Association between Physical Exercise and Mental Health

Physical exercise is usually associated with health benefits including, reduced mortality, improved musculoskeletal health, stress regulation, and reduced risk of obesity, cardiovascular disease, and cancer (Chekroud, S., et al, 2018). Still, past research has provided conflicting results based on poor statistical power to examine exercise types, since everyone will engage in a particular type of exercise. The study displays the effects of varying features of exercise such as frequency, intensity, or duration while examining its relationship to mental health (Chekroud, S., et al, 2018). The study was published by The Lancet, a medical journal that “has evolved as a family of journals…but retains at its core the belief that medicine must serve society,” (The Lancet). The Lancet Psychiatry, one of the eighteen medical journals under The Lancet, is a peer-reviewed general medical journal that “features clinical research, expert reviews, and provocative comment and opinion in mental health (The Lancet Psychiatry). The lead researcher, Sammi Chekroud, is associated with the Oxford Centre for Human Brain Activity, a part of the Wellcome Centre for Integrative Neuroimaging in the Department of Psychiatry at the University of Oxford. Chekroud is currently a Research Assistant under the supervision of Professor Kia Nobre in the Brain and Cognition Lab. The purpose of writing this rhetorical analysis was to read critically and inspect the contents of a professional research paper, as well as, learn about national research shaping clinical advances.

The study’s purpose was to inform the audience of the varying types of exercise, in terms of frequency and duration, and its influence on overall mental health. The study was published in 2018, at a time when confusion regarding the frequency, intensity, and duration of exercise and its relationship to mental stability existed. Mental health complications are extremely prevalent today as mental disabilities negatively impact millions of people of all ages. In this “cross-sectional study” over one million adults, aged eighteen and above, that resided in the United States during the years 2011, 2013, and 2015 were the subjects of the study. All the subjects belonged to the Behavioral Risk Factor Surveillance System (BRFSS) conducted by the Centers for Disease Control (CDC), a nationwide survey in which risk behaviors that contribute to mortality are monitored. Previous studies have determined an association between exercise and mental health; however, this study examines specificity in exercise types from household activities to popular sports and its association with a reduced mental health burden. In addition, the study “compared the number of days of bad self-reported mental health between individuals who exercised and those who did not, using an exact non-parametric matching procedure to balance the two groups in terms of age, race, gender, marital status, income, education level, body-mass index category, self-reported physical health, and previous diagnosis of depression,” (Chekroud, S., et al, 2018). Thus, exigency is to provide an informative analysis of physical activity to treat mild psychological disorders.

The intended audience is most likely psychologists, psychiatrists, psychoanalysts, and holistic doctors since the study includes terms such as “Behavioral Risk Factor Surveillance System” and “Non-parametric two-sample Wilcoxon rank-sum tests,” which are unfamiliar to the general population. The study would most interest those specializing in brain development and function and those seeking nuanced methods for diagnosis and treatment because the association was not observed in individuals without a diagnosis of depression, suggesting that exercise benefits were restricted to clinical populations (Chekroud, S., et al, 2018). Mental health professionals could prescribe exercise as a form of treatment for patients diagnosed with mild depression, which is the leading cause of the global disability burden. The findings could have a greater effect on future studies as the mental health burden can be reduced more efficiently.

Following the traditional IMRAD format, the research paper begins with an abstract that acts as a summary for the paper, it provides background information on the topic of physical activity and its association to mental health. The authors utilize the three moves of the CARS model in their introduction afterward. The first move is, “establishing a territory;” step one of the first move is “claiming centrality,” in which “the writer states that the topic of research is useful, relevant, important, or worth investigating,” (Swales). The topic sentence of the second paragraph in the introduction, “One factor that might explain conflicting results,” claims centrality by drawing a conclusion based on previous research which is then followed by evidence to support the statement, “Such studies lack statistical power,” (Chekroud, S., et al, 2018). Step two (in Move 1) is “making topic generalizations” consisting “of statements concerning the current state of either knowledge, consensus, practice or description of phenomena,” (Swales). The third paragraph of the introduction opens with a general statement, “Because depression is now the leading cause of global disability burden,” to describe the phenomenon of mental disability (Chekroud, S., et al, 2018). Step three (in the first move) entails “reviewing items of previous research” in which “the writer needs to relate what has been found (or claimed) with who has found it (or claimed it),” (swales). The authors complete the final step in the “Research in Context” section of the introduction to allude to previous research by identifying inconclusive results of earlier studies into the topic by writing, “We searched PubMed,” (Chekroud, S., et al, 2018). The inclusion of outside studies appeals to ethos for the authors can convey trustworthiness through tone and style, as well as, establish their credentials in their respective fields.  The “Research in Context” section of the introduction provides “Evidence before this study” to showcase the “added value of this study” and its “implications of all the available evidence,” (Chekroud, S., et al, 2018).

Additionally, in the second move of the CARS model, the research paper tries “establishing a niche” by “showing that the previous research (or solutions) are not complete,” (Swales). The first step in the second move would require “counter-claiming” which “is used to…pinpoint a weakness in previous research,” (Swales). The “Research in Context” section mentions “inconsistencies across previous studies of exercise and mental health” not necessarily to weaken the findings of past studies but to strengthen the findings of this one. The following step in move two requires “indicating a gap” and that is done when the authors showcase the inconclusive data of previous studies. The research paper goes on to complete the third step of “raising a question” by demonstrating that past research recognized a correlation between exercise and mental health, but duration, frequency, or intensity of the physical activities were not considered. Step four is “continuing a tradition” that is “frequently signaled by logical connectors,” (Swales). The authors satisfy the final step of move two by stating “the goal” which appeals to pathos as it recognizes that this study is for the common good of each person suffering from the mental health burden (Chekroud, S., et al, 2018). This captures the audience’s heart and emotions as superordinate goals establish personal connections.

In the third move of “occupying the niche” the authors “reveal their solution to help fill the gap,” (Swales). The third move consists of four steps in which the two are fulfilled by the research paper. The first part of step one is “outlining purposes” which is done “by stating the main purpose or aim of the study,” (Swales). The authors use the present tense when writing, “We examined the association between exercise and mental health,” to describe their intentions relative to the physical copy of the research paper (Chekroud, S., et al, 2018). Past tense is also seen in the introduction when the authors mention previous studies, “Among many of these studies, it has been argued,” (Chekroud, S., et al, 2018). This draws the audience to mental inquiry hence previous and new concepts from the study can be interconnected. Part two of step one is “announcing present research” where “the writer describes the aims in terms of what the research sets out to ‘do’,” (Swales). In this case, the inanimate agent is used over the human agent as the authors constantly refer to their findings versus past findings; inclusive words like “we” are not seen in any facets of the research paper. In the second step of “announcing main findings” the authors “[consider] the results to be the most important aspect of the research and therefore reports these as a part of the introduction,” (Swales). To draw a distinction between this study and past studies, the authors based their findings on “patterns of mental health burden across a diverse set of exercise types, durations, and frequencies while accounting statistically for a range of sociodemographic and physical health characteristics,” (Chekroud, S., et al, 2018). This completes the second step in the third move because it establishes a reason for why the findings of this should be effective for the treatment of the mental health burden. Although the remaining two steps of “indicating structure of the paper” and “evaluation of findings” are not met, the research paper still addresses most of the moves of the CARS model (Swales).

Through the study, the authors seek to convince their audience that physical exercise is a viable strategy to treat mild mental health disorders. This is a further implication of the IMRAD format as the “methods” section is divided into subcategories of “data sources and dataset description, outcome variable, data preprocessing, statistical analysis, and role of the funding source,” (Chekroud, S., et al, 2018). Ethos is used when referring to previous studies since it displays that the authors are expert researchers in their field and the study will provide new information that will make the implications of past, present, and future studies of physical exercise and mental health clearer. The BRFSS and use of human subjects exemplify the use of pathos for it allows the audience to empathize with those suffering from the mental health burden. BRFSS is a survey conducted over the phone, person to person, and it directly influences the data of this study as it “measured mental health burden according to participants’ self-report,” (Chekroud, S., et al, 2018). Furthermore, the details, graphs, and data were designed to appeal to logos. The statistical analysis provides two graphs, “Figure 1: Cross-sectional data from more than 1.2 million individuals in the USA”, and “Figure 2: Mental health burden as a function of exercise duration” which “formally [analyze] the effects of exercise duration and frequency using a generalized additive model to allow us to observe non-linear relationships with [the] mental health burden,” (Chekroud, S., et al, 2018). This appeals to the audience’s logical reasoning ability, which in turn builds ethos too. The use of logos allows the audience to understand the presented data and ethos provides authority to the authors to dictate their findings. Logos serves as evidence for the researchers, ethos is the reputation the authors gain from presenting reliable evidence and applying to the topic, and pathos is a call of action to the audience since the findings should be implemented by mental health professionals.

To add on, the results section followed the method section as the research paper maintained its IMRAD format. The results are clumped into an essay-like format that appeals to logos since it provides an in-depth analysis of the recorded data, it is an explanation of what the numbers mean. It can be difficult to comprehend the varying types of statistics such as the “mean mental health burden,” “zero-inflated negative binomial regression model,” and “covariate set,” even for other professionals in the field (Chekroud, S., et al, 2018). The results section is essentially a continuation of the method section since the text puts the data into the context of the study making the findings of the study crystal clear. The charts and graphs of “Figure 3: Mental health burden as a function of exercise frequency,” are visual representations of the collected data in which the numbers prove that “people exercising…had the lowest mental health burden,” (Chekroud, S., et al, 2018). Every aspect of the results appeal to logos because the organization of the information into graphs validate the claims made earlier, it serves as evidence for the audience.

Finally, to conclude the IMRAD format of the research paper, the authors’ discussion interprets the results since “this study shows a meaningful association between exercise and mental health,” (Chekroud, S., et al, 2018). It compares the findings of this study with that found in previous studies by saying, “it has previously been argued,” (Chekroud, S., et al, 2018). This further establishes the ethos of the authors since they were able to improve the knowledge of psychologists, psychiatrists, psychoanalysts, and holistic doctors about this topic. This study successfully concludes by presenting the limitations of the experiment, which is highly imperative in the view of the fact that “the cross-sectional nature of this study…limits the ability to establish the direction of causality for the association between exercise and mental health,” (Chekroud, S., et al, 2018). Since the study was conducted on random individuals from the BRFSS, it does not recognize any person outside the survey which decreases “causality.” Also, every individual is different, so the experiment lacks a proper control group to compare with the experimental group. Future implications of the study are also discussed to show that this study can be improved, “an important next step for this line of research is to collect longitudinal passive mobile,” (Chekroud, S., et al, 2018). Granting that the study was conducted in an extremely professional environment, it is important to understand that the findings are not one-hundred percent conclusive. Sure, confusion regarding physical exercise and mental health has decreased, but future research still needs to be done.

In writing the rhetorical analysis, I learned plenty. I still do not understand the information in the research paper, but it has allowed me to step beyond my comfort zone. This study was an addition to past research, so I had to look back and navigate through previous studies to locate distinctions. I have written rhetorical analysis papers and research papers before, yet when writing this paper, the experience was new. While analyzing the research paper using the IMRAD/CARS model and the rhetorical appeals (ethos, logos, pathos), it became abundantly clear that every research paper must be organized following a certain procedure. As a pre-medical student my goal one day, hopefully by my senior year in college, is to publish my very own research paper. This assignment allowed me to realize how research is conducted and presented.

References

Chekroud, Sammi R, Gueorguieva, Ralitza, Zheutlin, Amanda B, Paulus, Martin, Krumholz, Harlan M, Krystal, John H, & Chekroud, Adam M. (2018). Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: A cross-sectional study. The Lancet Psychiatry, 5(9), 739-746. doi:10.1016/S2215-0366(18)30227-X

Swales, John, Genre Analysis, CUP, 1990, “Creating A Research Space” CARS model, Helsinki University of Technology, Language Centre, http://www.cs.tut.fi/kurssit/SGN-16006/academic_writing/cars_model_handout.pdf.

The Lancet, About Us, https://www.thelancet.com/about-us.

The Lancet Psychiatry, About the Lancet Psychiatry, https://www.thelancet.com/lanpsy/about.

---

Rhetorical Analysis of a Research Paper

---