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Physical Activity & Sport
in the Lives of Girls
Physical &
Mental Health Dimensions fom an Interdisciplinary Approach
Under the Direction
of
The Center for Research
on Girls & Women in Sport University of Minnesota
Supported By
The Center for
Mental Health Services / Substance Abuse and Mental
Health Services Administration, U.S. Department of Health
and Human Services
Spring 1997
PROJECT DIRECTORS
Mary Jo Kane, Ph.D.
Associate Professor and Director, Center for Research
on Girls & Women in Sport
University of Minnesota, Minneapolis, Minnesota
Deborah Slaner Larkin
Council Member, Presidents Council on Physical
Fitness and Sports Washington, D.C.
Steward, Womens Sports Foundation, East Meadow,
New York
RESEARCH ADVISORY PANEL
Elizabeth Arendt, M.D.
Associate Professor, Department of Orthopaedic Surgery,
University of Minnesota Minneapolis, Minnesota
Linda K. Bunker, Ph.D.
Associate Dean of Academics and Students Affairs, University
of Virginia
Charlottesville, Virginia
Juliann DeStefano, R.N.,
M.P.H.
Special Assistant, Office of the Director, Center for
Mental Health Services,
Substance Abuse and Mental Health Services Administration,
U.S. Department of
Health and Human Services
Rockville, Maryland
Mary Ann Hill, M.P.P.
Director of Communications, Presidents Council
on Physical Fitness and Sports
Washington, D.C.
Gwendolyn Puryear Keito,
Ph.D.
Director, Womens Programs Office, American Psychological
Association
Washington, D.C.
Judy Mahle Lutter
President, Melpomene Institute
St. Paul, Minnesota
Sandra Perlmutter
Executive Director, Presidents Council on Physical
Fitness and Sports
Washington, D.C.
Don Sabo, Ph.D.
Professor of Sociology, DYouville College
Buffalo, New York
Christine G. Spain, M.A.
Director of Research, Planning, and Special Projects
Presidents Council on Physical Fitness and Sports,
Washington, D.C.
CONTENT EDITOR: Linda
K. Bunker, Ph.D.
COPY EDITOR: Katherine Pradt
PUBLICATION DESIGN: Nance Longley
PRODUCTION: Jonathan Sweet, Arlene West
Message from Donna E.
Shalala
Secretary of Health and Human Services
The year 1996 marked a breakthrough
in our understanding of the benefits of physical activity
and health for all Americans. With the publication of
the first Surgeon Generals Report on Physical
Activity and Health, we have clearly documented the
fact that men and women of all ages can improve the
quality of their lives through a lifelong practice of
regular moderate physical activity. And the research
indicates that physical activity need not be strenuous
to achieve real health benefits. A regular, preferably
daily routine of at least 30-45 minutes of brisk walking,
bicycling, or even dancing will reduce the risks of
developing coronary heart disease, hypertension, colon
cancer, and diabetes. Moreover, regular physical activity
can reduce symptoms of depression and anxiety; help
control weight; and help build and maintain healthy
bones, muscles and joints.
Childhood and adolescence are critical
times to lay the foundation for lifelong physical activity,
but, unfortunately, too many young people, especially
girls, are not active enough. As children grow into
adolescence, their participation in physical activity
declines dramatically. As the Surgeon Generals
report tells us, almost half our young people aged 12
to 21 are not vigorously active on a regular basis and
14 percent are completely inactive. And young females
are twice as likely to be inactive as young males.
These are dangerous trends, and we
need to change them. Fortunately, this landmark report
on Physical Activity & Sport in the Lives of Girls
from the Presidents Council on Physical Fitness
and Sports tells us some of the steps we can take to
enable girls to reach their full potential. It tells
us that we need to provide more quality school-based
physical education for girls. It tells us that we need
to encourage girls to get involved in sport and physical
activity at an early age. It tells us that we need to
challenge stereotypes that impede girls participation
in sports. And it tells us that we have made progress
in some areas. For example, the Title IX legislation
enacted in 1972 has opened the doors for millions of
girls to participate in school sports.
Americans took enormous pride in
the accomplishments of the 1996 Olympic gold medal female
athletes in soccer, softball, swimming, track and field,
gymnastics, basketball, and other sports. We need to
build on that spirit and develop a national commitment
to ensure that every girl receives the encouragement,
training, and support she needs to develop and maintain
an active lifestyle. Increasing physical activity among
girls is a formidable public health challenge, but the
potential rewards are great: a more vigorous nation,
better health and greater leadership opportunities for
girls, prevention of premature death and unnecessary
illness, and a higher quality of life for our citizens.
I strongly encourage all Americans to join us in this
effort.
Message from the Presidents
Council on Physical Fitness and Sports
In the summer of 1996, our nation
cheered the performance and achievements of the U.S.
women Olympians and Paralympians. The images of strong,
active women were inspiring, a long way from the days
when females were relegated to lady-like
sports and young girls were left on the sidelines as
their brothers played.
Following on the heels of the Surgeon
Generals Report on Physical Activity and Health,
this landmark review makes clear that participation
in physical activity and sport can help girls weather
the storms of adolescence and lay the foundation for
a healthier adult life. The report looks at the
complete girl through an interdisciplinary approach
to investigate the impact of physical activity and sport
participation.
The conclusions are striking: regular
physical activity can reduce girls risk of many
of the chronic diseases of adulthood; female athletes
do better academically and have lower school drop-out
rates than their nonathletic counterparts; and, regular
physical activity can enhance girls mental health,
reducing symptoms of stress and depression and improving
self-esteem.
But further vigilance and research
are needed to ensure that all girls and boys can experience
these same benefits. While Title IX has a tremendous
impact on expanding physical activity opportunities
for females, its compliance and enforcement have often
wavered. Parents, teachers, and coaches should be encouraged
to challenge stereotypes about girls participation
in physical activity and sport. There is a lack of information
and research about how race, ethnicity, and socioeconomic
status might affect girls sport and fitness involvement.
I greatly appreciate the support
of the Members of the Presidents Council for this
endeavor, which stemmed from the Councils Task
Force on Girls and Minorities. Their enthusiasm and
unflinching support for expanding the reach of the PCPFS
into important areas such as this have been critical
to the successful completion of this important project.
Council Member Deborah Slaner Larkin
deserves special recognition for her vision and commitment
to this report and for her many years of leadership
in promoting opportunities in physical activity and
sports for girls and women.
I would like to thank the Center
for Research on Girls & Women in Sport, under the
able leadership of Dr. Mary Jo Kane, and the Center
for Mental Health Services, our partners in this endeavor.
It is my hope that this report will
serve as a catalyst for parents, coaches, educators,
researchers, and community leaders to encourage and
create opportunities for girls and young women to become
and remainmore physically active throughout their
lives.
Sandra Perlmutter
Executive Director
Letter from the Project
Directors
Dear reader:
On behalf of the Presidents
Council on Physical Fitness and Sports, we are honored
to present this research report. All of us who have
been involved with the project have a great respect
for the power that sport and physical activity can wield.
Such involvement has helped shape our lives. In fact,
it is a major reason why many of us have chosen this
area as our lifes work.
Physical Activity and Sport in the
Lives of Girls: Physical and Mental Health Dimensions
from an Interdisciplinary Approach was created to highlight
the multiplicity of ways in which physical activity
and sport have become an integral part of girls
lives. It examines the benefits girls derive from participation
in physical activity and sport; the barriers that prevent
them from reaching their full potential; and the kinds
of environments in which girls learn how to develop
and foster the best parts of themselves both on and
off the playing fields. The report was also created
to develop future research paths and policy recommendations
as a guide for planning and programming.
This is a groundbreaking report because
it marks the first time an interdisciplinary approach
has been used in a government document that examines
the impact of sport and physical activity in the lives
of girls. We have chosen authors who are experts in
the physiological, sociological, psychological and mental
health fields to each write a section discussing significant
issues in their respective academic areas. The interdisciplinary
approach is particularly important because it enables
us to talk about the complete girlher
social, physical, emotional and cultural environmentrather
than just one aspect of a girls experience. It
should be noted that, on occasion within the report,
the authors present differing points of view with respect
to certain research findings. For example, scientific
studies in the mental health field may suggest a particular
relationship between self-esteem and physical activity
that has not been identified in the area of sport sociology.
This should not be interpreted as problematic or contradictory;
instead, it can be viewed as an opportunity for further
discussion and for reinforcement of the need for future
interdisciplinary research. Finally, one strength of
this report is a reference list that includes numerous
citations from a variety of academic disciplines. Such
a list can be an invaluable resource for academics,
educators and practitioners.
Related to the issue of interdisciplinarity,
you will find when reading the report that different
authors use different terminology when talking about
girls. As a general rule, however, the word girl
is used when authors are referring to girls 18 and under.
Other terminology is used to further delineate age.
For example, adolescent female typically
refers to girls between the ages of 13-18, while young
girl generally signifies 11 and under.
While the amount of research covered
in this report is thorough and in-depth, because of
space limitations, we could not include every aspect
of what is known about the many ways in which sport
and physical activity influence girls. We also addressed
many issues related to diversity such as cultural or
racial heritage and different physical abilities. However,
what is clear from the authors findings is that
we have a great deal more to learn about the particular
ways in which involvement in sport and physical activity
affects minority groups of girls. We urge others to
use this document as a way to pursue future areas of
research; many potential directions are outlined in
detail in the authors research sections.
It is important that the information
presented in this document reaches a variety of audiences
from parents, teachers and coaches to administrators
and policy makers in educational institutions and government
agencies. Everyone involved in the lives of our children
needs to know what factors contribute to girls
development. Our hope is that those most able to effect
change will use this information as a vehicle for pursuing
future areas of research and developing and implementing
programs that will make a difference in one of this
countrys most important assetsgirls.
Finally, this report is dedicated
to all of the parents, physical education teachers,
coaches and athletic administrators who recognize the
importance of sport and physical activity for all girls.
These hard-working individuals spend their days on the
ball fields and playgrounds teaching skills and developing
a young girls character. They are on the phone
at night organizing the next game, event or season.
Their weekends are often spent at meetings and conferences.
They fight for Title IX compliance, coverage of a game
or a walkathon in the local paper, new uniforms, adequate
facilities and safe fields.
Without their commitment and dedication
to bettering the lives of girls throughout this country,
this report would not have been possible. We are all
in their debt!
Mary Jo Kane
Project Director |
Deborah Slaner Larkin
Project Director |
Acknowledgments
THE PRESIDENTS COUNCIL
ON PHYSICAL FITNESS AND SPORTS (PCPFS) serves as a catalyst
to promote, encourage and motivate the development of
physical activity, fitness and sports participation
for all Americans of all ages. Established by Executive
Order in 1956, the PCPFS is made up of twenty members
appointed by the President. Assisted by elements of
the United States Office of Public Health and Science,
the PCPFS provides guidance to the President and the
Secretary of Health and Human Services on how to get
more Americans physically active.
THE CENTER FOR RESEARCH ON GIRLS
& WOMEN IN SPORT (CRGWS) is dedicated to examining
how sport and physical activity impact the lives of
young girls and women. The first of its kind in the
country, the CRGWS is an interdisciplinary research
center leading a pioneering effort on significant social
and educational issues. The CRGWS is equally committed
to teaching and mentoring students and to community
outreach and public service.
THE CENTER FOR MENTAL HEALTH SERVICES,
Substance Abuse and Mental Health Services Administration,
U.S. Department of Health and Human Services, provides
national leadership for improving the quality and availability
of treatment and prevention services for mental illness,
particularly with respect to adults with serious mental
illness and children with serious emotional disturbances.
This comprehensive report is funded
by the Center for Mental Health Services, Substance
Abuse and Mental Health Services Administration, U.S.
Department of Health and Human Services. The Project
Directors are grateful to the Center for Mental Health
Services, Substance Abuse and Mental Health Services
Administration, U.S. Department of Health and Human
Services, for their support in making this study possible.
It will enable us to provide information to educators
and decision makers who are in a position to make a
difference in the lives of girls across the country.
SPECIAL THANKS
Appreciation is extended to the following
individuals, all of whom have made a significant contribution
to the preparation of this report: Leslie Fisher, Ph.D.
(University of Virginia); Darlene Kluka (Oklahoma State
University); Judy Mahle Lutter, President (Melpomene
Institute, St. Paul MN); Gloria Solomon, Ph.D., (Texas
Christian University); Diane Wakat, President (Intelligent
Nutrition Systems, Charlottesville VA); Art Weltman,
Ph.D. (University of Virginia); Jennifer Fiedelholtz,
M.P.P., Acting Associate Administrator (Office of Womens
ServicesSubstance Abuse and Mental Health Services
Administration); Nance Longley, Publications Designer/Production
Assistant (College of Education and Human Development,
University of Minnesota); Debra Haessly, Executive Assistant
(School of Kinesiology and Leisure Studies, University
of Minnesota); Shelly Shaffer, Ph.D. (Center for Research
on Girls & Women in Sport, University of Minnesota);
LeeAnn Kriegh, M.A. (Center for Research on Girls &
Women in Sport, University of Minnesota); Jonathan Sweet,
Executive Assistant (Center for Research on Girls &
Women in Sport, University of Minnesota); Janet Spector,
Associate Professor (Departments of Anthropology and
Womens Studies, University of Minnesota); Bernard
S. Arons, M.D., Director (Center for Mental Health Services,
Substance Abuse and Mental Health Services Administration,
U.S. Department of Health and Human Services); Layne
Owens, Special Assistant to the Executive Director (Presidents
Council on Physical Fitness and Sports).
Executive Summary
THE PRESIDENTS COUNCIL ON PHYSICAL
FITNESS AND SPORTS (PCPFS) serves as a catalyst to promote,
encourage and motivate the development of physical activity,
fitness and sport participation for all Americans. This
report expresses the PCPFSs mission to inform
the general public of the importance of developing and
maintaining physical activity and fitness in our daily
lives, and to heighten awareness of the links that exist
between regular physical activity and good health. In
the past, involvement in sport and physical activity
has been primarily associated with males. Over the past
two decades, however, girls and womens involvement
in such activity has increased dramatically. This is
in large part due to the impact of Title IX, federal
legislation passed in 1972 designed to prohibit sex
discrimination in educational settings. For example,
prior to Title IX, 300,000 young women participated
in interscholastic athletics nationwide; today, that
figure has leaped to approximately 2.25 million participants.
In the wake of this participation explosion, scholars
and educators have begun to explore its impact on girls
and women.
Physical Activity and Sport
in the Lives of Girls: Physical and Mental Health Dimensions
from an Interdisciplinary Approach was created in
order to highlight relevant research and draw on expert
opinion regarding girls involvement in physical
activity and sport. This is the first report that brings
together research findingsand practical suggestions
for implementing these findingsfrom three interdisciplinary
bodies of knowledge: physiological, psychological and
sociological. An additional section explores the relationships
among physical activity, sport and the mental health
of girls. The primary goal was to identify and discuss
the beneficial ways that physical activity and sport
influence girls physical health, psychological
well-being and overall social and educational development.
An additional goal was to identify the problematic aspects
of girls involvement. These include, but are not
limited to, eating disorders, gender stereotyping and
institutional barriers such as lack of opportunity and
access to various resources. Although this report examines
some of the most current and cutting-edge issues, because
of space limitations, the authors do not claim to include
all relevant research and concerns surrounding girls
involvement with sport and physical activity.
The report focuses on girls and not
boys (other than for comparison where appropriate) for
several reasons. First, with respect to sport and physical
activity, girls have been neglected by researchers in
the biomedical sciences, education, physical education
and the social sciences. Second, though girls and boys
share common experiences, girls also exhibit unique
physiological, emotional and social outcomes that merit
special investigation. Next, scholars need to keep pace
with the aforementioned explosion and diversification
of girls involvement with sport and physical activity
in the wake of Title IX. And finally, researchers increasingly
recognize that the social world of physical activity
and sport is not a one-dimensional universe, but a highly
complex set of institutions populated by two genders
with diverse racial and ethnic backgrounds, cultural
values, physical abilities and sexual orientations.
Public apathy about physical education,
and the glitzy distractions of commercialized sports
in mass media, sometimes hide the basic fact that physical
activity is a public health resource for millions of
American girls as well as their families and communities.
In order to advance knowledge regarding the real and
potential contributions of physical activity and sport
in the lives of millions of girls, several areas for
future research are highlighted by the authors at the
end of each section. Finally, a set of policy recommendations
is also included in order to encourage responsible action
on the part of parents, coaches, educators, sport leaders
and elected officials. With such a teamwork
approach, we can make a difference in the lives of girls.
KEY RESEARCH FINDINGS
Some of the most important research
findings documented and highlighted in this report suggest
that:
- More girls are participating
in a wider array of physical activities and sports
than ever before in American history. (Introduction)
- Regular physical activity
in adolescence can reduce girls risk for obesity
and hyperlipidemia (i.e., high levels of fat in the
blood)which, in turn, have been known to be associated
with lower adult onset of coronary heart disease and
certain cancers. Regular physical activity can also
help girls build greater peak bone mass, thereby reducing
adult risk for osteoporosis. (Research Report, Section
I)
- Exercise and sport participation
can be used as a therapeutic and preventative intervention
for enhancing the physical and mental health of adolescent
females. (Research Report, Section IV)
- Exercise and sport participation
can enhance mental health by offering adolescent girls
positive feelings about body image, improved self-esteem,
tangible experiences of competency and success and
increased self-confidence. (Research Report, Sections
II and IV)
- Research suggests that physical
activity is an effective tool for reducing the symptoms
of stress and depression among girls. (Research Report,
Sections II and IV)
- Sports are an educational
asset in girls lives. Research findings show
that many high-school female athletes report higher
grades and standardized test scores and lower dropout
rates, and are more likely to go on to college than
their nonathletic counterparts. (Research Report,
Section III)
- Recognition of physical activity
and sport as an effective and money-saving public
health asset is growing among researchers and policy
makers. (Introduction; Research Report, Sections I,
II and IV)
- Poverty substantially limits
many girls access to physical activity and sport,
especially girls of color who are overrepresented
in lower socioeconomic groups. (Introduction; Research
Report, Section III)
- Excessive exercise and certain
forms of athletic participation have been found to
be associated with a higher prevalence of eating disorders.
(Research Report, Sections I, II, III and IV)
- The potential for some girls to
derive positive experiences from physical activity
and sport is marred by lack of opportunity, gender
stereotypes and homophobia. (Research Report, Sections
III and IV)
CONCLUSIONS AND RECOMMENDATIONS
A summary of some of the most important
conclusions and practical recommendations discussed
in this report suggest that:
- Girls should be encouraged
to get involved in sport and physical activity at
an early age because such involvement reduces the
likelihood of developing a number of deleterious health-related
conditions. For example, active girls high caloric
expenditure decreases their risk of becoming obese.
(Introduction; Research Report, Section I)
- Specific mechanisms which
enhance girls opportunities to be physically
active must be developed and supported. Recreational,
school-based physical education and sport programs
are ideal ways to facilitate both health-related fitness
and the acquisition of fundamental motor skills for
a lifetime of activity. (Research Report, Section
I)
- Involvement in sport and
physical activity has tremendous potential to enhance
a girls sense of competence and control. Therefore,
leaders should incorporate cooperative as well as
competitive opportunities to learn physical skills
in a nonthreatening environment. (Research Report,
Sections II and III)
- Parents, coaches and teachers
must be aware of girls motives for participating
in sport and physical activity. Girls participate
not only for competitive reasons, but to get in shape,
socialize, improve skills and have fun. All motives,
not just those related to highly competitive activity,
must be respected and validated. (Research Report,
Sections II and III)
- Physical educators, exercise
leaders and coaches are in a primary position to recognize
disordered eating patterns among girls. These individuals
must be knowledgeable about the physical and psychological
signs and be able to make referrals to specialists
as necessary. (Research Report, Section II)
- Girls and boys need to work
and play together, starting from an early age. It
is often easier for both sexes to play together and
learn in small, relaxed groups where children know
each other well and have the prerequisite skills.
(Research Report, Section III)
- Coaches and physical educators
should give girls equal access and attention. Girls
as well as boys should play the important and interesting
positions in a game and receive feedback to help improve
their physical skills. (Research Report, Section III)
- Professionals must actively
intervene in the face of discrimination. When adults
observe inequities or gender stereotyping on the playing
field or in the physical education classroom, it is
often best to openly confront issues of prejudice
such as sexism. (Research Report, Section III)
- Involvement in physical activity,
exercise and sport promotes psychological well-being;
the therapeutic use of physical activity and exercise
for improving the mental health of adolescent girls
goes beyond traditional treatment and mental health
programs. (Research Report, Section IV)
- Physical activity and exercise
have been shown to be a mood enhancer and an anxiety
reducer, thereby acting as a natural, cost-effective
intervention for the mental health of adolescent girls.
(Introduction; Research Report, Sections II and IV)
DIRECTIONS FOR FUTURE RESEARCH
Because of the importance of sport
and physical activity in the lives of girls, it is incumbent
for us to continue to expand our scientific knowledge
base regarding the physiological, psychological, sociological
and mental health consequences of participation in these
activities. A summary of some of the most important
directions and agendas for future research suggests
that:
- Research studies must be
conducted to develop and implement motivational strategies
encouraging physical activity during childhood and
into adulthood. (Research Report, Section I)
- Research should establish
guidelines for appropriate training levels. When establishing
these guidelines, scholars should consider areas that
are particularly critical for girls, such as the prevalence
of overuse injuries and issues related to body composition.
For example, specific guidelines for appropriate activity
levels can prevent injuries due to excessive training
and/or early specialization in one sport. Knowledge
regarding appropriate levels of training can also
minimize an undue focus on body composition (e.g.,
body image) that can lead to exercise addiction. (Research
Report, Sections I and II)
- Research studies need to
be designed that better distinguish between sport-specific
or sport- general dropoutsversus sport transfersto
ascertain if girls are leaving organized sport entirely
or simply sampling a variety of sporting activities.
These investigations should collect and analyze participation
statistics and conduct exit interviews with children
who drop out in order to identify negative reasons
for cessation and address them in future programs.
(Research Report, Section II)
- We need to increase our research
agenda to be more inclusive. For example, future research
must be expanded beyond an analysis of highly competitive
sport to include a broader range of activities (e.g.,
personal fitness) and settings (e.g., physical education
classrooms). Additionally, studies should include
participants from racially, ethnically, economically
and ability-diverse backgrounds because gender interacts
with these diversities in complex ways (Gill, 1993).
(Research Report, Sections II, III and IV)
- Research studies must utilize
an interdisciplinary perspective. For example, we
need to adopt a biopsychosocial perspective that takes
into account physical, psychological and social context
variables simultaneously. We also need to develop
research teams that enhance partnerships
between scholars and practitioners. (Research Report,
Sections II and IV)
- Future research should be
guided by the principle that strategies for improving
participation rates must also address the quality
of the sport and physical activity experience for
girls. (Research Report, Section III)
- Scientific studies should identify
which factors influence exercise as treatment interventions.
When using exercise as a treatment intervention to
restore mental health for adolescent girls, we need
to examine the impact of peer (same-sex and cross-sex)
influences and individual versus group approaches.
(Research Report, Section IV)
Introduction
DON SABO, PH.D., DYOUVILLE COLLEGE
WHEN THE PRESIDENTS COUNCIL
ON PHYSICAL FITNESS AND SPORTS was established by Executive
Order in 1956, few Americans could have imagined the
surge of participation in physical activity and sport
among girls and women over the last two decades. Millions
of girls now participate in a rapidly expanding variety
of physical activities, and female athletes perform
feats that once were deemed physiologically impossible.
Despite the startling speed of these recent changes,
however, the explosion of womens participation
and ability is more accurately viewed as an acceleration
of a centuries-long march toward greater physical freedom
and athletic excellence.
During the nineteenth century, health
reformers and educators included female gymnastics,
walking, riding and dancing as key components of young
womens education (Vertinsky, 1994). In the countryside
and towns, archery, tennis, bicycling, ice boating,
roller skating, croquet, golf and dance became popular
among girls and women. A new model of able-bodied
womanhood emerged, which challenged traditional
notions about female frailty and ladylike behavior (Verbrugge,
1988, p. 196). The integration of exercise and athletic
activity into school curricula expanded during the twentieth
century. Recreational athletics for girls became popular
in the form of play days between 1920 and
1950 and competitive varsity sports such as basketball
and track and field multiplied after World War II (Hult,
1994). The passage of Title IX in 1972 ushered in an
era of coed physical education and greater opportunities
for girls to play high school and college sports. The
fitness revolution also grabbed the attention and allegiance
of millions of girls and women during the 1970s and
1980s.
Physical Activity and Sport
in the Lives of Girls: Physical and Mental Health Dimensions
from an Interdisciplinary Approach presents an interdisciplinary
portrayal of the connections among the physical, psychological,
social and cultural aspects of physical activity and
sport in girls lives. When viewed collectively,
the research findings discussed here show how physical
activity and sport impact the complete girl:
that is, the many interrelated aspects of a girls
life ranging from musculoskeletal and cardiovascular
functioning, to psychological well-being, gender identity,
relationships with friends and family and performance
in school. Physical activity and sport offer girls more
than gateways to fun, competition or an elevated heart
rate. While the authors of this report are aware that
girls experiences vary a great deal, the vision
of the complete girl fosters a comprehensive awareness
that exercise and sport are not just about physical
movement but personal development, identity and values
as well.
PARTICIPATION, OPPORTUNITY
AND BARRIERS
American girls now participate in
a wider range of physical activities and sports, and
at more levels of competition, than ever before in our
history. While Oregon girls learn to square their shoulders
to the volleyball net, a group of girls play four
squares in rural New Hampshire, an Arkansas teenager
teaches hopscotch to her little sister, and Native American
teenagers meet for lacrosse practice. As girls bounce
and chatter through double-dutch jump rope in Bedford-Stuyvesant,
in-line skaters glide through a Houston suburb. As an
Ohio high school basketball team runs through drills,
friends from DeKalb, Illinois, meet for an aerobics
class. And women give gutsy performances while winning
gold medals at the 1996 Summer Olympic Games in sports
ranging from softball, soccer and basketball to gymnastics,
track and field and swimming.
Females have become prime movers
in the fitness realm. A recent nationwide survey conducted
by the National Sporting Goods Association indicated
that more women (55.4 million) than men (43.4 million)
participate in several leading fitness activitiesaerobic
exercising, bicycling, exercising with equipment, exercise
walking, running and swimming. A more specific breakdown
reveals that an estimated 18.3 million women do aerobics,
26.5 million bike for exercise or mountain bike, 23.8
million exercise with weights, 45.2 million walk, 8.65
million run or jog and 32.6 million swim (National Sporting
Goods Association, 1995).
Girls participation in school
athletic programs and community-based programs is also
mushrooming. Girls now comprise about 37 percent of
all high-school athletes, representing an increase from
one in 27 girls who participated in 1971 to one in three
girls in 1994. The ratio for boys during this timeframe
remained constant at one in two. In 19941995,
2,240,000 girls participated in high-school sports,
compared to 3,554,429 boys, 37 percent and 63 percent
respectively (National Federation of State High Schools
Associations, 19951996). In terms of some specific
sports, an estimated eight million girls under age 17
played basketball in 1994 (compared to 12.5 million
boys) while 6.7 million girls played soccer. As more
girls developed athletic interests and physical skills
at the grassroots levels of competition during the 1970s
and 1980s, participation in college and Olympic sports
also exploded. Women now comprise 33 percent of all
college athletes and approximately 39 percent of United
States Olympic team members. Reciprocally, as more female
role models become available for young girls to emulate,
their interest and involvement in fitness and athletic
activities will continue to grow.
Despite these gains, it is important
to realize that womens historical trek toward
greater physical and athletic opportunity has been filled
with barriers. In the past, various individuals have
condemned exercise and sport as unladylike and eminent
physicians warned women against overstrain and sterility.
One of the authors of this report, sport sociologist
Margaret Duncan, points out that stereotypes associated
with traditional notions of femininity and masculinity
exalted boys strength and athletic feats while
equating girls athletic talents with tomboyism.
Parents, coaches and teachers often encouraged boys
to test their physical and emotional limits while ignoring
or coddling girls.
Today, girls achievements in
physical activity and sport remain overshadowed by the
cultural prominence of mens sports. In school
and community-based programs, boys still receive a disproportionate
share of opportunities to participate in exercise and
sport. Male-dominated sports organizations remain mired
in policies and beliefs that shortchange girls and women,
and parents or advocates of girls are forced to wage
expensive legal battles in the pursuit of gender equity.
Indeed, it is unlikely that the large increase in girls
athletic participation and growing cultural acceptance
of physically active and athletic females would have
occurred without the passage of Title IX (Birrell &
Cole, 1994; Cahn, 1994a; Messner & Sabo, 1990).
Pressured by the perceived threat of lawsuits or payment
of legal fees, and pulled by increasing demands for
greater opportunity for girls, Parent Teacher Associations
and school administrators began to rethink traditional
clichés like girls just arent as physical
as boys or sports are more important for
boys than for girls.
And finally, harsh economic conditions,
prejudice and institutional barriers have limited the
participation of many poor girls, girls of color and
girls with disabilities. Ironically, where the real
and potential health outcomes of physical activity and
sport are probably most needed, participation rates
and access to resources are most lacking. As the authors
of this report repeatedly document, girls increasing
participation and interest in physical activity and
sport bode well for their health. Yet these positive
national trends are being undermined by the growing
numbers of adolescents who are becoming sedentary and
obese, the substantial numbers of girls who are dropping
out of sports, and the persistence of social and economic
barriers that limit girls opportunities to develop
physically active lifestyles.
UNDERSTANDING THE COMPLETE
GIRL
Physical activity and sport are not
simply things young girls do in addition to the rest
of their lives, but rather, they comprise an interdependent
set of physiological, psychological and social processes
that can influence, and, in varying degrees, sustain
girls growth and development. The interdisciplinary
approach that underpins this report is designed to make
more visible some of the connections among physical
activity, sport and the rest of girls lives. Some
examples of the broader linkages that are examined in
the body of this report are highlighted below.
Psychological Well-Being
Within the traditional framework
of psychoanalytic theory, nonconformity to traditional
gender expectations was considered pathological. Hence,
womens interest and involvement in business, science,
sport or other masculine activities were
clinically suspect. In contrast, the review of psychological
research presented in this report shows that physical
activity and sport are apt to strengthen rather than
worsen the psychological health of girls. The authors
document a combination of psychosocial benefits such
as self-confidence, self-esteem, higher energy levels
and positive body image. It is important to note that
these gains appear to be influenced by interactions
with parents, who can either encourage or dampen a daughters
interest and involvement. So, too, do persistent and
narrow cultural prescriptions for appropriately feminine
behavior erode the potential of physical activity and
sport to enhance girls mental health. On the other
end of the interdisciplinary spectrum, some of the biological
and chemical processes associated with health and fitness
concerns are also highlighted. And finally, two of the
authors of this report, psychology of sport scholars
Doreen Greenberg and Carole Oglesby, discuss the growing
recognition among mental health professionals that exercise
and sport can be effective treatment interventions for
the significant number of girls who suffer from depression
or anxiety disorders.
Obesity
The Surgeon Generals report
on nutrition and health (Public Health Service, 1988)
identified obesity as a major public health problem
in the United States; subsequently, the Surgeon Generals
report on physical activity and health (United States
Department of Health and Human Services, 1996) identified
physical inactivity as a serious public health problem
nationwide. Aware of this concern, the authors of this
report discuss a variety of factors associated with
the rising rate of obesity among American adolescents.
Social factors include the influence of television,
dwindling requirements for physical education in the
schools, and the steep sport dropout rate among adolescents.
Related to physical health concerns, this report explores
the physiological and epidemiological aspects of obesity
such as the links between the development of hyperlipidemia,
hypercholesterolemia, hypertension and diabetes, which
in turn elevate risk for coronary heart disease. Finally,
in her section on the psychological dimensions of participation,
psychology of sport scholar Diane Wiese-Bjornstal stresses
the need to help overweight or obese girls overcome
social pressures and personal misgivings about physical
activity so that they can become less sedentary.
The Female Athlete Triad
Several authors discuss the complex
combination of psychological and physiological processes
that operate in relation to the female athlete triad.
In Section I, exercise physiologist Patty Freedson and
psychology of sport scholar Linda Bunker document many
physiological benefits of exercise and sport participation
for girls such as potential gains in strength and aerobic
power. It also appears promising that girls involvement
in sport and exercise could effect increased immune
functioning and the prevention of certain cancers in
adult life. They also express their concerns about the
female athlete triad, which refers to three
interrelated health problems that are prevalent among
some types of female athletes and some girls who engage
in excessive exercise: eating disorders, exercise-induced
amenorrhea and bone loss. Several authors demonstrate
how these syndromes have complex psychological, physiological
and social origins and profiles. For example, girls
perceptions of their bodies are partly shaped by unrealistic
media images that create false connections between a
lean body type or washboard abs and subsequent
success, sex appeal and self-mastery. The obsession
with thinness can also be fed by a coach who demands
weight loss from the athlete, or the desire to be attractive
to boys and accepted by ones peers. Because we
are in the early stages of investigating this syndrome,
the data we have are very limited. Female athletes most
at risk should certainly be aware of the dangers, but
we should not assume that the triad is limited to an
athletic population (Lutter & Jaffee, 1996).
Sport and Academic Achievement
It is said that the fish are
the last ones to discover the ocean. In Section
III, Margaret Duncan illustrates how several research
findings debunk the dumb jock stereotype
that high school athletes perform poorly in the classroom.
School administrators are often unaware of the positive
interplay between high-school athletics and academic
achievement as measured by grade point average, standardized
achievement test scores, lowered risk for dropout and
greater likelihood to attend college. On average, female
athletes fare better academically than female nonathletes,
though Caucasian and Hispanic female athletes are more
apt to derive some direct educational gains than are
their African- American counterparts (Womens
Sports Foundation Report: Minorities in Sport,
1989). Good physical and mental health are also correlates
of academic performance and social adjustment. Hence,
from an interdisciplinary perspective, it is likely
that athletic participation is part of a mutually reinforcing
array of physical, psychological and social processes
that enhance the overall educational experiences and
commitments of many girls.
In summary, understanding the role
of physical activity and sport in the life of the complete
girl is a dauntingly complex agenda. The mosaic
of interdisciplinary findings and interpretations assembled
in this report will deepen both insight and resolve
in this regard.
POVERTY, RACE AND PHYSICAL
ABILITY
Girls from economically disadvantaged
backgrounds, girls of color and girls with disabilities
can face unique obstacles in relation to physical activity
and sport. Poor families cannot afford to invest in
health club memberships, exercise machines and equipment
for their daughters. Families of color, who are disproportionately
poor, often cannot pay user fees or transportation costs
to bring daughters back and forth between home and school.
Fitness and sport are often seen as unattainable luxuries
rather than potential resources. Dual-worker parents
or single parents (most often mothers) sometimes depend
on older daughters to cook or care for smaller children
after school, thus curbing their involvement with extracurricular
activities. Poor or working-class girls often work part-time
jobs to help families make ends meet, thereby reducing
the amount of time and energy available for exercise
or sports. Parental perceptions of the benefits of exercise
and athletic participation for daughters also vary by
race and class. For example, one national survey found
that Caucasian parents more often mentioned health-
related benefits, character benefits and social factors
than did African-American parents (The Wilson
Report: Moms, Dads, Daughters and Sports, 1988).
Many of the problems girls of color
experience in relation to physical activity and sport
grow out of the same soilpoverty. Epidemiological
research shows that exposure to violence, family fragmentation,
substance abuse, sexually transmitted diseases and greater
risk for unwanted sexual activity often share the common
causality of poverty. Lack of physical activity and
athletic opportunity can be added to this list. Economically
disadvantaged girls of color are more likely to suffer
from an unsafe and unhealthy environment. The simple
act of walking or jogging may be problematic in neighborhoods
where crime flourishes. Poor girls often do not have
access to athletic resources, effective coaching and
expert training. There is a lack of basic information
about exercise, diet and sport. They are less apt to
receive quality physical education and athletic training
at earlier ages which, in turn, erodes the foundation
for subsequent motor development. Because school and
community athletic programs depend on tax dollars to
thrive, capital flight from many urban areas is undermining
the provision of adequate exercise and athletic opportunities
for both minority girls and boys. The rising cost of
liability insurance is also making it difficult for
school districts, especially poorer ones, to provide
quality athletic and intramural programs.
Little is known about the dreams,
interests and physical activities of girls of color.
Although women of color are often more visible in sport
media, and in certain sports like basketball and track
and field, they are underrepresented in sports such
as swimming and tennis (Abney & Richey, 1992). During
the early 1980s, African-American and Hispanic adolescent
females comprised about 4.4 percent and 3.2 percent
of high school athletes respectively, compared to 29.1
percent of their Caucasian counterparts (Melnick, Sabo,
& Vanfossen, 1992). There is also indirect evidence
that African-American and other ethnic minority females
are less physically active than Caucasian females (King
et al., 1992; Pate et al., 1995).
And finally, despite the accomplishments
of the Special Olympics and Paralympics, few opportunities
exist for emotionally or physically challenged adolescents
to engage in exercise and sport. Differently-abled children
are three times more likely to be sedentary than their
able-bodied peers and the physical activity levels of
children with disabilities drop precipitously during
adolescence (Longmuir & Bar-Or, 1994). It should
be noted that the authors of this report make only periodic
references to socioeconomic status, race, ethnicity
and physical disability. This is due not so much to
choice, however, as to the fact that so little research
has focused on these groups of girls.
WHAT RESEARCHERS DONT
KNOW CAN HURT GIRLS
This report is the first to assemble
the bulk of existing research on girls involvement
with physical activity and sport. However, because of
the lack of available data and analysis, the authors
of this report were unable to address in any depth some
key aspects of girls experiences with physical
activity and sport. Three emerging research concerns
are briefly discussed below.
Unwanted Sexual Behavior
and Adolescent Pregnancy
Adolescent pregnancy is a major social
problem in the United States. Though the belief that
sports can help many young girls avoid unwanted sexual
behavior and pregnancy is widespread among coaches and
athletes, precious little research has been done in
this area (Sabo & Melnick, 1996). Two recent studies
shed some initial empirical light on the hypothesized
connections among exercise, athletics and adolescent
girls sexual behavior. First, Brown, Ellis, Guerrina,
Paxton and Poleno (1996) analyzed female adolescents
responses to the United States Department of Health
and Human Services, Public Health Service, Centers for
Disease Control and Prevention (1995) survey, Health
Risk Behavior for the Nations Youth. The
researchers found that the more days adolescent females
exercised per week, the more likely they were to postpone
their first experience with sexual intercourse. Second,
preliminary analysis from a study of adolescents from
western New York (an area with one of the highest rates
of adolescent pregnancy in the United States) indicated
that higher rates of athletic participation among adolescent
females were significantly associated with lower rates
of both sexual activity and pregnancy (Sabo, Farrell,
Melnick, & Barnes, 1996).
Sexual Harassment
Sexual harassment is experienced
by approximately 31 percent of female high school students
(American Association of University Women Educational
Foundation [AAUW], 1993). Sport scholars have recently
begun to study the prevalence and social-psychological
dynamics of sexual harassment in athletic settings (Sabo
& Oglesby, 1995). Many key questions need to be
addressed. For example, how do female athletes perceive
and react to sexual harassment from boys and adults?
Do higher self-esteem and physical prowess fostered
by sports help females to be more assertive with inappropriately
invasive males than their non-athletic counterparts?
Additional research needs to be done on the ways that
athletic participation may empower girls to more effectively
cope with sexually hostile situations.
Exercise and Sport as
a Family Asset
Regretfully, little research has
focused on the ways that exercise and sport promote
interaction and insight between parents and children.
As is the case with sexual harassment, many important
questions in this area remain unanswered. Do parents
look to sport to provide after-school activities that
keep daughters physically active, socially engaged and
off the streets? To what extent do physical activity
and sport help parents nurture moral development and
values in their children? In what ways can parents effectively
encourage their daughters involvement with physical
activity and sport? Clearly, more investigation of the
interdependencies among physical activity, sport, families
and schools is needed.
CONCLUSION: EXPANDING THE
RESOURCE
This report will fuel the growing
awareness that physical activity and sport are enormously
important in the lives of girls. Perhaps this message
is being sent by girls themselves who are, as the saying
goes, voting with their feet, and entering
the realms of fitness and sport in vastly increasing
numbers. In contrast to the nineteenth century naysayers
who decried strenuous exercise and athletic participation
for women as dangerous and unladylike, today, educators
and public health advocates recognize the overall benefits
for girls physical health and emotional well-being.
As health care costs continue to escalate, and pressures
on the American health care system to provide quality
care intensify, the logic of preventive health strategies
that involve physical activity and sport becomes economically
salient.
The overall vision that emerges from
this report frames physical activity as a developmental
aid and public health asset for girls and, by inference,
for boys as well. Physical activity can serve as a social
and cultural intersection where adolescents, parents
and caring adults can come together in mutually supportive
ways. The aerobics class, fitness run or basketball
court are safety zones where young girls can hang out
together, test and challenge themselves, learn about
competition, develop physical fitness components such
as cardiovascular endurance, strength and flexibility,
and have fun all at the same time.
The real and potential benefits that
physical activity and sport have to offer girls, their
families and communities, however, continue to be stymied
by several factors. Economic and cultural barriers block
wider participation, especially for poor girls and girls
of color. Despite increasing interest and participation
rates, physical activity and sport remain underutilized
resources for the many girls who are mired by sedentary
lifestyles or dissuaded from getting involved because
of gender stereotypes, discriminatory practices and
lack of opportunity. There are also appreciable numbers
of girls for whom athletic participation is associated
with illness, injury and addiction to exercise rather
than with physical and mental well-being. And finally,
there needs to be more systematic research on the numerous
ways that physical activity and sport influence girls
lives. Simply put, too little research has been done
in an area where girls have too much to gain. For this
reason, each of the authors has listed priorities for
future research at the end of their respective sections.
This report concludes with a list
of policy recommendations. The information and analyses
gathered here hold implications for parents, educators,
coaches, athletic administrators, public health officials
and lawmakers. There is more at stake in the struggle
to expand girls physical abilities and athletic
opportunities than learning to do jumping jacks or winning
and losing games. Future policy decisions need to be
grounded in the broader understanding that girls
involvement with physical activity and sport is just
as much about physical vitality, emotional well-being,
community health and educational opportunity as it is
about who runs the farthest or scores the most points.
SECTION I:
Physiological Dimensions
PATTY FREEDSON, PH.D., UNIVERSITY OF MASSACHUSETTSAMHERST
LINDA K. BUNKER, PH.D., UNIVERSITY OF VIRGINIA
MUCH IS KNOWN FROM RESEARCH ON THE
EFFECTS OF EXERCISE and sport participation on adolescents
and adults. However, the majority of this research was
conducted on males, or focused on comparisons between
boys and girls, with little research focusing exclusively
on females. The present review must therefore include
research on adults and males, as well as the biophysical
effects of physical activity and sport on girls and
the potential impact of these experiences on their maturation
and adult lives.
The acquisition of fundamental motor
proficiency, which is directly linked to physical activity,
is an important goal for early childhood. Not only must
children learn to control their bodies in space, they
also need to acquire the fundamental skills which will
aid daily living, vocational pursuits and recreational/leisure
activities. These skills are interdependent with health-related
physical fitness and must be considered in any discussion
of the biophysical effects of physical activity on girls.
It is important that activities in
childhood include both the motor and health aspects
of physical fitness. Both health-related fitness and
motor skill development are important because: (a) children
need a reasonable level of motor skill proficiency to
participate in activities that build endurance, power
and strength, and (b) they need reasonable levels of
fitness to engage in exercise and sport activities which
will provide them with physical activity as adults.
Recognizing the need for both motor skill development
and adequate fitness is critical because the benefit
of lifetime participation in physical activity has an
impact on psychological aspects (see also Section II:
Psychological Dimensions), social aspects (see also
Section III: Sociological Dimensions) and the mental
health of young girls and women (see also Section IV:
Mental Health Dimensions).
The simultaneous acquisition of both
motor and physical fitness begins in early childhood,
as children use movement as their mechanism to learn
about their world. It continues in school where all
children should participate in daily physical education
activities which set both the pattern of physical activity
and the fundamental skills to be successful and happy
when participating.
Physical activity has long been recognized
for its effects on the maturing child. However, one
of the challenges of interpreting research on children
is the difficulty of differentiating between the changes
in physiological functioning which may be affected by
regular exercise or strenuous training, and those effects
which are the natural result of maturation. This problem
is compounded by the traditional use of control groups
to help differentiate between the effects of the exercise
intervention and those of normal growth and development,
because most children are already quite active (Bar-Or,
1989). This makes the experimental designs more complicated,
the exercise interventions more intensive than those
which would be adequate for adult participants, and
the interpretation of the data more challenging for
the researcher.
The biophysical changes which result
from exercise and training may shift in the same direction
as those which occur due to maturation, or they may
change in the opposite direction. For example, peak
anaerobic power increases due to both maturation
and physical training. Similarly, decreases in
oxygen cost of moving are also caused by both maturation
and physical training. With respect to biophysical changes
in the opposite direction, the bodys ability to
use oxygen (i.e., anaerobic threshold, percent V. O2
max) decreases due to maturation but increases
as a result of training (Bar-Or & Malina, 1995).
It is possible to consider the known
effects of physical activity in many different ways.
The following information clusters the research into
three categories related to biophysical considerations:
benefits for girls, potential deleterious effects and
potential long-term effects related to disease prevention
and quality of life.
BENEFITS OF PHYSICAL ACTIVITY
FOR GIRLS
Research on the biophysical impact
of exercise on children and adolescents is quite extensive
although, as previously mentioned, investigations focusing
exclusively on girls is limited. The following information
addresses those benefits specifically relevant to girls.
We focus in particular on benefits related to power
(i.e., aerobic power or endurance and anaerobic power),
strength, weight management and health-related issues
such as immune function effects and reproductive maturation.
Strength
Muscular strength is defined as the
ability to generate force and includes dynamic or isotonic
strength (i.e., the ability to generate force through
a range of motion) and isometric strength (i.e., the
ability to generate force at a single point in the range
of motion where muscle length does not change). With
respect to the maturing female, girls grow stronger
as they mature, making it difficult to assess whether
changes are the result of maturation or physical activity
levels. However, several studies have found that short-term
training programs can produce increases in muscle strength
in children (Grodjinovsky & Bar- Or, 1984; Sale,
1989). Pfeiffer and Francis (1986) have suggested that
the relative gain in strength due to exercise is similar
for all children, whether they be prepubescent, pubescent
or postpubescent. According to Malina and Beunen (1996),
prepubescent is defined as the absence of
development of secondary sex characteristics, pubescent
is initial and continued development of secondary sex
characteristics, and postpubescent is adult
or mature state of development for secondary sex characteristics.
Increases in physical activity and short-term training
programs can produce positive changes in several forms
of strength-related factors, including anaerobic
power and muscle endurance.
Maturation-related strength increases
at a linear rate for most girls up until about age 14.
Beyond that point, the rate of increase slows and for
sedentary girls may actually decrease (Blimkie, 1989;
Parker, Round, Sacco, & Jones, 1990). However, systematic
physical activity can produce marked improvement in
strength for girls, probably due to the improvement
in motor unit activation and coordination (Sewall &
Micheli, 1986; Wilmore, 1974).
Power
The concept of power is related to
the capacity to do work per unit time and is directly
related to both muscular strength and cardiovascular
functioning. The following discussion of power includes
both aerobic power which is necessary for endurance
activities and anaerobic power which is necessary for
short-term, high-energy demanding activities.
Aerobic Power and Endurance
Performance
Cardiorespiratory fitness represents
the maximal transport of oxygen, which is a function
of the product of heart-rate and stroke volume (i.e.,
cardiac output), the oxygen-carrying capacity of the
blood (i.e., hemoglobin content) and the maximal arterio-venous
oxygen difference. Aerobic power is typically measured
by V. O2 max as determined by either cycle
ergometry or treadmill exercise. Expressed as an absolute
measure (l min-1) or as relative to
body mass (ml kg-1 min-1),
measurements of aerobic power are extremely reliable
in both children and adults if standard criteria defining
maximal responses are used and if subjectschildren
and adultsparticipate with maximum effort.
The general pattern of change in
absolute aerobic power (l min-1) for
girls suggests that it increases with growth prior to
adolescence, but in the absence of systematic exercise,
it steadily declines into adulthood. Summarizing cross-sectional
data from several studies testing children of different
ages, Armstrong and Weisman (1994) reported a decrease
in absolute aerobic power in adolescent girls 13 to
15 years of age.
Despite the apparent decrease in
absolute aerobic power in females ages 13 to 15, the
overall rate of increase in treadmill absolute aerobic
power for females between the ages of eight and 16 was
approximately 12l yr-1. Examination
of treadmill-relative aerobic power across age revealed
a steady decline for females (Armstrong & Weisman,
1994). Aerobic power relative to body mass (i.e., V.
O2 max expressed as ml kg-1
min-1) averaged 50ml kg-1
min-1 for girls at eight years of age which decreased
to approximately 40ml kg-1
min-1 by age 16. This trend was not observed
for males across the same age span; they maintained
a relatively stable aerobic power of approximately 55ml
kg-1 min-1 (Armstrong &
Weisman, 1994).
This decrease in aerobic power is
most apparent at the time of puberty when there is an
increase in body fat. Additionally, cross-sectional
data indicate that inactive children have lower V.O2
max than normally or highly active children (Malina
& Bouchard, 1991). Fortunately, this decline in
aerobic power can be reversed with aerobic training
(Rowland, 1989). Both short-term and long-term training
programs seem to result in about the same improvements
in maximal aerobic power among sedentary older children
and adults (Bar-Or & Malina, 1995; Pate & Ward,
1990).
Aerobic power and endurance performance
are closely related in adults, but seem to be dissociated
in adolescents. Specific to adolescent females, aerobic
power expressed relative to body mass declines through
normal growth and development, yet endurance performance
(e.g., timed mile run) improves. For example, time to
complete a one-mile run improves by approximately 15
percent in females between eight and 17 years of age,
despite a 20 percent decrease in relative aerobic power
(Rowland, 1989). Nonetheless, it should be pointed out
that regular exercise can increase oxygen uptake and
diminish some of the decline that would otherwise occur.
Improvements in running economy that occur with maturation
most likely explain the dissociation between aerobic
power and endurance performance in adolescence.
Anaerobic Power
Anaerobic power, or the capacity
to perform strenuous activities in short bursts of time,
does not rely as extensively on the cardiovascular system.
For most girls, anaerobic power (such as that required
to do a vertical jump) increases throughout early childhood,
but decreases in adolescence and young adulthood. However,
anaerobic power improves in children who exercise, especially
those who train systematically. Gains as a result of
training for adolescents (10 to 13 years) range up to
about 20 percent.
Weight Management
Juvenile obesity is arguably
the most prevalent chronic illness among children in
North America and represents an immense public health
challenge (Bar-Or & Malina, 1995, p. 110).
A child is considered obese when his or her weight-height
ratio is 20 percent or more above the upper limit of
the desirable weight as assessed by primary care physicians
and pediatricians using standard growth charts (Insel
& Roth, 1991).
According to data from the National
Center for Health Statistics (1991), approximately twice
as many children are overweight today compared to children
in the 1960s (Blair et al., 1996). It should be noted
that juvenile obesity is particularly prevalent in girls
from highly urbanized areas (Dietz & Gortmaker,
1984), some ethnic groups (e.g., Hispanic Americans,
Pima Indians [King & Tribble, 1990]) and those with
disabilities (Dietz, 1995).
Problems with weight control occur
when the caloric intake does not match the caloric expenditure.
Though the major problem for obese individuals may be
the nature of the calories consumed (especially excess
fat intake in terms of the percent of the total calories),
exercise is an important adjunct in weight control for
high-school girls (Wells, 1991; Moody, Wilmore, Girandola,
& Royce, 1972) and for women 18 and over (Miller,
Lindeman, Wallace, & Niederpruem, 1990). Exercise
has the effect of increasing caloric expenditure, and
also seems to protect fat-free mass while promoting
the loss of fat mass (King & Tribble, 1990).
For the general population of girls,
their daily routine provides an adequate balance of
physical activity and caloric intake. However, to assist
the obese child, it is essential that a multidisciplinary
program include nutrition education and increased physical
activity both during weight loss and afterward. Many
of these programs are provided in physical education
programs within our schools and, as Ward and Bar-Or
(1986) have suggested, this is the most practical way
to combat this national problem.
Vogel (1986) presented an extensive
review of physical education programs and concluded
that daily programs can produce changes in body composition
(i.e., percent lean versus fat mass), aerobic fitness,
balance, endurance performance and lipoprotein profiles
(especially for children with elevated lipoproteins).
In addition, when programs are designed to promote motor
skills and aerobic fitness, changes in skinfold thickness
may occur (Simons-Morton, Parcel, & OHara,
1988). The key to controlling obesity is a combination
of caloric reduction and increasing caloric expenditure.
However, when controlling obesity, one must keep in
mind the concurrent need to support the growth process
and to maintain nutritional adequacy.
Immune System
The relationship between immune function
and physical activity must be discussed in relation
to the intensity of the activity (Liesen & Uhlenbruck,
1992). A great deal of research reports that low- to
moderate-intensity training enhances immune function
with increases in levels of interleukin-1 and interferon
and increased numbers of natural killer cells, circulating
lymphocytes, granulocytes, monocytes and phagocytic
macrophages (Kramer & Wells, 1996). However, with
exhaustive or very intense and prolonged training, there
may be a depression of immunological function. Overtraining
may depress the levels of immunoglobulin in blood and
saliva, reduce the responsiveness of T-lymphocytes to
antibody synthesis and increase the risk of infectious
and viral diseases (Newsholme & Parry- Billings,
1994).
The T-lymphocytes and natural killer
cells seem to function as a tumor inhibitor to retard
the growth of cells which have been genetically damaged
(i.e., cancer). Similarly, monocyte and macrophage function
also decreases the likelihood that aberrant cells will
be facilitated or that metastases will occur. Thus it
appears that moderate intensity exercise may have a
positive effect in retarding diseases such as cancer
or those caused by viruses such as colds or influenza
(Newsholme & Parry-Billings, l994). See the section
below entitled Potential Long-Term Effects
for a more detailed discussion of this topic.
Research on the effects of exercise
on the immune system is mixed, depending on both age
and intensity of physical activity. There is some evidence
that increased physical activity produces moderate immune
response suppression, but the clinical importance of
this response is debatable (Calabrese, 1990). For example,
adolescent athletes have been found to be more susceptible
to infections than nonathletes (Shephard, 1984), but
this may also be true for other children who participate
in group activities in close proximity to one another
(e.g., band, drama). In contrast, in a prospective study,
Osterback and Ovarnberg (1987) found no difference in
immune function between 12 year-old athletes and nonathletes.
Reproductive Functioning:
Menarche
There are many anecdotal reports
of the positive influence of regular physical activity
on the menstrual cycles of pubescent girls. Many girls
report less physical distress associated with the cycle
and increased periodicity (i.e., regularity) when moderate
physical activity is part of their lifestyle.
For many years it was believed that
delayed onset of the menstrual cycle (i.e., menarche)
was the result of sports participation by young female
athletes. This conclusion was based on the observation
that menarche occurred later in athletes than nonathletes.
An alternative explanation was offered by Malina (1983)
who suggested that young females who mature early are
socialized away from sports participation. For the young
female athlete, late maturation accompanied by delayed
fat deposition favors athletic success and may result
in a type of self-selection. In other words, delayed
menarche may result in continued participation in competitive
sport (Stager, Wigglesworth, & Hatler, 1990). Wells
(1991) summarized data from several studies and reported
the age of menarche for girls participating at different
competitive levels: nonathletes = 12.29 years, athletes
= 13.02 years, college athletes = 13.05 years, national-level
track and field athletes = 13.58 years, Olympic athletes
(Montreal) = 13.66 years, national-level middle-distance
runners = 14.10 years, Olympic volleyball athletes =
14.18 years and national-level runners = 14.20 years.
It should be noted that these data were collected retrospectively
and may be influenced by recall bias in which athletes
remember later menarche.
Delayed menarche is a particularly
complex issue which could have both positive and negative
consequences. Historically, delayed menarche, which
is often found in female athletes who train at high
levels, was viewed as a problem because it supposedly
compromised fertility (Frisch, Wyshak, & Vincent,
1980). More recently, concern about delayed menarche
has focused on its impact on peak bone density. Menarche
is associated with an increase in circulating levels
of estrogen. Estrogen is a necessary hormonal trigger
for increasing bone density in adolescence and maintaining
bone density in the mature female. Studies have reported
that early menarche is associated with increased bone
density (Fehily, Coles, Evans, & Elwood, 1992; Johnell
& Nilsson, 1984). Research examining the relationship
between delayed menarche in athletic females and bone
density is lacking. Nevertheless, it is possible that
delayed menarche and/or amenorrhea with their associated
reduced circulating estrogen may result in reduced peak
bone mass and increased risk of osteoporosis in later
life because the available time for laying down bone
is reduced (Wells, l991). This concern seems to be greatest
for females who train at very high levels and who may
experience both delayed menarche and amenorrhea.
On the other hand, delayed menarche
may be of some positive significance because the early
onset of menarche has been linked with increased risk
for breast cancer (Doll & Peto, 1981).
Participation in regular exercise
or sport may also reduce the likelihood of childhood
obesity, which often produces earlier onset of menarche.
See sections below entitled Amenorrhea and
Cancer.
POTENTIAL DELETERIOUS EFFECTS
OF PHYSICAL ACTIVITY ON GIRLS
In general, moderate to strenuous
physical activity poses few risks to the healthy girl
and, when deleterious effects do occur, they seem to
involve the musculoskeletal system. Benefits to cardiovascular
functioning seem to be unanimously supported, with no
known evidence to suggest detrimental effects (Nudel
et al., 1989). There is, however, growing evidence to
suggest that we should be concerned for girls who are
training at the elite level, primarily because of overuse
injuries and changes in reproductive system maturation
and functioning. Three of these concernsosteoporosis,
amenorrhea and disordered eatinghave sometimes
been lumped together and described as the Female
Athlete Triad. The foundation for these problems
is that there is often a preoccupation with body weight
and composition among female athletes. This may lead
to undereating and overexercise and underconsumption
of calories which together produce undesirable health-related
consequences. It should be noted that this is not a
problem unique to girls, but one which is also found
in boys who participate in such activities as gymnastics,
ice skating and wrestling (Hui, 1995).
Injuries
Increased levels of physical activity
and sport participation are bound to produce increases
in injuries. Many of these injuries are caused by inappropriate
grouping of children based solely on age, without respect
to maturation, weight or skill level. When children
are grouped by chronological age, the smaller, less
mature individual may be forced to compete against a
more mature individual who is larger, stronger and faster.
Similarly, increased participation in competitive sport
for children may necessitate making a distinction between
injuries caused by physical contact or purposeful intent
(e.g., sliding into second base to break up a double
play), versus those that occur as routine injuries (e.g.,
a sprained ankle). Differences in maturation and in
the childs purpose of participationas well
as intensity/seriousness of training and competitionmay
present the potential for decreased performance and
physical harm. All of these factors may discourage children
from participating.
Injuries may also be caused by inappropriate
levels of strength and flexibility needed for particular
activities. Through appropriate educational programs
generally provided in school physical education, children
and coaches/teachers should learn appropriate techniques
for proper warm-up, stretching and physical conditioning.
Amenorrhea
Some young women experience irregular
or interrupted menstrual cycles which have been associated
with excessive exercise. It is not clear whether this
is a benefit (in relation to reduced estrogen- dependent
cancers due to fewer ovulatory cycles) or a liability
(in relation to such outcomes as lower bone density).
The etiology of amenorrhea (i.e.,
interrupted menstrual cycle) may not simply be a high
level of energy expended in exercise, but may also be
related to energy imbalance, which is a function of
both energy intake and energy expenditure (Loucks &
Heath, 1994; Wakat, Sweeney, & Rogol, 1982). This
concept is supported by studies that have shown normal
reproductive function even with increased exercise energy
expenditure when caloric intake was not limited (Rogol
et al., 1992).
Strenuous physical training may produce
ovulatory dysfunction and shortened luteal phases of
the menstrual cycle, perhaps combined with a prolonged
follicular phase (Loucks, Vaitukaitis, & Cameron,
1992). One explanation for this is the activity of the
hypothalamic-pituitary-adrenocortical axis which may
depress the hypothalamic GnRH pulse generator (Kramer
& Wells, 1996).
A potential negative consequence
of excessive physical activity accompanied by persistent
reduced estrogen levels may be lower bone density, often
linked to amenorrhea and osteoporosis. Female athletes
who are amenorrheic or oligomenorrheic (i.e., irregular
cycles) have been found to have lower bone densities
than the general population (Drinkwater et al., 1984;
Myburgh, Bachrach, Lewis, Kent, & Marcus, 1993;
Rencken, Drinkwater, & Chesnut, 1993).
Disordered Eating
Much has been written about the problems
of disordered eating in elite female athletes or those
who train at extreme levels. The pressures to maintain
the so-called ideal physique may produce
dysfunctional eating habits and result in body fat levels
which drop too low (Steen, 1991; Wilmore, 1974). The
negative health consequences of anorexia and bulimia
(i.e., bingeing on food then purging) are great and
deserve attention, but it is important to realize that
this is not a problem which is caused by
exercise, but rather by psychological issues in the
life of girls (see also Section II: Psychological Dimensions,
on the psychological effects of exercise on girls).
Female athletes who participate in sports where body
weight and appearance are considered to be essential
components for optimal performance (e.g., distance runners,
figure skaters, gymnasts and dancers) are particularly
vulnerable to this problem (Montgomery, 1991).
A survey by Rosen and Hough (1988)
indicated that one hundred percent of gymnasts studied
were on a diet, 62 percent were using a method of weight
control that was extreme, and 75 percent were told by
their coaches that they had to lose weight. Similar
observations have been reported in ballet dancers (Braisted,
Mellin, Gong, & Irwin, 1985). Although data are
lacking, it seems reasonable to conclude that adolescent
female athletes involved in sports where weight and
body fat are predictors of successful performance, have
an increased risk for developing disordered eating patterns.
In addition, it should be noted that
the presence of disordered eating is not only seen in
elite-level athletes but also among young girls who
strive to be elite-level performers. Young athletes
who are not particularly successful in sport may also
be susceptible to this problem as they see dietary practices
as something they can control and use to please their
coach or parent despite the fact that high level performance
is not possible.
POTENTIAL LONG-TERM EFFECTS
OF PHYSICAL ACTIVITY
Children grow into adulthood with
the body they have lived with and nurtured or abused
while growing up. Much of the early support for physical
activity for children focused on the advantages of adequate
strength and flexibility in the prevention of low-back
pain and the importance of regular physical activity
to prevent obesity. However, in recent years, the focus
has expanded to include the positive effects of physical
activity on chronic diseases, some of which often begin
in childhood and adolescence and may later manifest
in adulthood (e.g., cancer, diabetes, osteoporosis,
heart disease) (Després, Bouchard, & Malina,
1990).
Moderate to high levels of physical
activity, and the consequent increase in health-related
fitness, are important for children for at least three
reasons: (a) they may lead to a habit of physical activity
which may carry over to adulthood; (b) they may contribute
to overall health status in later life; and (c) they
may have a preventive function in some adult diseases.
As Bar-Or and Malina (1995) have suggested, there are
at least two reasons for encouraging active lifestyles
in girls:
- Regular physical activity
during childhood and youth may prevent or impede the
development of several adult conditions in which physical
inactivity is only one part of a complex, multifactorial
etiology (e.g., obesity, degenerative diseases of
the heart and blood vessels and musculoskeletal disorders,
specifically osteoporosis and low-back syndrome).
- Habits of engaging in regular physical
activity developed during childhood and adolescence
may persist into adulthood and thereby reduce the
later incidence of such conditions. (p. 107)
There is growing evidence about the link between several
prominent adult degenerative diseases and the lack of
adequate physical activity and improper diet. This seems
to suggest that there are potentially positive effects
from physical activity in childhood and the consequent
likelihood of developing a lifestyle and attitude that
may encourage continued activity as adults. In particular,
the apparent link between physical activity and coronary
heart disease, diabetes, obesity and osteoporosis seems
to suggest a preventive function for physical activity,
exercise and sport participation.
Coronary Heart Disease
It was noted in the recent Surgeon
Generals Report on Physical Activity and Health
(U.S. Department of Health and Human Services, 1996)
that, in the United States, coronary heart disease has
a higher mortality rate than all types of cancer combined.
The disease is thought to begin in childhood and results
in atherosclerotic plaques lining the arteries of the
heart and reducing blood flow and oxygen delivery to
the heart. The primary pathology associated with coronary
heart disease (CHD) is atherosclerosis, which is linked
to elevated blood cholesterol levels and hypertension.
There appears to be a direct link between CHD and elevated
levels of total cholesterol, low-density lipoprotein
cholesterol (LDL), very-low- density lipoprotein cholesterol
(VLDL) and low levels of high-density lipoprotein cholesterol
(HDL) (National Cholesterol Education Program [NCEP],
1991).
Children who have higher than average
levels of body fat reportedly have a greater risk for
elevated blood pressure, total cholesterol and LDL cholesterol
(Williams et al., 1992). The link here is dramatic,
because children who have high levels of cholesterol
are almost three times more likely than other children
to have high cholesterol levels as adults (NCEP, 1991).
In a major review article examining
relationships among physical activity, nutrition and
chronic disease, Blair et al. (1996) found that the
best strategies for lowering cholesterol levels appear
to be a combination of diet and exercise. These authors
also discovered that exercise may be beneficial because
it lowered blood pressure, perhaps through decreased
cardiac output and decreased peripheral resistance,
and exercise may also reduce the risk of thrombosis
because of positive effects on blood clotting. It is
important to note that this major review examined studies
which sampled males and females across the lifespan.
Cancer
The link between cancer and exercise
is probably intimately related to diet and body composition.
Obesity is associated with an increased risk for endometrial
and gall-bladder cancers in women and the magnitude
of excess weight is also related to breast cancer in
postmenopausal women (Kimm & Kwiterovich, 1995).
Though little evidence exists that the physical activity
of girls directly affects such cancers, it is likely
that establishing a habit of regular exercise may continue
into adulthood and aid in the maintenance of appropriate
weight.
Few studies have been done that are
prospective or that begin with younger women. One exception
is a case-control study by Bernstein, Ross and Henderson
(1992). These authors reported that with respect to
cancer, a strong link exists between exercise and menstrual
cycles. The authors also state that for every year that
menarche is delayed, breast cancer is reduced five to
15 percent. Finally, these authors found that women
who start menstruating at an early age, and establish
regular cycles quickly, have a higher risk of cancer
than those with later menarche or irregular cycles.
This is a particularly salient finding because later
onset of menarche and/or irregular cycles are typical
of girls who participate in high levels of training
associated with interscholastic or intercollegiate athletics.
One promising development is that
estrogen-dependent cancers (breast, endometrial and
ovarian) may be less prevalent in women who exercise
regularly, especially those for whom exercise is part
of their occupation. Kramer and Wells (1996) have postulated
four mechanisms which might account for the preventive
effects of exercise on these cancers:
- Maintenance of low body fat
and moderation of extraglandular estrogen
- Reduction in number of ovulatory
cycles and subsequent diminution of lifetime exposure
to endogenous estrogen
- Enhancement of natural immune
function
- The association of other healthy
lifestyle habits (p. 322)
Questions remain regarding the link between physical inactivity
and increased incidence of estrogen-dependent cancers;
further research is thus needed in this area. One of the
difficulties in interpreting these data is the confounding
variable of body mass. It is not absolutely clear if the
beneficial effects result from the physical activity itself,
or are the result of less body fat because of an active
lifestyle. High body fat and obesity are related to low
levels of sex-hormone binding globulin (SHBG), which is
the primary carrier for estradiol, an active form of endogenous
estrogen. These low levels of SHBG may facilitate more
free estradiol which may stimulate tumor growth (Bernstein
& Ross, 1993). Further research is needed in this
important area of investigation.
Another link to physical activity
and reduced cancer may be the effect of serious training
on menarche. Research has suggested that the risk of
breast cancer is reduced up to 15 percent for each later
year of age at menarche (Hsieh, Trichopoulos, Katsouyanni,
& Yuasa, 1990). Women whose natural menopause occurs
before age 35 have been found to have a decreased incidence
of breast cancer, while those with natural menopause
after age 55 have an increased incidence. This may suggest
an association between the cumulative number of ovulatory
menstrual cycles and estrogen-dependent breast cancer
(Kampert, Whitemore, & Paffenbarger, 1988). If this
is true, an increase in physical activity during adolescence
may be an ideal nonhormonal approach to decrease the
number of lifetime ovulatory cycles and reduce exposure
to estrogen (Bernstein et al., 1992).
Diabetes Mellitus
Diabetes mellitus is one of the ten
most prevalent causes of death in the United States
(Blair et al., 1996). Many of the debilitating effects
of diabetes are associated with the increased risk of
heart disease and hypertension. Developing the habit
of exercise as a child may help to maintain activity
levels into adulthood.
Noninsulin dependent diabetes (NIDDM),
known as the insulin-resistance/ hyperinsulinemia
syndrome (Blair et al., 1996, p. 336), often occurs
with other problems such as hypertension, hyperlipidemia
and atherosclerosis. Regular exercise is important in
both the prevention and management of NIDDM by increasing
glucose transporter concentration and disposal and by
increasing insulin sensitivity and lowering plasma insulin
concentrations (Horton, 1986). Women who participate
in vigorous exercise at least once per week have shown
a reduced risk of NIDDM (Manson et al., 1991), while
children (both obese and lean) have better glucose control
in response to regular exercise (Zierath & Wallberg-Henriksson,
1992).
Osteoporosis and General
Bone Health
The decrease in bone mass that accompanies
the aging process and the loss of estrogen levels after
menopause often results in osteoporosis. The risk factors
associated with osteoporosis include age, race, height-to-weight
ratio and menopause in women. The three most important
factors that contribute to healthy bones appear to be
hormonal, nutritional and mechanical (Blair et al.,
1996). Because there is no cure for this condition once
it occurs, efforts must focus on prevention.
In young childhood and adolescence,
the development of peak bone mass is directly affected
by regular physical activity combined with adequate
calcium and vitamin D intake. Greater bone mass develops
due to weight bearing, which is most often experienced
during physical activity, and helps to protect against
osteoporosis later in life when bone loss occurs. In
fact, it is essential to place demands on bone for it
to remain healthy. For example, a young adult at bed-rest
for one week will lose about one percent of spinal density,
which could take up to four months to regain (Krolner
& Toft, 1983). In contrast, it has been found that
young tennis players have higher bone density in their
preferred (racket holding arm) than in their other arm,
thus supporting the positive role of placing demands
on bone (Jacobson, Beaver, Grubb, Taft, & Talmage,
1984).
In order for bones to grow properly,
it is important for children, particularly adolescents,
to participate in regular (preferably daily) physical
activity (Kimm & Kwiterovich, 1995). The growth
and development of children should also be monitored
in terms of optimal weight and the balance of strength
and flexibility. Because weight is linked to spinal
bone density, it is critical to monitor underweight
children carefully. In particular, any adolescent female
who is very lean, has an eating disorder or has amenorrhea
should be considered at high risk for osteoporosis (Ponder
et al., 1990).
The interrelationships among such
chronic diseases as diabetes, coronary heart disease
and stroke argue for a greater need to maintain appropriate
weight levels based on ones age, body size and
structure. At the same time, caution should be used
in overtraining as bone-mineral density may be compromised,
especially when linked to amenorrhea.
CONCLUSIONS AND RECOMMENDATIONS
Physical activity, which includes
the opportunity to develop an active lifestyle, to be
physically fit and to acquire fundamental motor skills,
can positively impact the overall health of girls in
several ways. For example, increased fitness levels
can contribute to better posture, the reduction of back
pain and the development of adequate strength and flexibility,
qualities which allow girls to participate fully in
their daily activities, both vocational and recreational.
The information presented below represents a summary
of the contributions of sport and physical activity
to the health and fitness of girls, as well as some
recommendations for ensuring that all girls benefit
from such involvement.
- Girls participation
in physical activity and sport positively impacts
their aerobic power by increasing V.O2
max stroke volume, O2 uptake and ventilatory
capacity. Additionally, girls can accrue strength
gains through increased muscle activation, improve
flexibility due to increased range of motion and perhaps
enhance immune functioning (Rowland, 1990).
- Girls early involvement
in physical activity and sport can reduce the likelihood
of developing a number of deleterious health-related
conditions. For example, being physically fit positively
influences blood lipid profiles which in turn minimize
the development of atherosclerosis. In addition, the
increased caloric expenditure of active girls decreases
their risk of becoming obese (Rowland, 1990).
- There is a growing public
health consensus (McGinnis, 1992) that diet
and physical exercise patterns have a synergistic
effect in reducing mortality (Blair et al.,
1996, p. 341). However, professionals must remain
cognizant of the potential health concerns associated
with high levels of physical activity and overtraining,
as well as some sport participation, namely, athletic
injuries and the development of amenorrhea, which
may be linked to osteoporosis in post-menopausal women.
We must establish and maintain health- and fitness-related
programs to reduce the occurrence of such deleterious
conditions.
- Given that the biophysical
benefits of exercise for girls dramatically outweigh
the disadvantages, mechanisms providing opportunities
for enhanced physical activity must be developed and
supported. Independently organized clubs and sports,
recreational programs and school-based physical education
and sport programs are ideal ways to facilitate both
health-related fitness and the acquisition of fundamental
motor skills for a lifetime of activity.
- The United States Department of
Health and Human Services document, Healthy
People 2000: National Health Promotion and Disease
Prevention Objectives (1991), recommends that
the daily physical education rate for school-aged
children should reach 50 percent by the year 2000.
In all probability, this recommendation will not be
attained because even once-per-week participation
rates barely meet this standard. There has been a
statistically significant decline in overall daily
physical education attendance in grades nine to 12
from 41.6 percent to 25.4 percent from 1991 to 1995
(U.S. Department of Health and Human Services, 1996).
Many sources, including the National Children and
Youth Fitness Study I (NCYFS I) (Ross & Gilbert,
1985) and NCYFS II (Ross & Pate, 1987), have identified
the availability of daily physical education programs
as the key to improved health and fitness for our
children.
DIRECTIONS FOR FUTURE RESEARCH
A great deal of information is available
about the effects of physical activity on the biophysical
characteristics of girls. However, numerous issues remain
unresolved.
- Determine optimal levels
of physical activity. The daily life of active girls
seems to be adequate for growth and maturation. However,
for girls in school, or for those who have difficulty
with weight maintenance, enhanced levels of activity
have beneficial effects on health, while relative
inactivity has deleterious effects. It has been recommended
by the United States Department of Health and Human
Services (1991) that all children participate in daily
physical education. This seems like the appropriate
delivery mechanism to ensure that all children, without
respect to gender, ethnicity or socioeconomic status,
have access to this foundation for healthy adulthood.
- Research should establish
guidelines for appropriate levels of training so that
parents and coaches can capitalize on appropriate
activity levels and sport experiences. When establishing
such guidelines, scholars should consider areas that
are particularly critical for girlsthe prevalence
of overuse injuries and issues related to body composition
(i.e., the relative amounts of fat and lean mass).
Specific guidelines for appropriate levels of activity
can prevent, for example, injuries due to excessive
training and/or early specialization in one sport.
Additionally, appropriate levels of training and activity
can minimize an undue focus on body composition (e.g.,
body image) that can contribute to eating disorders
or excessive exercising for the purpose of weight
control.
- Develop and implement motivational
strategies encouraging physical activity during childhood
and into adulthood. Girls who begin exercise and sport
programs outside of school often drop out due to competing
desires and time pressures. This trend may extend
into adulthood where currently less than 25 percent
of adults exercise regularly and may drop out of even
the most well-meaning exercise programs (Blair et
al., 1996). Research studies must be conducted to
develop and empirically support strategies which emphasize
the importance of regular physical activity and to
motivate young girls and adults to participate.
- Identify the role of physical
activity in health-related problems for girls. A significant
childhood health problem is obesity. The combination
of increased physical activity and decreased caloric
intake is the most effective technique for weight
control. In addition, the management of several childhood
diseases is enhanced by regular exercise, but physical
activity and exercise may be more difficult due to
other life changes that often accompany these conditions
(e.g., diabetes and cerebral palsy). There is need
for increased research focusing on the diverse ways
in which physical activity can be used in the management
of a variety of health problems of children and teenagers.
- Determine the links between
early childhood behaviors and risk factors for serious
disease in adults. It appears that many of the chronic
diseases of adulthood have their biological
and ecological roots in childhood (Kimm &
Kwiterovich, 1995, p. 269). Research is needed to
identify prudent preventive strategies which can be
encouraged for all children, particularly those at
risk for chronic diseases.
- Delineate the factors that impact
the association between exercise and reproductive
functioning. The delay in menarche, which sometimes
accompanies strenuous exercise and training, may have
both positive and negative consequences. More research
is needed on the relationship between the type and
level of exercise, and various factors related to
reproductive functioning such as the onset of menarche,
risk of estrogen-linked cancers, bone density and
osteoporosis, and amenorrhea.
SECTION II:
Psychological Dimensions
DIANE WIESE-BJORNSTAL, PH.D., UNIVERSITY OF MINNESOTA
ACCORDING TO A RECENT STATEMENT issued by the International
Scientific Consensus Conference on Physical Activity,
Health and Well-Being (Research Quarterly for Exercise
and Sport, 1995), physical activity positively influences
physical and psychosocial health at all stages of the
life cycle; thus, the promotion of physical activity
is an effective means of improving health and
enhancing function and quality of life (p. v).
As young girls and women have increased their involvement
in physical activity and competitive sport, there have
indeed been corresponding psychological benefits. Some
of these benefits include enhanced motivation, increased
self-esteem and improved mood states. Although participation
in physical activity is an overwhelmingly positive experience
for the vast majority of girls, some negative factors
associated with participation in physical activity may
include increased stress and anxiety, greater tolerance
for aggression and the use of pathogenic (i.e., potentially
injurious) weight control methods such as self-induced
vomiting and the use of laxatives, diet pills and/or
diuretics. Psychological benefits are integrally linked
with the physical and social dimensions of female sport
involvement and must be interpreted in light of these
disciplines as well (Weiss & Glenn, 1992).
The existing research on the psychological
dimensions of girls physical activity participation
is quite limited (Dewar & Horn, 1992; Gill, 1993),
and there is even less on those girls from diverse racial
and ethnic backgrounds (Duda & Allison, 1990) or
with disabilities (Steadward & Wheeler, 1996). However,
this is not to suggest that nothing is known about the
psychological impact of sport and physical activity
in the lives of females. What is known is based upon
major themes that have emerged in the research literature
of sport psychology: motivation, self-perceptions, moral
development, emotional well-being, stress and anxiety,
body image and disordered eating. Each of these major
themes or areas of investigation is highlighted below.
The concluding section presents specific directions
for much needed research as well as practical suggestions
for those working with young girls in physical activity
contexts.
MOTIVATION
It is clear from the vast body of
information on why youths play organized sport that
girls and boys are more alike in this respect than they
are different. Children and adolescents often have multiple
motives for participation in organized sport, with having
fun rated as the most important motive for both
boys and girls. Other primary reasons that children
play organized sports typically include improving skills,
being with friends, becoming physically fit, liking
the challenges and experiencing success (Weiss &
Petlichkoff, 1989). A recent diverse, nationwide survey
of ten thousand boys and girls ages ten to 18 found
that when asked about their reasons for playing their
best school sport, girls rated to have fun
first, followed by to stay in shape, to
get exercise and to improve skills
as their next most important reasons (Ewing & Seefeldt,
1989). The Wilson Report: Moms, Dads, Daughters
and Sports (1988) also found that girls who participate
in sports most often report fun as their major motive,
with physical, health and social factors frequently
mentioned. The majority of motives cited, and certainly
the most important motives, are intrinsic or internally-based,
rather than extrinsic or externally-based. Only limited
research is available on motives for exercise, as opposed
to competitive sport involvement, in youngsters (Rowland,
1990), though one study of junior high-school students
revealed that girls exercised primarily because they
wanted to look better whereas boys wanted to have fun
(Godin & Shephard, 1986).
Those children who leave organized
sport, either temporarily or permanently, also tend
to have multiple reasons for sport withdrawal. Though
these reasons are primarily centered on conflicts of
interest and wanting to do other things, children also
cite injury, lack of fun and skills not improving as
reasons for withdrawal (Weiss & Petlichkoff, 1989).
Petlichkoff (1996) placed sport withdrawal on a continuum,
because many children who drop out of one sport often
move on to try another sport or activity and are really
sport transfers rather than sport dropouts.
Children and adolescents who withdraw from sport entirely
tend to have lower perceptions of their sport ability
than those who remain involved. The important role of
having confidence in ones physical abilities will
be examined in the self-perceptions section.
Examining motivation on a more theoretical
level, Gill (1992) defined the construct of sport orientation
noting three distinct dimensions: competitiveness, win
orientation and goal orientation. Competitiveness is
an achievement orientation focused on entering and striving
for success in competitive sport. Win orientation represents
a desire to win and avoid losing in competitive sport,
while a goal orientation places an emphasis on achieving
personal goals in competitive sport. There are consistent
gender differences in sport orientation; notably, females
typically score higher on goal orientation, while males
typically score higher on competitiveness and win orientation.
Research by Garcia (1994) provides an example of how
this affects the learning of physical activities. This
field study of a culturally, racially and socioeconomically
diverse sample of preschool children found that girls
were cooperative, sharing and caring when learning fundamental
motor skills; competitiveness seemed to inhibit their
ability to learn efficiently. Girls cooperated with
and supported their friends who were practicing motor
skills, while boys adopted a competitive, egocentric
practice style. Interestingly, Asian girls and boys
both adopted the cooperative learning style, reinforcing
the notion of socially constructed and culturally developed
gender differences in behavior patterns. Activities
allowing for social interaction and cooperative learning
can enhance girls learning of motor skills. Gill
(1992) has suggested that competition and a focus
on winning may act as extrinsic motivating forces to
decrease intrinsic motivation and that the undermining
of intrinsic motivation is especially likely for females
(p. 149).
Related to the overall motivation
of youth in physical activity settings are their attributions
or perceived causes for success and failure in achievement
areas such as sport. These attributions are important
because they affect emotions as well as future expectations
and motivated behavior. Competitive athletes typically
make more internal than external attributions for both
success and failure in sport; however, some interesting
ethnic and gender differences have emerged. For example,
in their survey of the attributional literature in competitive
sport, Morgan, Griffin and Heyward (1996) noted that
when explaining why they are successful in sport, Caucasian
females, Hispanic athletes and Navajo athletes emphasize
the controllable aspect of effort while African-American
and Caucasian males emphasize their ability. Related
to failure in sport, Caucasian females, Navajo athletes
and Hispanic athletes tend to emphasize low ability,
whereas Caucasian males attribute the cause of failure
to low effort. Morgan et al. (1996) reported the results
of their own study of the role of ethnicity, gender
and experience in attributions for success and failure
among male and female high-school track and field athletes
(ages 13 to 18). Success in sport was deemed more internal,
controllable and stable than failure for both girls
and boys across all levels of experience. However, Caucasian
children perceived success in sport as more internal
and controllable than either African-American or Native-American
children. Outside of the competitive sport context,
attributions are also important in understanding the
motivated behavior of children in broad based physical
activity programs. One study looked at eight to 13 year-
old boys and girls attending an educational summer sports
program. Findings showed that children higher in self-esteem
made attributions for their physical competence that
were more internal, stable and personally controllable
than did low self-esteem children (Weiss, McAuley, Ebbeck,
& Wiese, 1990). This key finding documented that
children in physical activity settings tend to make
attributions consistent with the way they view their
abilities, supporting the importance of enhancing self-
perceptions as a means of encouraging motivation for
physical activity participation. Parents, teachers and
coaches who provide encouragement and feedback to girls
practicing physical skills should focus on combining
contingent feedback and praise with skill-relevant information
on how to improve in future attempts in order to enhance
the self-perceptions and motivated behavior of girls
(Horn, 1987).
In sum, it appears that girls typically
have multiple motives for participation in physical
activity and that for optimum enjoyment of the physical
activity experience, varied opportunity to meet these
motives should be provided. The motivational orientation
of girls, however, may be somewhat different from boys
in physical activity settings and consideration needs
to be given to developing programs to meet their needs.
Motivational dimensions of girls participation
are integrally linked with self- perceptions, which
is the topic of the next section.
SELF-PERCEPTIONS
The following section summarizes
the available information on several slightly different
yet related constructs: self-esteem, self-concept, self-confidence,
perceptions of competence and self-efficacy. One leading
expert in sport psychology has suggested that all of
the self-perception constructs essentially refer to
the description of, evaluation of and affect toward
ones competencies (Weiss, 1993, p. 41).
Regardless of the label used, these are all important
for understanding the psychological dimensions of young
girls participation in physical activity because
self-perceptions are predictive of both positive emotions
and actual behavior in achievement settings such as
sport (Weiss, 1993).
Among secondary physical education
instructors, 59 percent said that self-esteem (or self-regard
related to Who am I and How do I regard
myself) was a primary benefit of physical fitness
(Chrysler FundAmateur Athletic Union, 1989). McAuley
(1994) also reported that self-esteem development was
one of several positive psychosocial outcomes related
to exercise and physical activity participation. He
noted that 69 percent of the studies reviewed supported
a positive relationship between physical activity and
psychological well-being. Another examination of multiple
studies on this topic found a positive association between
physical activity and self-esteem in children (Gruber,
1986). Gruber noted that emotionally disturbed, mentally
handicapped, perceptually handicapped and economically
disadvantaged children showed greater gains in self-concept
as a result of physical activity than other children.
Three recent studies by the Melpomene Institute examined
the relationship between self-esteem and physical activity
in female children (Jaffee & Manzer, 1992) and adolescents
(Jaffee & Ricker, 1993; Jaffee & Wu, 1996) from
diverse geographic, economic and racial backgrounds.
The findings were remarkably similar across both age
groups (ages nine to 12 and 12 to 17, respectively).
The primary reason girls engaged in physical activity
was to have fun, followed by positive health benefits.
All three studies found a strong positive relationship
between physical activity and self-esteem. Girls who
felt most confident about themselves and their abilities
were more likely to participate in physical activities
at higher levels than girls who felt less confident.
Younger girls derived positive self- esteem through
challenge, achievement in sports, risk-taking experiences
and skill development, while older girls cited these
sources of self-esteem as well as gaining esteem from
the approval of others and through a belief that girls
are capable of playing sports well.
Exercise programs, particularly weight
and strength training, can enhance the self-concepts
of adolescent female participants as well (Gill, 1993).
For example, Brown and Harrison (1986) found that participation
in a 12-week program of weight training significantly
enhanced self-concept in both younger and older girls
and women. Another study examined the use of competitive
and cooperative physical fitness programs with high-school
girls (Marsh & Peart, 1988). Both the competitive
and cooperative programs resulted in enhanced physical
fitness; however, the cooperative program enhanced physical
ability self-concept and physical appearance self-concept,
while the competitive program lowered them. The competitiveness
of physical education programs was one of the more negative
aspects of the experience for girls. Reinforcing this
finding was a study of young girls (Jaffee & Manzer,
1992) in which several reported not liking the competitive
nature of fitness testing in their physical education
classes. When asked to complete physical education task
challenges, these girls preferred working with small
groups as opposed to engaging in individualistic, competitive
activities.
Moving from more global measures
of self-esteem and self-concept as associated with physical
activity participation, researchers have also examined
more specific aspects of self-confidence in physical
activity abilities. There is, however, some debate as
to the interaction of physical activity and confidence.
For example, a recent synthesis of multiple studies
by Lirgg (1991) examined the magnitude of gender differences
in self-confidence in physical activity and found that
gender differences were fairly small, with boys having
greater confidence. One explanation for this finding
was the perceived gender appropriateness of physical
activity tasks. As summarized by Gill (1992), when
tasks are perceived as appropriate for females, when
females and males have similar experiences and capabilities
and when clear evaluation criteria and feedback are
present, females and males display similar levels of
confidence (p. 150). Further examination of the
perceived appropriateness of physical tasks
is necessary to help clarify these relationships (see
also Section III: Sociological Dimensions). It is also
important to note the possibility that girls assessments
of their abilities are more accurate than boys,
who may tend to overestimate their actual abilities.
Research by Eccles and Harold (1991)
has evaluated the way gender role stereotypes affect
sport confidence, even at an early age. In a survey
of 875 elementary school children (third to sixth grades),
even though girls scored only two percent lower than
boys on a battery of motor skills tests, girls self-
rated their skills as 14 percent lower than boys. Apparently
even by the first grade, girls assess their general
athletic ability more negatively than do boys in spite
of their objective equality in skill. Both boys and
girls felt it more important for boys than girls to
have ability in sport. The more girls saw sport as appropriate
for girls, the higher their estimates were of their
own ability in sports. To the extent that children thought
their parents valued sport competence they rated their
own sport competence higher.
Other research has also documented
the critical role of parents and other significant individuals
such as coaches and peers in developing girls
physical self-perceptions. For example, in terms of
the role of significant others in encouraging physical
activity, one interesting difference between younger
(Jaffee & Manzer, 1992) and older (Jaffee &
Ricker, 1993) girls noted in the Melpomene studies was
that younger girls cited parents as a more important
source of encouragement and information than did older
girls, who cited peers as more influential. Weiss and
Ebbeck (1996) have documented this tendency for children
of different ages to use different information sources
as a basis for physical competence judgments. Children
under the age of ten rely more on adult comments, from
ages ten to 14 rely more on peer comparison and evaluation
and from ages 16 to 18 rely more on self-referenced
information. There do not appear to be gender differences
in these dominant sources of information in early childhood.
In adolescence, however, females place greater emphasis
on the use of self-comparison and comments from adults
than males, who rely on competitive outcomes and ease
of learning skills as their basis for personal judgments
of physical competence (Weiss & Ebbeck, 1996).
Given that girls rely on adult comments,
it is important to realize that parents in particular
play an important role in the affective responses of
children to physical activity participation (Brustad,
1996). Children are more likely to enjoy their sport
experience if they perceive that their parents have
realistic expectations, provide support and encouragement
for their efforts and respond infrequently with negative
evaluations of their performance. Unfortunately, girls
perceive themselves to have lower competence in sport,
assign less importance to sport and perceive less parental
encouragement for participation than do boys (Brustad,
1993a). Attitudes toward physical activity were somewhat
different among parents of girls from various cultural
groups in the Melpomene studies (Jaffee & Ricker,
1993). A focus group of Hmong girls, for example, said
their parents held differential attitudes about physical
activity for boys and girls. Parents deemed participation
in physical activity as childish for older
girls in the Hmong culture, but acceptable for older
boys. The Wilson Report: Moms, Dads, Daughters
and Sports (1988) identified race and gender differences
in parental attitudes toward physical activity for their
children as well. In their survey of more than one thousand
parents, African-American parents were significantly
more likely than Caucasian parents to say that sports
were more important for boys than girls. Peer groups
are also important influences on self-perceptions, as
highlighted by Weiss and Duncan (1992). In a study of
eight to 13-year-old males and females enrolled in an
educational summer sport program, children higher in
both actual and perceived physical competence had better
levels of acceptance among their peers.
To summarize, self-perceptions are
strongly connected to motivated behavior in physical
activity settings. It appears to be a cyclic relationship,
in that better perceptions of oneself and ones
abilities lead to enhanced effort, persistence and achievement,
which in turn further benefit self-perceptions. The
role of significant others is critical in positively
affecting this cycle. Parents, coaches, and peers should
be realistic, supportive and encouraging in reinforcing
girls capabilities in physical activity.
MORAL DEVELOPMENT
Participation in sport and physical
activity certainly has the potential to act in a positive
fashion, affecting moral development through such processes
as observing positive role models in coaches, parents
and other children (Martens, 1993) and having the opportunity
to engage in prosocial, or ethical, behavior. However,
adult leaders must explicitly encourage this development.
For example, in a field study of students in a fifth-grade
physical education class, systematically structured
activities elicited more mature moral reasoning strategies
than did traditional teaching approaches (Romance, Weiss,
& Bockoven, 1986). These structured moral development
activities emphasized the students rights and
responsibilities in the gymnasium and consisted of incorporating
moral dilemmas and resolution strategies into basketball,
gymnastics and physical fitness instruction units. A
recent investigation involving more than four hundred
female and male physical education class students in
fourth, fifth and sixth grades similarly noted that
the implementation of a specially designed moral education
program resulted in positive changes in several facets
of moral development (Gibbons, Ebbeck, & Weiss,
1995).
Although sport is often proclaimed
a character-building activity, organized childrens
sports programs may develop negative character instead.
When children observe other children and adults cheating,
engaging in aggressive behavior and successfully using
intimidation to achieve desired goals (Martens, 1993),
it may undermine the positive moral development which
can occur. A number of scholars have provided empirical
support for such claims. For example, Bredemeier and
Shields (1993) examined the relationship between moral
reasoning (i.e., the decision process that determines
the rightness or wrongness of a course of action) and
tolerance for aggressive actions. A study of children
ages nine to 13 (Bredemeier, 1994) found that those
more mature in moral reasoning described themselves
as more assertive and less aggressive in response to
conflict situations than children with less mature moral
reasoning. Among girls and boys in grades four to seven,
girls participation in medium contact sports (i.e.,
basketball and soccer, the highest level of contact
sport reported for girls) was associated with less mature
moral reasoning and greater tendency to aggress (Bredemeier,
Weiss, Shields, & Cooper, 1986). In a study examining
the relationship between motivational orientation and
moral behavior among ten to 14-year old female soccer
players (Stephens & Bredemeier, 1996), those players
who were more ego-oriented (similar to the win
orientation described earlier) were more tempted to
violate moral norms (e.g., lying to an official, hurting
an opponent or breaking one of the rules).
Game reasoning
is one explanation that has been offered to describe
the less mature moral reasoning and increased tolerance
for aggression common in sport; the unique, egocentric
context of competitive sport encourages legitimized
regression to less mature moral reasoning (Bredemeier
& Shields, 1996). For example, among the soccer
players described above (Stephens & Bredemeier,
1996), greater temptation to play unfairly was associated
with greater approval of behaviors designed to obtain
an unfair advantage over an opponent and the belief
that many of their teammates would play unfairly in
the same situation. This game reasoning
view represents a double standard and is problematic
both in terms of the messages it conveys to young athletes
and in terms of the increased risk of injury and harm.
Other research in sport has supported
more general findings that females accept and express
less aggression than males (Bredemeier & Shields,
1993). In a study of male and female high school basketball
players and nonathletes, no moral reasoning differences
between athletes and nonathletes were observed. However,
high-school females reasoned at a more mature level
than males in response to both sport and life dilemmas
(Bredemeier & Shields, 1986).
The key to establishing positive
relationships between physical activity participation
and moral development seems to be in the provision of
quality, adult leadership that places high priority
on the development of prosocial or ethical behavior
in sport and physical activity settings. As Gibbons
et al. (1995) concluded, enhancing moral growth
is not an automatic consequence of participation in
physical activity (p. 253). To attain these positive
benefits, deliberate and systematic focus on moral development
is essential.
EMOTIONAL WELL-BEING
Physical fitness is positively associated
with mental health and well-being. Exercise has beneficial
emotional effects across all ages, in both sexes and
among those differing in health status (Biddle, 1995;
Morgan, 1994). It is apparent from the existing research
that adults and youth alike consider mental health an
important benefit of physical activity participation.
The Wilson Report: Moms, Dads, Daughters and Sports
(1988) surveyed parents of girls ages seven to 18 and
found that 41 percent of the parents believed that promoting
mental health was an important benefit of sport involvement
for their daughters (see also Section IV: Mental Health
Dimensions).
An examination of the exercise and
mental health literature specifically related to young
females and subgroups of young females (e.g., those
with physical disabilities) reveals a paucity of research
(Willis & Campbell, 1992). However, the few studies
that have been conducted in this area yield promising
results. Two experimental programs involving minority
adolescent youth combined physical activity with stress
management and other health education strategies and
found that these components resulted in positive physical
and psychosocial outcomes (Fardy et al., 1995; Fardy,
1988). A cross- sectional study of 220 adolescent females
investigated the relationship between physical activity
and physical and emotional distress accompanying periods
of high stress. Participants classified as low exercisers
experienced significantly more stress and ill effects
than high exercisers or those who adhered to a regimen
of vigorous physical activity (Brown & Lawton, 1986).
As illustrated by the above findings,
physically active individuals typically have lower levels
of depression (Morgan, 1994) and anxiety (Landers &
Petruzzello, 1994) than sedentary individuals. Given
this relationship, there is a growing interest among
health care professionals in the role played by physical
activity in preventing the onset of emotional problems
and in serving as a treatment adjunct once such problems
have developed (Landers & Petruzzello, 1994). For
example, in the treatment of anxiety disorders, many
physicians routinely prescribe exercise as part of a
patients therapy (Ryan, 1983). One study of youth
(ages six to 13) found that incorporating running into
a treatment program for emotional and behavioral disorders
improved their emotional states (Shipman, 1984). In
a recent review paper, Biddle (1995) documented that
exercise is associated with small to moderate reductions
in anxiety. When comparing anxiety scores before and
after engaging in an exercise program, participants
tend to report lower anxiety scores after an aerobic
exercise training program. It is not clear, however,
that exercise produces larger anxiety reductions than
other interventions such as meditation, resting or reading
(Weinberg & Gould, 1995). It does seem that individuals
who are initially in poor physical condition or are
highly anxious achieve the greatest reductions in anxiety
from an exercise training program. In dealing with depression,
various modes of exercise have been shown to have a
moderate effect in reducing depression (Biddle, 1995).
It has been demonstrated, for example, that among individuals
who are moderately depressed at the time of exercise
program initiation, the adoption of aerobic exercise
is associated with decreased depression. (See also Section
IV: Mental Health Dimensions.)
Conversely, it is also essential
to consider the possible negative consequences of exercise
involvement as studies have linked some negative outcomes
to excessive exercise. According to Johnsgard (1989),
exercise is not inherently dangerous or abusive,
but it is not without its risks (p. 269). Several studies
have shown that mood states can worsen with increased
training volumes (Morgan, 1994). For example, healthy,
nondepressed individuals may become depressed as a result
of high training loads (i.e., overtraining). Exercise
that becomes an addiction or compulsion may also lead
to adverse psychological effects. Sachs and Pargman
(1984) refer to excessive chronic exercise as an addiction
which can control the persons life
(p. 249). Addictive exerciseexcessive chronic
exercisemay lead to such problems as decreased
ability to concentrate, social problems, fatigue, judgment
difficulties, anxiety and depression (Sachs & Pargman,
1984; Shisslak & Crago, 1992; Singer, 1992). It
must be emphasized, however, that moderate exercise
has never been shown to cause these types of psychological
harm (Martinsen & Stephens, 1994).
In general, it appears that participation
in physical activity can have a mental health buffering
effect before the onset of problems, and a beneficial
treatment effect in alleviating existing negative emotional
states. Participation in excessive levels of exercise,
however, can have deleterious effects on emotional well-being.
Involvement in highly competitive youth sport can also
result in negative effects, as illustrated in the subsequent
section.
STRESS AND ANXIETY
In addition to the anxiety-reducing
benefits of exercise just described, there are important
considerations in the competitive sport domain as well.
Competitive sport is an important achievement area for
children because physical competence is publicly demonstrated
and socially evaluated (Scanlan & Passer, 1979).
For the majority of young athletes, this situation does
not pose a problem; however, left unchecked, highly
competitive sport contexts can lead to stress and anxiety.
For example, in a significant number of children and
youth, particularly at the elite levels of competitive
sport, stress, anxiety and burnout are of major concern.
Stress is a process where there is
an imbalance between the perceived demand of the situation
and perceived ability of the individual to meet that
demand, particularly under conditions in which failure
to meet the demand has important consequences. Anxiety
has two major components: trait anxiety, considered
to be an enduring attitude or personality disposition,
and state anxiety, or a negative feeling experienced
at a particular point in time. Trait anxiety has been
consistently shown to influence ones level of
state anxiety (Gould, 1993).
Personal and situational factors
affect stress and anxiety both before and after a competitive
contest. Intrapersonal factors, which reflect perceived
inadequacy in successfully meeting demands of competition,
are related to pregame stress. These factors include
high competitive trait anxiety, low self- esteem and
low personal and team performance expectancies (Scanlan
& Passer, 1979). In a study of female basketball
players, Brustad (1988) found that players with high
competitive trait anxiety had lower self-esteem and
more frequent worries about evaluation and performance
than did their counterparts with low competitive trait
anxiety. Highly trait-anxious youngsters have less favorable
views of their own competence and frequent worries about
personal performance; in addition, they appear to worry
extensively about receiving negative performance evaluations
from others (Brustad, 1993b). Postgame stress is most
influenced by actual response in meeting demands of
competition. In one early study, game outcome dramatically
influenced postgame stress reactions in girls, such
that losers felt significantly higher stress than did
winners (Scanlan & Passer, 1979).
Burnout is a special form of sport
withdrawal and is a response to constant stress in which
a young athlete ceases to participate in a previously
enjoyable activity. The child may withdraw from sport
physically, psychologically or emotionally because of
her perception that it is impossible to meet the physical
and psychological demands associated with such activity
(Smith, 1986). On the basis of interviews with 15 adolescent
athletes who had burned out of sports in
which they had been intensively training, Coakley (1992)
found that these children (a) saw themselves and were
viewed by others only in terms of their specialized
athletic roles, and (b) were involved in power relationships
with others that left them feeling little sense of control
over their own lives. Both situational and personal
factors are associated with burnout in young athletes
(Gould, 1993). Situational characteristics include such
things as extremely high training volumes and time demands,
demanding performance expectations that are either imposed
by self or others, constant intense competition, inconsistent
coaching practices and little personal control in sport
decision-making. Personal characteristics include perfectionism,
a need to please others, nonassertiveness and unidimensional
self-conceptualizations focusing only on ones
athletic involvement.
Another troubling aspect of highly
intense sport experiences can be a win at all
costs philosophy which is emphasized in some elite
female athletic arenas. Controversial training methods
sometimes include verbal abuse and result in extensive
physical and emotional damage to these young women.
Ryan, a sports journalist, has reported that sometimes
girls are called fat cows by the coaching
staff. Not surprisingly, these athletes begin to get
a distorted view of what they should (and do) look like.
These elite girlsparticularly in gymnastics and
figure skatingare in a race against time
to transform into perfect little machines (Ryan,
1995, p. 31). However, machines do not have emotional
breakdowns, sustain psychological damage or commit suicide,
yet these are experiences for some elite young female
athletes. Coaches and trainers are in important positions
of influence and power over these girls (Shisslak &
Crago, 1992), and it is incumbent upon them to use such
influence wisely and in the best interest of the athletes,
rather than for personal glory or gain.
The focus of educators and coaches
working with young athletes affected by stress and anxiety
should be on emphasizing personal improvement rather
than absolute outcome. It is also essential to help
these girls maintain a healthy balance between the intense
demands of sport and other important areas of their
lives, such as academics and social development.
BODY IMAGE
From a psychological perspective,
there are very important concerns about the relationship
of body image to females attitudes about physical
activity and to actual behavior in sport and exercise
settings (Gill, 1993). Physical activity is associated
with enhanced self-esteem and body image (Plaisted,
1995; Snyder & Spreitzer, 1977) though female adolescents
in general report greater body image disturbances and
dissatisfaction than do males (Overdorf & Gill,
1994; Plaisted, 1995). Females are generally more negative
about their bodies and are concerned with physical beauty
and maintaining an ideal, thin shape (as identified
by media and societal images), whereas males are concerned
with size, strength and power (Gill, 1995). According
to Hart, Leary and Rejeski (1989), such dissatisfaction
with body image is associated with both low self-esteem
and depression. Both social and sport-based pressures
on female athletes to be thin can be implicated in this
excessive focus on appearance (Plaisted, 1995). For
example, societal pressure idealizing a body image that
is not particularly healthy or attainable for many females
has important consequences in terms of self-esteem and
disordered eating (see also Section III: Sociological
Dimensions). Although the ideal physique
in todays society is a slender, lean female body,
it is much less than ideal with respect to physical
and mental health (Gill, 1993). Sport-based pressures
may include factors such as negative comments from coaches,
teammates and officials and the standards and demands
of the specific sport. Females that do not match this
ideal, particularly those who are overweight or obese,
are evaluated negatively and discriminated against (Gill,
1993). For example, some elite female swimmers lose
self-esteem due to derogatory comments or punitive
measures for failing to meet what may be an unfair or
unhealthy assigned weight standard (Benson, 1991,
p. 107).
One key problem regarding body image
lies in the conflict between perception and reality.
Even in the face of objective evidence to the contrary,
many young females perceive themselves to be overweight.
Overdorf and Gill (1994) found that female adolescent
athletes perceived their bodies as heavier than they
actually were. In their sample of children predominantly
within normal weight ranges, 43.8 percent admitted to
using some form of pathogenic weight control method
at least occasionally because they felt the need to
lose weight.
Body image may differ among girls
of different racial and ethnic backgrounds. A recent
study of a diverse sample of adolescent girls (ages
11 to 17) has identified some of the factors related
to low and high body image (Jaffee & Lutter, 1995).
Girls who received positive comments about their appearance
and achievements from their parents had more positive
body images than did those who received negative comments.
Playing on more school and nonschool sport teams was
also associated with a better body image. With respect
to ethnic differences, it was found that more African-American
girls (44.0 percent) reported having a good body image
than did Native American girls (33.3 percent) or Caucasian
girls (31.8 percent). More than four times as many African-American
girls as Caucasian girls considered themselves attractive
and 12 times as many African-American girls as Caucasian
girls reported liking the way they looked. With respect
to perceived physical competence, 36.0 percent of the
African-American girls said that they felt competent
and capable about their bodies, while only 7.6 percent
of the Caucasian girls did. The dramatic differences
noted in this study illustrate the need to jointly consider
sociological factors such as race and ethnicity with
psychological factors to better understand the causes
of variable self-perceptions.
It is also important to consider
the relationship between physical activity participation
and body image for overweight or obese girls, since
overweight females have often been excluded from physical
activity based on their physical characteristics, social
pressures and psychological perceptions (Gill, 1993).
Since the prevalence of overweight children has increased
over the past 30 years among (a) females of all age
groups, and (b) females of color in particular, this
is certainly a cause for concern (Wells, 1996) (see
also Section I: Physiological Dimensions). While exercise
is recommended as an important factor in the physical
management of childhood obesity (Rowland, 1990), there
may be corresponding psychological benefits as well
(King & Tribble, 1990). However, since obese children
typically possess negative attitudes toward physical
activity, it is important to gradually introduce them
to enjoyable forms of exercise so that they begin to
feel more confident in their physical abilities and
their self-image. When this happens, their sense of
self-mastery can also improve (King & Tribble, 1990;
Rowland, 1990).
Clearly these findings imply that
negative body images are common even among physically
active girls (Plaisted, 1995). Many physical activity
leaders unwittingly contribute to these negative images.
As will be illustrated in the next section, such preoccupation
with physique can lead to dangerous attempts to control
weight.
DISORDERED EATING
Disturbed body imagesand the
associated low self-esteemlay the groundwork for
weight preoccupation and disordered eating. Under these
conditions, physical activity participation can often
cross a very dangerous line. An increased level of physical
activity is typical during the dieting and weight loss
stage of eating disorders such as anorexia nervosa (Polivy,
1994). In this sense, excessive physical activity can
have potentially harmful consequences. As Polivy suggested,
There is a range of compulsiveness connected to
physical activity, with some individuals crossing a
hypothetical line between what is normal and acceptable
and what is destructive or pathological (p. 883).
There are far more athletes who hold
unhealthy attitudes and use unhealthy weight-loss methods
(e.g., excessive exercise) than there are athletes with
true eating disorders (Plaisted, 1995), although both
are certainly of concern since they represent points
along a continuum. Female athletes may be a high-risk
group for developing either disordered eating patterns
or actual eating disorders such as anorexia and bulimia
(Shisslak & Crago, 1992; Thurstin, 1992), especially
in: (a) sports with certain weight requirements, like
lightweight rowing or horse racing, (b) sports in which
low body fat is encouraged, like running and swimming,
and (c) sports in which aesthetic appeal is important,
like gymnastics, diving, ballet, body building and figure
skating (Plaisted, 1995). Females in these sports sometimes
use unhealthy weight loss methods such as self-induced
vomiting and the abuse of diuretics, diet pills and
laxatives.
Some of the influential factors in
the development of disordered eating are unhealthy family
dynamics, peer and teammate modeling and acceptance
and pressure from coaches (Plaisted, 1995). For example,
a study of elite female swimmers ranging in age from
14 to 30 noted that almost 70 percent of the swimmers
had coaches who told them to lose weight, in spite of
the fact that 36 percent reported that pressure to lose
weight was detrimental to helping them meet performance
goals (Benson, 1991). A recent survey of youth coaches
attitudes, knowledge, experiences and recommendations
regarding weight control revealed a tendency for these
coaches to make decisions about the need for weight
control in their athletes on the basis of appearance
rather than more objective indicators (Griffin &
Harris, 1996). Coaches also were more likely to say
that female athletes needed to lose weight but male
athletes needed to gain weight.
Examples from research in a variety
of sports illustrate that there are additional factors
that may contribute to disordered eating. In a sample
of adolescent and college-age female gymnasts, Harris
and Greco (1990) found that gymnasts were extremely
concerned about their weight, although on objective
measures, they were actually low in weight. Many considered
themselves too fat and over half of them reported that
they felt pressure from their coaches to lose weight.
Similarly, a study of nine to 18-year old competitive
swimmers (Dummer, Rosen, Heusner, Roberts, & Counsilman,
1987) found that females were particularly likely to
misperceive themselves as overweight. These athletes
based decisions to lose weight on these misperceptions
as well as others opinions of their weight. Furthermore,
15.4 percent of these girls used pathogenic weight loss
methods to address weight concerns tied more to appearance
than performance. Another study of adolescent swimmers
(Taub & Benson, 1992) found that young female swimmers
desired weight loss more than their male counterparts
did, but neither males nor females reported much use
of pathogenic weight control methods. Overdorf (1991)
reported that the body self-perceptions of high school
and collegiate female athletes differed markedly from
the objective evidence, such that over half of the athletes
saw themselves as heavy while only three percent were
overweight by objective standards. Such standards are
based on BMI (body mass index) which is widely used
in the literature because it is moderately correlated
with percent body fat (Brooks, Fahey, & White, 1996).
Approximately half of the sample also reported using
pathogenic weight control methods, including exercise
abuse. Elite adolescent figure skaters, ballet dancers
and swimmers were compared with nonathletes by Brooks-Gunn,
Burrow and Warren (1988) and findings revealed that
compulsive dieting behaviors were more common in the
two sports emphasizing thin body shape (i.e., figure
skating and ballet dancing) than among swimmers or nonathletes.
A recent study comparing female high-school and college
cheerleaders noted that the high-school cheerleaders
exhibited greater body dissatisfaction and disordered
eating patterns (Reel & Gill, 1996, p. 195)
than did their college counterparts.
Participating in extreme measures
such as disordered eating can have harmful, even life-
threatening consequences. It is important to note that
it is only a subgroup of female athletes who develop
clinical eating disorders, although the numbers are
significant enough to be a cause for concern. Estimates
of female athletes with eating disorders typically range
from 10 to 20 percent. It may be, however, that it is
not the sport context that causes the disordered eating,
but rather that individuals prone to eating disorders
gravitate toward sports that require a low body weight
(Shisslak & Crago, 1992, p. 31). Given the available
evidence, both avenues seem likely.
Societal attitudes toward physical
appearance may also affect self-esteem, body image and
eating behaviors in athletes with physical disabilities.
In examining the literature on children with motor disability
and their participation in sports, Steadward and Wheeler
(1996) pointed out that coaches must consider complicating
factors that affect dietary behaviors in addition to
the existing cultural pressures on young athletes to
attain ideal body shapes. They suggested a triple
jeopardy of eating problems related to the child
with a disability: the impact of physical activity on
existing eating problems, disability-specific implications
for eating problems and the role of cultural influences.
Coaches of all athletesboth able-bodied and disabledhave
an ethical duty not to promote questionable dietary
practices or weight loss methods.
In spite of the above-mentioned factors
that often contribute to disordered eating, it is important
to remember that all females can nevertheless learn
positive nutritional habits through their experiences
in physical activity participation. For example, many
coaches and athletic trainers include nutritional advice
as part of their educational responsibility to young
athletes. Those working with obese youngsters on weight
management typically adopt a combined approach of dietary
changes, exercise, behavior modification and education
(Rowland, 1990). (See also Section I: Physiological
Dimensions.)
In summary, problems with disordered
eating appear to affect a substantial number of young
females. Participation in excessive levels of physical
activity can be one dangerous method of weight control.
Clearly, coaches must establish and encourage healthy
nutritional habits among their female athletes.
CONCLUSIONS AND RECOMMENDATIONS
The information presented below represents
conclusions and practical recommendations derived from
this review of the literature. This information can
be particularly helpful for those individuals working
with females in sport and physical activity settings.
- Physical activity leaders must
be aware of girls motives for participating
in physical activity (Jaffee & Ricker, 1993).
Girls participate not only for fun, but also to get
in shape, socialize and improve skills. We must provide
opportunities to achieve these varied motives in physical
activity programs.
- Even though girls may lack confidence
in their sport and exercise capabilities, it appears
that physical activity has tremendous potential to
enhance a girls sense of competence and control
(Gill, 1993). Physical activity leaders should incorporate
cooperative as well as competitive opportunities for
girls to learn and practice physical skills in a nonthreatening
environment.
- Sport administrators should emphasize
moral education (e.g., prosocial) goals in physical
activity and youth sport programs (Shields & Bredemeier,
1995). We must make prosocial, ethical reasoning processes
and behavior an explicit, rather than implicit, part
of the agenda.
- Coaches, parents and health care
professionals need to identify girls who are at risk
for excessive stress; this includes particularly those
girls who have low self-esteem or unrealistic expectations
about their abilities as well as those who experience
frequent criticism from others (Martens, 1993). The
most important factor to communicate to children is
that they should be striving to achieve personal rather
than outcome goals.
- With respect to disordered eating
patterns, physical educators, exercise leaders and
coaches can practice preventive medicine
by being careful about the kinds of remarks they make
to female students-athletes and clients about their
weight and appearance. Additionally, because these
individuals are in a primary position to recognize
disordered eating patterns (Weinberg & Gould,
1995), they must be knowledgeable about the physical
and psychological signs that accompany such behavior
and be able to make referrals when appropriate.
- Professionals should consider whether
they can enhance the sport experience for all individuals
by incorporating such values as tolerance for error,
cooperation and sharing, relaxation rather than stress,
and process-orientation rather than outcome-orientation
(Gill, 1993).
DIRECTIONS FOR FUTURE RESEARCH
The following are some priority areas
for future research on the psychological dimensions
of girls participation in physical activity.
- Accurately determine sport cessation
rates. Research studies need to be designed which
better distinguish between sport-specific or sport-general
dropouts versus sport transfers to ascertain if girls
are leaving organized sport entirely or simply sampling
a variety of sporting activities (Weinberg & Gould,
1995). These investigations should collect and analyze
participation statistics and conduct exit interviews
with children who drop out in order to identify negative
reasons for cessation and address them in future programs.
- Identify strategies to improve
and enhance girls self-perceptions of physical
ability. Scientific investigations must identify specific
ways to enhance girls self-perceived ability
in sport and physical activity because prior research
indicates girls often lack self-confidence in these
important areas (Weinberg & Gould, 1995). Such
analysis will lead to a better understanding of how
sport and physical activity can contribute to self-perceptions
whether they be positive or negative. Finally, studies
should also develop and implement intervention strategies
aimed at raising females perceptions of their
physical ability (Eccles & Harold, 1991).
- Identify appropriate gender-specific
teaching methods. Although some isolated studies suggest
that girls learn best in small, relaxed groups where
children know each other, further investigation is
needed to establish which will specifically determine
how girls best learn motor skills (Garcia, 1994),
sport skills (Wiese-Bjornstal & Weiss, 1992) and
exercise skills (Marsh & Peart, 1988). It is important
to gather and critically analyze such data because
girls learning styles may be different from
the conventional approaches designed for boys.
- Examine the ways in which females
are affected by involvement in highly competitive
sports. Research must examine the impactboth
positive and negativeof competitive sport participation
for females. How sport influences moral development
is a particularly fruitful line of inquiry. For example,
the temptation to cheat or to take performance enhancing
drugs (e.g., steroids) must be examined in conjunction
with prosocial behaviors such as always being respectful
toward opponents and officials.
- Determine the various social factors
associated with eating disorders. Research studies
must examine rates and causes of disordered eating
patterns among adolescent female athletes since this
may lead to the development of eating disorders and
pathogenic weight control behaviors. It is necessary
to study the influences of significant others in the
process as well, particularly coaches, teammates,
parents, judges and teachers. We also need to establish
whether adolescent athletes are more likely to have
eating disorders than their nonathletic peers (Caldwell,
1993), and to design appropriate intervention programs.
- Develop and implement more inclusive
research agendas. Future research must be expanded
beyond an analysis of highly competitive sport and
physical activity to include a broader range of activities
(e.g., personal fitness) and settings (e.g., physical
education classrooms). Additionally, studies should
include participants from racially, ethnically, economically
and ability-diverse backgrounds because gender interacts
with these diversities in complex ways (Gill, 1993).
- Utilize interdisciplinary research
perspectives. Much of the previously cited literature
employed a unidimensional approach where only one
particular sport-related dimension was examined (e.g.,
the psychological impact of participation). Future
research must adopt a biopsychosocial perspective
which simultaneously takes into account physical,
psychological and social context variables (Gill,
1995). It is clear that contextual and maturational
factors moderate the influence of socialization, physical
ability and psychological factors on girls participation
in physical activity (Weiss & Glenn, 1992).
SECTION III:
Sociological Dimensions
MARGARET DUNCAN, PH.D., UNIVERSITY OF WISCONSINMILWAUKEE
THE SOCIAL CONSTRUCTION OF FEMININITY
CAN INFLUENCE girls preferences for physical activity
and their expressions of physicality. Gender is a key
theme in physicality because most girls learn and reproduce
appropriate female styles of movement (Young,
1990). Therefore, an exploration of the social factors
that underlie the development of gender is necessary
to understand girls involvement in sport, exercise
and physical activity.
This review begins with a discussion
of how childrens gender is socially constructed
at a very young age. The second part examines how adolescence
can exaggerate gender differences and how, in order
to avoid compromising their femininity, many girls drop
out of sport and physical activity altogether. The third
part outlines the problems associated with lack of involvement
in physical activity. The fourth part describes the
benefits that accrue to those who are physically active.
The fifth part discusses the influence of Title IX,
which has significantly increased physical activity
opportunities for girls, and as a result, seems to have
changed the attitudes of some parents, teachers and
physical educators regarding the importance of sport
and active leisure for girls. The sixth part suggests
specific ways to enable young girls participation
in physical activity, sport and leisure. The last section
offers directions for future research.
LEARNING GENDERED BEHAVIOR
The social construction of gender
begins in early childhood perhaps as early as infancy,
as children respond to cues from parents, teachers and
others (Greendorfer, 1983). Children first identify
notions of gender by focusing on a few obvious physical
or external cues such as hairstyle, dress and name (Bailey,
1993). By age two, clear sex differences in interests
appear (Pitcher & Schultz, 1983). By age three,
children know many of the implicit social rules that
guide feminine and masculine behavior. They may also
start to believe that it is wrong for people to engage
in cross-sex activities (Bailey, 1993; Ignico, 1990).
Younger children (i.e., preschool to first or second
grade) tend to adopt more stereotypical attitudes about
gender than older children. Such early experiences often
shape later behavior, although children may revise their
ideas of femininity or masculinity in the light of new
information and experiences (Bailey, 1993). For example,
a girl who believes only boys should play football and
climb trees may revise her belief when she witnesses
her favorite female cousin doing both.
Creating a gendered self is crucial
to a childs sense of social competence and psychological
well-being (Davies, 1989, 1990; Pitcher & Schultz,
1983), and for this reason, children internalize gender
categories and practice corresponding behaviors. Through
their own active efforts to engage in what they perceive
as gender-appropriate behaviors, children take on social
roles and characteristics labeled as feminine or masculine;
this in turn restricts girls opportunities and
aspirations, unless they also receive cues from parents,
teachers and others that are not limiting.
ESTABLISHING GENDER DIFFERENCE
One of the first things that contemporary
society teaches children about the process of becoming
gendered is that it involves establishing differences
between females and males (Birrell & Cole, 1990;
Duncan, 1990). These differences are not merely distinctionsthey
are sometimes interpreted as direct opposites (Beauvoir,
1952; Betterton, 1987; Connell, 1987; Kuhn, 1985; Orenstein,
1994). In particular, the media, parents, teachers and
peers tell children in many obvious and subtle ways
that if boys are one thing, girls are its opposite (Duncan,
Messner, Williams, & Jensen, 1994; Kane & Greendorfer,
1994). Thus, a crucial component of social competence
for many girls may depend on maintaining and defending
that opposition.
The emphasis on gender opposition
often shapes the ways in which children physically express
themselves (Duncan & Sayaovong, 1990). Girls learn
a specific repertoire of gestures, postures and
movements (Bartky, 1988, p. 64) that can be quite
different from that of boys; early on, girls discover
that stereotypic femininity requires delicate, restrained
movements (e.g., crossing the legs, folding the arms)
and limited use of space (Henley, 1977; Young, 1990).
Activities such as sports that require more vigorous
movements and greater use of space are often socially
coded as masculine. Although children may engage in
activities coded for the other sex, the social norms
that have been established for each gender, and the
sense of identity that these norms may foster, are a
powerful influence. As Hasbrook (1995) noted in her
ethnography of grade-school children, both girls and
boys believe that girls are not supposed to be
big, strong, powerful or physical; such attributes are
[seen as] shameful and a source of offense to others,
particularly boys (p. 17).
In early childhood, children strengthen
their sense of gender identity by associating with others
of the same skill level and sex while generally rejecting
opposite-sex groups, an arrangement that typically reinforces
the differences between girls and boys activities
(Adler, Kless, & Adler, 1992; Bailey, 1993; Pitcher
& Schultz, 1983). For example, girls often say that
they prefer not to engage in boys games and play
(Green, 1987). This preference should not be surprising
given the way that boys treat girls who encroach on
their territory. As Hasbrook (1995) notes,
girls who display strength, power or physicality
when interacting with boys run the risk of being disliked,
chastised and/or marginalized (p. 17). The notion
of gender difference and opposition can occur even in
kindergarten. For example, in recreational sports such
as tee ball aimed at five and six year-old girls and
boys, coaches and peers have been found to clearly communicate
the stereotypic attitude that girls do not belong in
such male activities (Landers & Fine,
1996).
Some girls may shun sport altogether
to avoid compromising their femininity, or they may
prefer sports and physical activities that appear to
be more gender-appropriate: cooperative, aesthetically
pleasing, expressive, graceful activities such as cheerleading,
gymnastics, diving, swimming, tennis, figure skating
and dance (Duncan & Hasbrook, 1988; Kane & Snyder,
1989; Metheny, 1965; Young, 1990). These activities
contrast with those that are socially prescribed for
boys: aggressive, competitive, territorial, strength-focused
team sports that involve a great deal of body contact.
Children as young as four have identified playing with
dolls, picking flowers, dressing up, skipping and dancing
as appropriate for girls, and activities such as football,
baseball, basketball, soccer, hockey, karate and fighting
as appropriate for boys (Bailey, 1993).
Regardless of the social prohibitions
against girls participation in some forms of physical
activity, a number of researchers argue that girls are
not naturally less athletic than boys (Costa & Guthrie,
1994). While girls activities may be different
(such as jumping rope, swinging on the bars, performing
complicated dance routines), they still require agility,
coordination, strength and attentional focus (Bailey,
1993; Green, 1987; Hasbrook, 1995; Thorne, 1993). In
fact, girls possess the physical capabilities to perform
well in all kinds of movement activities. What they
may lack is the social support to do so.
More and more girls are daring to
cross the gender divide and are insisting
on their right to play baseball/softball, basketball,
football and soccer despite the fact that they may be
pejoratively labeled as tomboys, either
by their parents and teachers, or by other boys and
girls. This unfortunate tendency to label others was
corroborated by Hasbrooks 1995 ethnographic study
of a mostly African- American grade school in Milwaukees
inner city which suggested that certain cultures (i.e.,
African- American, Asian-American) may be less tolerant
of girls who defy gender stereotypes than is white,
middle-class society. Thornes 1993 discussion
of two working class schools with culturally diverse
students revealed a similar intolerance for tomboys.
Some girls may find the sport itself
sufficiently rewarding to continue playing despite social
disapproval (Nelson, 1991). Girls who manage to carve
out a niche for themselves in boys games are far
more likely to be committed sports participants later
in life. In a research report surveying seven thousand
female sports enthusiasts, one of the most interesting
findings was that the most active sportswomen shared
the childhood experience of playing mostly with boys
or in mixed gender groups, rather than mostly with girls
(Miller Lite Report on Women in Sports,
1985).
ADOLESCENCE: THE COSTS OF
GENDER DIFFERENCE
A number of researchers have suggested
that sharp declines in girls self-esteem, academic
performance, athletic involvement and body-image during
adolescence are perhaps heterosexualization
and emphasized femininity (AAUW and the
Wellesley College Center for Research on Women, 1992;
Daley, 1991; Orenstein, 1994; Pipher, 1994; Simmons
& Blyth, 1987; Thorne, 1993). Pipher (1994) describes
this adolescent fall as a social and developmental
Bermuda Triangle in which girls lose their
assertive, energetic and tomboyish personalities
and become more deferential, self-critical and depressed.
They report great unhappiness with their own bodies
(p. 19). In short, the social status of adolescent girls
often depends on conformity to the feminine stereotype
and the intensification of gender difference.
Girls may perceive that it is socially
unacceptable to be strong, physical and athletically
talented; this is the very definition of a popular boy.
An erroneous but particularly persistent and long-standing
belief is that sports are masculinizing and that physically
active girls are more likely to become lesbians, or
that all successful female athletes are lesbians (Cahn,
1994b; Kane, 1996; Lenskyj, 1986). Though this homophobic
belief is unfounded, it leads some girls to avoid physical
activity. It is also not surprising that as girls approach
adolescence, many of them lose interest in vigorous
physical activity and sport and may even stop participating
altogether (The Wilson Report: Moms, Dads, Daughters
and Sports, 1988). For girls and boys, the dramatic
physical transformations that occur during puberty are
accompanied by equally dramatic social changes. However,
although both sexes grapple with new roles and restrictions,
those that adolescent girls must face present different
challenges. While skill at sport is a significant factor
in determining social status for many boys, physical
attractiveness and success with boys tend to determine
social status for girls (Adler et al., 1992; Thorne,
1993). This means that girls are placed in the very
difficult position of being valued not for what they
achieve but for how they look. Indeed, being pretty
and being skilled at courtship rituals may take primacy
over getting good grades, joining athletic teams or
engaging in regular physical activity. The media (e.g.,
rock videos, television, teenage magazines, romance
novels) are particularly powerful influences at this
age (Adler et al., 1992; Bailey, 1993; Duncan, 1994;
Thorne, 1993). The popular media tend to sexualize,
romanticize and objectify young women. Many girls start
to regard themselves in these ways and are indeed treated
as such by others (Adler et al., 1992; Pipher, 1994).
In spite of the findings mentioned
above, there is growing evidence that cultural differences
may temper mainstream expectations for girls appearance
and activities. For example, the Womens
Sports Foundation Report: Minorities in Sport
(1989) found that Hispanic, Caucasian and African-American
high-school females who engaged in athletics perceived
themselves as more popular than did their nonathletic
counterparts in those same categories. Findings from
this report also revealed that 87 percent of the mothers
and fathers sampled accept the idea that sports
are equally important for boys and girls (p. 1).
This is an important area of research that needs further
development.
MINORITY GIRLS: AT
SPECIAL RISK
Some subgroups of girls face particularly
daunting obstacles to participating in sport and physical
activity. For example, some subcultures or minority
groups are less tolerant of behavior that defies gender
stereotypes such as tomboyism (Hasbrook,
1995). A retrospective study of working women found
that girls of color were less likely than Caucasian
girls to participate in intramural sports (Miller
Lite Report on Sports & Fitness in the Lives of
Working Women, 1993). While 31 percent of Caucasian
girls played intramural sports, only 19 percent of minority
girls did so. These differences may be compounded by
differences in socioeconomic status and geographical
location (i.e., urban versus rural areas). Furthermore,
girls of color were significantly less likely than Caucasian
girls to receive encouragement from their parents to
engage in athletic and fitness activities (11 percent
versus 16 percent).
These findings were partly corroborated
by another study that revealed that African-American
girls were more likely to have parents who believed
sports were more important for boys than for girls;
that African-American girls were more likely to feel
boys make fun of girls who play sports;
and that African-American girls had fewer financial
resources for lessons, equipment and transportation
to games (The Wilson Report: Moms, Dads, Daughters
and Sports, 1988). Finally, according to the recently
released Surgeon Generals report on physical activity
and health (U.S. Department of Health and Human Services,
1996)which offers 1992 National Health Interview
Survey data from the Youth Risk Behavior supplementwhite,
non-Hispanic females had higher levels of vigorous physical
activity (49%) than black, non-Hispanic (42.3%) or Hispanic
females (41.7%); males had statistically similar levels
regardless of race/ethnicity status (60.2%, 62.7% and
56.7%, respectively).
THE CONSEQUENCES OF REJECTING
PHYSICAL ACTIVITY
Unfortunately, rejecting involvement
in sport and physical activity due to socialized stereotypes
has its costs. (See also Section II: Psychological Dimensions.)
The most obvious drawbacks are the health costs, both
physical health (see also Section I: Physiological Dimensions)
and mental health (see also Section IV: Mental Health
Dimensions). Without regular exercise, girls and women
tend to tire easily, have less energy (Rowland, 1990),
and be more susceptible to infection and disease (Calabrese,
1990; Kramer & Wells, 1996). On the credit side,
regular exercise makes young girls and women have more
energy, feel better and cope more effectively with stress
(Lutter & Jaffee, 1990).
Children who are physically unskilled
may frequently be excluded from group activities and
games (Ignico, 1990). Failure to develop a range of
fundamental motor skills (a movement vocabulary
[Bennett et al., 1987]) at a young age makes it more
difficult to take up physical activities and sport later
in life. Adolescents and adults lacking movement
literacy (e.g., competence) find it doubly hard
to learn new ways of moving their bodies, both because
of the unaccustomed physical demands and because of
the fear of appearing awkward and unskilled. Even if
women wish to begin regular fitness activities for the
first time in adulthood, fear of embarrassment may deter
them (Nelson, 1991).
Another potential consequence of
not participating in sport and physical activity is
related to the development of ones character.
Although conventional wisdom would have us believe that
sport builds character, research on character
development in youths who participate in sport is equivocal.
Some research findings suggest that sport involvement
does not necessarily build character (Miracle &
Rees, 1994; see also Section II: Psychological Dimensions).
However, Fejgins 1994 study found a weak, but
significant, correlation between participation in competitive
high-school sports and higher grades, higher self-concept,
higher educational aspirations and fewer discipline
problems. Despite these contradictory findings, there
are certain unequivocal personal benefits (e.g., a sense
of personal accomplishment, the development of social
networks, the pleasure of movement) from participation
in physical activities (Whitson, 1994).
BENEFITS OF PHYSICAL ACTIVITY
Sporting skills can lead to the development
of important social skills. People form new acquaintances,
consolidate old friendships and learn how to cooperate
and negotiate on the tennis court, golf course or softball
diamond. Successful sport experiences can also build
confidence, self-esteem and positive body- image (Jaffee
& Manzer, 1992; Miller Lite Report on Women
in Sports, 1985), personal qualities that adolescents
especially need (see also Section II: Psychological
Dimensions). Participation in physical activity has
also been linked to a lower incidence of depression
(National Council for Research on Women, 1995) (see
also Section IV: Mental Health Dimensions). Moreover,
being physically strong is a practical benefit in many
day-to-day undertakings: carrying grocery bags or suitcases,
moving furniture, digging a garden, mowing the lawn.
Those who view their bodies as useful and powerful are
less likely to abuse their bodies. This is of particular
importance since a number of contemporary disorders
such as anorexia, bulimia and chemical abuse begin in
adolescence (Chernin, 1981) (see also Section II: Psychological
Dimensions). At all ages, involvement in sport and fitness
activities is pleasurable and satisfying in and of itself
(Pellett & Harrison, 1992).
The association between physical
activity and other performance domains seems
especially critical for minority students when it comes
to the educational and academic benefits of involvement
in varsity sports. For example, based on a nationwide
probability sample of thirty thousand high-school students,
a study conducted in the late 1980s revealed that Caucasian
female athletes had lower school dropout rates than
Caucasian female nonathletes in suburban and rural schools
(Womens Sports Foundation Report: Minorities
in Sport, 1989). This study also indicated that
Caucasian female athletes tended to do better in high
school and college, feel more popular, be more involved
in extracurricular activities and be more likely to
aspire to community leadership than did Caucasian female
nonathletes. In addition, Hispanic female athletes had
a significantly lower dropout rate than did Hispanic
female nonathletesone-third lower. Furthermore,
Hispanic female athletes were much more likely than
their nonathletic counterparts to attend and stay in
college. In relation to social involvement (e.g., participation
in non-sport activities such as school newspaper and
Girl Scouts), minority athletes of both sexes were more
socially involved than nonathletes, and African-American
and Hispanic athletes of both sexes scored higher on
standardized tests.
In a study conducted during this
same time period, Melnick, Vanfossen and Sabo (1988)
found that athletic participation was strongly related
to extracurricular involvement and modestly related
to perceived popularity for high-school girls. However,
these relationships are quite complex and may involve
interactions with socioeconomic status, subcultures
and specific sport experiences. For example, an intriguing
analysis of longitudinal survey data by Hanson and Kraus
(1996) found a relationship between girls involvement
in high-school sports and achievement in science (e.g.,
GPA, standardized scores). For Caucasian girls, participation
in sports was positively associated with attitudes toward
science (i.e., perceived relevance of math for ones
future occupation) and access to science (i.e., course-
taking). However, for African-American girls, participation
in sports was found to negatively influence their achievement
in and access to science classes. In contrast, sports
participation had no effect on the science experiences
of Hispanic girls. These findings must be regarded with
caution, however, since the data were first collected
in 1980.
What seems clear from the preceding
information is that females experience many benefits
from their involvement in sport and physical activity.
At the same time, some researchers have argued that
females may have special contributions to make to physical
activity and sport. For example, many of the young women
who responded to the Miller Lite Report on Women
in Sports of 1985 felt they could teach men something
about humane competition. In addition, research on childrens
play styles suggests that girls put a high value on
positive social interaction and self-expression, important
antidotes to the competitive excesses of contemporary
sport (Evans, 1986; Gilligan, 1982; Lenskyj, 1994; cf.
Nelson, 1991).
In short, it is clear that girls
can either gain or lose out on important benefits related
to sport and physical activity. (And although the focus
of this report is on girls, it is important to note
that the same is also true for boys). While many barriers
still exist, fortunately, attitudes and behaviors towards
girls involvement are changing. One significant
instance of such social change was the passage of Title
IX legislation. The following section outlines the impact
of Title IX and suggests how people in key social roles
such as teachers, parents and coaches can support girls
sport participation, and in so doing, can also transform
our sporting institutions.
EFFECTS OF TITLE IX
In 1972, the government mandated
equivalent programs for males and females in schools
receiving federal funds through the passage of Title
IX. Combined with the advocacy efforts of the womens
sports movement, this legislation had a significant
impact by expanding physical activity opportunities
for girls and women (Miller Lite Report on Sports
& Fitness in the Lives of Working Women, 1993)
and changing attitudes about the appropriateness of
sports for females (Durant, 1992). During the decade
and a half that followed the passage of Title IX, the
number of girls participating in high school sports
rose from 294,015 in 1971 to 1,836,356 in 19861987
(Sage, 1990), and a 1993 survey showed that 37 percent
of high-school athletes were female (Miller Lite
Report on Sports & Fitness in the Lives of Working
Women, 1993). Another study (Womens
Sports Foundation Report: Minorities in Sport,
1989) reported that 30.5 percent of high-school girls
took part in interscholastic sports in 19901991,
compared to less than one percent of high-school girls
who participated in such sports in 1971, before the
enactment of Title IX. These figures not only reflect
an unprecedented increase, but also demonstrate that
when girls sporting involvement is vigorously
supported by social institutions, they participate in
record numbers.
It is important to point out, however,
that Title IX has had an uneven history of enforcement
and advances in equity. During leaner times, when educational
funding has been decreased, fewer gains in equity and
some backsliding have occurred (Blum, 1993; Fox, 1992).
For example, from 1980 to 1988, federal enforcement
of Title IX was slowed to a standstill. In 1988, the
passage of the Civil Rights Restoration Act infused
new life into equity efforts (Blum, 1993). Although
many inequities have been identified and corrected,
there are many more cases of discrimination that must
be countered (Durant, 1992; Fox, 1992). As one analyst
summarized, The face of sex discrimination in
athletics has changed. It was often no longer the purposeful
exclusion of the past, but a collection of more subtle
inequities that could be explained away by a lack of
resources (Fox, 1992, p. 50).
Unfortunately, institutions have
attempted to reverse the Title IX gains made by girls
and women in sport programs. For example, financially
strapped school administrators and coaches have argued
against equivalent sport provisions (National Womens
Law Center, 1995). In addition, organizations such as
the Womens Sports Foundation and the National
Association for Girls and Women in Sport have offered
assistance in the interpretation and implementation
of Title IX. A Title IX Coalition was formed to disseminate
information about Title IX to parents, athletes and
administrators, and as a result of these efforts, it
appears that some high schools and colleges are actively
complying (D. Larkin, personal communication, May 1995).
It seems clear that the future of girls sporting
participation depends in part upon continually monitoring
progress toward compliance and vigorously working to
educate the public.
CONCLUSIONS AND RECOMMENDATIONS
Because involvement in physical activity
and sport is so beneficial for females of all ages,
it is important to ensure that girls are given sufficient
opportunities to develop their physical skills. How
are girls to fully capitalize on the potential benefits
of physical activity and sport? Much of the research
previously cited offers specific recommendations for
fostering and increasing girls participation in
physical activity, leisure and sport. Some specific
guidelines for teachers, parents, physical educators,
coaches and others who work with children follow.
- It is essential to eliminate gender-typing
whenever possible. Activities should never be labeled
as girls games or boys
games, feminine or masculine
(Ignico, 1990; Pellett & Harrison, 1992; Thorne,
1993). When children come to school with preconceptions
about girls games and boys
games, teachers may wish to introduce new activities
that arent already gender- typed (e.g., hackey-sack,
croquet, New Games).
- Leaders should avoid using sex
as a basis for forming physical activity groups (Thorne,
1993). If children need to be grouped, use criteria
that are gender-neutral (e.g., kids with brothers
versus kids with sisters; kids who like dogs versus
kids who like cats). Girls and boys need to work and
play together, starting from an early age. Arbitrarily
segregating girls and boys may create hostility and
perpetuate power imbalances (Goodenough, 1987), and
although there has been a great deal of recent interest
in gender-segregated schools (see Sadker & Sadker,
1994), there is as yet no direct evidence that gender-segregated
physical activity is desirable. The important consideration
is to be sure that all children have adequate preparation.
It is easiest for both sexes to play together and
learn in small, non-competitive groups where children
know each other well and have the prerequisite skills
(Goodenough, 1987; Thorne, 1993).
- Professionals must actively intervene
in the face of discrimination. When adults observe
inequities or gender stereotyping on the playing field
or in the classroom, it is often best to openly confront
issues of sexism, prejudice or discrimination (Thorne,
1993). Encourage children to develop critical thinking
about gender-based biases.
- Coaches and physical educators
should give girls equal access and attention. Both
girls and boys should play the important and interesting
positions in a game (e.g., pitcher, goalie, forward).
In addition, both should receive feedback to help
improve their skills.
- All of us must challenge stereotypes
whenever possible. When teachers choose games and
lead activities, a female teacher might play football,
a male teacher might jump rope (Thorne, 1993).
- Physical educators, exercise leaders
and coaches should develop and implement new models
of sport and physical activity. For example, professionals
can emphasize learning new skills, having fun, cooperating
and making friends (Lenskyj, 1994). Although competitive
skills and attitudes may be valuable preparation for
todays working world (D. Sabo, personal communication,
1996), competition should not be allowed to displace
other sports values and experiences.
- Parents, coaches and physical activity
leaders should avoid the use of gender-typed language.
For instance, do not refer to athletes as he
or use the generic male to mean both males and females.
It may be helpful to tell children stories that allow
them to imagine situations where traditional gender
roles are reversed (Davies, 1989). At a very young
age, children may seem resistant to change (Bailey,
1993), but adults can provide them with nonsexist
information which they will rely on as they mature.
(Pitcher & Schultz, 1983). Children who are in
fifth and sixth grade may be ready to apply some critical
thinking skills and challenge gender stereotyping.
DIRECTIONS FOR FUTURE RESEARCH
As our research agendas are developed
and implemented, we must remember that providing girls
with sufficient participation opportunities depends
on rejecting stereotypic definitions of femininity and
masculinity. As Davies succinctly puts it, to move beyond
male-female dualism, all we have to do is stop
doing the work that maintains the difference (1989,
p. 136). The following are some priority areas for future
research related to the sociological dimensions of girls
participation in physical activity and sport.
- Examine the impact of participation
in sport and physical activity for females across
the lifespan. The findings of this review suggest
that involvement in physical activity from early childhood
through girlhood to womanhood needs more in-depth
investigation. Such research should encompass fundamental
fitness activities and spontaneous, informal play
and games as well as highly organized and competitive
sports.
- Expand our research agenda to be
more inclusive of diversity. There is very little
information about how social factors such as ethnicity,
class, religion or sexual orientation intersect with
the construction of femininity and girls participation
in sport and physical activity. For example, only
a handful of studies have examined how race affects
girls sport and fitness involvement, and even
these studies have limitationssuch investigations
have failed to differentiate between African-Americans
and the various ethnic/racial groups that comprise
Asian-Americans, Hispanic-Americans, and American
Indians and Alaskan Natives.
- Determine the best strategies for
enabling females participation in sport and
physical activity. Future research needs to address
a series of important questions related to strategy
development and implementation. For example, how can
we ensure that girls and women receive adequate opportunities
for involvement in fitness, sport and play activities?
How can we respect the needs of girls and women to
feel competent using their bodies in a variety of
settings? Our research should be guided by the principle
that strategies for improving participation rates
must also address the quality of the experience.
SECTION IV:
Mental Health Dimensions
DOREEN GREENBERG, PH.D., FARLEIGH DICKENSON UNIVERSITY
CAROLE OGLESBY, PH.D., TEMPLE UNIVERSITY
ADOLESCENCE IS A TIME OF SIGNIFICANT
AND PRECIPITANT biological, cognitive and emotional
changes for girls. Changes related to physical development,
self-evaluation, peer standing and relationships with
family and friends have a powerful influence on mental
health and psychological well-being. Even though this
time period is marked by transition, adaptation and
stressful events, the majority of our youth traverse
the landscape of adolescence successfully. However,
failure to find adequate coping strategies can lead
to emotional distress, anxiety disorders and clinical
depression for some children and adolescents. Especially
impacted are adolescent females who have been found
to have higher rates of anxiety and depressive disorders
than their male counterparts (Glied & Kofman, 1995;
Lewisohn, Hops, Roberts, Seeley, & Andrews, 1993;
McGrath, Keita, Strickland, & Russo, 1990; Nolen-Hoeksema
& Girgus, 1994). Adolescent girls are saplings
in a hurricane. They are young and vulnerable trees
that the winds blow with gale strength (Pipher,
1994, p. 22). Although most girls weather the
storm of adolescence, it is important that opportunities
to acquire the needed skills are provided for those
who cannot. Young girls can learn to be strong, resilient
and powerful, particularly as a result of physical activity
and sport experiences.
This section of the report offers
both empirical and anecdotal evidence that supports
increasing the use of exercise and sport as promising
alternative psychological health interventions. In contrast
to the broad approach of Section II: Psychological Dimensions,
this section focuses specifically on mental health,
especially its maintenance among at-risk adolescent
girls. The first part reviews empirical support for
the positive relationships among exercise, fitness and
mental health, particularly focusing on the effect of
exercise on anxiety and depression, two disorders prevalent
among adolescent females. The second part presents both
empirical and anecdotal evidence concerning female adolescent
mental health and the use of exercise and sport as an
ameliorative influence. The third part highlights some
conclusions and recommendations as well as identifies
significant areas of needed research.
THE EFFECTS OF EXERCISE
ON MENTAL HEALTH
Research has provided significant
findings related to physical activity in two distinct
areas of interest for mental health professionals: the
use of sport and exercise to enhance psychological well-being,
and its use to reduce problematic levels of anxiety
and depression among individuals with mental health
problems (Surgeon Generals Report on Physical
Activity and Health, USDHHS, 1996). A summary of this
information is presented in three areas: 1) exercise
and the enhancement of psychological well- being; 2)
exercise and the reduction of problematic levels of
anxiety and depression; and 3) hypotheses advanced by
scholars and educators to explain the psychological
benefits of exercise and sport.
Exercise and the Enhancement
of Psychological Well-Being
In general, research has demonstrated
that engaging in exercise and physical activity significantly
enhances mental health. Participating in an exercise
program has a positive impact on elevating mood and
improving self-concept and self-esteem (Brandon &
Loftin, 1991; Jackson & Marsh, 1986; King, Taylor,
Haskell, & DeBusk, 1989; MacMahon, 1990; Mutrie
& Biddle, 1995). Plante and Rodin (1990) and Plante
(1993) determined from extensive meta-analyses that
exercise has a positive impact on enhancing mood, self-concept
and self-esteem. In addition, feelings of depression,
anger and anxiety tend to dissipate after exercise (Smyth,
1991).
Optimism is crucial to psychological
well-being and has been shown to be influential in achievement
behavior, self-mastery and enhanced motivation. A recent
investigation by Kavussanu and McAuley (1995) demonstrated
the relationship between high physical activity and
optimism. Their findings also revealed an inverse
relationship between regular exercise and trait anxiety
levels (p. 254), suggesting that those who exercise
have lower anxiety. In an earlier study, Buffone (1984)
discussed the potential of exercise as a psychological
enhancer and stated that current research in counseling,
psychology and medicine points to physical exercises
positive effect on mental health. Running and other
forms of exercise or sport participation, seem to build
confidence, alleviate moderate anxiety and reactive
depression, increase body awareness and image, reduce
weight, promote habit control and improve sleep
(p. 222).
The potential benefits of physical
activity participation such as self-concept, self-esteem
and body concept are especially important for
the emotional well-being of women (Berger, 1984b, p.
172). Jackson and Marsh (1986) concur with this finding
stating that the emotional benefits of exercise participation
are especially important to women, particularly the
significant improvements in self- concept found in athletic
women.
Recent studies have indicated that
involvement in exercise, rather than actual fitness
levels, may be the key to enhancing mental health. For
example, in a study investigating the positive influence
of physical activity on psychological well-beingparticularly
as it relates to the ability to cope with stressful
situationsLong (1993) suggested that exercise
can be used to function as a coping mechanism for stress,
to regulate emotions and mediate stress reactions. This
same author advocated physical activity that involved
large muscle groups, such as jogging, swimming and cycling.
Similarly, Thirlaway and Benton (1992) determined that
it is participation in physical activity, rather than
actual physical fitness, that has greater impact on
improving mental health. Finally, Biddle (1995) suggested
that there may be no empirical basis to support the
necessity of rigorous exercise regimes in order to impact
feelings of well-being.
In a comprehensive review of the
research findings, Singer (1992) found that there are
many psychological rewards of physical activity. Some
of these are improved self-image, increased self- confidence,
positive changes in mood, relief of tension, relief
of premenstrual tension, increased alertness, increased
energy and increased ability to cope.
Exercise and the Reduction
of Anxiety and Depression
It is estimated that as much as 25
percent of the population suffer from anxiety and depressive
disorders which may range in severity from mild to more
severe forms (Singer, 1992). Such mental health states
have been shown to be particularly responsive to exercise
and/or physical activity that can decrease many of the
symptoms associated with a number of psychiatric conditions
(Plante, 1993; Surgeon Generals Report on Physical
Activity and Health, USDHHS, 1996).
There are specific criteria for the
diagnosis of acute depression including nine symptoms
of depression: (a) depressed mood, (b) diminished interest
or pleasure in most activities, (c) significant weight
loss or weight gain that is unintentional or a daily
decrease or increase in appetite, (d) insomnia or hypersomnia,
(e) psychomotor agitation or retardation, (f) fatigue
or loss of energy, (g) feelings of worthlessness or
excessive or inappropriate guilt, (h) diminished ability
to think or concentrate or indecisiveness, and (i) recurrent
thoughts of death or suicide attempts (American Psychiatric
Association, 1994). The criteria for a major depressive
episode is having five or more of these symptoms present
for a two-week period.
A position paper from the International
Society of Sport Psychology (ISSP) states that there
is clinical evidence that exercise can have a beneficial
effect on some psychiatric disorders. Physical
activity can be a promising aid for people suffering
from symptoms of depression (Singer, 1992, p. 199).
Further, the majority of studies show that both aerobic
and nonaerobic exercise can have an antidepressive effect
with those patients experiencing mild to moderate depression
(Martinsen, 1995; Plante, 1993). However, most published
studies have been concerned with directly impacting
the symptoms of depression with no differentiation made
between the levels of depression of participants and
with few studies specifying the degree to which clinically
diagnosed participants were utilized (Martinsen, 1995;
North, McCullagh, & Tran, 1990). This section focuses
on persons who have moderate rather than severe mental
health problems (e.g., mild versus severe depression).
In two studies, Greist (1987) found
exercise to be effective with clinically depressed outpatients
in reducing moderate depression. In addition, exercise
was shown to be as effective as group psychotherapy:
those who continued to exercise maintained their improvements,
while those who only participated in group therapy failed
to maintain some of their improvements. Greist and Jefferson
(1992) found that a combination of walking and running
on a regular basis was highly effective in reducing
mild to moderate depression.
North, McCullagh and Tran (1990)
conducted a meta-analysis of studies that ranged from
a general population of individuals with depressive
symptoms to clinically depressed participants. The authors
concluded that both acute and chronic exercise in either
aerobic or anaerobic forms significantly decreased unipolar
depression. The largest decreases in depression levels
were in participants under medical and psychological
care. Exercise therapy (both aerobic and anaerobic)
was a better antidepressant than relaxation and other
enjoyable activities, and exercise
was as effective in decreasing depression as was psychotherapy
(p. 404). Exercise in combination with psychotherapy
was a better intervention than exercise alone.
Similarly, other extensive reviews
of the relevant research on exercise intervention with
clinically depressed patients suggest that both aerobic
and nonaerobic exercise are as beneficial as psychotherapy
in reducing depression (Martinsen, 1994; Martinsen &
Stephens, 1994). These studies were with inpatient and
outpatient populations with mild to moderate unipolar
depression; no sound empirical studies were found which
addressed the value of exercise intervention in bipolar,
psychotic or melancholic disorders. It was also noted
that no study has compared exercise and medication in
the treatment of depression.
A recent meta-analysis of the research
literature differentiates between clinical and nonclinical
studies (Biddle, 1995). This review concluded that exercise
has antidepressant properties with both clinical and
nonclinical populations, across all age groups, both
genders and using all modes of exercise. The findings
confirmed that exercise was as effective as psychotherapy
in reducing depression and that exercise combined with
psychotherapy yielded increased effectiveness.
In several meta-analyses and single
studies, researchers have reported positive sport- and
exercise-related effects on anxiety or on the joint
examination of anxiety and depression. For example,
Long and van Stavel (1995) reviewed 40 studies on the
effects of exercise on reducing anxiety. The findings
supported the view that exercise training is an
effective means of anxiety reduction (p. 181).
The authors also stated that the most important finding
was that exercise was especially effective for those
people with elevated levels of stress. Brown (1987)
reported successfully using a prescription of exercise
as a therapeutic intervention with anxious and depressed
outpatients for many years and found this therapy to
be effective and powerful for reducing anxiety and depression
levels. Similarly, through a comprehensive analysis
of the relevant literature since 1980 on nonclinical
populations, Plante and Rodin (1990) found that exercise
has been consistently shown to decrease mild to moderate
anxiety, depressive symptoms and stress.
Plante (1993) conducted another meta-analysis
of the research evidence regarding the use of aerobic
exercise as a preventative and treatment intervention
for more serious psychopathology. He found that this
intervention was used most commonly with depressive
and anxiety disorders. Exercise was found in many
studies to be an effective adjunct treatment with panic
disorder and other anxiety- disorder patients
(p. 366).
Russoniello (1991, 1992) studied
the effects of exercise therapy on both physiological
and psychological variables associated with mood and
stress among alcoholic patients in a rehabilitation
center setting. He found significant positive results
including decreases in sympathetic arousal (cortisol
levels) and increased positive mood states (POMS) following
the use of controlled exercise regimens. While these
clinically-oriented studies have usually employed an
aerobic program of walk/jog/run for exercise, other
literature has demonstrated that both aerobic and nonaerobic
exercise programs are effective in reducing depression
and anxiety and increasing self-concept (Holloway, Beuter,
& Duda, 1988; Singer, 1992; Stein & Motta, 1992).
The following conclusions of the
International Society of Sport Psychology (Singer, 1992)
are based on examining the research literature regarding
depressed and anxious patients:
- Exercise can help reduce state
anxiety.
- Exercise can help decrease the
level of mild to moderate depression.
- Long-term exercise can help reduce
neuroticism and anxiety.
- Exercise may be an adjunct to the
professional treatment of severe depression.
- Exercise can help reduce various
kinds of stress.
- Exercise can have beneficial emotional
effects across all ages for both sexes. (p. 201)
Hypotheses to Explain
the Psychological Benefits of Exercise and Sport
It has been well documented that
exercise positively impacts psychological well-being
and functions as an antidepressant (Johnsgard, 1989;
MacMahon, 1990; Martinsen & Stephens, 1994; North
et al., 1990; Oler et al., 1994; Plante & Rodin,
1990). However, there is no clear theory concerning
underlying mechanisms to account for these effects.
Several hypotheses have been offered to explain how
exercise functions to reduce symptoms of depression,
though none has been consistently sustained in empirical
studies. It is possible that the beneficial consequences
of exercise and physical activity may be mediated by
a physiological, chemical or psychosocial component.
According to Johnsgard, It may turn out to be
the case that all of these hypotheses will be shown
to play a legitimate role in explaining the antidepressant
effects of exercise (1989, p. 146).
Biochemical Mechanisms
Numerous biological and chemical
hypotheses have been proposed to explain the effects
of exercise on positive psychological health. One theory
implies that exercise increases levels of brain norepinephrine
and serotonin levels and that the release of endogenous
opiods from the pituitary gland act as a mood enhancer
and antidepressant. Another hypothesis is the thermogenic
theory which suggests that increases in body temperature
have a tranquilizing effect (Greist & Jefferson,
1992; Page & Tucker, 1994; Plante, 1993; Sime, 1987;
Tuson & Sinyor, 1993).
According to Greist and Jefferson,
some experts believe that simply moving large
muscle masses in regular rhythmical ways is inconsistent
with depression (1992). North et al. (1990) endorse
a psychobiological theory to explain the antidepressant
effect of exercise. They suggest that there are both
biochemical and psychological changes resulting from
exercise that influence depression.
Psychosocial Mechanisms
Several psychosocial hypotheses have
been presented concerning the connection between exercise
and improved perceptions of well-being. Exercise and
physical activity can furnish a sense of achievement,
promote feelings of personal control, provide a channel
for emotional release and reconnect one to the play
of childhood (Baumel, 1995). The positive feelings derived
from exercise and physical activity may also be due
to feelings of mastery, self-efficacy and accomplishment
of a task (Bandura, 1990). Involvement in physical activity
has also been suggested to provide a sense of competence,
an emotional catharsis and a form of biofeedback, which
teaches participants how to regulate their emotions
(Brown & Siegel, 1988; Fox, 1988; Kavussanu &
McAuley, 1995; Plante, 1993; Sime, 1987; Stein &
Motta, 1992; Tuson & Sinyor, 1993).
Other psychosocial mechanisms that
have been suggested include the possibility that physical
activity provides a distraction from problems, and that
exercise can offer a change of scenery and divert ones
mind from anxious thoughts (Baumel, 1995; Long, 1993;
Martinsen & Stephens, 1994; Norris, Carroll, &
Cochrane, 1991; Page & Tucker, 1994; Thirlaway &
Benton, 1992). King et al. (1989) found that among their
participants, awareness of secondary physical changes
(e.g., weight loss) was responsible for some of the
psychological benefits associated with exercise. For
depressed females, it may be a combination of the physical
benefits (e.g., increased endurance, reduced fatigue,
improved appearance and strength) and the psychological
benefits (e.g., increased competence and success, becoming
better organized, loss of passivity and helplessness)
that works to alleviate depression (Berger, 1984a).
Social interactions have been suggested
as mediators to the perceptions of improved well-being
associated with sport and exercise. Social relationships
(e.g., coach/athlete) that function in place of or in
addition to parental relationships, as well as peer
support, have also emerged as significant factors in
a few studies (Oler et al., 1994; Page & Tucker,
1994; Thirlaway & Benton, 1992).
FEMALE ADOLESCENTS AND MENTAL
HEALTH
This section focuses on three themes
found in the literature. The first theme concerns the
mental health problems of girls, especially during their
adolescence. An alarming feature of this review is the
prevalence of depression as well as the growing awareness
of Post-Traumatic Stress Disorder (PTSD) symptoms among
some adolescent girls. The second theme concerns the
empirical and anecdotal material on programs using exercise
as an intervention for adolescent girls. The third theme
focuses on sport and exercise as preventative measures
in the mental health treatment of adolescent females.
The research literature on female
mental health is sparse (McGrath et al., 1990; Mufson,
Moreau, Weissman, & Klerman, 1993). Some prevalent
psychological disorders that affect adolescent girls
(and boys) are depression, anxiety disorders and suicidal
ideation (Nolen-Hoeksema, 1990). Adolescent female depression,
with its many co-occurring manifestations, is of great
concern both to professionals and to loved ones.
Research on adolescent depression,
consistent with other depression research, has focused
on three constructs: depressed mood, chronic syndromes
and acute disorder. All share a common set of symptoms.
The duration and severity of the symptoms are critical
factors in determining the level of depression (Compas,
Ey, & Grant, 1993). Furthermore, a noted author
addressing depression among females has criticized the
trivialization of reported symptoms of depression which
fail to meet the criteria for acute depression when
the line between subclinical and clinical levels
of depression is blurry at best (Nolen-Hoeksema,
1990, p. 5).
Female Adolescents and
Depression
The Harvard Medical Schools
Mental Health Newsletter estimates that as many as nine
percent of adolescents suffer from serious depression
(Grinspoon, 1993). However, gender differences have
been discovered in this domain: there are twice as many
adolescent females as males suffering from depression
(Glied & Kofman, 1995; Greist, 1987; Grinspoon,
1993; Mufson et al., 1993; Nolen- Hoeksema & Girgus,
1994; Singer, 1992). Many girls feel pain and confusion
during adolescence. In addition, they are often expected
to have emotional difficulties during this time period.
But socially withdrawn adolescents with dramatic mood
swings, cognitive distortions and increasing conflicts
with parents and peers are not the norm and such behavior
should be considered as possible manifestations of psychiatric
illness (Mufson et al., 1993; Pipher, 1994). Similarly,
Grinspoon (1993) suggests that serious despair, rage
and suicidal fantasies are not the norm.
Adolescent depression resembles adult
depression. The similarities include recurring symptoms
of negative self-cognition, depressed mood, sleep
and appetite disturbances, tearfulness, difficulty functioning
at job or school due to poor concentration and suicidal
ideation (Mufson et al., 1993, p. 25).
There are some developmental differences
between adolescent and adult depressives. Adolescents
experience more hypersomnia and hyperphagia (i.e., sleeping
and eating disorders) than do adults. An important distinction
between these two groups is that depressed adolescents
make more suicide attempts than depressed adults. Female
adolescent depression has its own distinct causes. Girls
are often unprepared for the bodily and social changes
that mark their lives during this period. These changes
engender feelings of shame, guilt and inferiority (Grinspoon,
1993; McGrath et al., 1990; Mufson et al., 1993; Pipher,
1994).
There has been a substantial rise
in the rate of adolescent suicide in the last 30 years.
Suicide has been found to be correlated with depression
in adolescents and one in three depressed adolescents
has suicidal thoughts (McGrath et al., 1990; Nolen-Hoeksema,
1990). Mary Pipher, a clinical psychologist and expert
in the field of female adolescent psychotherapy, describes
the manifestations of female adolescent depression in
the following statement:
It makes some adolescent girls
sluggish and apathetic, others angry and hate-filled.
Some girls manifest their depression by starving themselves
or carving their bodies. Some withdraw and go deep within
themselves and some swallow pills. Others drink heavily
or are promiscuous. Whatever the outward form of the
depression, the inward form is the grieving for the
lost self, the authentic girl who has disappeared with
adolescence. (1994, p. 149)
There are many types of psychological
and biochemical therapies that have been utilized for
the treatment of depression in the adult population.
But there are few studies that address the issue
of differential effectiveness of treatment strategies
for depressed female adolescents. It should not be surprising,
therefore, that the literature on treatment outcomes
for depressed female adolescents is almost nonexistent
(McGrath et al., 1990, p. 83). The information that
we do have indicates that therapeutic interventions
that are effective for treating adult depression (e.g.,
traditional talk therapy and antidepressant
drugs) are often ineffective for adolescents (Grinspoon,
1993; Harrington, 1992; Mufson et al., 1993). Published
studies on the efficacy of pharmacotherapy for depressed
adolescents have not yielded significantly positive
results (Garland, 1994; Harrington, 1992; Hazell, OConnell,
Heathcote, Robertson, & Henry, 1995; Kutcher et
al., 1994). The reasons that adolescents fail to respond
to antidepressant medication are not yet known (Grinspoon,
1993; Mufson et al., 1993). Additionally, for some clients
there are mild to serious side effects in response to
antidepressant drug therapy (Johnsgard, 1989; Mufson
et al., 1993).
Several contemporary writers suggest
that a cost effective, alternative treatment is exercise
therapy (Johnsgard, 1989; MacMahon, 1990; Stuhlmiller,
1994; Welsh & Labbe, 1994). A prescription for exercise
can provide enrichment to the whole girl. Exercise can
offer adolescent girls improved cognitions about their
body image, self-esteem and competency. Exercise therapy
can also promote physiological well-being with its increased
energy and improved sleep and eating patterns (Johnsgard,
1989; Martinsen & Stephens, 1994).
Post-Traumatic Stress
Disorder
Sadly, for some of todays adolescents
and children, unchosen circumstances of their lives
expose them to physical and sexual abuse, violence and
disaster to such an extent they reflect the symptoms
of Post- Traumatic Stress Disorder (PTSD) (Parson, 1994;
Wilson, 1994). Recent studies of institutionalized children
from dysfunctional families identified eight common
categories of stressors in their lifestyle (Wilson,
1994). These stressors were said to have low-level,
insidious effects which were compounded or additive
over time producing symptoms similar to classic
PTSD (Berk, 1992). The stressors include: (a) failure
to provide positive role modeling, (b) failure to protect
from continued trauma or aid to experience safety, (c)
failure to provide structure, (d) failure to provide
unconditional positive regard, (e) failure to teach
suitable problem-solving methods, (f) failure to teach
the norms of society, (g) chaotic, conflicted, abnormal
environments which become the normal baseline of experience,
and (h) high levels of inconsistency, unpredictability,
role reversal and anxiety-inducing intrafamilial or
interpersonal relationships. It is the position here,
and throughout this section of the report, that the
structural setting of sport and exercise programs can
be organized to supply the antidote to the very deficits
identified in the backgrounds of these children.
Unfortunately, there is a paucity
of research on these matters. However, a few studies
have shown that exposure to violence and family dysfunction
is associated with PTSD symptomology among nonclinical
children and adolescents (Foa, Riggs, & Gershuney,
1995; Schwarz & Perry, 1994), male juvenile offenders
(Burton, Fox, Bwanausi, Johnson, & Moore, 1994)
and male and female adolescents who have been physically
abused (Pelcovitz et al., 1994). After a review of the
literature (Miller-Perrin & Wurtele, 1990), it was
stated that clinical and empirical literature
shows that PTSD symptomology often develops in adolescence
and adulthood among female survivors of sexual abuse
(p. 91).
In order to grasp the seriousness
of this problem, it is necessary to estimate the prevalence
of sexual abuse among adolescent females. In a recent
random sample of 930 adult women, it was reported that,
before the age of 17, 12 percent had experienced intrafamilial
sexual abuse and 26 percent had been abused by someone
not in the family (McGrath et al., 1990). Further, in
a study of the records of 188 male and female psychiatric
inpatients discharged over an 18-month period, 53 percent
of females and 23 percent of males had been abused.
Of the 28 patients who were adolescent, 75 percent had
been abused (McGrath et al., 1990).
Exposure to violence and physical
and sexual abuse is a phenomenon which cuts across social
classes and neighborhoods. It has been pointed out,
however, that additional forms of trauma, including
ethnocultural strife and cultural alienation, can add
layers of challenge for adolescents (Parson, 1994).
Parson specifically describes post-traumatic ethnotherapy
as a therapeutic orientation characterized by ethnic/cultural
sensitivities. Such an orientation will enhance amelioration
of the damages caused by stressors both natural (e.g.,
housefire, earthquake, hurricane) and political (e.g.,
being the victim of having a swastika placed in your
yard or painted on your house, racial epithets directed
toward you or your children).
In the PTSD literature, voices are
calling for experimentation with and use of exercise
and sport programs for therapeutic purposes. Stuhlmiller
(1994) calls action-based programs one of the
most powerful, yet generally overlooked approaches to
PTSD (p. 386). One program, Ending Violence Effectively
(EVE), was specifically designed for females who had
been victims of rape, incest, physical and verbal assault,
sexual harassment and other forms of trauma. In wilderness
settings, traditional counseling was offered in addition
to an action-based component which included movement
and meditation, massage, relaxation training and hypnosis
(p. 387).
In order to provide a possible explanation
for the effectiveness of exercise and sport programs,
Stuhlmiller (1994) pointed out that over time, exposure
to trauma has been shown to result in reduced production
of serotonin, catecholamines, norepinephrine and endogenous
opiods. These biochemical deficiencies are associated
with the avoidance, emotional constriction and depressive
symptoms characteristic of PTSD. As has been pointed
out throughout this report, the role of regular exercise
in increasing these chemical levels, thereby contributing
to a heightened sense of well-being, has been substantiated
(Page & Tucker, 1994; Plante, 1993; Tuson &
Sinyor, 1993).
Exercise and Adolescent
Mental Health
Much more research is needed regarding
the effect of sport and exercise on female adolescent
mental health, but promising findings are emerging in
recent investigations. Holloway et al. (1988), studied
the effectiveness of strength training on self-efficacy
for adolescent girls. When these girls participated
in free-weight training, they reported significant gains
in self-efficacy and confidence levels. Participants
experienced improvements in self-esteem for their bodies
in particular and for their lives in general. In another
study working with a junior high and high school population,
more than three hundred adolescent girls reported an
inverse relationship between experienced life stress
and exercise participation. Based on longitudinal observations,
Brown and Siegel (1988) concluded that exercise was
a viable technique for stress reduction.
Koniak-Griffin (1994) conducted a
study in which an aerobic exercise program was introduced
to nonclinically depressed pregnant adolescents. The
results demonstrated a significant decrease in depressive
symptoms and an increase in total self-esteem. The researcher
suggested that participation in the aerobic exercise
program may have created general feelings of self-accomplishment
among exercisers which offset symptoms of depression
and reduced the adverse impact of the crisis of premature
parenthood (p. 259).
Oler et al. (1994) explored the relationship
between participation in athletics and depression, suicidal
ideation and substance abuse in male and female adolescents.
The researchers conducted a survey and compared high-school
athletes to nonathletes. They report that Athletic
participation is a marker for decreased likelihood of
depression and some high-risk behaviors in adolescents,
particularly suicide ideation (p. 784). The study
also revealed that female athletes reported fewer suicide
attempts than female nonathletes.
In two studies with adolescents,
Norris et al. (1991) determined that aerobic training
was effective, to a statistically significant degree,
in improving psychological well-being. In a large study
of the impact of exercise on psychosocial functioning
in male and female high school students, Page and Tucker
(1994) found that physically active adolescents tend
to feel less lonely, shy and hopeless.
Four studies were identified that
focused on clinically diagnosed or special populations.
Horn and Claytor (1993) found that exercise as a therapeutic
intervention had the greatest impact on the self- esteem
of emotionally disturbed youth. Studying a small group
of inpatient adolescents, researchers Brown, Welsh,
Labbe, Vitulli and Kulkarni (1992) found significant
improvements in depression and anxiety due to an aerobic
training procedure. Fridinger and Dehart (1993) studied
an inpatient adolescent drug and alcohol treatment program
that had a distinctive component of exercise and physical
activity incorporated as an adjunct to the psychotherapy
intervention process. Exercise was found to be an effective
coping strategy for stressful situations: using a walk/jog
procedure, the authors reported significant reductions
in depression and anxiety levels. Similarly, MacMahon
and Gross (1988) conducted a study on incarcerated adolescent
males (ages 14 to 18) who participated in a three-month
aerobic exercise program. They found a significant increase
in self-concept and a decrease in depression levels.
Anecdotal Evidence from
the Field
It is important to realize
that we are all doing the same thingworking to
build self-esteem, strengthen mental health, prevent
pregnancy and AIDS and prevent drug abuse. There is
a real need to integrate exercise and sport into existing
programs, says Dr. Debra Klein-Walker, Assistant
Commissioner, Bureau of Family and Community Health,
Massachusetts Department of Public Health.
The following examples offer tangible
support for the use of exercise and physical activity
as a treatment intervention for the mental health of
adolescent females. The most successful programs provide
meaningful and consistent activities, are goal-oriented
and are administered by a knowledgeable and supportive
interdisciplinary services team. It should be noted
that the information provided in this section comes
from phone interviews with practitioners and thus provides
anecdotal rather than empirical support.
Montanari Residential Treatment
Center
Working with emotionally disturbed
youth at the Montanari Residential Treatment Center,
in Hialeah, Florida, the staff reports success with
exercise and sport as a treatment intervention with
adolescent girls.
Columbus College Counseling
Center
From 1980 to 1986, Dr. Lawrence Meisel
was involved in a program that integrated both aerobic
and nonaerobic exercise training into a counseling treatment
program for inpatient delinquent adolescents. The program
involved running and weight lifting and the entire counseling
staff provided outstanding support. According to Meisel,
one of the major results of this cost-effective intervention
was that after six months of training, the girls and
boys showed considerable improvements in self-concept
and confidence and always had significantly more internal
locus of control. Meisel would run with the students
and, at the point where they were struggling, he would
whisper in their ears, This is what it feels like
to want to give upbut in about ten minutes you
will know what it means to succeed!
Villa Maria Treatment Center
Greg Mobley, a therapist at the Villa
Maria Treatment Center near Baltimore, Maryland, has
found exercise and physical activity interventions more
successful if they are coeducational. The exercise training
has had a positive effect on other programs at the center.
He reports that exercise and sport provides the adolescent
girls with improved body image and that they are more
relaxed and cooperative in group therapy sessions.
Three Springs Treatment
Center
Three Springs Treatment Center in
Huntsville, Alabama, has a physical activity program
that is supplemental to the main therapeutic program.
It is a challenging outdoors program that includes such
activities as a ropes course, caving, rappelling, rock
climbing, backpacking, hiking and orienteering. They
have had success with adolescent girls in improving
self-esteem and teaching goal-setting and problem-solving
skills (Jim Chritzberg, Director).
Millcreek Schools Psychiatric
Residential Treatment Facility
At the Millcreek Schools Psychiatric
Residential Treatment Facility, in Magee, Mississippi,
Kelly Alderman is in charge of the sport and exercise
programs for the inpatient adolescents. The professional
staff has noted benefits from exercise intervention
with the emotionally disturbed and behaviorally disordered
patients. The adolescents are more stable, aggression
has decreased, and the staff found a marked reduction
in stress following the exercise intervention
program.
Project Light
Project Light was started in 1991
as a Boise State University research study. The research
conducted confirmed that exercise reduces symptoms of
depression and depression-related illnesses in many
cases. It has now developed into an ongoing program
in the community to promote exercise as one of the treatment
modalities for persons suffering from depression. Of
special note is the integration of the medical community
into this project. Physicians and mental health professionals
are encouraged to include this exercise program as a
treatment modality in addition to traditional medication
and psychotherapy treatments.
The funding for the project came
from the Boise Chapter of the National Alliance for
the Mentally Ill via the Healthwise Medical Self-Care
Small Grants Fund. Persons with depressive disorders
referred by mental health care professionals are not
charged for participating in the eight-week program.
Participants engage in three 45-minute small group exercise
sessions per week. Each session consists of a variety
of prescribed exercise experiences in stretching and
warm-up activity, resistance and flexibility training
and cardiovascular exercise (e.g., walking, jogging).
The workouts are of moderate intensity in a noncompetitive
setting. A buddy system is developed for
the participants. A follow-up group class is conducted
once a week for an entire year to promote program maintenance
and to increase the chances of long-term success. Classes
are taught by trained fitness professionals at the Human
Performance Center of Boise State University.
The success rate of this program
has been high. Participants report improvement in many
areas commonly associated with depression: immediate
help with their emotional state, prompt improvement
in feelings of isolation and the ability to counteract
lack of motivation. Although the program has not yet
been offered to adolescentsmost members in this
first year are women in their twentiesit appears
to be a good model for all age groups.
Exercise as a Preventative
Measure
Several researchers report that participation
in a regular exercise program may actually prevent future
symptoms and disorders. Exercise may help to prevent
some forms of psychopathology by assisting people in
managing some of the symptoms associated with psychopathology
(Plante, 1993, p. 373). Participation in exercise and
sport enhances psychological well-being (Baumel, 1995;
Norris et al., 1991; Oler et al., 1994; Plante, 1993;
Plante & Rodin, 1990; Singer, 1992), thus playing
a role as a preventative measure for deterring mental
illness in adolescent girls.
Adolescent girls often have difficulties
accepting the changes in their bodies; feelings of inferiority
and insecurity haunt them (McGrath et al., 1990; Millstein,
Petersen, & Nightingale, 1993; Nolen-Hoeksema, 1990).
Exercise can provide a young girl with a positive image
of her bodyof its capabilities, its power and
agility. Participating in a physical activity can provide
feelings of competence and success (Holloway et al.,
1988; Stein & Motta, 1992; Vealey, 1992). Adolescents,
whose problems are not particularly amenable to traditional
forms of verbal psychotherapy, may also respond to an
organized running program (Buffone, 1984, p. 221).
When adolescent girls have some passion and strong interest
in participating in activities, it can give them
some perspective and sustain them through the toughest
times (Pipher, 1994, p. 266). For adolescents
participating in a physical activity training program
exercise does operate as a buffering mechanism
between stress and anxiety/depression (Norris
et al., 1991, p. 63).
There are feelings of powerlessness
associated with adolescent depression and anxiety that
can be counteracted by exercise and sport, where young
girls and women can gain feelings of personal control
(Stein & Motta, 1992). Positive mental health is
enhanced by an involvement in a meaningful, goal-directed
endeavor. Exercise, sport and physical activity can
provide meaningful, goal-oriented experiences for adolescent
girls in individual or group settings, or in community-
and school-based environments.
CONCLUSIONS AND RECOMMENDATIONS
The consensus of the exercise science
and behavioral medicine literature is that exercise
and physical activity can promote psychological well-being.
The information presented below represents some important
conclusions and practical recommendations derived from
this review of literature. This information can be particularly
helpful for those individuals working with females in
physical activity and sport settings.
- Involvement in physical activity,
exercise and sport promotes psychological well-being.
Additionally, the therapeutic use of exercise for
improving the mental health of adolescent girls goes
beyond traditional treatment and mental health programs.
In effect, the use of physical activity as a mental
health intervention would enhance the therapeutic
opportunities for treating adolescent girls.
- Adolescent girls can achieve a
healthy mental state through a variety of experiences
related to exercise, sport and physical activity:
the establishment of constructive relationships with
peers, the influence of healthy role models, the tangible
experiences of success and the lessons of how to deal
with positive and negative physiological and psychological
changes. Given the importance of such experiences,
we should develop and implement mental health programs
that foster females participation in physical
activity.
- Regular participation in exercise
and physical activity can allay many of the symptoms
of hopelessness and worthlessness, feelings typically
associated with anxiety and depression. Involvement
in physical activity not only counteracts these negative
affective responses, but can instead create expectations
of success. It is particularly important to facilitate
regular participation in physical activity given that
anxiety and depression are two mental health disorders
prevalent among adolescent females (Nolen-Hoeksema,
1990).
- Exercise and sport can teach young
girls problem-solving skills and promote feelings
of self- worth. Additionally, exercise, physical activity
and sport have been shown to be an antidepressive,
a mood enhancer and an anxiety reducer, thereby acting
as a natural, cost- effective intervention for the
mental health of adolescent girls. The beneficial
lessons learned through participation in physical
activity can counteract the negative perceptions of
self, the world and the future that often accompany
feelings of anxiety and depression.
DIRECTIONS FOR FUTURE RESEARCH
The role and efficacy of exercise
as a treatment intervention for all girls, and in particular
adolescent girls, has not been adequately addressed
in the literature. Filling this informational void will
allow us to more fully develop exercise programs that
can be used as preventative and treatment interventions.
Therefore, we must empirically document issues related
to the mental health benefits of girls participation
in physical activity. Some research priorities are highlighted
below.
- Identify mediating factors associated
with physical activity and mental health. More empirical
data need to be obtained to further our understanding
regarding the mechanisms underlying the enhancement
of girls psychological well-being through physical
activity. Additionally, we must conduct studies that
determine the effects of socioeconomic status, race
and/or ethnicity that singly or coactively influence
the factors mediating the relationship between exercise
and mental health.
- Examine the relationship between
mood state and exercise. Investigations must examine
the effect of exercise and sport participation on
all levels of mood disorders experienced by girls.
Conditions ranging from depressive symptoms to chronic/dysthymic
disorders to major depression and their response to
physical activity warrant examination.
- Determine the efficacy of exercise
as a therapeutic modality. Research studies should
examine the efficacy of exercise as a separate treatment
intervention as compared with psychotherapy and pharmacotherapy
for adolescent girls. Additionally, we must investigate
the efficacy of exercise as an adjunct to both forms
of traditional therapy. Relatedly, we must assess
the cost- effectiveness of anti-depressant medication
treatment, psychotherapy and exercise when used singularly
as well as jointly.
- Identify factors influencing exercise
as a treatment intervention. When using exercise as
a treatment intervention to restore mental health
for adolescent girls, studies must be designed to
consider the impact of peer (same-sex and cross-sex)
influences and individual versus group approaches
when determining program effectiveness. Additionally,
treatment programs employing physical activity as
a therapeutic modality should be empirically tested
in clinical settings to determine the efficacy and
cost-effectiveness of the intervention.
- Understand variables associated
with exercise adoption and maintenance. Investigations
should identify and critically analyze various physical,
psychological and sociological factors (both singularly
and in combination) which influence exercise adoption
and maintenance among adolescent girls.
- Broaden the scope of our research
to include factors related to diversity. Traditionally,
research has been confined to how certain psychological
and physical characteristics of both the leader and
the participant impact exercise involvement. Future
studies should also investigate the influence of factors
related to diversity such as gender, race and ethnicity.
- Determine the perceptions of mental-health
service providers in prescribing exercise as a form
of treatment. Studies must be conducted to identify
and implement those factors that enhance partnerships
between traditional mental health service providers
and sport science scholars/practitioners. In order
to achieve this interdisciplinary approachand
thus make exercise an integral part of treatment interventionwe
need to understand the perceptions and attitudes of
mental health service providers.
Policy Recommendations
GIRLS NEED SAFE, HEALTHY AND SUPPORTIVE
ENVIRONMENTS to grow and excel. Policies need to tap
the power and potential of physical activity and sport
to advance girls health, physical and emotional
development, social well-being and educational aspirations
and achievements. Efforts must be directed toward increasing
girls participation in physical activity and sport.
It should also be noted that many of the following policy
recommendations would, if implemented, enrich the experience
of boys as well as girls.
In order to foster greater
participation among girls in physical activity and sport:
- Consonant with the goals of Healthy
People 2000: National Health Promotion and Disease
Prevention Objectives (U.S. Department of Health
and Human Services, 1991), school administrators and
principals should require daily physical education.
- As student populations become more
ethnically diverse, curriculum planners should develop
innovative strategies to make physical activities
closely suited to girls interests, predilections
and cultural backgrounds. An example of this is providing
sports and physical activities such as soccer and
dance which may be more likely to resonate with cultural
familiarity for girls from African, Latin or Caribbean
origins.
- Federal and state lawmakers should
explore ways to provide school districts and municipalities
with relief from high liability insurance costs that
may limit their ability to provide fitness and athletic
opportunities for children and adolescents. Such relief
would also allow for greater use of existing facilities
by the wider public.
- Enforcement of Title IX should
be vigorously pursued by government and administrative
officials at the federal, state and local levels.
- Develop after-school and community-based
programs that provide safe environments for girls
to engage in a variety of exercise and athletic activities.
- Organizations with public mandates
to foster a better quality of life through sport and
athletic involvement (e.g., USOC, NCAA) should focus
not only on elite athletes, but on grassroots/community-based
programs as well. It is particularly important that
some of these programs be designed to appeal to girls.
Given what we know about the powerful effects of role
modeling, we should also promote the inclusion of
females in leadership positions at all levels of organizational
structure, thus sending the message that women are
leaders too.
In order to better utilize
physical activity and sport as vehicles for promoting
girls physical and mental health:
- Expand health education efforts
in schools and community health programs that educate
youth and the general public concerning the impact
of physical activity and sport in the lives of girls.
- Physical educators and community
health care providers should develop multidisciplinary
programs that include a combination of exercise, diet
and nutritional information to help lower risks for
obesity, high cholesterol and osteoporosis.
- Identify programs that effectively
use physical activity and sport as vehicles for lowering
girls risk for unwanted sexual behavior and
pregnancy.
- Encourage print and broadcast journalists
to project appropriate role models for girls. For
example, mass media should avoid using images that
create unrealistic expectations related to body image
such as an excessively thin body composition.
- Longitudinal, retrospective and
case research studies should be funded so that we
can determine the extent to which promotion of daily
physical activity for girls reduces later risk for
adult diseases such as coronary heart disease, diabetes
and certain cancers.
- Health care providers should explore
innovative ways to promote physical activity among
girls through counseling, anticipatory guidance and
education.
- In keeping with the interdisciplinary
team treatment approach now highly valued in
most mental health settings, steps should be taken
to initiate and increase partnerships between sport
science researchers and practitioners (e.g., sport
psychology scholars working with sport psychology
consultants and kinesiotherapists) when addressing
the research and educational challenges identified
in this report.
In order to enhance the
contributions of physical activity and sport to girls
educational achievements and social development:
- Coaching certification programs
should include information about the real and potential
benefits of physical activity and sport for girls
health and development, as well as prevention of eating
disorders, injury and sexual harassment.
- Continue to revise the content
and process of physical education classes in order
to more closely meet girls preferences and concerns.
Involve girls in the selection of these activities.
- Foundations and government agencies
should fund research that examines how athletic participation
can be more fully used as a tool to enhance girls
academic performance and lower their risk for school
dropout.
- Research should be encouraged to
investigate the various ways in which diversityrace,
ethnicity and disabilityimpacts girls
involvement in sport and physical activity. Particular
attention should be given to those research efforts
utilizing comparative samples across different groups
(e.g., socio-economic status, sexual orientation).
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FOR MORE INFORMATION, PLEASE
CONTACT
The Presidents Council on Physical Fitness
and Sports
200 Independence Avenue S.W., Room 738-H
Washington, D.C. 20201
(202) 690-9000
Center for Research on Girls &
Women in Sport
203 Cooke Hall
1900 University Avenue S.E.
University of Minnesota
Minneapolis, MN 55455
(612) 625-7327 voice, (612) 626-7700 fax
crgws@tc.umn.edu
http://www.coled.umn.edu/KLS/crgws/
Center for Mental Health Services
/ Substance Abuse and Mental Health Services Administration
5600 Fishers Lane, Room 15-99
Rockville, MD 20857
(301) 443-0001
The Executive Summary is available
at the following:
National Mental Health Services Knowledge Exchange
Network
bulletin board: (800) 790-2647
world wide web: http://www.mentalhealth.org/
Center for Research on Girls
& Women in Sport web site
http://www.coled.umn.edu/KLS/crgws/pcpfs_es.html
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