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Clinical Psychology Review, Vol. 21, No. 1, pp. 33–61, 2001 Copyright © 2000 Elsevier Science Ltd. Printed in the USA. All rights reserved 0272-7358/01/$–see front matter PII S0272-7358(99 )00032-X 33 EFFECTS OF PHYSICAL EXERCISE ON ANXIETY, DEPRESSION, AND SENSITIVITY TO STRESS: A UNIFYING THEORY Peter Salmon University of Liverpool  ABSTRACT. Until recently, claims for the psychological benefits of physical exercise have tended to precede supportive evidence. Acutely, emotional effects of exercise remain confusing, both posi- tive and negative effects being reported. Results of cross-sectional and longitudinal studies are more consistent in indicating that aerobic exercise training has antidepressant and anxiolytic ef-  fects and protects against harmful consequences of stress. Details of each of these effects remain unclear. Antidepressant and anxiolytic effects have been demonstrated most clearly in subclinical disorder, and clinical applications remain to be exploited. Cross-sectional studies link exercise habits to protection from harmful effects of stress on physical and mental health, but causality is not clear. Nevertheless, the pattern of evidence suggests the theory that exercise training recruits a  process which confers enduring resilience to stress. This view allows the effects of exercise to be un- derstood in terms of existing psychobiological knowledge, and it can thereby provide the theoretical base that is needed to guide future research in this area. Clinically, exercise training continues to offer clinical psychologists a vehicle for nonspecific therapeutic social and psychological processes. It also offers a specific psychological treatment that may be particularly effective for patients for whom more conventio nal ps ychologica l interventions are le ss a cceptab le. © 200 0 Else vier S cience Ltd.  KEY WORDS.  Exercise, Stress, Anxiety, Depression. BENEFITS OF PHYSICAL exercise are well established in the cardiovascular system and are becoming clear in a range of physical disorders including diabetes, renal dis- ease, and osteoporosis (Fentem, 1994)). Increased physical activity therefore reduces premature mortality (Paffenbarger & Hyde, 1988), and the establishment and mainte- nance of exercise habits has become a target for clinical and health psychologists on these grounds alone (Dubbert, 1992). However, physical exercise is relevant to clini- cal psychology as a possible psychological intervention in its own right. Correspondence should be addressed to Peter Salmon, Department of Clinical Psychology, University of Liverpool, Whelan Building, Liverpool L69 3GB, United Kingdom. E-mail: [email protected]

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