Retraining Body and Brain to Conquer Compulsions
Condition: Compulsive Behavior
MeSH terms: Compulsive Behavior
Study type: Interventional

Summary: 
      Following the realisation that many aspects of the way we live our life, such as our diet,
      activity levels, and amount of screen time, can have a potent impact on mental health and
      brain functioning 'lifestyle' based interventions have become topical in medical research. In
      particular, much scientific attention has been devoted to the impact of physical exercise and
      various stress reduction techniques on mood disorders. We aim to extend this work and
      investigate their impact on compulsivity.

      We will do this by conducting a pilot proof-of-principal intervention study. The study will
      compare the impact of eight-weeks of:

        1. regular physical exercise + stress management activity A,

        2. regular physical exercise + stress management activity B,

        3. lifestyle as usual.

      The participant cohort will be adults who endorse mild-moderate behavioural compulsivity on
      one of the following domains:

        -  drinking alcohol

        -  gambling

        -  eating

        -  washing or cleaning

        -  checking

        -  ordering or arranging objects
    

Detailed description: 
      This study is investigating the impact of regular physical exercise and stress management
      activities on mental health and brain function. It is specifically focusing on how engaging
      in these activities might impact activity in brain circuits associated with compulsivity, and
      help to reduce compulsive patterns of behaviour.

      A compulsive behaviour is something that we do regularly, feel pressured to do, and have
      difficulty stopping even though it is not benefiting us. Having compulsive patterns of
      behaviour is very common. It's been estimated that as many as 80% of the general population
      experience compulsivity at some point in their lives. That's most of us! Compulsive
      behaviours range in severity from mild to entrenched, and can take many forms. For example,
      gambling too often or washing ones hands excessively. For some people what starts out as a
      mild pattern of behaviour, such as a glass of wine every night after a stressful day, can
      develop into a problem, like alcohol dependence. As so many people experience mild to
      moderate compulsivity it would be helpful to have accessible evidence-based strategies that
      reduce compulsive tendencies.

      One promising candidate is physical exercise. In addition to the well-known physical health
      benefits, regular exercise also has a potent positive effect on brain health and mental well
      being. Other candidates are specific stress management activities. Certain stress management
      techniques, such as brain training, meditation, psycho-education, music therapy, yoga, and
      guided relaxation, can promote optimal mental health, improve cognitive functioning and help
      keep the body's physiological arousal systems within a healthy range. Some stress management
      activities may also help to reduce compulsive behavioural patterns. Importantly, as physical
      exercise increases neuroplasticity (i.e. malleability of the brain), engaging in regular
      exercise may enhance the effectiveness of concurrent stress management activities.

      This research study is investigating the impact of eight-weeks of regular physical exercise
      paired with two different stress management activities on brain health, mental health, and
      compulsivity. Both of these activities have previously been shown to reduce stress and
      improve mental health, we are investigating whether one is more effective than the other.

      As regular exercise and stress management training are time consuming, taking part in the
      study will reduce the opportunity to engage in compulsive behaviours. As such, our primary
      focus for the study will not be a reduction in the time spent engaging in compulsive
      behaviour. Instead, we will focus on whether the interventions modulate aspects of brain
      function associated with compulsivity (e.g. hippocampal integrity, functional brain activity
      during reward processing), aspects of cognition associated with compulsivity (e.g. affective
      processing bias and decision making), indices of the bodies stress system (e.g. cortisol
      awakening response), and aspects of mental health and quality of life that can be compromised
      in sub-clinical compulsive populations (e.g. experiential avoidance, general well being,
      symptoms of anxiety and depression).
    

Intervention name(s): Physical Exercise; Stress management training A; Stress management training B
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Physical exercise: Amount of time exercising gradually titrated from 90-minutes in week one to 180-minutes in week eight. Intensity titrated concurrently from 40 - 60% VO2 max in week one to 40 - 90% VO2 max in week eight. Eight week gym membership provided to all participants to facilitate engagement in exercise.; Stress management training A: Daily stress management training for eight weeks with training activity delivered via app. Session lengths titrated from 10-minutes per day in the first week to 20-minutes per day in week eight.; Stress management training B: Daily stress management training for eight weeks with training activity delivered via app. Session lengths titrated from 10-minutes per day in the first week to 20-minutes per day in week eight.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment