training (n=13) 
vs running (n=12) vs a physical activity control such as swimming (n=10) control on 
self-esteem using the Tennessee Self-concept Scale and the Bem Sex Role Inventory 
as measurements. Results found that both the running and weight training group 
showed a significant increase in self-esteem from pre- to post-programme 
([t,(11)=2.11, p<0.05] and [t,(12)= 1.82, p<0.05], respectively), however the control 
group showed a nonsignificant loss in self-esteem [t,(9) =0.55, p>0.05]. Although 
both the weight training and running groups reported significant change in the level 
of self-esteem, the amount of actual change when compared with between groups 
was significantly higher for only the weight training group: with the gain scores in 
weight training as compared to the control group at tD(31)=2.83, p<0.05, while the 
gain scores comparing weight training to running [tD(31)=1.00, p >0.05] and running 
to the control were both non-significant [tD(31) = 1.75, p>0.05]. With regards to the 
Bem Sex Role Inventory, the majority of participants in all 3 groups were 
androgynous in nature at pre-test measurement (n=7, N=11, n=7 for the weight 
training, running and control groups respectively), with no change occurring at 
post-test measurement in either of the groups87.  
6 
Tuckman 
(1986) 
Impact of three 
30 minute runs 
per week on an 
outdoor running 
track for 12 
weeks on 
psychological 
affects in 
children 
(creativity, 
perceptual 
function, 
behaviour & self-
concept 
An American randomised non-controlled trial by Tuckman et al. (1986) used 154 
children aged 9-11 to compare how three 30 minute running sessions on an 
outdoor running track per week for 12 weeks, vs 12 weeks of the school’s regular 
physical education schedule, effected psychological affects such as creativity, 
perceptual function, behaviour and self-concept, using the Alternate Uses Test, 
Bender-Gestalt Test, Devereaux Elementary School Behaviour Rating Scale and 
Piers-Harris Children’s Self-Concept Scale, respectively, as measurements. Running 
significantly improved creativity of school children compared to regular physical 
education participants (F ratio = 17.00, p<0.001), with running treatment children 
averaging 3 to 5 more creative responses than controls. However running had no 
significant difference on classroom behaviour (F = 0.91), self-concept (F = 1.02), or 
perceptual functioning (F = 2.17)88.  
7 
Doyne (1987) 
Impact of 3 runs 
on an indoor 
track per week 
for 8 weeks on 
depression in 
women with a 
diagnosis of 
major or minor 
depression 
An American randomised controlled trial by Doyne et al. (1987) used 40 women all 
with a diagnosis of major or minor depression and a mean age of 28.52 to compare 
the impact of 8 weeks of 3 sessions per week of running on an indoor track vs 8 
weeks of weight lifting vs a wait-list control on depression using the Beck's 
Depression Inventory, Hamilton Rating Scale for Depression and Depression 
Adjective Checklists as measurements. Results found statistically and clinically 
significant decreases (F(4, 138) = 14.98,p < .01) in mean depression scores from 
baseline to post-measurements in both running (22.27 vs 8.18) and weight lifting 
(22.07 to 5.93) relative to the wait-list control group (20.17 to 15.25), with 
improvements reasonably well maintained at 1 year follow-up, however no 
significant overall differences found between the two exercise groups89. 
8 
Fremont (1987) 
Impact of 3 runs 
per week for 10 
week on 
depression, 
anxiety and 
mood  
An American randomised non-controlled trial by Fremont et al. (1987) used 49 
participants (13 male and 36 female) aged between 19 and 62) to compare how 10 
weeks of running (3 runs per week) vs 10 weeks of counselling vs 10 weeks of a 
combination of running and counselling impacted depression, anxiety and mood 
state using the Beck's Depression inventory, State-Trait Anxiety Inventory and The 
Profile of Mood States as measurements. There were no significant differences 
between the three programmes, they all produced similar improvements in 
depression, anxiety and mood states; with improvement maintained at 4 months 
follow-up. Depression (BDI), trait anxiety and state anxiety scores all decreased 
significantly over the 10 weeks ([F(4,184) =50.3, p < 0.0001]; [F(1, 46) = 27.1, p < 
0.0001]; [F(1,46) = 21.9, p < 0.0001] respectively). Mood improved over the 10 weeks 
(F(18,378) = 4.5, p < 0.001), with significant decreases over time for depression (F(3, 138) 
= 23.6, p < 0.0001), confusion (F(3, 138) = 15.6,p < 0.0001), anger (F(3, 138) = 12.4, p < 
0.0001), fatigue (F(3, 138) = 17.9, p < 0.0001), and tension (F(3, 138) =16.1, p < 0.0001), 
whilst there was significant increase in vigor over time (F(3,138) = 14.6,p < 0.001)90. 
9 
Hannaford 
(1988) 
Impact of three 
30 minute runs 
per week for 8 
weeks on 
depression and 
anxiety in 
psychiatric 
patients with 
major psychiatric 
disorders 
An American randomised controlled trial by Hannaford et al. (1988) used 27 male 
psychiatric patients with major psychiatric disorders and an age range of 25 to 60, 
to compare the impact of three 30 minute runs per week for 8 weeks (n=9) vs 
corrective therapy 3 days a week for 8 weeks (n=9) vs waiting list controls (n=9) on 
depression and anxiety using the Zung Self Rating Depression Scale and State Trait 
Anxiety Index as measurements. Results found significant reductions in depression 
scores (F(2,23) = 3.61, p= 0.043) for the running treatment group compared to the 
waiting list controls (adjusted means = 45.99 and 51.67, respectively), while the 
corrective therapy group was intermediate between (adjusted mean = 47.12), but 
not significantly different from either of the other two groups. Results regarding 
anxiety scores were in the hypothesized direction, but were not significant (F(2,23) = 
1.085, p=0.354) with the running group not significantly lower than either the 
corrective therapy group or the waiting list control group (adjusted means = 38.92, 
42.76 and 38.98, respectively)91. 
10 
Long (1988) 
Impact of an 8 
week running 
programme 
consisting of a 
weekly group 
session plus 
twice weekly 
solo jogs on 
A 14 month follow-up from a Canadian randomised non-controlled trial by Long et 
al. (1988) used 39 chronically stressed, sedentary working women with a mean age 
of 40 to compare how an 8 week running programme of a weekly group session 
plus twice weekly solo jogs (n=18) vs 8 weeks of progressive relaxation intervention 
(n=21) impacted stress, anxiety and self-efficacy using the Trait Anxiety Inventory, 
Sherer et al.'s inventory for self-efficacy and a modified version of the Ways of 
Coping Checklist.  
 
stress, anxiety 
and self-efficacy 
At follow-up, considerably more subjects in the exercise group compared to the 
relaxation group self-reported program maintenance (67% vs. 14%, respectively). At 
follow-up, both intervention groups reported significantly less anxiety and greater 
self-efficacy. In addition, subjects tended to increase their use of problem-focused 
coping as compared to emotion-focused coping, and 64% of them were still 
regularly using some structured form of relaxation or exercise. The proportion of 
subjects reaching clinically significant improvements was 24% at the end of 
treatment and 36% at the 14-month follow-up. 
 
Regarding trait anxiety and self-efficacy results showed a significant group main 
effect (F(2, 36)=3.16, p<.05), however, only the univariate for self-efficacy was 
significant (p<.02). Overall, the exercise group exhibited higher self-efficacy. The 
time effect for the pre to the post/follow-up average was significant (F(2, 36)= 15.38, 
p<.001) with significant univariate Fs for both measures (both ps<.001). 
Furthermore, the time effect for post to follow-up approached significance at 
p<.07, with only the univariate F for trait anxiety significant, F(1, 37)=5.01, p<.03. 
These analyses indicated that both the exercise and relaxation groups maintained 
treatment effects on self-efficacy, with even further reductions on trait anxiety 
from post to follow-up. However, despite the exercise group's higher self-efficacy 
scores, there were no significant interaction effects (Fs<1), suggesting that the 
exercise and relaxation groups did not change differentially over time.  
 
Regarding coping, there was a significant group main effect on the two coping 
dependent measures (F(2, 35) =4.97, p<0.01), with both the exercise and relaxation 
groups decreased emotion- focused coping and increased problem-focused coping, 
while total coping scores did not change (F(2, 35) =2.88, p<.07) for the pre to the 
post/follow-up average contrast. The time effect for post to follow-up was not 
significant (F(2, 35) = 1.30, p=0.28) indicating that posttreatment changes were 
maintained at follow-up. Finally, there were no significant interaction effects, 
indicating that the coping within both groups changed similarly over time (both 
Fs<1)92. 
11 
Simons (1988) 
Impact of two 30 
minute 
walk/runs per 
week for 8 
weeks on mood 
An American non-randomised controlled trial by Simons et al. (1988) used 128 
participants consisting of 53 experimental subjects (24 male, 30 female and mean 
age 44.9) and 75 control subjects (28 male, 47 female and mean age of 42.0) to 
compare how two 30 minute walk/run per week for 8 weeks vs a weekly 30 minute 
fitness lecture for 8 weeks effected mood using the Profile of Mood States (POMS), 
Nowicki-Strickland Internal-External Control Scale for Adults (ANSIE) and Marlowe-
Crowne Social Desirability Scale for measurements. Exercise class subjects had 
significant improvement in mood compared to non-treatment controls, with mean 
pre- to post-test summed mood change scores improving significantly for 
experimental (28.8 to 15.6) in comparison with control subjects (23.5 to 20.9), 
F(1,126) = 4.46, p < 0.05. There was also significant improvement in pre- to follow-up 
mood change scores, F(1,98) = 7.63, p < 0.01. Mood improvement was predicted by 
initial mood, with improvement limited to the most mood-disturbed subjects93. 
12 
Moses (1989) 
Impact of 
varying intensity 
10 week walk-
jog programmes 
on mood and 
mental wellbeing  
A British randomised controlled trial by Moses et al. (1989) had 75 sedentary adult 
volunteers with an average age of 38.8 years who were assigned to one of four 10 
week conditions: high intensity aerobic walk-jog programme (n=18), moderate 
intensity walk-jog programme (n=19), attention-placebo including strength, 
mobility and flexibility exercises (n=18) or a waiting list control (n=20). The study 
compared the 4 conditions effects on mood and mental wellbeing using the Profile 
of Mood States and the Hospital Anxiety and Depression Scale as measurements. 
There were no significant differences before training between groups on any of the 
POMS, coping or self-efficacy measures. There was a significant group by time 
interaction for ratings on the tension/anxiety scale of the POMS [F(3,71) = 2.94, 
p<0.05], with reductions in tension/anxiety reported only by subjects in the 
moderate exercise condition. There were also significant differences in the POMS 
subscale of confusion, were there were differences over time [F(1,71) = 3.70, p<0.06] 
and group by time [F(3,71) = 2.61, p<0.06], with greater decreases in the moderate 
exercise group (mean change - 0.193) than in the high exercise (-0.039), attention-
placebo (-0.0003) or waiting list (+0.008) conditions. No significant effects were 
found on the perceived coping scales, but there was significant effects on the 
physical well-being scale [F(3,71) = 3.82, p<0.01], with all three active treatment 
groups showed improvements after the 10 week programmes, while the waiting list 
group ratings decreased. (+0.046, + 0.046 and +0.146, in the high intensity, 
moderate intensity and attention-placebo condition, respectively). At follow-up 
there was a significant group by time interaction on the coping deficits scale [F(2,55) 
= 3.45, p<0.05] and ratings of depression/ dejection [F(2,55) = 3.00, p<0.06] with 
decreases reported in the moderate exercise group, but not in the high exercise or 
attention-placebo conditions. Also, the group by time interaction approached 
significance for the perceived coping assets scale [F(2,55) = 2.56, p<0.08] where 
again, positive changes were confined to subjects in the moderate exercise 
condition94.  
13 
Ossip-Klein 
(1989) 
Impact of 
running on an 
indoor track 4 
times per week 
for 8 weeks on 
self-concept in 
clinically 
depressed 
women  
An American randomised controlled trial by Ossip-Klein et al. (1989) used 32 
clinically depressed women with an average age of 28.52 to compare the effects of 
8 weeks of running 4 times weekly on an indoor track vs weight lighting 4 times 
weekly vs a delayed treatment (assessment only) control on self-concept using the 
Beck Self-Concept Test as measurement. Results did not detail the number of 
participants in each group. No significant differences between exercise groups were 
found, with results showing that both running (F( 3,99) =7.62, p<0.0001) and weight 
lifting (F(3,99) = 11.92,p <0.0001) exercise programs significantly improved self-
concept in the clinically depressed women compared to wait-list controls. Scores 
for the track and universal conditions were significantly higher than those for the 
wait-list condition at post treatment for the Beck Self-Concept Test (F(2, 33)= 4.69, 
p<0.05). Improvements were also reasonably well-maintained over time. In general, 
no significant differences were found between exercise groups; but where 
differences did occur, they slightly favoured the weightlifting group95. 
14 
Morris (1990) 
Impact of 
stopping running 
for 2 weeks on 
anxiety and 
depression 
A UK based pre-post study with randomised comparison by Morris et al. (1990) 
used 40 male regular runners with a mean age of 37 years to compare how 
stopping running for 2 weeks (n=20) vs continuing to run as normal (n=20) over a 6 
week timeframe impacted anxiety and depression using the General Health 
Questionnaire and short forms of the Zung Anxiety and Zung Depression scales as 
measurements. The groups did not differ at baseline on any scale (all Fs for group 
main effects and interactions). Scores on the GHQ subscales, Somatic Symptoms, 
Anxiety/Insomnia and Social Dysfunction, were all significantly greater in deprived 
than in continuing runners after both the first and second week of deprivation, and 
significantly more deprived (11 & 9 subjects in weeks 3&4 respectively) than non- 
deprived subjects (3 & 2 subjects in weeks 3&4 respectively) exceeded the 
suggested cut-off score for a psychiatric case after both the first and second weeks 
of deprivation (x2 = 5.38, 4.51, respectively, df = 1, p <0.05). Symptoms of 
depression were greater in the withdrawn than in the control group at the end of 
the second week of withdrawal, the effect reached significance by a randomization 
test (t = 2.33, df = 38, p < 0.05, l-tailed). There was a tendency for a similar, 
although reduced, effect after the first week of resumed running (Table IV) but this 
did not reach significance (t = 1.60, p = 0.05 at 1.68). A significant difference 
between the groups arose only after the second week of deprivation, with scores in 
the Zung depression and anxiety scales only reaching significance after week 2 of 
deprivation (F(1,37) = 22.64, p<0.001 for depression and F(1,37)  =11.51, p<0.01 for 
anxiety). Despite the tendency for the deprived group to continue to decline from 
weeks 5-6 in anxiety and depression scores, there was no statistical difference 
between the groups once the deprived group resumed running96.  
15 
Friedman 
(1991) 
Impact of 12 
weeks of jogging 
on stress and 
mood  
An American randomised controlled trial by Friedman et al. (1991) used 387 
students (188 female and 117 male) with an average age of 20.0 to compare how 
12 weeks of either jogging (n= 84), relaxation (n= 96), group interaction (n= 100), 
and lecture-control (n= 107) impacted stress and mood using the Profile of Mood 
States and Bem Sex Role Inventory as measurements. In initial measures the 
relaxation response, jogging, group interaction, and lecture-control groups did not 
differ on psychological masculinity [F(3, 367)= .38], femininity [F(3, 367)= .38] or the six 
POMS subscales. High masculinity male and female joggers reported significantly 
more mood improvement than those who were low, indicating that psychological 
masculinity, rather than gender, was associated with joggers’ short-term mood 
improvement. Although all women reported significant mood benefits, high 
masculinity women benefitted more than low masculinity women, with greater 
reductions in tension, depression, and anger. For men, psychological masculinity 
was related to benefits on tension and vigor, but not on the other subscales. 
Although all women reported significant reductions in depression after the 
relaxation and jogging sessions, women joggers who were high in psychological 
masculinity experienced significantly greater reductions than low masculinity 
joggers (p<0.04). The interaction between technique, gender, moderating variable, 
and pre-post session was significant for masculinity [F(18,843.4) = 2.14, p < .004], but 
not for femininity [F(18,843.4) =.62]. Femininity had a significant effect on combined 
POMS scores [F(6, 297)= 2.79, p< .02], with higher psychological femininity associated 
with higher tension, depression, and fatigue and lower vigor and confusion scores 
compared to those low in femininity. There were significant pre-post session x 
technique interactions for both high and low masculinity women [F(18, 843.36)= 2.47, 
p<0.0007; F(18, 843.36)= 2.49, p<0.0006, respectively]. In both the jogging and group 
interaction techniques, the masculinity x pre-post session interaction was 
significant [Fs(6,298)= 3.32,3.53;p’s < .004,.003,respectively]. Short- term 
improvements in POMS scores depended upon masculinity for women joggers and 
participants in group interaction. For the relaxation response and lecture-control 
groups, the hypothesized interactions between masculinity and pre-post session 
were not significant [Fs(6,298) = 1.48, 1.15;p’s < .19, .38]. Short-term improvements in 
mood did not depend on masculinity in these groups; women reported significant 
improvements in mood from pre- to post session [Fs(6,298) = 6.01, 4.36; p’s< .0001, 
.0003]97.  
16 
Williams (1991) 
Impact of 4 
weeks of 
treadmill 
running 5 times 
per week at set 
paces reflecting 
50, 60 & 70% 
VO2 max on 
mood  
An American pre-post non-controlled within-subject design by Williams et al. (1991) 
used 10 moderately trained male runners with a mean age of 25.6 to assess the 
impact of 4 weeks of treadmill running 5 times a week at set paces reflecting 50, 60 
& 70% VO2 max, on mood using the Profile of Mood States as measurement. The 
within-subject data indicated a positive correlation, showing that an increase in 
mean VO2 (decrease in RE) is associated with an increase in mood disturbance, as 
reflected by the total mood disturbance score (r = 0.88; p<0.01) as well as 5 of the 6 
POMS subscales: tension (r = 0.81; p<0.01), depression (r = 0.73; p<0.01), anger (r 
=0.58; p<0.01), vigor (r = -0.60; p<0.01), fatigue (r = 0.18; not significant) and 
confusion (r = 0.60; p<0.01). This positive correlation indicates that, when the focus 
of attention was on within-subject variation, weeks featuring more economical 
values were associated with more positive mental health profiles. However, in 
moderately trained male runners considered as a group, there is no relationship 
between running efficiency and total mood disturbance98. 
17 
Kerr (1993) 
Impact of a 
weekly 40 
minute fixed 
distance run 
(5km for 
females, 6.6km 
for males) 
through a 
wooded area for 
7 weeks on 
mood 
A Netherlands based pre-post non-controlled study by Kerr et al. (1993) used 32 
regularly exercising university students (18 male and 14 female) aged between 18 & 
22 to investigate the effect of a weekly 40 minute fixed distance, running session in 
a wooded area (5.0km for females, 6.6km for males) for 7 weeks on mood using the 
Stress-Arousal Checklist and Telic State Measure as measurements. Over the 
running programme, subjects’ mood experience was generally pleasant, 
characterized by high arousal and low stress. In males, from pre- to post-running 
there were significant increases in TSM felt arousal scores (F(1,16)=52.37, p=0.0001), 
SACL arousal scores (F(1,16)= 15.34, p=0.001) and TSM preferred arousal scores 
(F(1,16) = 4.49, p=0.05). In contrast, TSM arousal discrepancy scores were found to 
decrease significantly for males (F(1,16)= 6.74 , p=0.02) pre- to post-running. Similar 
significant effects were observed pre-post running for females, with strongly 
significant increases in TSM felt arousal scores (F(1,12)=16.16 ,p=0.002), SACL arousal 
scores (F(1,12)=25.19, p=0.0001) and TSM preferred arousal scores (F(1,12)= 11.82, 
p=0.005). Female runners’ TSM arousal discrepancy scores also decreased 
significantly (F(1,12)= 11.86, p=0.005) pre- to post-running. When comparing mood 
responses of fast runners to slow runners, both female and male fast runners 
scored higher on TSM felt arousal than slow runners ([F(1,12)= 6.50, p=0.03] and 
[F(1,16)= 4.97, p=0.04], respectively)99.  
18 
Long (1993) 
Impact of 3 runs 
per week for 10 
weeks on anxiety 
and stress 
A Canadian randomised controlled trial by Long (1993) used 35 participants (14 
males and 21 females) with a mean age of 35.6 to compare the effects of running 3 
times per week for 10 weeks (n = 12) vs stress inoculation for 10 weeks (n = 9) vs 
waiting list controls (n = 14), on anxiety and stress using the Cornell Medical 
Symptom Checklist as measurement. Although the exercise group was more likely 
to report using exercise to cope with stress, compared to the stress inoculation 
group, there was no significant differences found between groups on stress or 
coping classifications. There were also no significant difference of scores of the 
Cornell Medical Symptom Checklist between the aerobic conditioning and the 
stress inoculation treatment groups (F<1; M = 87.4, SD = 16.7; Ms = 86.2, SD = 13.5, 
respectively)100.  
19 
Berger & 
Friedman 
(1998) 
Impact of three 
jogs per week 
for a minimum 
of 20 minutes 
over 12 weeks 
on stress and 
mood  
 
 
 
An American randomised controlled trial by Berger & Friedman (1998) used 387 
undergraduate college students (188 women and 117 men) with an average age of 
20.0 to compare how: jogging three times per week for a minimum of 20 minutes 
per session over 12 weeks (n=84) vs 12 weeks of relation response (n=96), 12 weeks 
of discussion groups (n=100) and a control group (n=107), impacted stress and 
mood using the Profile of Mood States as measurement. All three techniques were 
significantly more effective in reducing stress than the control activity (p<0.03): 
with joggers, students practicing the relaxation response, and discussion group 
members collectively reporting significantly greater stress reduction than the 
control group during October F(18, 280) =1.79, p<0.03, and November, F(18, 280) =1.85, 
 
p<0.03. However, jogging and practice of the relaxation response were significantly 
more beneficial in helping students reduce short-term stress than group support 
(p<.04), with joggers and members of the relaxation response group reporting 
larger and more numerous reductions in tension, depression, and anger than 
members of the discussion and control groups. Changes in vigor, fatigue, and 
confusion were sporadic. There were no long-term benefits observed101. 
20 
Berger & Owen 
(1998) 
Impact of twice 
weekly walking/ 
jogging for 14 
weeks on mood 
and anxiety 
An American pre-post with comparison study by Berger & Owen (1998) used 91 
college students to compare how 14 weeks of twice weekly walking/jogging (n=67, 
35 female and 32 male) vs a weekly health science class (n =24, 15 female and 9 
men) impacted mood and anxiety using the Profile of Mood States and State-Trait 
Anxiety Inventory as measurements. The interaction between exercise intensity and 
pre-post mood benefits was not significant (F(12,50) = 1.27, ns), however, joggers 
reported short-term mood benefits on the combined subscales of the Profile of 
Mood States, and each subscale contributed to the benefits. Regardless of their 
exercise intensities, the pre-post-test exercise effect was significant (F(6,56) = 4.87, p 
< ,0005), with joggers reporting significant pre-post exercise mood changes on each 
of the six subscales of POMS: tension (F=15.67, p <.0002), depression (F=15.64, p< 
.0002), anger (F=12.77, p< .0007), vigor (F= 22.29, p<.00005), fatigue (F=20.14,p< 
.00005), and confusion (F=26.34, p<.00005). Regarding sex differences, the largest 
interaction was on the fatigue subscale with women's scores decreasing more after 
jogging than the men's (Fl,6,=9.85)', while the F ratios (1 and 61 df) for the other 
subscales were for tension 0.60, depression 1.17, anger 0.33, vigor 1.96, and 
confusion 1.50102.  
21 
Szabo (1998) 
 
 
Impact of 
running vs non-
running days on 
anxiety and 
mood over 21 
consecutive days 
A UK based pre-post non-controlled observational cohort study by Szabo et al. 
(1998) used 40 members of an amateur running club (30 males with a mean age of 
40.5, and 10 females with a mean age of 37) to assess how anxiety and mood 
(exhaustion, tranquillity, positive engagement and revitalization) varied on running 
vs non-running days over 21 consecutive days, using daily night time recording of 
the their own individual running time/distance on running days and the 
Commitment to running scale, Spielberger State Anxiety Inventory and Exercise 
induced Feeling Inventory as measurements. There were statistical differences, but 
small effect sizes, between average values for anxiety and mood on running and 
non-running days, with runners reporting lesser anxiety and better mood on 
running days in contrast to non-running days. Mean state anxiety on running days 
was 35.7 (SD=7.1) compared to 37.2 (SD=7.9) on non-running days, with a period 
main effect (F(1,38)=5.22, p<0.03). All subscales for mood (exhaustion, tranquillity, 
revitalisation and positive engagement) were significantly different (p<0.05) on 
running days as compared to non-running days, with (F(1,38)=4.34,p<0.04) for 
exhaustion; (F(1,38)=5.56, p<0.02) for tranquillity; (F(1,38)=18.32, p<0.001) for 
revitalisation and (F(1,38)=11.79, p<0.001) for positive engagement. There were 
gender differences in the commitment to running (F(1,36)=10.5, p<0.03) with males 
having a higher value than females103.  
22 
Broman-Fulks 
(2004) 
Impact of six 20 
minute treadmill 
sessions of 
either high or 
low intensity 
aerobic exercise 
across 2 weeks 
on anxiety 
sensitivity in 
participants with 
elevated anxiety 
sensitivity scores  
An American randomised non-controlled trial by Broman-Fulks et al. (2004) used 54 
participants (41 women) with elevated anxiety sensitivity scores with a mean age of 
21.17 to compare how six 20 minute treadmill exercise sessions across 2 weeks of 
either high intensity aerobic exercise (n=29) vs low intensity aerobic exercise (n=25) 
impacts anxiety sensitivity using the Anxiety Sensitivity Index, State-trait Anxiety 
Inventory and Body Sensations Questionnaire as measurements. Results indicated 
that both high- (34.17 to 25.03) and low-intensity (31.44 to 28.56), exercise reduced 
anxiety sensitivity. However, high-intensity exercise caused more rapid reductions 
in a global measure of anxiety sensitivity and produced more treatment responders 
than low-intensity exercise [x2(1, N = 54) = 6.27, p = 0.01]. A significant simple effect 
for assessment session emerged for the high-intensity exercise group, F(2, 56) = 
42.50, p <0.001, n2 = 0.60. An assessment session effect was also found for the low-
intensity comparison group, (F(2, 48) = 13.72, p < 0.001, n2 = 0.36). State anxiety 
mean scores from pre and post-intervention decreased for high intensity (35.10 to 
32.03) but increased from low intensity running (35.12 to 38.24), while trait anxiety 
decreased for both high (41.67 to 38.79) and low intensity running (42.72 to 42.32), 
however there were no significant effects for either state or trait anxiety. Only high-
intensity exercise reduced fear of anxiety-related bodily sensations (F(1, 52) = 9.44, p 
<0.01, n2 = 0.15) with mean BSQ scores for the high-intensity exercise group (M = 
2.12, SD = 0.10) significantly lower on average compared to the low-intensity 
comparison group (M = 2.56, SD = 0.11)104.  
23 
Haffmans 
(2006) 
Impact of 
running therapy 
for 3 days per 
A randomised controlled trial from the Netherlands by Haffmans et al. (2006) used 
60 psychiatric patients (19 men, 41 women) in a day treatment programme for 
affective disorders who had a mean age of 39 and were all suffering from a 
week for 12 
weeks on 
depression and 
self-efficacy in 
psychiatric 
patients all 
suffering from 
depression  
depressive disorder. They compared the impact of running therapy 3 days per week 
for 12 weeks (n=20) vs physio training therapy (n=21) and a control (n=19) on 
depression and self-efficacy using the Hamilton Rating Scale for Depression (HRSD), 
Becks Depression Inventory (BDI), Self-Efficacy Scale and Physical Self-Efficacy Scale 
(PSES) as measurements. Although both groups were positive about the training 
programme, participants in the PT group gave a significantly higher evaluation than 
participants in the running group (p<0.05). After 6 weeks, no significant differences 
were found between both the training groups and the control group; however, 
after 12 weeks, the physio training group showed significant improvement on 
scores for blind-rated HRSD and BDI scores (p= 0.004 and p=0.002, respectively). 
The running group had no significant difference in depression scores from baseline 
(26.7) to 12 weeks(25.5). Regarding self-efficacy, the RT group scored significantly 
higher in PSES after 6 weeks (p=0.03), feelings of self-efficacy did not change 
significantly in either the running or the physio groups after 12 weeks. Running 
group feelings of self-efficacy was 46.6 at baseline and 49.1 at 12 weeks105.  
24 
Thornton 
(2008) 
Investigating the 
relationship 
between anxiety 
and marathon 
An American cross sectional survey by Thornton et al. (2008) used 50 runners over 
age 18 to investigate the relationship between anxiety and marathon training using 
the Beck Anxiety Inventory as measurement. Mean anxiety scores decreased from 
baseline pre-training levels (0.9) compared to 2 months prior to marathon day (to 
0.7, respectively, with 72% had no change from baseline pre-training levels on the 
Beck Anxiety Inventory (0.9) compared to 2 months prior to marathon day (0.7; 
72% had no change from baseline, 22% were less anxious and 6% were more 
anxious than baseline). However, anxiety scores increased as race day approached: 
at 1 month prior to race day (1.4; 46% had no change from baseline, 19% were less 
anxious and 35% were more anxious than baseline) and 1 week prior to race (2.6; 
22% had no change from baseline, 14% were less anxious and 64% were more 
anxious than baseline, respectively). Overall results found that marathon training 
decreased anxiety initially, but overall anxiety increased as race day approached106.  
25 
Scholz (2008) 
 
 
Impact of a 1 
year marathon 
training 
programme on 
self-efficacy  
A pre-post non-controlled non-experimental longitudinal study based in Switzerland 
by Scholz et al. (2008) used 30 untrained participants (26 women, 4 men) with a 
mean age of 41.2 to investigate how a 1 year marathon training running 
programme impacted self-efficacy using a 4 part author-created measurement. 
There were no statically significant differences in baseline level, trend or fluctuation 
of self-efficacy between the participants who successfully completed the marathon, 
and those who did not. Self-efficacy had a baseline level mean of 3.45 (p<0.01), a 
linear trend mean of -0.05 (p<0.05), a fluctuation mean of 0.33 (p<0.01) and an 
intra-class correlations of 0.46. Baseline level of self-efficacy was positively 
associated with baseline level in running (correlation analyses =.27;p<0.05 (95% 
confidence intervals = .00; .53) and fluctuation in self-efficacy correlated positively 
with fluctuation in running .39;p<0.05 (95% confidence interval .03;.74). A 
substantial correlation between the trend in running and self-efficacy emerged as 
well (.39, not significant but was associated with a very wide confidence band (95% 
Confidence interval -.10; .87) and was not significant. As this was a non-
experimental longitudinal study, no causal statements can be drawn, hence cannot 
conclude that, self-efficacy leads to increased levels of exercise and vice versa107.  
26 
Kalak (2012) 
Impact of daily 
30 minute 
morning runs on 
weekdays for 3 
weeks (ie. 3x5 
runs) on stress 
and mood 
A Swiss randomised controlled trial by Kalak et al. (2012) used 51 adolescents (27 
female and 24 male) with a mean age of 18.3 to compare the effects of a daily 30 
minute morning run on weekdays for 3 weeks (ie. 3 x 5 runs) (n=27) vs a control 
group (n=24) on stress and mood using the Perceived Stress Scale, a daily mood log 
and a questionnaire assessing positive and negative comping strategies as 
measurements. Perceived stress and positive/ negative coping strategies did not 
differ significantly between the running and the control groups (F(1,49) =1.71, 
n2=0.034, not significant) nor was there a statistically significant group x time 
interaction (F(1,49) =2.97, n2=0.057, not significant). Mood in the morning was 
significantly higher in the running group than the control group (F(5,245) =4.42, 
n2=0.083, p<0.001); the group x time interaction was also significant (F(5,245) = 6.32, 
n2 = 0.114, p<0.01); mood in the morning also increased significantly over time in 
the RG compared with the CG (F(5,245) =16.08, n2 = 0.247, p<0.05). Over time, 
irrespective of group, mood in the evening improved, but there was no difference 
of mood in the evening between groups and the group x time interaction was not 
significant108.  
27 
Inoue (2013) 
Impact of 10 
organised runs 
on self-
sufficiency in 
homeless people 
An American pre-post non-controlled study by Inoue et al. (2013) used 148 
homeless people involved in the “Back on my feet” programme who had an average 
age of 29.9 and 90.5% of whom were male. They examined the impact of 10 
organised runs on self-sufficiency using an author-created scale to measure the 
psychological benefits of the program. Results suggested that increases in running 
involvement had a significant positive correlation with perceived self-sufficiency (r = 
.30, p < 0.01). The mean value of perceived self- sufficiency (M = 5.95) exceeded the 
midpoint (4.0), indicating on average participants agreed the program provided 
increased psychological benefits associated with self-sufficiency. Results suggested 
that the participants gained higher levels of perceived self-sufficiency as they 
became more involved with running during the program, with the regression model 
showing a significant proportion of the variation in perceived self-sufficiency (F = 
3.39, p < .01, Adjusted R2 = .08), and increases in running involvement was the sole 
significant predictor of the outcome (β = .29, t = 3.57, p < .01)109. 
28 
Samson (2013) 
Impact of a 15 
week marathon 
training program 
consisting of 3 
group training 
days per week 
plus one run of 
8-20 miles on 
the weekend, on 
general affect & 
self-efficacy 
An American pre-post non-controlled study by Samson et al. (2013) used 39 
Caucasian university students (11 males and 28 females) who all had running 
experience and a mean age of 20.5. They examined how a 15 week marathon 
training program, consisting of 3 group training days per week plus one training run 
of 8-20 miles during the weekend, impacted general affect and self-efficacy using 
the Positive and Negative Affect Scale (PANAS) and author-created measurements 
for self-efficacy. Results showed a significant increase in self-efficacy over the 
training programme (F(12,444)=5.81, p<0.01, partial eta2 =0.136). While there was a 
significant decrease of positive affect over time (F(12,444)=8.35, p<0.01, partial 
eta2=0.184), there was no significant change found for negative affect over the 
programme110.  
29 
Doose (2015) 
Impact of group 
walking/running 
3 times per week 
for 8 weeks on 
depression 
A German randomised controlled trial by Doose et al. (2015) used 46 outpatients 
aged 18-65 diagnosed with mild to severe depression to compare the impact of an 
8 week, 3-times weekly, group walking/running exercise programme (n=30) vs wait 
list (n=16) on depression using the Hamilton Rating Scale and Beck Depression 
Inventory as measurements. Out of forty-six participants, 11 participants (24%) 
dropped out: 7 (23%) from the intervention group and 4 (25%) from the control 
group. While both the exercise intervention and control group had reductions in 
scores for the Hamilton Rating Scale for Depression (-9.48 and -1.2, respectively), 
results attributed a large and clinically significant change to the exercise 
intervention (Cohen’s d= 1.8; mean change = 8.24; p = <0.0001). There were 
moderate changes in Becks Depression Inventory scores without clinical significance 
(Cohen’s d: 0.50; mean change = 4.66; p=0.09), with the intervention group BDI 
scores reducing a mean of -8.20, while the control had a mean reduction of -3.54111.  
30 
Von Haaren 
(2015) 
Impact of a 20 
week running 
training course 
on stress and 
mood during 
academic 
examinations 
A German randomised controlled trial, within subject design by Von Haaren et al. 
(2015) used 61 inactive male university students with a mean age of 21.4 to 
compare how a 20 week aerobic running training course vs a waiting list control, 
impacted stress and mood during academic examinations using a shorten mood 
scale based on the Multidimensional Mood Questionnaire and a one item test for 
perceived control and stress as measurements. Results did not detail the number of 
participants in each group. Significant emotional stress reactivity was evident in 
both groups during both academic assessment episodes, with an increase of mean 
perceived stress of 0.23 in control group, and 0.21 in aerobic group in the first 
academic assessment. However, participants in the aerobic training group showed 
lower emotional stress reactivity compared with the control participants after the 
20-week training programme, with perceived stress of the aerobic group remaining 
similar during both exam periods(2.27 to 2.24), however it increased further in the 
control group (2.43 to 2.51). After both academic assessment periods, the 
coefficient for the group by perceived stress interaction was higher (B= -0.18, 
p<0.001) compared with just the first academic assessment (B= -0.11, p<0.05), 
descriptively indicating a larger effect of the group x PS interaction at the end of the 
20 week exercise programme112. 
31 
Kahan (2018) 
Impact of 20 
running sessions 
alternating 
between game 
vs lap running on 
self-esteem and 
self-efficacy in 
children 
An American pre-post with comparison study by Kahan et al. (2018) used 11 
children (9 males and 2 females) aged 9 & 10 to compare the impact of 20 running 
sessions alternating between game vs lap running on self-esteem and self-efficacy 
using a 50-item, author-created questionnaire as measurement. High inherent 
interest participants (ie, higher MVPA% in the running laps condition) had 
statistically significant higher scores than low inherent interest participants on 
Recognition (p=0.01), Ego Orientation (p=0.03), and Expectancy Beliefs (p=0.03) 
subscales. No differences were detected between high and low response to 
treatment groups. Results for self-esteem: Cronbach’s alpha score was 0.69 and 
self-esteem mean was 3.63 on a 5 point scale; while mean for task-efficacy was 4.16 
on a 5 point scale. PA% (62.2% vs 76.1%, effect size [ES] = −0.65) was lower and 
moderate-vigorous physical activity (MVPA%) (33.3% vs 15.8%, ES = 0.75) and 
MVPA% of PA (53.6% vs 20.2%, ES = 0.91) were higher during game vs lap running 
conditions113. 
32 
Keating (2018) 
Impact of 12 
weeks of twice 
weekly running  
in a group 
setting that 
offers social 
support 
supervised by 
clinical 
professionals, on 
stress, anxiety 
and depression 
A Canadian pre-post non-controlled study by Keating et al. (2018) used 46 
participants with complex mood disorders (11 males and 35 females) consisting of 
29 youths (mean age 22.1) and 17 adults (mean age 45.2), to examine how 12 
weeks of twice weekly running groups impacted stress, anxiety and depression 
using the Cohen’s Perceived Stress Scale, Becks Depression Inventory, Becks Anxiety 
Inventory and Short Form Survey as measurements. Adults and youths with 
complex mood disorders benefited from the running therapy programme 
supervised by clinical professionals in a group setting that offers social support. 
There were significant decreases in depression (F=4.5, df=11, 201, p<0.0001), 
anxiety (F=4.8, df=11, 186, p<0.0001) and stress (F=2.3, df=11, 186, p=0.01) scores 
from baseline to the end of the study. Mean BDI scores from baseline to post-
exercise intervention, decreased by 39% in adults from high (30.8) to low levels 
(18.8) and by 27% in youths from moderate (26.9) to reduced moderate levels 
(19.5). Younger participant age, younger age at onset of illness and higher 
perceived levels of friendship with other running group members (ps ≤0.04) were 
associated with lower end-of-study depression, anxiety and stress scores, while 
higher attendance was associated with decreasing depression and anxiety (ps 
≤0.01) scores over time114. 
33 
Nezlek (2018) 
Impact of 3 
months of self-
prescribed 
running on 
psychological 
wellbeing, self-
esteem, self-
efficacy and 
affect 
A Polish pre-post observational cohort study with no control by Nezlek et al. (2018) 
used 244 recreational runners with a mean age of 32.5 and 48% of whom were 
women, to investigate how the volume of recreational running could impact 
psychological wellbeing, self-esteem, self-efficacy and affect. Over 3 months the 
participants recorded weekly how far they had run and the psychological outcomes 
were measured using the Rosenberg Self-esteem Scale, the Satisfaction With Life 
Scale and a circumplex model that distinguishes the valence (positive or negative) 
and arousal (activated or deactivated) of affect. Results found a positive within-
person relationships between how much people ran each week and self-reports of 
well-being. The more often and farther people ran during a week, the better they 
thought about themselves and their lives and the better they felt affectively. 
Results found that sex and age did not significantly moderate any of the 
relationships reported above (all ps > .13), however, how long people had been 
running significantly moderated the slope between number of days run each week 
PA (γ11 = −.033, p < .05). Self-efficacy was related to distance run, but not to 
frequency. When analyzed separately, both measures of running were significantly 
related to all measures of well-being, such that well-being was higher during weeks 
when individuals ran more often and further than it was during weeks when they 
ran less often and less far. By contrast, the average kilometers people ran each 
week moderated most relationships between running and well-being such that 
relationships between well-being and running were weaker for people who ran 
more than they were for people who ran less. For the kilometers people ran each 
week, significant moderation was found for weekly Satisfaction with Life Scale (γ11 = 
−.0002, p = .013), self-esteem (γ11 = −.0002, p = .015), positive activated affect  
(γ11=−.0003, p<.001), positive deactivated affect (γ11=−.0008, p<.01), negative 
activated affect (γ11= .0002, p = .046), and negative deactivated affect (γ11 = .0003, 
p = .01). Satisfaction with progress fully mediated relationships between all 
measures of well-being and number of days run each week and between all 
measures of well-being and kilometers run each week. In all of these analyses 
including self-efficacy and self-esteem, the direct effect of the predictor (running) 
on the outcome (well-being) was not significant (p>0.12), whereas the direct effect 
of the mediator (satisfaction with progress) was (p<0.001), and the indirect effect of 
running was significant (the critical path for demonstrating mediation) (p<0.001) 115.  
34 
Kruisdijk (2019) 
Impact of 6 
months of 
running-walking 
for one hour 
twice a week on 
depression in 
subjects with 
major depressive 
disorder 
A randomised controlled trial from The Netherlands by Kruisdijk et al. (2019) used 
48 participants with major depressive disorder with a mean age of 41.6 to compare 
how 6 months of running-walking for one hour twice a week (n=25) vs a control 
group (n=23) impacted depression using the Hamilton Depression Scale as 
measurement. Depression on the HDS decreased in both the intervention and the 
control group on average by 2–3 points after 3 months, but there was no significant 
difference or effect on depression in favour of the intervention group (Cohen’s d < 
0.2, F = .13, p = 0.73). Conclusions about the anti-depressive effect of this exercise 
intervention were not possible due to only 9 participants (19%) completing the 
study, low statistical power and lack of follow-up at six and 12 months. An 
integrated lifestyle intervention may be more effective than a single add-on 
exercise intervention for patients with major depressive disorder, as these results 
found that the exercise intervention and study design weren’t feasible in terms of 
motivation and compliance116. 
 
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A Scoping Review of the Relationship between Running and Mental Health.
Oswald, Freya,Campbell, Jennifer,Williamson, Chloë,Richards, Justin,Kelly, Paul