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Franke et al (2013) Article Summery


Study Importance

physical activity is a key component in the management of chronic diseases, provides physical and
cognitive benefits, and decreases anxiety levels
factors in the "built environment" may increase walking and mobility in older adults
o higher residential densities, accessible transportation, and local amenities (post offices,
newsstands, food stores) are all associated with increased walking
most research has been done on those older adults who are relatively inactive or who have limited
mobility;
this study looked at physically active older adults, and hoped to explain how these active older adults
sustain their mobility as they age
took a strengths-based perspective (focus on the individual's capabilities)
competence model - suggests that an individual's level of competence is matched with the demands of
the environment
concept of place attachment model - an individual's feeling of connectedness to their neighborhood
influences physical activity levels

Study Purpose and Participants

the purpose was to examine the secrets of active older adults that may explain how these individuals
sustain their mobility as they age
participants selected from a cross-sectional study; recruited from a provincial government agency
providing rental subsidies; narrowed down to 27 community-dwelling older adults from Metro Vancouver,
British Columbia (men and women over the age of 65) who received housing assistance, reported leaving
home at least once per week, were able to walk at least 10 minutes with or without assistance, spoke
English, and who did not have any significant memory problems; only 10 were chosen (the rest weren't
active enough)
The active older adults included in the study had an age range of 66 to 88 years old and an average MVPA
of 47.2 minutes/day

Major Results: Themes and Sub-Themes

resourcefulness - self help strategies that are used to maintain independence in daily tasks, despite
adverse situations
o self-efficacy
o self-control
o adaptability
social connections - includes living condition, social interactions, and a sense of connectedness or
belonging
natural and built environment influences physical activity

Implications

it's important to focus effort on programs for older adults and development of policies that promote
physical activity in this age group
o fitness classes

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o
o
o

2
social events at community centers
more appropriate fitness programming throughout the person's lifespan
planning neighborhoods/communities with physical activity in mind (sidewalks, more green
space, more availability of basic needs)

PA Groups - Group Cohesion II

a dynamic process that is reflected in the tendency for a group to stick together and remain united in
pursuit of its task objective and/or the satisfaction of a member affective needs
the more cohesive the group, the higher the adherence to exercise, and the fewer dropouts

Group Cohesion Model: Levels and Dimension of Group Cohesion

Attractions
to the
group-Task

1.

2.

Individual Level

Task
Aspects

Group
Cohesion

Group
IntegrationTask

Group Level

Attractions to
the
group -Social
Social
Aspects

Group
Integration
-Social

Level I: Individual vs. group basis for cohesion:


a. Individual level - "I" and "me" statements; ex, "I like this dance class"
b. Group level - "We" statements; "we like this class, because we like the instructor
Level II: task aspects vs. Social aspects of group involvement
a. Task aspects - wanting to achieve similar goals and outcomes
b. Social aspects - dealing with social relationships, feeling like part of the group

Group Cohesion Dimensions


1.
2.
3.

Individual attraction to the Group-Task (IAGT)


a. "I am unhappy with the group's level of commitment to exercise"
Individual attractions to the Group-Social (IAGS)
a. "Some of my best friends are in this exercise group"
Group Integration-Task (GIT)

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4.

a. "We all take responsibility if one of our exercise classes goes poorly"
Group Integration-Social (GIS)
a. "Members of our exercise class rarely socialize together" (this is a negative example)

Strategies to Increase Group Cohesion

clear class goals and objectives (increase fitness and socialize)


Standards of acceptable behavior (attendance, effort, cooperation, group-oriented behaviors)
roles (each group member has a role)
feedback
self-disclosure and interpersonal communication (weaknesses and strengths)
group meets after class for lunch
class awards
discuss exercise plans following the end of class

Social Support and PA

social support is a complex phenomenon with multiple definitions from different researchers
social support is important for health and well-being (tend to live longer and have a healthier life)

Social Support Taxonomies (social integration, support networks, supportive climates)


Social Integration

Support Networks

Supportive Climate

Enacted Support/Received Support

Perceived Support

taxonomy tries to clarify concepts of social support


concepts are arranged in a hierarchical manner (global --> specific)
we need social integrate in order to have support networks and so on
Social Integration
o degree to which the individual has contact with family, friends, and coworkers
Support Networks
o pool of available support resources for the individual (financial, emotional, etc)

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o women have lower depression levels than men because women seek emotional suport
Supportive Climates
o reflects the quality of support
Enacted and Received Support
o support involves at least two people: provider and recipient
Perceived Support
o does the individual perceive that they get enough quality support?

Negative Aspects of Social Integration

negative social influences: social inhibition, rejections, discrimination, barriers, etc.


the influence of negative social interactions vs. positive social support on health outcomes
o influence of negative social interactions is stronger and longer-lasting than positive social
interactions on health outcomes

Measurement of Social Support


Approach
Social network resources

Concept
Support availability

Support appraisal

Satisfaction, sufficiency, or support


helpfulness in important domains

Support behavior

Frequency of occurrence or
likelihood of behavior

Measure
Network size - total # of people who
can provide support
Network density - total # of people
who can provide a certain type of
support
Attachment
Social integration
Self-worth
Esteem support
Reliable alliance
Guidance
Financial assistance
Practical assistance
Emotional support
Advice or guidance
Positive interactions

esteem support - do people feel appreciated by helping others?


reliable alliance - tangible aid ("if I need support right now, do I have somebody?")

Support Appraisal Types

attachment - affective, emotional support


social integration - network support
self-worth - reflects the provider of support; you feel worthy because you provide support
esteem support - in order for self esteem to increase, you need assurance from the other party
reliability alliance - you can get assistance immediately when you need it
guidance - information support (trying to find out info about activities to do)

Measurement of Social Support

number of people available for social support

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satisfaction with social support


frequency of social support

Social Support vs. Subjective Norm

social support is positively related to group cohesion and subjective norm


however, these constructs are distinct in nature
what is the difference between social support and subjective norm?
o subjective norm is a perceived social pressure to be active; you feel like others want you to be
active
o social support has to do with caring, helping, bonding, rather than pressing and forcing someone

Social Support and PA Behavior (adherence vs. compliance behavior)

adherence behavior: maintaining involvement in a self-selected program


o internal regulation
compliance behavior: maintaining involvement in a prescribed program
o external regulation

Nature of Social Support


Nature of Behavior
ES
Support from family
Adherence behavior
.36
Support from family
Compliance behavior
.69
Support from important others
Adherence behavior
.44
Subjective norm
Adherence behavior
.18
support from family plays a larger role in compliance than adherence; why?
o compliance deals with a prescribed program, often from a doctor. because this is probably more
serious, family will often be more involved and help push you to be active/comply with the
doctor's prescription
subjective norm has a very small effect --> social pressure to be active doesn't work; why?
o being active is a choice, and it's something you either value or you don't
Kosma et al. (2004) Quest Article

looks at recruitment rate among understudied populations


recruitment rate =
recruitment rate is a ratio between number of people who participate in the study and all the eligigable to
participate
purpose: overview different recruitment techniques (active and passive) and their effectiveness in PA
promotion among understudied populations; identify strategies to increase recruitment rates in PA
promotion research

Recruitment Methods (active vs. passive)


1.

Active Recruitment
a. pre-identified population of interest (we know them, how many, who they are)
b. contact through phone, direct mail, face-to-face recruitment
c. more effective for the underserved population

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2.

Passive Recruitment
a. no direct solicitation of potential study participants (don't know how many, where they are)
b. contact through mass advertisements (study flyer, press-release, media, internet)
c. waits for participants to come to the researcher

Recruitment Methods and Underserved Populations (e.g., ethnic minorities)


Study
Fitzgibbon et al. (1998)

Purpose
active recruitment
techniques for PA
promotion and proper
diet

Population
Two African-American
populations of different
socio-economic status
(SES)

Yancey et al. (1991)

PA and nutrition
intervention program active vs. passive
recruitment

AA women of different
BMI and education levels

Results
Low SES: active
approaches
(presentations)
High SES: other
approaches
High BMI & low
education: personalized
approaches
Low BMI & high SES:
passive approaches

Recruitment Methods - Disabilities


Study
Kosma et al. (2004)

Purpose
Web-based PA promotion
using passive recruitment

Population
Adults with physical
disabilities

Warren-Findlow et al.
(200)

Exercise intervention
using a combo of active
and passive strategies

White and AA adults with


chronic illnesses

Results
Mostly White, welleducated participants;
50% recruitment rate
87% recruitment rate
Race did not affect
recruitment
Age and functional level
affected recruitment

50% is the general recruitment rate in PA studies

General Model of Recruitment (Levkoff & Sanchez, 2003)


Level
Macro
Barriers
Enablers
Mediator
Barriers
Enablers
Individual
Barriers
Enablers

Ethnic Minority Groups


Community agencies (retirement
center, church, school)

Researcher
Academic institutions (LSU)

Gate-keepers/health care providers


(directors of retirement centers,
priests, etc); trusted by community
Individual participants/caregivers

Research team (faculty)

Interviewers

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general model provides lessons learned related to successful recruitment of older, ethnic minority adults
to PA programs
there has to be an effective interaction on three levels: macro, mediator, and individual

Enablers at the Macro level

recognize local history and cultural beliefs


establish long term commitment to community
develop partnerships with local advisory groups
provide transportation for research interview

Enablers at the Mediator Level

understand multicultural differences


regular updates of research progress
provide incentive to gate keepers

Enablers at the Micro Level

match ethnicity of participants and researchers


clear study description and confidentiality
use quantitative and qualitative research
rely on existing networks

Barriers at Micro Level

language
lack of trust
fear of lack of confidentiality

Key Strategies for Effective Recruitement

functional level, SES, education, age, ethnicity, and attitudes affect participation in PA promotion research
and recruitment techniques
overcome fear and distrust through collaboration with community agents
understand cultural differences
diversify the cultural characteristics of research staff
give feedback to the community about the results
overcome transportation barriers

DePauw (2000) Quest Article


Disability Models (Medical vs. Social Minority)
1.

Medical Model
o disability = defective, inferior, less than
o biological/psychological anomalies and deficits

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2.

o negative terminology
o goal = give advice and prescription
o graphics are passive
Social Minority model
o disability - simply being different
o one shared experience = social stigma
o terminology = positive, neutral, person-first emphasized
o goal is to empower the individual, self-actualization
o graphics are active

Categorical vs. Non-Categorical Approach


1.

2.

Categorical approach
a. labeling, assumption of homogeneity, stereotypes
b. lined to medical model
c. Characteristics of this approach
i. people are identified by categories
1. need to target each group differently
2. experts need to communicate differently with each group
3. these labels can take another term - labeling
ii. labeling assumes the problem is in the individual, relieves responsibility from the
exercise leader
iii. assumption of population homogeneity
1. people within this group are the same
2. we assume that the group of people have the same or similar characteristics
3. this effects how we develop our exercise programs
4. we cannot assume this, because each person is different
iv. reinforces stereotypes and under-expectations
v. labeling becomes permanent; you don't see the person, you see the label
vi. relieves responsibility of exercise leaders
Non-Categorical approach
a. promotion of inclusion in the least restrictive environment
b. linked to social minority model
c. Characteristics of Non-Categorical approach
i. promotion of inclusion in the least restrictive environment
1. integrating disabled with non-disabled people
2. the people can function at optimal levels
ii. inclusion as an attitude, a philosophy
1. it starts with attitude before action
2. if the fitness center is acceptable, it will attract more people
iii. APA viewed as service, not a place

Disability Terminology
1.

Do NOT Use or Say


a. Aged (the) - elderly (the)
b. birth defect

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c. blind - visually impaired


d. confined to a wheelchair
e. epileptic (the)
f. insane, lunatic, psycho
g. invalid
h. spastic
i. normal
Do Use or say
a. older adults
b. persons with a disability since birth
c. person who is blind; person who has a visual impairment
d. wheelchair user
e. person who has epilepsy
f. person with a mental health disability
g. person with a disability
h. person who has spasms
i. person who is not disabled
people who are deaf are OK with "deaf person" because they don't think they have a disability, they just
have a different method of communication

2.

3.

Disability Infusion in Higher Education (Infusion Approach)

infuse content about disability throughout the required (and elective) coursework in the undergraduate
curriculum of Kinesiology
Level

Approach

Content Level

Participant
Commitment
Little or none

Additive

Comprehension

II

Inclusion

Application
Analysis

Partial

III

Infusion

Analysis
synthesis
Evaluation

Strong

Learning
Experience
Single
Isolated
Passive
Unrelated
Multiple
Reflective
Related
Integral
Integrated
Active

Value Level
Exposure
Initial awareness

Enrich
Partial
understanding
Enrich
Ownership
Understanding

Example:

Additive Level - students receive lectures about disability topics


Inclusion level - students observe APE classes or develop programs
Infusion Level - students implement and evaluate their programs (e.g., hands on experience in APE
classes)

Benefits of the Infusion Approach

increased knowledge and understanding of disability, individuals with a disability, and equity issues
o decreased nervousness in dealing with wheelchair users
commitment of faculty and students to disability issues

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increased working knowledge of faculty across disciplines and collaborations


increased inclusion of people with disabilities in GPE
o increased comfort level dealing with wheelchair users
increased commitment to the elimination of disability related social stigma
increased affirming environment and inclusive society

Disability Assumptions in Society

disability is a given (located in biology)


disability is a medical issue
having a disability means needing help
the person with the disability is a victim
disability is central to social concept, self-definition, social comparison, and reference groups
disability is a fundamentally negative situation

Challenging Disability Assumptions

Emancipatory research
o meaningful research in the disability community, that emphasizes the inclusive approach
participatory model of research
o people with disabilities as researchers, as well as the researched
focus on individual, environment, and their interaction
o disability as a social construct, not just a medical issue
challenge traditional images of the "ideal" athletic body
o women elite athletes with disabilities, amputee high jump without prosthesis, and wheelchair
dance in light of athletic ability
o look at the athlete/performance, not the disability

Feedback and Reinforcement

reinforcement - the use of rewards and punishments that increase or decrease the likelihood of a similar
response occurring in the future
the consequences of behavior (rewards or punishment) lead to a positive or negative response...the
behavior reoccurring or being terminated

General Principles of Reinforcement

positive consequence lead to behavior repetition


o example, soccer player who doesn't usually pass makes a pass and team scores a goal; next time
there is an opportunity, this player is more likely to repeat the passing behavior
negative consequences lead to behavior avoidance
o volleyball player tries a risky overhand serve and the ball doesn't make it over the net; the coach
yells at the player; this is a negative consequence, and they player will avoid serving like that
again

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Behavioral Strategy
Positive reinforcement
Negative reinforcement
Punishment
Punishment
Extinction

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Stimulus
Presented
Avoided
Presented
Removed
Does not change

Behavioral Effect
Increase positive behavior
Increase positive behavior
Decrease negative behavior
Decrease negative behavior
decrease

Principles of Reinforcement Examples

Positive reinforcement - positive stimulus presented; positive behavior increases


o ex, teacher praises student for effective engagement in drills
negative reinforcement - negative stimulus avoided; positive behavior increases
o ex, student does not wear gym uniform, teacher says "next time, you get 5 points off your grade"
Punishment - negative stimulus presented; negative behavior decreases
o student forgets tennis shoes second day in a row, the teacher takes 5pts off his grade
Punishment - positive stimulus removed; negative behavior decreases
o student shows overly aggressive behavior, result is no free-time place
Extinction - no stimulus, negative behavior decreases
o ignoring aggravating noises by a student (instructor ignores the behavior)

Principles for Effective Use of Positive Reinforcement

choose effective reinforcers


o social - praises, pat on the back
o material
o activity reinforcers - playing a game
o special outings - has been applied a lot to sports; going to a professional game, hearing a
presentation from a professional athlete, team party
o Extrinsic rewards - come from exercise leader or coach
o intrinsic rewards - people feeling proud of their accomplishment/what they achieved
schedule reinforcements effectively
o continuous and immediate
o intermittent - once they are proficient with a skill, if you praise too much, they won't listen
rewarding appropriate behaviors - not only winning
reward successful approximations - shaping
o if you wait until someone can perform the whole skill, they may not get positive feedback for awhile,
and may drop out
o reward the steps or parts of the skill
reward effort
reward emotional and social skills - fair play and good sporting skills
provide performance feedback (knowledge of results)
o contingent on a specific behavior
o feedback should be constructive

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Benefits of Feedback

motivational feedback - enhance confidence and effort, positive moods, reinforcement, and establish goal
setting
instructional feedback - behavior to be performed, goals, and current level of proficiency

Guidelines to Increase the Effectiveness of Behavioral Programs

target the behaviors


o identify only couple of behaviors to work with
define targeted behaviors
o observable and easy to record
record the behaviors
o use of checklists
provide meaningful feedback
o display one's progress
state the outcomes clearly
o state required behaviors
tailor the reward system
o extrinsic vs. intrinsic

Psychological Skills Training


What is PST?

such psychological skills as increased self-confidence and self-esteem, arousal regulation (e.g., attention
or concentration skills), stress management, and coping with injury can enhance performance,
motivation, self-satisfaction, and smooth and effective injury recovery
why is it important?
o to reduce nerves
o increase motivation to follow an exercise program because you are able to overcome depression
following an exercise-induced injury
o most sports are more mental than physical in nature (tennis, golf)

Who Conducts PST (clinical vs. educational sport psychologist)

educational sport psychologist, not clinical


clinical focuses on things such as eating disorders, depression, and other clinical mental health issues
educational sport psychologists emphasize the use of psychological skills training (e.g., goal setting,
imagery, arousal management) when working with clients by educating and instructing them on how to
use these skills effectively during performance situations

Three Phases of PST Programs


1.

Education phase - importance of PST


a. what your participants think about the psychological aspect, what is their experience with mental
training?

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2.

3.

Acquisition Phase
a. strategies and techniques for learning mental skills (positive self-talk, goal setting, relaxation,
imagery, etc)
Practice Phase
a. automate skills through over learning
b. skill integration into performance
c. skill simulation in actual competition

Five-Stage Model of Self-Regulation


1.

2.

3.

4.

5.

Stage 1 - problem identification


a. identify and accept problem
i. ex. accept inability to shoot at critical games dues to stress and low confidence
stage 2 - Commitment
a. to change and deal with obstacles
i. ex. need for regular practice of mental skills to improve and progress
stage 3 - Execution
a. learn to cope with problems (self-evaluation, self-monitoring, and self-reinforcement)
i. ex. videotape one's games or use logs to rate anxiety levels during key shots
b. may be most important stage
stage 4 - Environmental Management
a. manage the physical and social environment
i. ex. social support and guidance, quiet place to practice relaxation exercises
stage5 - Generalization
a. extend and apply behaviors to new conditions and settings
i. ex. apply psychological skills from basketball to academic tests

PST Program Development

who should conduct PST programs?


o sport psychologist, consultant, or coach (if trained)
o not a clinical sports psychologist (this is for athletes with clinical eating disorders, depression,
etc)
when to implement a PST program
o off season or preseason; 3-5d/wk for 10-15min; this is an ongoing process
discussing the approach
o educational vs. clinical approach
o establish trust with the athlete
assessing athlete's mental skills
o interviews, observations, surveys
determine with PS to include
o time to practice mental skill, interest of athletes
designing a schedule
o before or after practice; frequent, short meetings
evaluating the program
o evaluate program's effectiveness and provide feedback
Common problems with Implementing a PST program

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o
o
o
o

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lack of conviction
lack of time
lack of sport knowledge
lack of follow-up

Athletic Injuries and Psychology


Stress-Injury Relationship Model (Andersen & Williams, 1988)

Personality
Factors

Potentially
Stressful
Situation

History of
Stressors

Coping
Resources

Stress Response
Perception Increased Attention
of threat State
Distraction
Anxiety
Muscle
Tension

Injury

Psychological
Skill
Interventions

Causes (Moderators) of Injury Based on the Stress-injury relationship Model

personality factors - self-esteem, hardiness, trait anxiety


stress levels - life stress and athletic injuries; changing positions, starting PT, pain
coping resources (social support) and psychological skills: self-esteem, self-confidence, relaxation

Psychological Reactions to Exercise and Athletic Injuries

Five-Stage Grief Response Process


1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance and reorganization
identitiy loss
1. "my knee's shot. my knee's shot. There goes my whole career it's over. I'm through"
Fear and anxeity
1. will I be reinjured? will someone replace me?
Lack of confidence
1. will I be able to get back to my pre-injury condition?
post injury performance decrements

Psychological Rehabilitation - Three Phase Model (Bianco et al., 1999)

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1.
2.
3.

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Injury-Illness phase
Rehabilitation-Recovery Phase
Return to full activity phase

Psychological rehabilitation (e.g., build rapport, educate, foster social support)

build rapport
educate injured athlete about injury and recovery process
teach psychological coping skills (goal setting, positive self-talk, relaxation, imagery)
teach how to cope with setbacks - no panic
foster social support
learn from injured athletes

Coping with Season-Ending Injuries - Elite Skiers' Recommendations


Other Injured Athletes
Accept injury
Quality training
Use social support
Set goals
Work on mental skill training
Initiate/maintain involvement with
the team

Coaches
Understand individual variation in
injury
Foster social supprot
Motivate by optimally pushing
Patience and realistic expectations
Do not mention injury repeatedly
Individualized training

Sports Medicine Staff


Educate athlete
Motivate and optimally push
Empathy and support
Be warm, open, and confident
Competence and confidence
Encourage athlete's confidence

Burnout and Overtraining


Overtraining Definition and Process

overtraining - a short cycle of training during which athletes expose themselves to excessive training loads
that are near or at maximal capacity

based on the overload principle - when individuals are faced with higher volume, more intense workouts,
during recovery their body will recover and they will come back more fit and stronge r

Overtraining Process

Positive Overtraining
Improved performance

Overload Overtrain Overreach

Maintenance
No change in performance

Negative Overtraining
Burnout and Staleness
Impaired Performance

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the goal over overload is for the body to adapt to a higher volume
overreaching is a state where the individual experiences impaired performance levels for a short period of
time (3 days to a week)
this overreached state is what we call the recovery state (when body recovers from overtraining and tried
to adapt to the higher training volume)
three things can happen during the overreaching state
o positive overtraining and increased performance
o maintenance and no change in performance
o negative overtraining and impaired performance, leading the burnout and staleness

Signs and Symptoms of Overtraining

poor performance
apathy
lethargy/sleep disturbance
weight loss/appetite loss
elevated resting HR/BP
muscle pain or soreness
mood changes
GI disturbances
retarded recovery from exertion
overuse injuries
immune system deficiency
concentration loss

Staleness Definition

physiological state of overtraining which manifests as deteriorated athletic readiness and performance
lasts at least 2 weeks
80% of athletes are also depressed

Burnout Definition and Symptoms

exhaustion, both physical and emotional


feeling of low personal accomplishment, low self-esteem, failure, and depression
depersonalization and devaluation

Signs and Symptoms of Burnout


Low motivation or energy
Concentration problems
Loss of desire to play
Lack of caring
Sleep disturbance
Physical and mental exhaustion
Lowered self-esteem

Negative affect
Mood changes
Substance abuse
Changes in values and beliefs
Emotional isolation
Increased anxiety
Highs and lows

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Cognitive-Affective 4 Stage Stress Model

Personality and motivational factors


Cognitive appraisal
Stress
Situation
demands
Resources

Of demands
Of resources
Of consequences
Of meaning of
consequences

Burnout
Overload
Low social
support
Low
autonomy
Low rewards
Boredom

Perceived overload
Helplessness
Low meaningful
accomplishments
Devaluation of selfactivity

Physiological
responses

Tension, anger,
anxiety, depression
Insomnia, fatigue
Illness
susceptibility

Coping &
task
behaviors

Rigid
behavior
Decreased
performance
Interpersonal
difficulties
Activity
withdrawal

Personality and motivational factors

4 Stages
1.
2.
3.
4.

Situational Demands - an important game, stressful rehab program


Cognitive Appraisal - how they perceive the situation (maybe they don't value the activity, maybe they
don't want to follow the rehab program)
Physiological Responses - increase in tension, irritability, fatigue
Behavioral Responses - withdrawal or try to improve, decreased performance, interpersonal difficulties,
and withdrawal from the activity

Treatment and Prevention of Burnout

Monitor critical states in athletes


o think about life stress and the effect on the athlete
communicate
set short-term goals for competition and practice
take relaxation (time-out) breaks
learn self-regulation skills (relaxation, imagery, goal setting, positive self-talk)
keep positive outlook
manage post competition emotions
e.g., provide support; have a group activity; provide an unemotional, realistic
assessment; prepare for the next opponent in the very next practice
stay in good physical condition

What are the similarities and differences among overtraining, staleness, and burnout?

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all of these lead to lack of participation, high stress, increased rates of drop outs; differences in that
overtraining can lead to positive performance results, whereas staleness can lead to only negative burnout/withdrawal

Eating Disorders and Exercise Addiction


Exercise Addiction (definition, symptomatology, prevention)

"the craving for leisure time physical activity that results in uncontrollable excessive behavior and that
manifests in physiological (tolerance, withdrawal) and psychological symptoms (anxiety, depress)
symptomatology
o tolerance
exercising at high intensity isn't enough, they don't feel satisfied so they add more and
more
o withdrawal
if they have to stop (due to injury or vacation), they don't respond well...high stress
o lack of control
exercise controls their life.. scheduling activities around exercise
o time
o reduction
of non-exercise activities (time with family/friends)
o continuance
even when they are injured or should step back

Exercise Deprivation Symptoms


Affective Symptoms
Depression
Anxiety
Irritability
Hostility
Angry
Tension
Guilt
Frustration
Sexual tension
Low SE

Cognitive Symptoms
Low concentration
confusion

Physiological Symptoms
Muscle soreness
Fatigue
Lethargy
Low vigor
Sleep problems

Prevention of Negative Exercise Addiction

schedule rest days


work out regularly with a slower partner
if you are injured, stop exercising until you are rehabilitated ad healed
train hard - easy
exercise 3-4 times per week for 30min
set realistic short- and long-term goals

Anorexia

Social Symptoms
Need for social interaction

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refusal to maintain body weight at or above a minimally normal weight for age and height
intense fear of gaining weight, despite being underweight
negative perception about body shape/weight
amenorrhea
don't realize they have this problem, so it's more dangerous than bulimia

Bulimia Nervosa

recurrent episodes of binge eating (in privacy)


perceived lack of control over eating behavior during the eating binges
engaging in regular self-induced vomiting, use of laxative or diuretics, strict dieting or fasting, or vigorous
exercise
an average minimum of two binge eating episodes/wk for at least 3 months
persistent over-concern with body shape and weight
"less dangerous" than anorexia, because they people know they have a problem, and are more likely to
get help

Prevalence of Eating Disorders in Sport

more common in female athletes than male athletes


athletes have more disordered eating than non-athletes
athletes vs. non-athletes and psychopathology - it's the same
a high % of athletes engage in disordered eating or weight loss behaviors
eating disorders in athletes have a sport-specific prevalence (higher in gymnastics, swimming, wrestling,
sports with weight classes)
up to 66% of female athletes may be amenorrheic compared with 2-5% of non-athletes
about 63% of all female athletes develop eating disorder symptoms between the 9th and 12th grade

EXE and AN: Four Models, two proposed studies and practical implications

study purpose was to identify the links between excessive exercise (EXE) and anorexia nervosa (AN) under
the assumption that EXE is a syndrome (i.e., distinct diagnostic entity)
Model I
o EXE and exercise anorexia nervosa (E-AN) are distinct groups
o the main goal of people with E-AN is to lose weight through such behaviors as exercise, and the
main goal of people who are EXE is to increase performance
o Implications
the similarity between the two groups is superficial, bc the goals of each are different
undiagnosed cases of eating disorders
athletes (wouldn't think they have eating disorders)
male adults/exerciser
older adults
Model II
o EXE can lead to AN through
addiction to starvation mechanism
many athletes who exercise a lot diet to increase performance
through this diet, they are addicted to low food intake

FINAL REVIEW

20

physical activity and food intake


PA may induce a reduced food intake

Model III o Stronger model version: AN and EXE are a variant of another disorder --> these are symptoms of
another disorder (OCD, perfectionism, anxiety, depress)
limitation:
different course and symptoms and varying epidemiological data
o Weaker model version: another disorder might be a predisposing factor for both AN and EXE
another disorder leads to both; Depression or OCD or anxiety leads to AN and EXE
Limitation
lack of explanations about the link between AN and EXE
Model IV
o EXE is a variant of (the same thing as) AN
o AN and EXE have a similar etiology that explains the ratio differences between males and females
in the two disorders
o specifically: the same factors (family and social pressures) that form female adolescent AN also
form the "mid-life crisis" of the "obligatory male athlete"
o it is believed AN occurs mostly among adolescent females due to social pressure to be thin
o model limitation:
the use of two different age cohorts (groups)

Two Proposed Studies and Practical Implications


1.

2.

descriptive study of the "syndrome EXE (i.e., exercise dependence)


a. Implications
Support of Model I
the EXE syndrome maintains its separate identify over time (doesn't develop
into AN)
Support of Model II
the EXE syndrome sometimes develops into AN
Support for Model IV
there is a common family history between AN and EXE (adolescent daughter
has AN, and adult son has EXE)
Investigate attitudes of eating and exercising of non-clinical populations who may be considered "at risk"
for both AN and EXE (e.g., fashion models, ballet dancers, gymnasts, runners, and swimmers)
a. Implications
Support of Model I
different dominant factors for different groups
Support of Model IV
similar factors would cause all 5 groups to be equally at risk for developing both
types of disorder