JMERC
Owner
Janbazan Medical and Engineering Research Center (JMERC) is the owner of IJWPH.
0.5
Cite Score
SJR: 0.129 / SNIP: 0.140
Volume 17, Issue 2 (2025)
Iran J War Public Health 2025, 17(2): 169-174 |
Back to browse issues page
Article Type:
Subject:
Ethics code: IR.YAZD.REC.1401.062
History
Received: 2025/05/3 | Accepted: 2025/06/29 | Published: 2025/07/3
Received: 2025/05/3 | Accepted: 2025/06/29 | Published: 2025/07/3
How to cite this article
Barzegari M, Samadi H. Prediction of Resilience and Social Phobia in Veterans and Disabled Individuals Based on Physical Activity Levels. Iran J War Public Health 2025; 17 (2) :169-174
URL: http://ijwph.ir/article-1-1611-en.html
URL: http://ijwph.ir/article-1-1611-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Authors
M.H. Barzegari *1, H. Samadi2
1- Department of Physical Education and Sports Sciences, Faculty of Psychology and Educational Sciences, Yazd University, Yazd, Iran
2- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Yazd University, Yazd, Iran
2- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Yazd University, Yazd, Iran
Full-Text (HTML) (28 Views)
Introduction
Following the recent war, our country has seen a significant increase in the number of individuals with war-related disabilities. This group, which actively participated in daily life prior to the war, now faces challenges that prevent them from engaging in many of their former activities [1]. Additionally, there are children, the elderly, and others who experience temporary disabilities due to various circumstances [1]. Consequently, a substantial portion of our population consists of veterans and individuals with disabilities. Veterans and people with disabilities often encounter unique psychological and physical challenges, including exposure to traumatic events, physical injuries, and the stress of reintegrating into society [2]. Among the most common psychological difficulties are resilience and social phobia, which affect approximately 20-30% of veterans and individuals with disabilities [3]. These issues manifest in symptoms such as intrusive memories, hyperarousal, and emotional numbing, significantly impairing social functioning and overall quality of life [4]. According to the American Psychological Association, resilience, also referred to as psychological resilience, is defined as “the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands” [5]. Taylor et al. highlighted the significance of psychological resilience in later life among older male veterans, noting that those with higher levels of resilience may experience less functional impairment compared to their lower-resilience counterparts [6]. In their review of resilience theories, Fletcher and Sarkar categorized various subareas of resilience, which included protective factors, coping strategies for stress and adversity, as well as motivational influences [7]. Isaacs et al. conducted a prospective cohort analysis utilizing data from the National Health and Resilience in Veterans Study, revealing that a majority of veterans (67.7%) exhibit minimal to no current psychological distress and were classified as psychologically resilient [8].
Following the recent war, our country has seen a significant increase in the number of individuals with war-related disabilities. This group, which actively participated in daily life prior to the war, now faces challenges that prevent them from engaging in many of their former activities [1]. Additionally, there are children, the elderly, and others who experience temporary disabilities due to various circumstances [1]. Consequently, a substantial portion of our population consists of veterans and individuals with disabilities. Veterans and people with disabilities often encounter unique psychological and physical challenges, including exposure to traumatic events, physical injuries, and the stress of reintegrating into society [2]. Among the most common psychological difficulties are resilience and social phobia, which affect approximately 20-30% of veterans and individuals with disabilities [3]. These issues manifest in symptoms such as intrusive memories, hyperarousal, and emotional numbing, significantly impairing social functioning and overall quality of life [4]. According to the American Psychological Association, resilience, also referred to as psychological resilience, is defined as “the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands” [5]. Taylor et al. highlighted the significance of psychological resilience in later life among older male veterans, noting that those with higher levels of resilience may experience less functional impairment compared to their lower-resilience counterparts [6]. In their review of resilience theories, Fletcher and Sarkar categorized various subareas of resilience, which included protective factors, coping strategies for stress and adversity, as well as motivational influences [7]. Isaacs et al. conducted a prospective cohort analysis utilizing data from the National Health and Resilience in Veterans Study, revealing that a majority of veterans (67.7%) exhibit minimal to no current psychological distress and were classified as psychologically resilient [8].
Another common psychological difficulty is social phobia. Social phobia, characterized by an intense fear of being observed and evaluated by others during routine activities, such as eating, drinking, or public speaking, affects a significant number of individuals [9]. This disorder is marked by a persistent fear of one or more specific social and performance situations, leading individuals to feel that their actions are subject to scrutiny [9]. With a prevalence rate of 13%, social phobia ranks as the third most common psychiatric disorder, following depression and alcohol dependence, highlighting the need for further investigation into its contributing factors [10].
Traditional therapeutic methods, including pharmacotherapy and cognitive-behavioral therapy (CBT), have proven effective in addressing these challenges [11]. However, barriers, such as limited accessibility, stigma, and inconsistent adherence rates, necessitate the exploration of complementary or alternative interventions [11]. In recent years, physical activity has emerged as a promising non-pharmacological strategy with the potential to enhance both physical and psychological outcomes for veterans [12]. Exercise induces neurobiological changes, including reduced cortisol levels and increased release of endorphins and neurotrophic factors, which contribute to improved mood regulation and stress resilience [13]. Furthermore, engaging in structured physical activities—especially in group settings—promotes social interaction, peer support, and a sense of accomplishment, all of which are vital for alleviating social anxiety and fostering self-esteem [14].
Samadi et al. examined the impact of sports activities on cognitive emotion regulation strategies, perceived psychological stress, and psychological hardiness among veterans and individuals with disabilities. Their findings indicated that veteran and disabled athletes experience lower perceived stress and maladaptive emotion regulation strategies, along with higher levels of psychological hardiness compared to non-athletes [12]. Additionally, Parra et al. demonstrated that exercise and physical activities positively influence psychological well-being and mitigate medical disorders [15].
Despite the existing studies on the benefits of physical activity [16], the impact of physical activity on important psychological factors, including resilience and social anxiety, has not yet been investigated among veterans and individuals with disabilities [16]. Therefore, it is essential to examine the relationship between these variables.
This current study aimed to address gaps in existing research by examining the relationship between physical activity and resilience, as well as its role in reducing social phobia among veterans and individuals with disabilities. Understanding these relationships is crucial for developing tailored rehabilitation programs that meet the complex needs of veterans and individuals with disabilities, ultimately aiding their recovery and reintegration into society. Furthermore, the research will provide empirical evidence to support the inclusion of physical activity in standard care practices for veterans and individuals with disabilities, contributing to better mental health outcomes and an improved quality of life.
Instrument and Methods
Study design and participants
This descriptive-correlational study was performed on veterans and individuals with disabilities in Yazd Province during 2022-2023. A total of 91 participants (68 veterans and 23 individuals with disabilities) were selected using a convenience sampling method. The sample size was determined using G*Power software, with an effect size of 0.15, a type I error rate of 0.05, and a statistical power of 0.95. After making the necessary arrangements with the provincial sports board for veterans and individuals with disabilities, the researchers attended the relevant centers and provided the necessary explanations on how to complete the questionnaires for the subjects.
The inclusion criteria included completing an informed consent form, not taking psychiatric medications, not having mental disability, not having a severe inability to perform daily tasks, and not having very severe physical disorders (such as upper or lower limb amputation). The exclusion criteria for the study included unwillingness to fill out the questionnaires.
Traditional therapeutic methods, including pharmacotherapy and cognitive-behavioral therapy (CBT), have proven effective in addressing these challenges [11]. However, barriers, such as limited accessibility, stigma, and inconsistent adherence rates, necessitate the exploration of complementary or alternative interventions [11]. In recent years, physical activity has emerged as a promising non-pharmacological strategy with the potential to enhance both physical and psychological outcomes for veterans [12]. Exercise induces neurobiological changes, including reduced cortisol levels and increased release of endorphins and neurotrophic factors, which contribute to improved mood regulation and stress resilience [13]. Furthermore, engaging in structured physical activities—especially in group settings—promotes social interaction, peer support, and a sense of accomplishment, all of which are vital for alleviating social anxiety and fostering self-esteem [14].
Samadi et al. examined the impact of sports activities on cognitive emotion regulation strategies, perceived psychological stress, and psychological hardiness among veterans and individuals with disabilities. Their findings indicated that veteran and disabled athletes experience lower perceived stress and maladaptive emotion regulation strategies, along with higher levels of psychological hardiness compared to non-athletes [12]. Additionally, Parra et al. demonstrated that exercise and physical activities positively influence psychological well-being and mitigate medical disorders [15].
Despite the existing studies on the benefits of physical activity [16], the impact of physical activity on important psychological factors, including resilience and social anxiety, has not yet been investigated among veterans and individuals with disabilities [16]. Therefore, it is essential to examine the relationship between these variables.
This current study aimed to address gaps in existing research by examining the relationship between physical activity and resilience, as well as its role in reducing social phobia among veterans and individuals with disabilities. Understanding these relationships is crucial for developing tailored rehabilitation programs that meet the complex needs of veterans and individuals with disabilities, ultimately aiding their recovery and reintegration into society. Furthermore, the research will provide empirical evidence to support the inclusion of physical activity in standard care practices for veterans and individuals with disabilities, contributing to better mental health outcomes and an improved quality of life.
Instrument and Methods
Study design and participants
This descriptive-correlational study was performed on veterans and individuals with disabilities in Yazd Province during 2022-2023. A total of 91 participants (68 veterans and 23 individuals with disabilities) were selected using a convenience sampling method. The sample size was determined using G*Power software, with an effect size of 0.15, a type I error rate of 0.05, and a statistical power of 0.95. After making the necessary arrangements with the provincial sports board for veterans and individuals with disabilities, the researchers attended the relevant centers and provided the necessary explanations on how to complete the questionnaires for the subjects.
The inclusion criteria included completing an informed consent form, not taking psychiatric medications, not having mental disability, not having a severe inability to perform daily tasks, and not having very severe physical disorders (such as upper or lower limb amputation). The exclusion criteria for the study included unwillingness to fill out the questionnaires.
Research tools
Personal characteristics questionnaire: This questionnaire collected data on participants’ age, height, weight, medical conditions, and types of physical issues [17, 18].
Social Phobia Questionnaire: Developed by Connor et al., this questionnaire assesses social anxiety by measuring three clinical domains of social phobia, including fear, avoidance, and physiological symptoms. This questionnaire is a self-report scale consisting of 17 items [19]. The validity and reliability of this scale have been established in various studies. The reliability of the questionnaire in the study by Ghasemi et al. was obtained using Cronbach’s alpha coefficient of 0.75 [20].
Resilience Questionnaire: This instrument was developed by Connor and Davidson based on a review of resilience research literature from 1979 to 1991 [21]. The short version comprises 10 items from the Connor and Davidson Resilience Questionnaire, rated on a Likert scale ranging from zero (never) to five (almost always). Connor et al. confirmed the convergent and divergent validity of the instrument, achieving a reliability coefficient of 0.87 through the test-retest method. The reliability of the questionnaire in the study by Tavan et al. was obtained using Cronbach’s alpha coefficient of 0.73 [22].
Sharkey Physical Activity Questionnaire: This questionnaire was employed to assess individuals’ levels of physical activity [23]. The questionnaire comprises five questions, structured and scored according to a Likert scale. Each question is assigned a score ranging from a minimum of 1 to a maximum of 5. The overall score for the questionnaire is calculated by summing the scores of the individual questions, resulting in a total score ranging from 5 to 25 for each participant. This questionnaire has been widely utilized in numerous studies [24].
Data analysis
Descriptive statistics, including the mean and standard deviation, were used to summarize the research parameters and create tables. After verifying data normality, the data were analyzed using Pearson’s correlation coefficient to assess the relationships between parameters and multivariate regression to predict variables based on levels of physical activity. To check the normality of the data, the Kolmogorov-Smirnov test was used, which was confirmed. A significance level of α=0.01 was maintained for all statistical tests. Data analysis was done using SPSS 25.
Findings
There was a significant positive relationship between physical activity and resilience (p<0.01, r=0.28), and a significant negative relationship between physical activity and social phobia (p<0.01, r=-0.39). Approximately 16% of the variance in social phobia and 8% of the variance in resilience were explained by physical activity levels. Physical activity levels, with beta coefficients of -0.39 and 0.28 (p<0.01), made a significant contribution to predicting social phobia and resilience in veterans and individuals with disabilities. In other words, physical activity scores were significantly negatively predictive of social phobia (p<0.01) and, conversely, significantly positively predictive of resilience among veterans and individuals with disabilities (p<0.01; Table 1).
Table 1. Regression analysis to predict resilience and social phobia of veterans and disabled people based on physical activity
Discussion
Recognizing the particular importance of these issues among veterans and individuals with disabilities [12, 13], this study aimed to predict social phobia and resilience in veteran and disabled populations based on levels of physical activity. Attention to psychological issues has consistently been a significant focus for researchers, resulting in extensive efforts to enhance psychological well-being. Physical activity accounted for approximately 16% of the variance in social phobia and 8% of the variance in resilience.
Given the increasing prevalence of mental disorders, one area that has recently attracted attention for enhancing psychological well-being is the role of exercise and physical activity as a non-pharmacological treatment [3, 14]. This approach has been shown to assist veterans and individuals with disabilities by reducing stress, fear, and anxiety while also increasing self-confidence, self-esteem, self-belief, and, consequently, resilience. Engaging in physical activity can encourage individuals to connect with a network of complex social relationships, fostering the development of significant behaviors, attitudes, values, and representations that motivate, inspire, and cultivate a sense of community [25].
Our study provides compelling evidence for the beneficial impact of physical activity on enhancing resilience and reducing social phobia among veterans and individuals with disabilities. Physical activity significantly predicted resilience and social phobia, accounting for 8% and 16% of the variance in these psychological constructs, respectively. These findings align with prior research indicating that physical activity serves as a critical protective factor against the psychological consequences faced by veterans and individuals with disabilities [26, 27].
The positive correlations between physical activity and resilience are supported by established neurobiological and psychosocial mechanisms [28]. Regular exercise enhances neuroplasticity by increasing levels of brain-derived neurotrophic factor (BDNF), which improves cognitive flexibility and stress adaptation—essential components of resilience [29, 30]. A narrative review of existing studies provides encouraging evidence that exercise interventions, whether alone or as an adjunct to standard treatment, may positively impact PTSD symptoms. Potential mechanisms, by which aerobic exercise could exert a positive effect in PTSD include exposure and desensitization to internal arousal cues, enhanced cognitive function, exercise-induced neuroplasticity, normalization of hypothalamic-pituitary axis (HPA) function, and reductions in inflammatory markers [31]. On a social level, group-based physical activity programs foster camaraderie and peer support, which are crucial for veterans and individuals with disabilities. For example, Aghdasi et al. showed that Iranian veterans who participated in team sports report stronger social networks and enhanced emotional stability compared to their sedentary peers [32].
The inverse relationship between physical activity and social phobia may stem from physical activity’s ability to reduce avoidance behaviors [33]. Veterans and individuals with disabilities who experience social phobia often exhibit heightened physiological reactivity in social situations, which physical activity can help mitigate by regulating cortisol and adrenaline levels [34]. A 2021 meta-analysis of 15 studies published in PubMed found that veterans engaging in at least 150 minutes of moderate physical activity weekly report 27% lower levels of social anxiety symptoms compared to their inactive peers [35]. Furthermore, structured activities, such as yoga and martial arts, enhance mindfulness and self-efficacy, enabling veterans to reframe anxiety-inducing social interactions [18]. For instance, research has shown that a tai chi program results in a 41% reduction in social phobia severity among veterans, with effects maintained at a 6-month follow-up [36].
The relationship between physical activity, resilience, and social phobia in veterans and individuals with disabilities is supported by a growing body of research, although nuances exist in the mechanisms and population-specific outcomes. Studies consistently demonstrate that adaptive sports and regular physical activity correlate with reduced social phobia and enhanced resilience in these populations. For example, veterans participating in adaptive sports exhibit lower perceived stress, improved emotion regulation, and higher psychological hardiness compared to non-athletes [12]. These benefits are linked to physiological mechanisms, such as increased endorphin release and reduced cortisol levels, which mitigate stress responses. Additionally, social support gained through sports and exercise further reinforces resilience by fostering camaraderie and reducing isolation [4]. However, the mediating role of social networks presents complexities. While larger social networks partially mediate the inverse relationship between resilience and social phobia in clinical groups, the diversity and activity levels of these networks show weaker associations [32]. This suggests that the quality of social interactions (e.g., shared experiences in adaptive sports) may matter more than quantity.
Despite the above, key gaps remain in understanding the longitudinal effects and optimal activity thresholds. Future research should explore whether sustained physical activity yields cumulative resilience benefits or primarily offers short-term symptom relief. Emerging evidence indicates a U-shaped relationship between exercise frequency and prevalent psychological challenges, such as resilience and the severity of social phobia symptoms [37]. Moderate exercise (1-6 days per week) is associated with a reduction in symptoms, while daily intense exercise (7 days per week) correlates with an increase in re-experiencing symptoms. This may indicate physiological stress overload and insufficient recovery, emphasizing the need for personalized exercise prescriptions that effectively balance intensity, duration, and rest. Additionally, it should be noted that when comparing populations, conflicting findings may emerge. For example, studies of college students without disabilities show similar correlations between resilience and social phobia, but these results may not fully generalize to veterans or individuals with physical disabilities who face unique stressors [38, 39].
The limitations of this study include its correlational and cross-sectional design, which restricts the ability to draw definitive conclusions. Additionally, the sample comprised only veterans and individuals with disabilities from Yazd Province, and the convenience sampling method employed necessitates caution when generalizing the findings to other populations. Furthermore, the exclusive reliance on questionnaires and self-reports for data collection represents another limitation. Future research should also examine the relationship between other psychological constructs and physical activity.
This study contributes to the growing evidence demonstrating that physical activity serves as an effective strategy for enhancing resilience and mitigating social phobia among veterans and individuals with disabilities. By addressing both physiological factors (e.g., neuroendocrine regulation) and psychosocial aspects (e.g., social connectedness), physical activity offers a comprehensive approach to improving mental health outcomes within this population. It is imperative that clinicians and policymakers prioritize the development of accessible, veteran- and disability-centered physical activity programs to promote psychological well-being and facilitate societal reintegration.
Conclusion
Physical activity predicts resilience and social phobia in veterans and disabled individuals.
Personal characteristics questionnaire: This questionnaire collected data on participants’ age, height, weight, medical conditions, and types of physical issues [17, 18].
Social Phobia Questionnaire: Developed by Connor et al., this questionnaire assesses social anxiety by measuring three clinical domains of social phobia, including fear, avoidance, and physiological symptoms. This questionnaire is a self-report scale consisting of 17 items [19]. The validity and reliability of this scale have been established in various studies. The reliability of the questionnaire in the study by Ghasemi et al. was obtained using Cronbach’s alpha coefficient of 0.75 [20].
Resilience Questionnaire: This instrument was developed by Connor and Davidson based on a review of resilience research literature from 1979 to 1991 [21]. The short version comprises 10 items from the Connor and Davidson Resilience Questionnaire, rated on a Likert scale ranging from zero (never) to five (almost always). Connor et al. confirmed the convergent and divergent validity of the instrument, achieving a reliability coefficient of 0.87 through the test-retest method. The reliability of the questionnaire in the study by Tavan et al. was obtained using Cronbach’s alpha coefficient of 0.73 [22].
Sharkey Physical Activity Questionnaire: This questionnaire was employed to assess individuals’ levels of physical activity [23]. The questionnaire comprises five questions, structured and scored according to a Likert scale. Each question is assigned a score ranging from a minimum of 1 to a maximum of 5. The overall score for the questionnaire is calculated by summing the scores of the individual questions, resulting in a total score ranging from 5 to 25 for each participant. This questionnaire has been widely utilized in numerous studies [24].
Data analysis
Descriptive statistics, including the mean and standard deviation, were used to summarize the research parameters and create tables. After verifying data normality, the data were analyzed using Pearson’s correlation coefficient to assess the relationships between parameters and multivariate regression to predict variables based on levels of physical activity. To check the normality of the data, the Kolmogorov-Smirnov test was used, which was confirmed. A significance level of α=0.01 was maintained for all statistical tests. Data analysis was done using SPSS 25.
Findings
There was a significant positive relationship between physical activity and resilience (p<0.01, r=0.28), and a significant negative relationship between physical activity and social phobia (p<0.01, r=-0.39). Approximately 16% of the variance in social phobia and 8% of the variance in resilience were explained by physical activity levels. Physical activity levels, with beta coefficients of -0.39 and 0.28 (p<0.01), made a significant contribution to predicting social phobia and resilience in veterans and individuals with disabilities. In other words, physical activity scores were significantly negatively predictive of social phobia (p<0.01) and, conversely, significantly positively predictive of resilience among veterans and individuals with disabilities (p<0.01; Table 1).
Table 1. Regression analysis to predict resilience and social phobia of veterans and disabled people based on physical activity
Discussion
Recognizing the particular importance of these issues among veterans and individuals with disabilities [12, 13], this study aimed to predict social phobia and resilience in veteran and disabled populations based on levels of physical activity. Attention to psychological issues has consistently been a significant focus for researchers, resulting in extensive efforts to enhance psychological well-being. Physical activity accounted for approximately 16% of the variance in social phobia and 8% of the variance in resilience.
Given the increasing prevalence of mental disorders, one area that has recently attracted attention for enhancing psychological well-being is the role of exercise and physical activity as a non-pharmacological treatment [3, 14]. This approach has been shown to assist veterans and individuals with disabilities by reducing stress, fear, and anxiety while also increasing self-confidence, self-esteem, self-belief, and, consequently, resilience. Engaging in physical activity can encourage individuals to connect with a network of complex social relationships, fostering the development of significant behaviors, attitudes, values, and representations that motivate, inspire, and cultivate a sense of community [25].
Our study provides compelling evidence for the beneficial impact of physical activity on enhancing resilience and reducing social phobia among veterans and individuals with disabilities. Physical activity significantly predicted resilience and social phobia, accounting for 8% and 16% of the variance in these psychological constructs, respectively. These findings align with prior research indicating that physical activity serves as a critical protective factor against the psychological consequences faced by veterans and individuals with disabilities [26, 27].
The positive correlations between physical activity and resilience are supported by established neurobiological and psychosocial mechanisms [28]. Regular exercise enhances neuroplasticity by increasing levels of brain-derived neurotrophic factor (BDNF), which improves cognitive flexibility and stress adaptation—essential components of resilience [29, 30]. A narrative review of existing studies provides encouraging evidence that exercise interventions, whether alone or as an adjunct to standard treatment, may positively impact PTSD symptoms. Potential mechanisms, by which aerobic exercise could exert a positive effect in PTSD include exposure and desensitization to internal arousal cues, enhanced cognitive function, exercise-induced neuroplasticity, normalization of hypothalamic-pituitary axis (HPA) function, and reductions in inflammatory markers [31]. On a social level, group-based physical activity programs foster camaraderie and peer support, which are crucial for veterans and individuals with disabilities. For example, Aghdasi et al. showed that Iranian veterans who participated in team sports report stronger social networks and enhanced emotional stability compared to their sedentary peers [32].
The inverse relationship between physical activity and social phobia may stem from physical activity’s ability to reduce avoidance behaviors [33]. Veterans and individuals with disabilities who experience social phobia often exhibit heightened physiological reactivity in social situations, which physical activity can help mitigate by regulating cortisol and adrenaline levels [34]. A 2021 meta-analysis of 15 studies published in PubMed found that veterans engaging in at least 150 minutes of moderate physical activity weekly report 27% lower levels of social anxiety symptoms compared to their inactive peers [35]. Furthermore, structured activities, such as yoga and martial arts, enhance mindfulness and self-efficacy, enabling veterans to reframe anxiety-inducing social interactions [18]. For instance, research has shown that a tai chi program results in a 41% reduction in social phobia severity among veterans, with effects maintained at a 6-month follow-up [36].
The relationship between physical activity, resilience, and social phobia in veterans and individuals with disabilities is supported by a growing body of research, although nuances exist in the mechanisms and population-specific outcomes. Studies consistently demonstrate that adaptive sports and regular physical activity correlate with reduced social phobia and enhanced resilience in these populations. For example, veterans participating in adaptive sports exhibit lower perceived stress, improved emotion regulation, and higher psychological hardiness compared to non-athletes [12]. These benefits are linked to physiological mechanisms, such as increased endorphin release and reduced cortisol levels, which mitigate stress responses. Additionally, social support gained through sports and exercise further reinforces resilience by fostering camaraderie and reducing isolation [4]. However, the mediating role of social networks presents complexities. While larger social networks partially mediate the inverse relationship between resilience and social phobia in clinical groups, the diversity and activity levels of these networks show weaker associations [32]. This suggests that the quality of social interactions (e.g., shared experiences in adaptive sports) may matter more than quantity.
Despite the above, key gaps remain in understanding the longitudinal effects and optimal activity thresholds. Future research should explore whether sustained physical activity yields cumulative resilience benefits or primarily offers short-term symptom relief. Emerging evidence indicates a U-shaped relationship between exercise frequency and prevalent psychological challenges, such as resilience and the severity of social phobia symptoms [37]. Moderate exercise (1-6 days per week) is associated with a reduction in symptoms, while daily intense exercise (7 days per week) correlates with an increase in re-experiencing symptoms. This may indicate physiological stress overload and insufficient recovery, emphasizing the need for personalized exercise prescriptions that effectively balance intensity, duration, and rest. Additionally, it should be noted that when comparing populations, conflicting findings may emerge. For example, studies of college students without disabilities show similar correlations between resilience and social phobia, but these results may not fully generalize to veterans or individuals with physical disabilities who face unique stressors [38, 39].
The limitations of this study include its correlational and cross-sectional design, which restricts the ability to draw definitive conclusions. Additionally, the sample comprised only veterans and individuals with disabilities from Yazd Province, and the convenience sampling method employed necessitates caution when generalizing the findings to other populations. Furthermore, the exclusive reliance on questionnaires and self-reports for data collection represents another limitation. Future research should also examine the relationship between other psychological constructs and physical activity.
This study contributes to the growing evidence demonstrating that physical activity serves as an effective strategy for enhancing resilience and mitigating social phobia among veterans and individuals with disabilities. By addressing both physiological factors (e.g., neuroendocrine regulation) and psychosocial aspects (e.g., social connectedness), physical activity offers a comprehensive approach to improving mental health outcomes within this population. It is imperative that clinicians and policymakers prioritize the development of accessible, veteran- and disability-centered physical activity programs to promote psychological well-being and facilitate societal reintegration.
Conclusion
Physical activity predicts resilience and social phobia in veterans and disabled individuals.
Acknowledgments: We would like to express our appreciation and gratitude to the respected officials of the Foundation of Martyrs and Veterans Affairs of Yazd Province and to all the veterans and individuals with disabilities who cooperated in the research.
Ethical Permissions: The study received approval from the Research Commission of Yazd University, with ethics code IR.YAZD.REC.1401.062. Written informed consent was obtained from all participants.
Conflicts of Interests: There are no conflicts of interests.
Authors' Contribution: Barzegari MH (First Author), Introduction Writer/Assistant Researcher/Statistical Analyst (50%); Samadi H (Second Author), Methodologist/Statistical Analyst/Main Researcher/Discussion Writer (50%)
Funding/Support: The present study was not financially supported.
Keywords:
References
1. Kiyal M, Naderinasab M, Majedi N. The model of psychological components affecting the participation of veterans and disabled in sport activities. Sport Psychol Stud. 2020;9(32):41-58. [Link]
2. Arianpour S, Hosseininia SR, Bahrololoum H. The relationship of family and friends social support and self-efficacy with the participation of veterans and disabled athletes in physical activities. Sport Manag J. 2021;12(4):949-65. [Persian] [Link]
3. Samadi H, Kahdouei E, Heidari Y, Abdollahi D. Investigating the predictive role of body dimensions satisfaction in social phobia, resilience and self-esteem of veterans and the disabled. Iran J Rehabil Res Nurs. 2024;11(1):74-82. [Persian] [Link]
4. Thomas MM, Harpaz-Rotem I, Tsai J, Southwick SM, Pietrzak RH. Mental and physical health conditions in US combat veterans: Results from the National Health and Resilience in Veterans Study. Prim Care Companion CNS Disord. 2017;19(3). [Link] [DOI:10.4088/PCC.17m02118]
5. VandenBos GR. APA dictionary of psychology. Washington, D.C.: American Psychological Association; 2007. [Link]
6. Taylor MG, Ureña S, Carr DC, Min S. Early-life military exposures and functional impairment trajectories among older male veterans: The buffering effect of psychological resilience. J Gerontol B Psychol Sci Soc Sci. 2019;74(5):832-41. [Link] [DOI:10.1093/geronb/gby029]
7. Fletcher D, Sarkar M. Psychological resilience: A review and critique of definitions, concepts, and theory. Eur Psychol. 2013;18(1):12-23. [Link] [DOI:10.1027/1016-9040/a000124]
8. Isaacs K, Mota NP, Tsai J, Harpaz-Rotem I, Cook JM, Kirwin PD, et al. Psychological resilience in US military veterans: A 2-year, nationally representative prospective cohort study. J Psychiatr Res. 2017;84:301-9. [Link] [DOI:10.1016/j.jpsychires.2016.10.017]
9. Rezian S, Fathi-Ashtiani A, Hassanabadi H, Ashrafi E. Reliability and validity measurment of the Persian version of social phobia scale assessing the reliability and validity of social phobia scale. J Clin Psychol. 2019;11(3):1-10. [Persian] [Link]
10. Olgiati P, Liappas I, Malitas P, Piperi C, Politis A, Tzavellas EO, et al. Depression and social phobia secondary to alcohol dependence. Neuropsychobiology. 2008;56(2-3):111-8. [Link] [DOI:10.1159/000112952]
11. Ray LA, Meredith LR, Kiluk BD, Walthers J, Carroll KM, Magill M. Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: A systematic review and meta-analysis. JAMA Netw Open. 2020;3(6):e208279. [Link] [DOI:10.1001/jamanetworkopen.2020.8279]
12. Samadi H, Moradi J, Karimi H. Effectiveness of sports activities on cognitive emotion regulation strategies, perceived psychological stress, and psychological hardiness of veterans and the disabled. Iran J War Public Health. 2022;14(1):43-9. [Link]
13. Chen C, Nakagawa S. Recent advances in the study of the neurobiological mechanisms behind the effects of physical activity on mood, resilience and emotional disorders. Adv Clin Exp Med. 2023;32(9):937-42. [Link] [DOI:10.17219/acem/171565]
14. Li Z, Li J, Kong J, Li Z, Wang R, Jiang F. Adolescent mental health interventions: A narrative review of the positive effects of physical activity and implementation strategies. Front Psychol. 2024;15:1433698. [Link] [DOI:10.3389/fpsyg.2024.1433698]
15. Parra E, Arone A, Amadori S, Mucci F, Palermo S, Marazziti D. Impact of physical exercise on psychological well-being and psychiatric disorders. J Reatt Ther Dev Divers. 2020;3(2):24-39. [Link] [DOI:10.26407/2020jrtdd.1.39]
16. Samadi H, Moradi J, Dehghanzadehamedan H. Prediction of social trust, self-control and self-efficacy based on the level of physical activity in veterans and disabled. J Mil Med. 2023;25(2):1787-95. [Persian] [Link]
17. Behnke M, Tomczak M, Kaczmarek LD, Komar M, Gracz J. The sport mental training questionnaire: Development and validation. Cur Psychol. 2019;38(2):504-16. [Link] [DOI:10.1007/s12144-017-9629-1]
18. Allen MS, Laborde S. The role of personality in sport and physical activity. Cur Dir Psychol Sci. 2014;23(6):460-5.. [Link] [DOI:10.1177/0963721414550705]
19. Connor KM, Davidson JR, Churchill LE, Sherwood A, Weisler RH, Foa E. Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale. Br J Psychiatry. 2000;176(4):379-86. [Link] [DOI:10.1192/bjp.176.4.379]
20. Ghasemi Tabesh F, Torabi S, Mahmood M, Pak R. Investigating the relationship between symptoms of social anxiety and psychological well-being mediated by fear of negative evaluation and quality of life. J Appl Res Behav Sci. 2022;13(47):69. [Persian] [Link]
21. Connor KM, Davidson JR. Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC). Depress Anxiety. 2003;18(2):76-82. [Link] [DOI:10.1002/da.10113]
22. Tavan B, Jahani F, Rafeei M. The relationship between self-esteem and happiness among students of Arak University of Medical Sciences. Iran J Med Educ. 2014;14(6):474-82. [Persian] [Link]
23. Sharkey BJ, Gaskill SE. Fitness & health. Champaign: Human Kinetics; 2013. [Link] [DOI:10.5040/9781718209107]
24. Shahhosseini M, Vaez Mousavi SMK. Comparing job burnout and quality of life in physically active and inactive military personnel. J Mil Med. 2022;19(2):158-68. [Persian] [Link]
25. Ullrich-French S, McDonough MH, Smith AL. Social connection and psychological outcomes in a physical activity-based youth development setting. Res Q Exerc Sport. 2012;83(3):431-41. [Link] [DOI:10.1080/02701367.2012.10599878]
26. Kim G. Associations between physical activity and mental health in Korean military personnel [dissertation]. Seoul: Seoul National University; 2023. [Link]
27. Waldhauser KJ. An examination of military veteran health and well-being following transition from the armed forces, and the role of physical activity [dissertation]. Vancouver: University of British Columbia; 2024. [Link]
28. Erickson KI, Hillman C, Stillman CM, Ballard RM, Bloodgood B, Conroy DE, et al. Physical activity, cognition, and brain outcomes: A review of the 2018 physical activity guidelines. Med Sci Sports Exerc. 2019;51(6):1242-51. [Link] [DOI:10.1249/MSS.0000000000001936]
29. Liang J, Wang H, Zeng Y, Qu Y, Liu Q, Zhao F, et al. Physical exercise promotes brain remodeling by regulating epigenetics, neuroplasticity and neurotrophins. Rev Neurosci. 2021;32(6):615-29. [Link] [DOI:10.1515/revneuro-2020-0099]
30. Oyovwi MO, Ogenma UT, Onyenweny A. Exploring the impact of exercise-induced BDNF on neuroplasticity in neurodegenerative and neuropsychiatric conditions. Mol Biol Rep. 2025;52(1):140. [Link] [DOI:10.1007/s11033-025-10248-1]
31. Hegberg NJ, Hayes JP, Hayes SM. Exercise intervention in PTSD: A narrative review and rationale for implementation. Front Psychiatry. 2019;10:133. [Link] [DOI:10.3389/fpsyt.2019.00133]
32. Aghdasi MT, Samadi H, Ghari B. Comparison of body dimensions satisfaction and sociophysical anxiety between veteran athletes of team and single sports. Iran J War Public Health. 2015;7(28):167-73. [Persian] [Link]
33. Chen S, Jing L, Li C, Wang H. Exploring the nexus between moderate-to-vigorous physical activity, self-disclosure, social anxiety, and adolescent social avoidance: Insights from a cross-sectional study in central China. Children. 2023;11(1):56. [Link] [DOI:10.3390/children11010056]
34. Roelofs K, Van Peer J, Berretty E, De Jong P, Spinhoven P, Elzinga BM. Hypothalamus-pituitary-adrenal axis hyperresponsiveness is associated with increased social avoidance behavior in social phobia. Biol Psychiatry. 2009;65(4):336-43. [Link] [DOI:10.1016/j.biopsych.2008.08.022]
35. Zika MA, Becker L. Physical activity as a treatment for social anxiety in clinical and non-clinical populations: A systematic review and three meta-analyses for different study designs. Front Hum Neurosci. 2021;15:653108. [Link] [DOI:10.3389/fnhum.2021.653108]
36. Sheikhzadeh M, Zanjani Z, Baari A. Efficacy of mindfulness-based cognitive therapy and cognitive behavioral therapy for anxiety, depression, and fatigue in cancer patients: A randomized clinical trial. Iran J Psychiatry. 2021;16(3):271-80. [Link] [DOI:10.18502/ijps.v16i3.6252]
37. Zhou H, Jiang F, Liu H, Wu Y, Tang Yl. Dose-dependent association between physical activity and mental health, and mitigation effects on risk behaviors. iScience. 2025;28(2):111866. [Link] [DOI:10.1016/j.isci.2025.111866]
38. Ko CYA, Chang Y. Investigating the relationships among resilience, social anxiety, and procrastination in a sample of college students. Psychol Rep. 2019;122(1):231-45. [Link] [DOI:10.1177/0033294118755111]
39. Sundstrom MJ. The effects of adaptive yoga and sports programs on psychological wellbeing in individuals with disabilities [dissertation]. Minneapolis: University of Minnesota; 2021. [Link]