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Kazuhiro Harada, Kouhei Masumoto and Narihiko Kondo

Background: Although the beneficial effects of physical activity and exercise on mental health are well known, the optimal conditions for them for benefitting mental health are still unclear. Engaging in exercise with others might have more desirable effects on mental health than engaging in exercise alone. This study examined the associations between exercising alone, exercising with others, and mental health among middle-aged and older adults. Methods: Baseline and 1-year follow-up surveys were conducted with 129 individuals. Time spent exercising alone or with others was measured using a 7-day diary survey. Total physical activity was objectively measured using an accelerometer. Mental well-being was assessed using the simplified Japanese version of the World Health Organization Five Well-Being Index, and mental distress was assessed using the Japanese version of the Kessler Distress Scale (K6). Results: Cross-lagged and simultaneous effects models revealed that exercising with others positively influenced mental well-being. Exercising alone and total physical activity did not significantly influence mental well-being. Neither total physical activity, exercising alone, nor exercising with others was significantly associated with mental distress. Conclusion: Engaging in exercise with others could be effective in improving mental well-being relative to engaging in exercise alone.

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Jennifer Ann McGetrick, Krystyna Kongats, Kim D. Raine, Corinne Voyer and Candace I.J. Nykiforuk

Background: Attitudes and beliefs of policy influencers and the general public toward physical activity policy may support or impede population-level action, requiring improved understanding of aggregate preferences toward policies that promote physical activity. Methods: In 2016, the Chronic Disease Prevention Survey was administered to a census sample of policy influencers (n = 302) and a stratified random sample of the public (n = 2400) in Alberta and Québec. Using net favorable percentages and the Nuffield Council on Bioethics’ intervention ladder framework to guide analysis, the authors examined support for evidence-based healthy public policies to increase physical activity levels. Results: Less intrusive policy options (ie, policies that are not always the most impactful) tended to have higher levels of support than policies that eliminated choice. However, there was support for certain types of policies affecting influential determinants of physical activity such as the built environment (ie, provided they enabled rather than restricted choice) and school settings (ie, focusing on children and youth). Overall, the general public indicated stronger levels of support for more physical activity policy options than policy influencers. Conclusions: The authors’ findings may be useful for health advocates in identifying support for evidence-based healthy public policies affecting more influential determinants of physical activity.

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Lauren Burch, Matthew Zimmerman and Beth Fielding Lloyd

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Brigid M. Lynch, Charles E. Matthews, Katrien Wijndaele and on behalf of the Sedentary Behaviour Council of the International Society for Physical Activity and Health

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Viviene A. Temple, Dawn L. Lefebvre, Stephanie C. Field, Jeff R. Crane, Beverly Smith and Patti-Jean Naylor

This study examined the influence of physical health and well-being vulnerability on participation in physical activities, and whether motor skill proficiency mediated this relationship. Kindergarten children (n = 260) completed the Test of Gross Motor Development-2 and the Children’s Assessment of Participation and Enjoyment survey. A multivariate analysis of covariance was used to compare the motor skills and participation in physical activities of children in schools classified as more or less vulnerable. We also examined whether motor skill proficiency mediated the relationship between vulnerability status and participation. Children in neighborhoods with higher vulnerability demonstrated lower motor skill proficiency and participation. Object control skill proficiency mediated the relationship between vulnerability and participation. Children from more vulnerable schools started their school career with less developed motor skills and a narrower array of recreation participation. Children in vulnerable neighborhoods need more opportunities to master object controls skills and access recreational activities. Fortunately, motor skill proficiency among children considered ‘at risk’ is amenable to improvement and intervention early in the children’s school career may have a beneficial impact on children’s physical activity at school and beyond the school environment.

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Daniel Birrer

A rigorous training schedule with insufficient recovery can lead to nonfunctional overreaching (NFOR) or overtraining syndrome (OTS). Research has suggested the multifactorial etiology of these phenomena. Stressors that contribute to and are symptoms and consequences of NFOR and OTS and adjustment disorder are almost identical. In this case study of an elite rower, the author illustrates an intervention approach that can be taken when overtraining is viewed as a sport-specific form of adjustment disorder. The intervention involved treatment that improved the athlete’s awareness of his basic biopsychosocial processes, developed sources of self-worth beyond athletic performance, and challenged his 1-dimensional athletic identity. The intervention included cognitive-behavioral therapy methods (e.g., autogenic training) and mindfulness- and acceptance-based interventions to enhance the athlete’s psychological flexibility. Mood monitoring was used as a diagnostic and evaluative instrument. Intervention effectiveness was evaluated through an in-depth interview with the athlete. The consulting sport psychologist also engaged in reflection about treatment effectiveness and predominant challenges. Challenging the athlete and clarifying his personal values were judged to be very important. Evaluation suggested that viewing NFOR and OTS as forms of adjustment disorder may help us recognize the multifaceted nature of an athlete’s maladjusted state and widen treatment options.

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Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols

It is estimated that 1.6 million people in the United States are currently diagnosed with an eating disorder. Eating disorders (EDs) have high rates of morbidity and mortality and remain the most severe mental illness. Unfortunately, rates of EDs and disordered eating behaviors (DEBs) among athletes appear to be increasing. In this study, authors summarize ED-related risks that pose compromises in psychological and social functioning, medical health, and overall quality of life. The importance of early detection and formal evaluation in preserving the athlete’s health, well-being and sustaining successful sport participation, and performance are highlighted. Athlete-specific factors, which challenge the ease and accuracy of ED detection and assessment, are noted. The recommended components of effective ED assessment are identified, including use of self-report measures and clinical interviews conducted by ED certified and licensed professionals. The importance of being well informed in tenets of ED awareness, prevention and supporting early detection, and referral for formal ED assessment are noted. Conclusions reflect the vital roles that both the multidisciplinary sport personnel and the sport environment/culture play in reducing the serious health risks of DEBs and EDs. Each is needed to protect an athlete’s well-being while fostering safe and successful sport participation.

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Laura K. Fewell, Riley Nickols, Amanda Schlitzer Tierney and Cheri A. Levinson

The current study tested if athlete patients differed from non-athlete patients in measures of eating disorder (ED) and related pathology. Athlete (n = 91 in Study 1; n = 39 in Study 2) and non-athlete (n = 76 in Study 1; n = 26 in Study 2) patients completed self-report measures, and body mass index (BMI) was calculated. Athlete patients had significantly lower ED symptomatology and depression than non-athlete patients (ps < .05). ED impairment, worry, psychosocial functioning, BMI, obsessive-compulsiveness, and compulsive exercise did not significantly differ between groups (ps > .08). Greater ED symptomatology was associated with higher psychosocial functioning among athlete patients and higher obsessive-compulsive symptoms and compulsive exercise among non-athlete patients. This is a novel study comparing ED symptomatology and related measures of mental health in athlete and non-athlete patients engaged in residential or partial hospitalization ED treatment. Future research should further investigate how participation in high-level sport impacts the presentation, treatment, and outcome of individuals with EDs.

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Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols

Eating disorders (EDs) and disordered-eating behaviors (DEBs), pose a high risk of morbidity and mortality, threatening physical health, emotional health, and overall quality of life. Unfortunately, among athletes, prevalence rates continue to increase. This document summarizes the challenges of establishing and navigating the multidisciplinary care needed to effectively treat EDs and DEBs among athletes. The benefits of timely and frequent communication within the multidisciplinary treatment team (MDTT) are emphasized and discussed. Authors advise who should be selected as members of the MDTT and suggest that all personnel, including athletic coaches, athletic trainers, physical therapists, and certified fitness professionals be ED-informed and ED-sensitive. Vital components of care are noted including use of a variety of evidence-based psychotherapeutic modalities, interventions which target emotional regulation, and prioritize values based compassionate care. Authors caution that performance decrements and medical/physiological changes are not always easily observable in individuals with EDs and DEBs and therefore, attuned, consistent, and ongoing monitoring is needed. Consensus regarding previously established parameters for return to play and careful titration of physical activity throughout the ED recovery process are suggested as important for preserving health, preventing re-injury, or relapse and facilitating successful return to sport participation.