RESUMEN

The aim was to examine the effect of focus of attention cues on foot angle for retraining movement purposes. Twenty (females: 8) rearfoot-striking recreational runners (mass: 72.5 ± 11.8 kg; height: 1.73 ± 0.09 m; age: 32.9 ± 11.3 years) were randomly assigned to an internal focus (IF) (n = 10) or external focus (EF) (n = 10) verbal cue group. Participants performed 5 × 6 minute blocks of treadmill running (control run, 3 × cued running, retention run) at a self-selected running velocity (9.4 ± 1.1 km∙h-1) during a single laboratory visit. Touchdown foot angle, mechanical efficiency, internal and external work were calculated and, centre of mass (COM) and foot movement smoothness was quantified. Linear-mixed effect models showed an interaction for foot angle (p < 0.001, ηp2 = 0.35) and mechanical efficiency (p < 0.001, ηp2 = 0.40) when comparing the control to the cued running. Only the IF group reduced foot angle and mechanical efficiency during cued running, but not during the retention run. The IF group produced less external work during the 1st cued run than the control run. COM and foot smoothness were unaffected by cueing. Only an IF produced desired technique changes but at the cost of reduced mechanical efficiency. Movement smoothness was unaffected by cue provision. Changes to foot angle can be achieved within 6 minutes of gait retraining.

Asunto(s)

RESUMEN

OBJECTIVES: The purpose of this prospective cohort study was to assess the associations between lower limb injuries in female team-sport athletes and a number of factors. The potential risk factors explored included (1) lower limb strength, (2) history of life-event stress, (3) family history of ACL injuries, (4) menstrual history, and (5) history of oral contraception use. METHODS: One hundred and thirty-five female athletes aged between 14 and 31 years (mean: 18.8 ± 3.6 years) from rugby union (n = 47), soccer (n = 72), and netball (n = 16) volunteered to participate in this study. Demographics, history of life-event stress, injury history and baseline data were obtained prior to the competitive season. The following strength measures were collected: isometric hip adductor and abductor strength, eccentric knee flexor strength and single leg jumping kinetics. Athletes were then followed for 12 months, and all lower limb injuries sustained were recorded. RESULTS: One hundred and nine athletes provided one-year follow-up injury data, of whom, 44 suffered at least one lower limb injury. All athletes who reported high scores for negative life-event stress sustained lower limb injuries. Non-contact lower limb injury was positively associated with weak hip adductor strength (OR: 0.88; 95%CI: 0.78-0.98; p = 0.017), and between-limb adductor (OR: 5.65; 95%CI: 1.61-19.7.; p = 0.007) and abductor (OR: 1.95; 95%CI: 1.03-3.71; p = 0.039) strength asymmetries. CONCLUSION: History of life event stress, hip adductor strength, and between-limb adductor and abductor strength asymmetries offer potential novel avenues for investigating injury risk factors in female athletes.

Asunto(s)

RESUMEN

This paper adopts a novel, interdisciplinary approach to explore the relationship between stress-related psychosocial factors, physiological markers and occurrence of injury in athletes using a repeated measures prospective design. At four data collection time-points, across 1-year of a total 2-year data collection period, athletes completed measures of major life events, the reinforcement sensitivity theory personality questionnaire, muscle stiffness, heart rate variability and postural stability, and reported any injuries they had sustained since the last data collection. Two Bayesian networks were used to examine the relationships between variables and model the changes between data collection points in the study. Findings revealed muscle stiffness to have the strongest relationship with injury occurrence, with high levels of stiffness increasing the probability of sustaining an injury. Negative life events did not increase the probability of injury occurrence at any single time-point; however, when examining changes between time points, increases in negative life events did increase the probability of injury. In addition, the combination of increases in negative life events and muscle stiffness resulted in the greatest probability of sustaining an injury. Findings demonstrated the importance of both an interdisciplinary approach and a repeated measures design to furthering our understanding of the relationship between stress-related markers and injury occurrence.

RESUMEN

Competitive state anxiety is an integral feature of sports performance but despite its pervasiveness, there is still much debate concerning the measurement of the construct. Adopting a network approach that conceptualizes symptoms of a construct as paired associations, we proposed re-examining competitive state anxiety as a system of interacting components in a dataset of 485 competitive athletes from the United Kingdom. Following a process of data reduction, we estimated a network structure for 15 items from the modified Three Factor Anxiety Inventory using the graphical LASSO algorithm. We then examined network connectivity using node predictability. Exploratory graph analysis was used to detect communities in the network and bridge expected influence calculated to estimate the influence of items from one community to items in other communities. The resultant network produced a range of node predictability values. Community detection analysis derived three communities that corresponded with previous research and several nodes were identified that bridged these communities. We conclude that network analysis is a useful tool to explore the competitive state anxiety response and we discuss how the results of our analysis might inform the assessment of the construct and how this assessment might inform interventions.

RESUMEN

The aim was to investigate the biomechanical, physiological, and perceptual responses to different motor learning strategies derived to elicit a flatter foot contact. Twenty-eight rearfoot-striking recreational runners (age 24.9 ± 2.8 years; body mass 78.8 ± 13.6 kg; height 1.79 ± 0.09 m) were matched by age, mass, and height and assigned to one verbal cue group: internal focus of attention (IF), external focus of attention (EF), and a clinically derived condition (CLIN) incorporating an IF followed by an EF statement. Participants completed two treadmill runs at 10 km h-1 for 6 minutes each: normal running (control) followed by the experimental condition (IF, EF, or CLIN). Lower limb kinematics, oxygen consumption ( V ˙ O 2 ), and central and peripheral ratings of perceived exertion (RPE) were recorded for each run. Compared to the control condition, foot angle was reduced in the IF (difference = 5.86°, d = 2.58) and CLIN (difference = 3.00°, d = 1.31) conditions, but unchanged in the EF condition (difference = 0.33°, d = 0.14), while greater knee flexion at initial contact in the EF and CLIN conditions was observed (difference = -5.19°, d = 1.97; difference = -3.66°, d = 1.39, respectively). A higher V ˙ O 2 was observed in the CLIN condition (difference = -4.56 mL kg-1  min-1 , d = 2.29), but unchanged in the IF (difference = -1.87 mL kg-1  min-1 , d = 0.94) and EF conditions (difference = -0.37 mL kg-1  min-1 , d = 0.19). All experimental conditions increased central and peripheral RPE (difference = -1.08, d = 0.54 and difference = -2.39, d = 1.33, respectively). Providing gait retraining instructions using an internally directed focus of attention was the most effective way to target specific changes in running kinematics, with no detrimental effect on physiological responses. Yet, perceptual effort responses increased regardless of the type of cue provided.

Asunto(s)

RESUMEN

This qualitative study explored the career termination experiences of 9 male, retired professional cricketers between the ages of 28 and 40 (mean value 34, s = 4.65 m). The participants took part in retrospective, semi-structured interviews. Data from the interviews were inductively content analysed within three transition phases of the retirement process: reasons for retirement, factors affecting adaptation and reactions to retirement. The reasons for retirement were multicausal with the majority of the participants highlighting contractual pressures and a lack of communication as important precursors to retirement. Three main themes accounted for the factors affecting adaptation: a limited pursuit of other interests, developmental experiences and coping strategies. In terms of reactions to retirement, all of the participants reflected negatively on the termination of their career, with a sense of loss and resentment characterising the post-retirement period. The findings illustrated the sport-specific nature of career termination in professional cricket and added further support to the emerging consensus that the distinction between voluntary and involuntary retirement is, at best, unclear.

Asunto(s)

RESUMEN

Previous studies have demonstrated that an external focus can enhance motor learning compared to an internal focus. The benefits of adopting an external focus are attributed to the use of less effortful automatic control processes, while an internal focus relies upon more effort-intensive consciously controlled processes. The aim of this study was to compare the effectiveness of a distal external focus with an internal focus in the acquisition of a simulated driving task and subsequent performance in a competitive condition designed to increase state anxiety. To provide further evidence for the automatic nature of externally controlled movements, the study included heart rate variability (HRV) as an index of mental effort. Sixteen participants completed eight blocks of four laps in either a distal external or internal focus condition, followed by two blocks of four laps in the competitive condition. During acquisition, the performance of both groups improved; however, the distal external focus group outperformed the internal focus group. The poorer performance of the internal focus group was accompanied by a larger reduction in HRV, indicating a greater investment of mental effort. In the competition condition, state anxiety increased, and for both groups, performance improved as a function of the increased anxiety. Increased heart rate and self-reported mental effort accompanied the performance improvement. The distal external focus group also outperformed the internal focus group across both neutral and competitive conditions and this more effective performance was again associated with lower levels of HRV. Overall, the results offer support for the suggestion that an external focus promotes a more automatic mode of functioning. In the competitive condition, both foci enhanced performance and while the improved performance may have been achieved at the expense of greater compensatory mental effort, this was not reflected in HRV scores.

RESUMEN

OBJECTIVE: Suicidality among patients with schizophrenia remains a major concern. The consumer-oriented concept of recovery has been recognised as important in recent years. We aimed to assess whether there was any relationship between stages of recovery and suicidality among people with schizophrenia in community care. METHOD: In a community mental health service, 85 patients with schizophrenia consented to an interview during which their stages of recovery were assessed using the Stages of Recovery Instrument. They were asked about suicidality and screened for depression using the Revised Clinical Interview Schedule. Insight was assessed via the Insight and Treatment Attitudes Questionnaire. Data analysis involved logistic regression. RESULTS: In the past year 14% of the patients reported having wanted to die and 13% had considered suicide. Scores indicating the highest stage of recovery were associated with lower odds of suicidal thoughts. In contrast, suicidality was not significantly associated with depression or stage of insight. CONCLUSION: The link found between suicidality and stages of recovery has practical implications for suicide prevention among those with schizophrenia in community care. Approaches that facilitate the recovery process may reduce suicidal thoughts in this population.

Asunto(s)

Asunto(s)

RESUMEN

OBJECTIVE: This study examined whether patients' perception of recovery differed for those receiving treatment under a compulsory treatment order (CTO) compared to those who were not. METHOD: A total of 86 participants with schizophrenia/schizo-affective disorder were interviewed about their views on recovery, and their clinical files were examined to ascertain if they were under a CTO at time of interview. RESULTS: No association between being under a CTO and recovery beliefs was found. Irrespective of whether patients were under a CTO or not, the majority of participants (82%) reported that they thought recovery is possible and half of the participants (51%) reported that they were in recovery. CONCLUSION: The present study found no evidence that being under a CTO was related to additional pessimistic views about recovery or being recovered. Participants under a CTO were no more or less likely to report that recovery was possible, and that they were recovered, as participants who were not under a CTO.

RESUMEN

OBJECTIVE: This study systematically examined the empirical literature on the themes and correlates of coercion as defined by the subjective experience of patients in psychiatric care. METHODS: The study was a systematic review of the literature on coercion as covered in MEDLINE, PsycINFO, and CINAHL. From qualitative studies, themes that the authors identified were extracted. From quantitative studies, correlational and outcome data were extracted. RESULTS: The final analysis included 27 articles. Themes related to perceived coercion were almost all negative. Correlation and outcome data were insufficiently homogeneous to allow meaningful combined statistical analysis. There was no strong quantitative evidence that the experience of coercion is negatively or positively associated with psychopathology or general well-being. CONCLUSIONS: Coercion was commonly felt by patients as dehumanizing. Compulsory actions likely to increase perceived coercion had mixed correlates, and it was therefore difficult to predict who is at greatest risk of experiencing coercion as a "side effect" of intervention. Clinicians should routinely consider that all patients have the potential to experience an intervention as coercive.

Asunto(s)

RESUMEN

The three experiments reported here examined the process goal paradox, which has emerged from the literature on goal setting and conscious processing. We predicted that skilled but anxious performers who adopted a global movement focus using holistic process goals would outperform those who used part-oriented process goals. In line with the conscious processing hypothesis, we also predicted that performers using part process goals would experience performance impairment in test compared with baseline conditions. In all three experiments, participants performed motor tasks in baseline and test conditions. Cognitive state anxiety increased in all of the test conditions. The results confirmed our first prediction; however, we failed to find unequivocal evidence to support our second prediction. The consistent pattern of the results lends support to the suggestion that, for skilled athletes who perform under competitive pressure, using a holistic process goal that focuses attention on global aspects of a motor skill is a more effective attentional focus strategy than using a part process goal.

Asunto(s)

RESUMEN

The relationship between delusions and overvalued ideas is uncertain, and has clinical as well as conceptual implications. This study aims to compare delusions and overvalued ideas on several characteristics that might further describe and distinguish them. A total of 24 individuals with delusions and 27 with overvalued ideas were recruited from a psychiatric service and assessed using a semistructured interview. Deluded individuals were less likely to identify what might modify their belief, less preoccupied, and less concerned about others' reactions than those with overvalued ideas. Delusions were less plausible and their onset less likely to appear reasonable. Delusions were more likely to have abrupt onset and overvalued ideas a gradual onset. Conviction and insight were similar in the 2 groups. Belief conviction and insight may be an inadequate basis for separating delusions from overvalued ideas. Abrupt onset, implausible content, and relative indifference to the opinions of others may be better distinguishing features.

Asunto(s)

RESUMEN

For the first time in a sport setting this study examined the intensity and direction of the competitive state anxiety response in collegiate athletes as a function of four different coping styles: high-anxious, defensive high-anxious, low-anxious and repressors. Specifically, the study predicted that repressors would interpret competitive state anxiety symptoms as more facilitative compared to high-anxious, defensive high-anxious, and low-anxious performers. Separate Multivariate Analyses of Variance (MANOVA) were performed on the intensity and direction subscales of the modified Competitive State Anxiety Inventory-2 (CSAI-2). A significant main effect was identified for trait worry revealing that low trait anxious athletes reported lower intensities of cognitive and somatic anxiety and higher self-confidence and interpreted these as more facilitative than high trait anxious athletes. The prediction that performers with a repressive coping style would interpret state anxiety symptoms as more facilitative than performers with non-repressive coping styles was not supported.

Asunto(s)

RESUMEN

AIM: This study aimed to assess the extent of defensive clinical practice by psychiatrists and psychiatric nurses in a New Zealand Mental Health Service. METHOD: An anonymous questionnaire survey, addressing perceptions of a variety of defensive practices, was sent to all psychiatrists and psychiatric nurses working in acute clinical settings in the publically funded mental health service in Dunedin, New Zealand. RESULTS: Defensive practice is perceived as widespread in psychiatric settings. In particular, practices such as questioning patients about their safety, admissions to hospital, and delayed discharge from hospital were often perceived as occurring for defensive purposes. Psychiatric nurses were more likely than psychiatrists to perceive such practices as defensive. CONCLUSION: Defensive practice is common in mental health. This is despite New Zealand's no-fault compensation scheme, and so presumably results from concerns other than the risk of financial liability. There may be particular pressures in mental health to practice defensively.

Asunto(s)

RESUMEN

BACKGROUND: Somatoform disorders can be understood to mimic supposedly more 'legitimate' physical disorders. To the extent that mental disorders are now also often considered legitimate, might clinicians expect to encounter the psychiatric equivalent of somatoform disorders, 'psychiatriform disorders'? METHOD: The relevant literature on somatoform disorders is reviewed in light of the tendency for mental and physical symptoms to co-occur. DISCUSSION: Illness attribution and behaviour may explain some of the recent rise in the prevalence of mental disorder. Hypotheses regarding the cause and nature of somatoform disorders are applied to their proposed psychiatric equivalent. Despite lack of current recognition, there is a strong theoretical basis for the existence of psychiatriform disorders. Psychiatriform disorders can be expected to have similar causes, comorbidity, and response to treatment, as somatoform disorders. A variety of cultural forces may be contributing to a rise in prevalence. CONCLUSION: As with somatoform disorders, psychiatriform disorders present problems in their distinction from conscious fabrication and from the ;legitimate' disorders they mimic. Given their likely prevalence and associated impairments, psychiatriform disorders warrant further examination, despite the methodological difficulties this presents.

Asunto(s)

Asunto(s)

RESUMEN

Two studies have questioned Masters' (1992) contention that skills acquired in implicit practice conditions are less likely to fail under pressure than those acquired explicitly. The studies produced conflicting results. The aim of the present study was to revisit the designs of both studies in an attempt to clarify the situation. Thirty-two participants were allocated to one of three separate implicit training groups or an explicit training group, and practised putting golf balls. Participants were exposed to an anxiety intervention at two points during practice. Putting performance across practice and anxiety phases were analysed using the number of putts successfully completed as the main dependent variable. We found further evidence for the suggestion that motor skills are robust under pressure when acquired in implicit practice conditions.

Asunto(s)

RESUMEN

Clinicians who treat patients using Community Treatment Orders (CTOs) face many potential dilemmas in their relations with involuntary outpatients and the exercise of their powers. We compare the dilemmas identified in the literature with those reported by responsible clinicians in New Zealand (NZ). These clinicians experienced a number of well-known dilemmas, such as determining the right moment for a person's discharge from a CTO, but they seemed less troubled by some other difficulties than might be expected, usually because they considered involuntary outpatient treatment the best option for the patient or the best way to manage the risks involved. Further dilemmas were identified by the NZ clinicians that have not been widely discussed, concerning the proper scope of clinical authority over patients under CTOs and the decision to revoke involuntary outpatient status. In conclusion, some suggestions are made as to how clinicians might best manage the dilemmas involved.

Asunto(s)

RESUMEN

BACKGROUND: People with serious mental disorders typically live with family members. Despite increasing interest in compulsory community treatment for such patients, the experience and views of their family members have been little studied. MATERIAL: Qualitative interviews with 27 family members, whose relatives have been subject to compulsory community treatment. DISCUSSION AND CONCLUSIONS: Family members are generally in favour of the use of compulsory community treatment orders. They perceive a positive influence on their relative, on themselves, on family relationships, and on relations with the clinical team. Family members are aware of the ethical and other dilemmas that attend the use of compulsory community care.

Asunto(s)