Psychology of Sport and Exercise 5 (2004) 153–167
The effect of ﬁtness training on clinically depressed patients:
an intra-individual approach
P. Van de Vliet
, Y. Vanden Auweele
, J. Knapen
, R. Rzewnicki
, H. Van Coppenolle
Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Leuven, Belgium
Department of Sport and Movement Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Leuven,
University Centre Sint-Jozef, Leuvensesteenweg 517, B 3070 Kortenberg, Belgium
Department of Educational Sciences, Katholieke Universiteit Leuven, Vesaliusstraat 2, B 3000 Leuven, Belgium
Received 2 January 2002; received in revised form 10 July 2002; accepted 13 September 2002
Objectives. To use hierarchical class analysis (HICLAS) in a case study to offer insight into the effect
of exercise on aspects of functioning of a depressed patient.
Methods. Based on a retrospective interview with a 32-year-old depressed male patient, immediately
preceding discharge from the hospital, a HICLAS grid analysis of interactions between relevant situations
in the hospital, including different treatment components, and emotional and behavioural reactions is
described and explained.
Results and conclusions. Although there is no support for a direct antidepressant effect of ﬁtness training,
the results reveal that ﬁtness training embedded in a cognitive-behavioural treatment program, is associated
with positive changes in other relevant aspects of the patients’ functioning. This includes enhanced coping
strategies, sustained efforts to continue activities, and improved awareness of physical well-being. Other
therapeutic interventions and pharmacotherapy are associated with a more ambivalent reaction pattern of
positive as well as negative emotional and behavioural characteristics. The present ﬁndings are discussed
in light of the multidisciplinary approach to clinical depression. Furthermore, the application of intra-
individual research methodology is highly recommended to complement more traditional research designs
to investigate the effect of exercise on depressed patients, not least because new research hypotheses can
2003 Elsevier Ltd. All rights reserved.
Keywords: Exercise; Clinical depression; Intra-individual methodology; HICLAS
Corresponding author. Tel.: +32-16-32-91-28; fax: +32-16-32-91-96.
E-mail address: peter.vandevliet@ﬂok.kuleuven.ac.be (P. Van de Vliet).
1469-0292/$ - see front matter 2003 Elsevier Ltd. All rights reserved.