Background: Regular exercise can have positive effects on both the physical and mental health of individuals with\nschizophrenia. However, deficits in cognition, perception, affect, and volition make it especially difficult for people\nwith schizophrenia to plan and follow through with their exercising intentions, as indicated by poor attendance and high\ndrop-out rates in prior studies. Mental Contrasting and Implementation Intentions (MCII) is a well-established strategy to\nsupport the enactment of intended actions. This pilot study tests whether MCII helps people with schizophrenia in highly\nstructured or autonomy-focused clinical hospital settings to translate their exercising intentions into action.\nMethods: Thirty-six inpatients (eleven women) with a mean age of 30.89 years (SD = 11.41) diagnosed with schizophrenia\nspectrum disorders from specialized highly structured or autonomy-focused wards were randomly assigned to\ntwo intervention groups. In the equal contact goal intention control condition, patients read an informative\ntext about physical activity; they then set and wrote down the goal to attend jogging sessions. In the MCII\nexperimental condition, patients read the same informative text and then worked through the MCII strategy. We\nhypothesized that MCII would increase attendance and persistence relative to the control condition over the course\nof four weeks and this will be especially be the case when applied in an autonomy-focused setting compared to when\napplied in a highly structured setting.\nResults: When applied in autonomy-focused settings, MCII increased attendance and persistence in jogging group\nsessions relative to the control condition. In the highly structured setting, no differences between conditions were\nfound, most likely due to a ceiling effect. These results remained even when adjusting for group differences in the\npre-intervention scores for the control variables depression (BDI), physical activity (IPAQ), weight (BMI), age, and\neducation. Whereas commitment and physical activity apart from the jogging sessions remained stable over the\ncourse of the treatment, depression and negative symptoms were reduced. There were no differences in pre-post\ntreatment changes between intervention groups.\nConclusions: The intervention in the present study provides initial support for the hypothesis that MCII helps patients to\ntranslate their exercising intentions into real-life behavior even in autonomously-focused settings without social control.
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