The impact of an exercise and sport intervention on cognitive function and pain among forcibly displaced individuals at risk for PTSD: a secondary analysis of the SALEEM randomized controlled trial.

BACKGROUND: In response to the global scope of forced displacement, international organizations highlight the need of scalable solutions to support individuals' health and integration into host societies. Exposure to high mental and physical stress perceived before, during, and after displacement can impair functional capabilities, essential for adapting to a new environment. This secondary analysis examined the impact of an exercise and sport intervention on cognitive function and pain severity among individuals living in a refugee camp in Greece. METHODS: We implemented a randomized controlled trial involving n = 142 (52.8% women) forcibly displaced individuals from Southwest Asia and Sub-Saharan Africa. Participants were randomly assigned to a waitlist or a 10-week co-designed exercise and sport intervention with a 1:1 allocation rate between groups and sexes. Assessments at baseline and follow-up included the Flanker task, the Oddball paradigm, pain severity via visual analog scales, and the Åstrand-Rhyming indirect test of maximal oxygen uptake. We analyzed the intervention effects using structural equation modeling. RESULTS: Our findings did not indicate a direct intervention effect on cognitive function or pain (p ≥ .332). However, the intervention group significantly improved cardiorespiratory fitness, ß = .17, p = .010, which was associated with faster reaction times in cognitive tasks, ß = - .22, p = .004. Moreover, there was some evidence that adherence might be linked to reduced pain severity, ß = - .14, p = .065. CONCLUSIONS: Exercise and sport did not directly impact cognitive function and pain severity among a sociodemographically diverse sample living in a refugee camp, suggesting the need for complementary measures. Nevertheless, our results indicate that improvements in cardiorespiratory fitness benefit aspects of attention. TRIAL REGISTRATION: The study was approved by the local ethics committee of the University of Thessaly (no. 39) and registered prospectively on February 8, 2021 at the ISRCTN registry (no. 16291983).

Ironic processes of concentration and suppression under pressure: A study on rifle shooting in Norwegian elite biathletes.

In rifle shooting, suppressing unwanted thoughts can backfire in one's performance, causing athletes to behave contrary to their desired intention and further deteriorate their performance. PURPOSE: This study examined how priming attentional and negative cues affected participants' shooting performances toward ironic error targets under cognitive load conditions in Stroop task across two experiments. METHODS: Semi-elite biathletes (Experiment 1, n = 10; Experiment 2, n = 9) participated in the study. The study used a within-subject quasi-experimental design, particularly a one-way repeated measures multivariate analysis of variance and a 2 × 2 fully repeated measures analysis of variance, to determine the participants' hit rates and shooting response times (RTs). In both experiments, the participants completed the reverse-Stroop-based target shooting performance under low- and high-cognitive load conditions while receiving frequent priming attentional and negative cues. RESULTS: The findings from Experiment 1 suggest that regulating repetitive priming attentional thoughts is efficacious in mitigating the likelihood of ironic performance errors and interference effects. The results of Experiment 2 show that repetitive priming negative cues resulted in negligible ironic error hit rates and slower RTs in target hits under high-cognitive load conditions. The Bayesian analyses provided evidence supporting the null hypotheses. CONCLUSION: Trying to control repetitive priming attentional and negative thoughts reduces ironic performance errors to a similar degree under cognitive load conditions among biathletes, regardless of interference effects. Further research is needed to determine the effectiveness of suppressing task-relevant negative instructions in reducing the likelihood of ironic performance errors under pressure.

A Moral Intervention Reduces Doping Likelihood in British and Greek Athletes: Evidence From a Cluster Randomized Control Trial.

OBJECTIVES: The authors aimed to develop a moral intervention and to determine whether it was more effective in preventing doping than an educational (i.e., knowledge-based) intervention; their primary outcome was doping likelihood, and the secondary outcomes were moral identity, moral disengagement, moral atmosphere, and anticipated guilt. METHODS: Eligible athletes (N = 303) in the United Kingdom and Greece took part in the study. The authors randomly assigned 33 clubs to either the moral or the educational intervention. They measured outcomes pre- and postintervention and at 3- and 6-month follow-up. RESULTS: Athletes in both interventions in both countries reported lower doping likelihood and moral disengagement and higher guilt from pre- to postintervention. These effects were maintained at the 3- and 6-month follow-ups. There were no effects on moral identity or moral atmosphere. CONCLUSIONS: In addition to disseminating information about doping, doping prevention programs should include content that focuses on moral variables.

Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta-analysis.

Although exercise is associated with depression relief, the effects of aerobic exercise (AE) interventions on clinically depressed adult patients have not been clearly supported. The purpose of this meta-analysis was to examine the antidepressant effects of AE versus nonexercise comparators exclusively for depressed adults (18-65 years) recruited through mental health services with a referral or clinical diagnosis of major depression. Eleven e-databases and bibliographies of 19 systematic reviews were searched for relevant randomized controlled clinical trials. A random effects meta-analysis (Hedges' g criterion) was employed for pooling postintervention scores of depression. Heterogeneity and publication bias were examined. Studies were coded considering characteristics of participants and interventions, outcomes and comparisons made, and study design; accordingly, sensitivity and subgroup analyses were calculated. Across 11 eligible trials (13 comparisons) involving 455 patients, AE was delivered on average for 45 min, at moderate intensity, three times/week, for 9.2 weeks and showed a significantly large overall antidepressant effect (g = -0.79, 95% confidence interval = -1.01, -0.57, P < 0.00) with low and nonstatistically significant heterogeneity (I2 = 21%). No publication bias was found. Sensitivity analyses revealed large or moderate to large antidepressant effects for AE (I2 ≤ 30%) among trials with lower risk of bias, trials with short-term interventions (up to 4 weeks), and trials involving individual preferences for exercise. Subgroup analyses revealed comparable effects for AE across various settings and delivery formats, and in both outpatients and inpatients regardless symptom severity. Notwithstanding the small number of trials reviewed, AE emerged as an effective antidepressant intervention.

Countering the Consequences of Ego Depletion: The Effects of Self-Talk on Selective Attention.

This study examined the effects of a self-talk intervention on selective attention in a state of ego depletion. Participants were 62 undergraduate students with a mean age of 20.02 years (SD = 1.17). The experiment was conducted in four consecutive sessions. Following baseline assessment, participants were randomly assigned into experimental and control groups. A two-session training was conducted for the two groups, with the experimental group using self-talk. In the final assessment, participants performed a selective attention test, including visual and auditory components, following a task inducing a state of ego depletion. The analysis showed that participants of the experimental group achieved a higher percentage of correct responses on the visual test and produced faster reaction times in both the visual and the auditory test compared with participants of the control group. The results of this study suggest that the use of self-talk can benefit selective attention for participants in states of ego depletion.

Exploring proportions of spontaneous and goal-directed self-talk - It is not always the one or the other.

The dichotomous classification of self-talk statements into goal-directed as a more controlled type of self-talk and spontaneous as a more uncontrolled type of self-talk might be an oversimplification. To address this issue, two studies were conducted aiming to explore the idea that the distinction between the two self-talk types should rather be proportional and not mutually exclusive. In Study 1, football players took part in a penalty competition and were subsequently asked to state the self-talk they had before and after the penalty. In Study 2, table tennis players took part in two activities (i.e., a precision task and a competitive set) and were subsequently asked to state the self-talk they had before the individual rounds in each activity. In both studies, the players subsequently rated for each self-talk statement the extent to which it was spontaneous and the extent to which it was goal-directed. The majority of self-talk statements were rated to some extent as both spontaneous and goal-directed. For Study 1, paired-sample t-tests showed that before a penalty kick self-talk was more goal-directed than spontaneous and after the penalty kick it was more spontaneous than goal-directed. In the more exploratory Study 2, multilevel regression analyses showed that the two types of self-talk could not predict sports performance. While the results support the usefulness of the distinction between spontaneous and goal-directed self-talk, treating the two types of self-talk as proportional rather than dichotomous might reflect more accurately the mental activity. Key words: dual-process, organic self-talk, self-regulation, System 1, System 2.

Self-Reported Physical Activity and Mental Health Among Asylum Seekers in a Refugee Camp.

BACKGROUND: Global forced displacement has been rising steeply since 2015 as a result of wars and human rights abuses. Forcibly displaced people are often exposed to physical and mental strain, which can cause traumatic experiences and poor mental health. Physical activity has been linked with better mental health, although such evidence is scarce among those populations. The purpose of the study was to examine the relationships of self-reported physical activity and fitness with mental health indices among people residing in a refugee camp in Greece as asylum seekers. METHODS: Participants were 151 individuals (76 women, 75 men; mean age 28.90 y) displaced from their homes for an average of 32.03 months. Among them, 67% were from Afghanistan and countries from southwest Asia, and 33% from sub-Saharan African countries. Participants completed self-report measures assessing physical activity, fitness, symptoms of post-traumatic stress disorder, depression, anxiety, and well-being. RESULTS: High prevalence of mental health disorder symptoms and poor well-being were identified, with women and Asians showing poorer mental health. Symptoms of post-traumatic stress disorder, depression, and anxiety were related to perceived fitness, but not to self-reported physical activity. Regression analysis showed that perceived fitness (ß: 0.34; 95% CI, 0.43 to 1.52) and low-intensity physical activity (ß: 0.24; 95% CI, 0.001 to 0.009) significantly positively predicted well-being, showing small to medium effect. CONCLUSIONS: The findings provide useful insights regarding the link between physical activity and well-being; nevertheless, further research examining objectively measured physical activity is warranted to complement these data and further explore the associations between physical activity and mental health.

Effects of a co-designed exercise and sport intervention on cardiorespiratory fitness and metabolic syndrome components among individuals living in a refugee camp in Greece: A randomized controlled trial.

Background: The metabolic syndrome epidemic, including in forcibly displaced individuals, requires cost-effective prevention and treatment strategies. Yet, the health needs of forcibly displaced individuals often remain underserved. Our study evaluated the effect of a co-designed exercise and sport intervention on cardiorespiratory fitness and metabolic syndrome components among individuals in a refugee camp in Greece and examined the indirect effect through cardiorespiratory fitness on metabolic syndrome components. Methods: We conducted a randomized controlled trial involving an intervention and a wait-list control group with n = 142 (52.8 % women) forcibly displaced Southwest Asians and Sub-Saharan Africans. The intervention group participated for 10 weeks in exercise and sport activities. Outcomes were cardiorespiratory fitness and single metabolic syndrome components. Effects were analyzed with structural equation modeling. Results: In total, 62.7 % of participants presented with low cardiorespiratory fitness levels (<40th percentile), and 24.6 % met the criteria for metabolic syndrome. In the intervention group, 73.5 % attended the exercise and sport sessions at least once a week. There was evidence for a direct intervention effect on cardiorespiratory fitness, ßdirect = 0.12, p = 0.022, but not for any of the metabolic syndrome components (p ≥ 0.192). Cardiorespiratory fitness significantly facilitated the intervention's indirect effect on abdominal obesity, ßindirect = -0.03, p = 0.012, high diastolic blood pressure, ßindirect = -0.04, p = 0.011, and elevated triglycerides, ßindirect = -0.03, p = 0.025. Conclusion: Implementing exercise and sport activities in a refugee camp in Greece effectively reaches a wider target population and improves cardiorespiratory fitness among forcibly displaced individuals. The intervention contributes to a decrease in abdominal obesity, high diastolic blood pressure and elevated triglycerides indirectly via improved cardiorespiratory fitness.

Examining the relation between emotional experiences and emotional expressions in competitive tennis matches.

Introduction: Emotions consist of different components such as the emotional experience, physiological reactions, action tendencies, or emotional expressions. Assessing the relation of these components may help to better understand the role of emotions in sport competitions. Based on the component process model of emotions, the goal of the present study was to assess the relation between emotional experiences and emotional expressions. Methods: Twenty tennis players (7 female) with an average age of 23.10 (SD = 4.88) were taped during competitive tennis matches. Thereafter, in individual meetings, after having watched themselves on the footage at pre-selected points, the players had to indicate whether, immediately after the end of a rally, they had a positive or a negative emotional experience and, in case they had one, rate its intensity. Moreover, based on their observable behavior, the players were also asked to state whether they could recognize a positive or a negative emotional expression and, in case they recognized one, rate its intensity. The occurrence of emotional expressions was additionally rated by two external coders. Using multilevel models, separate analyses were conducted for positive emotions after won points and negative emotions after lost points. Results and discussion: For both positive and negative emotions, the results indicated a positive correlation between emotional experiences and emotional expressions. Moreover, the intensity of emotional experiences could predict the occurrence of an emotional expression rated by both the players or external coders. These insights into the relation between emotional experiences and emotional expressions may help players to more effectively regulate their emotions.

Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp.

Muscular strength represents a specific component of health-related fitness. Hand grip strength is used as a simple and dynamic marker of maximum voluntary force of the hand and to estimate overall strength. Today, little is known about the relationship between grip strength and health in forcibly displaced populations. In the present study, we examined whether grip strength is associated with various health outcomes in a sample of forcibly displaced people living in a Greek refugee camp. The present analyses are part of a larger pragmatic randomized controlled trial. In this paper, cross-sectional baseline data of 143 participants (71 men, 72 women) will be presented. In addition to grip strength, the following physical and mental health outcomes were assessed: body weight and body composition, blood pressure, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, blood glucose levels (HbA1c), post-traumatic stress disorder (PTSD) symptoms, depressive and anxiety symptoms, pain, and quality of life. Linear regression analyses were carried out to examine how grip strength is associated with the health outcomes, separately for absolute and normalized grip strength scores. Grip strength was positively and strongly associated with percentage muscle mass (normalized grip strength: Stand. B = 0.58, p < .001), whereas a negative association existed for percentage body fat (normalized grip strength: Stand. B = - 0.58, p < .001). No statistically significant associations occurred between grip strength and the other cardiovascular risk markers. In contrast, we found that participants with higher normalized grip strength reported higher levels of PTSD (normalized grip strength: Stand. B = 0.36, p < .05) and depressive symptoms (normalized grip strength: Stand. B = 0.29, p < .05). No significant association occurred between grip strength, anxiety, pain and quality of life. Measuring grip strength in forcibly displaced people can be a useful way to assess their overall muscle strength. Grip strength tests are easy to implement, and results can be used to assess the effects of specific intervention measures. Nevertheless, our results question the usefulness of grip strength as a marker of cardiovascular health and mental wellbeing in a refugee camp setting.