Excessive Smartphone Use is Associated with Depression, Anxiety, Stress, and Sleep Quality of Australian Adults.

Problematic smartphone use has been associated with poorer mental health in different population groups; however, little is known about how levels of smartphone use were associated with mental health outcomes of adults in Australia. Using data from a cross-sectional survey among Australian adults aged 18-59 years (n = 655, Mean = 24.55 [SD = 5.59] years; 66% female), the current study aimed to examine association between problematic smartphone use and different psychological outcomes. Participants completed measures of problematic smartphone use with Mobile Phone Problem Use Scale (MPPUS), mental health outcomes with Depression, Anxiety, and Stress Scale (DASS-21), and Pittsburgh Sleep Quality Index (PSQI), in addition to some socio-demographics. Smartphone use was categorised into three groups: low-moderate, moderate-high, and high-severe. A total of 160 adults (24.4%) reported high-severe smartphone use. Multivariable linear regression analyses showed that smartphone use was inversely associated with psychological outcomes in a dose-dependent manner with high-severe smartphone uses having the most adverse effects. Compared to low-moderate use, average depression score was 3.5 points higher for moderate-high smartphone use (ß = 3.51, 95% CI: 1.63-5.40) and 6.9 points higher for high-severe smartphone use (ß = 6.91, 95% CI: 4.74-9.07). Similarly, average stress score was 3.4 points higher for moderate-high smartphone use (ß = 3.40, 95% CI: 1.75-5.06) and 7.0 points higher for high-severe smartphone use (ß = 7.02, 95% CI: 5.11-8.93). Similar association estimates were found for anxiety and sleep quality. Reducing smartphone use has the potential to optimise depression, anxiety, stress, and sleep quality; however, longitudinal research is warranted to establish directionality of the association.

Core procedural skills competencies and the maintenance of procedural skills for medical students: a Delphi study.

BACKGROUND: It is well recognised that medical students need to acquire certain procedural skills during their medical training, however, agreement on the level and acquisition of competency to be achieved in these skills is under debate. Further, the maintenance of competency of procedural skills across medical curricula is often not considered. The purpose of this study was to identify core procedural skills competencies for Australian medical students and to establish the importance of the maintenance of such skills. METHODS: A three-round, online Delphi method was used to identify consensus on competencies of procedural skills for graduating medical students in Australia. In Round 1, an initial structured questionnaire was developed using content identified from the literature. Respondents were thirty-six experts representing medical education and multidisciplinary clinicians involved with medical students undertaking procedural skills, invited to rate their agreement on the inclusion of teaching 74 procedural skills and 11 suggested additional procedures. In Round 2, experts re-appraised the importance of 85 skills and rated the importance of maintenance of competency (i.e., Not at all important to Extremely important). In Round 3, experts rated the level of maintenance of competence (i.e., Observer, Novice, Competent, Proficient) in 46 procedures achieving consensus. RESULTS: Consensus, defined as > 80% agreement, was established with 46 procedural skills across ten categories: cardiovascular, diagnostic/measurement, gastrointestinal, injections/intravenous, ophthalmic/ENT, respiratory, surgical, trauma, women's health and urogenital procedures. The procedural skills that established consensus with the highest level of agreement included cardiopulmonary resuscitation, airway management, asepsis and surgical scrub, gown and gloving. The importance for medical students to demonstrate maintenance of competency in all procedural skills was assessed on the 6-point Likert scale with a mean of 5.03. CONCLUSIONS: The findings from the Delphi study provide critical information about procedural skills for the Clinical Practice domain of Australian medical curricula. The inclusion of experts from medical faculty and clinicians enabled opportunities to capture a range of experience independent of medical speciality. These findings demonstrate the importance of maintenance of competency of procedural skills and provides the groundwork for further investigations into monitoring medical students' skills prior to graduation.

Explaining individual differences in cognitive performance: The role of anxiety, social support and living arrangements during COVID-19.

The present study investigated the relationship between anxiety, social support, living arrangements and cognitive performance of university students during the global pandemic. Two hundred and fifteen students participated by completing online questionnaires. Separate moderated multiple regression models were used to test whether social support (Family, Friends, Significant Other subscales of the Multidimensional Scale of Perceived Social Support) moderated the relationship between anxiety (Anxiety subscale of Depression, Anxiety Stress Scale), living arrangements (Living Alone vs Living with Friends and Family) and cognitive performance (Cognitive Failures Questionnaire), after controlling for comorbid depression. The results for each level of perceived social support suggested that anxiety was negatively associated with cognitive performance. Our most significant finding was that for students living alone, social support from a significant other offered a protective factor, whereby buffering the anxiety related cognitive deficits prevalent in those who reported lower social support. These data have important practical implications for supporting the social-emotional and academic needs of university students during the global pandemic.

The effect of trait emotional intelligence on working memory across athletic expertise.

Research attests to the important contributions of emotional, athletic, and cognitive expertise for sport performance. However, little is known regarding the interplay between trait emotional intelligence, athletic expertise, and working memory. The aim of this research was to examine the interplay between working memory (emotional, capacity and ability), trait emotional intelligence and athletic expertise. In total, 437 participants aged between 18 and 27 years with a range of athletic expertise (i.e., non-athlete n = 96, novice n = 92, amateur n = 85, elite n = 83, and super-elite n = 81) completed the Trait Emotional Intelligence Questionnaire Short Form, an Emotion Recognition Task (i.e., working memory-emotional), a Spatial Span Task (i.e., working memory-capacity), and a Spatial Working Memory Test (i.e., working memory-ability). Structural equation modelling indicated a significant positive relationship between trait emotional intelligence and all three components of working memory (i.e., emotional, capacity and ability). Also, this differed over athletic expertise whereby those with more expertise reported larger effects than those with less expertise. These findings suggest that trait emotional intelligence is important for working memory in athletes. Moreover, the link between cognitive and affective processes are increasingly relevant as athletes develop expertise levels.

Inhibitory Control Across Athletic Expertise and Its Relationship With Sport Performance.

Inhibitory control may be vital in elite sport. The authors examined the link between athletic expertise, inhibitory control, and sport performance in a two-part quasi experiment. Inhibitory control was indexed using the Stop-Signal Task, athlete expertise was categorized on literary recommendations, and sport performance was assessed using athlete and coach ratings. Study 1 examined cross-sectional and longitudinal patterns of inhibitory control across athletic expertise. Study 2 investigated whether the inhibitory control-sport performance relationship was moderated by expertise. Study 1 showed that expertise was linked to greater inhibitory control cross-sectionally and longitudinally. Study 2 revealed that expertise was related to superior performance on the Stop-Signal Task and athlete and coach performance ratings, and this relationship was moderated by athletic expertise. Inhibitory control relates to sport performance, increases with greater athlete expertise, and develops longitudinally. Long-term participation in sport may bring about changes in inhibitory control, which may lead to improved sport performance.

Twelve tips for teaching brief motivational interviewing to medical students.

BACKGROUND: Shifting from paternalistic to patient-centred doctor-patient relationships has seen a growing number of medical programs incorporate brief motivational interviewing training in their curriculum. Some medical educators, however, are unsure of precisely what, when, and how to incorporate such training. AIMS: This article provides educators with 12 tips for teaching brief motivational interviewing to medical students, premised on evidence-based pedagogy. METHODS: Tips were drawn from the literature and authors' own experiences. RESULTS: The 12 tips are: (1) Set clear learning objectives, (2) Select experienced educators, (3) Provide theoretical perspectives, (4) Share the evidence base, (5) Outline the "spirit", principles, and sequence, (6) Show students what it looks like, (7) Give students a scaffold to follow, (8) Provide opportunities for skill practice, (9) Involve clinical students in teaching, (10) Use varied formative and summative assessments, (11) Integrate and maintain, and (12) Reflect and evaluate. CONCLUSIONS: We describe what to include and why, and outline when and how to teach the essential components of brief motivational interviewing knowledge and skills in a medical curriculum.

Cognitive trait anxiety, stress and effort interact to predict inhibitory control.

Few studies have focussed on the link between anxiety and inhibitory control in the absence of stimulus-driven external threat. This two-part experiment examined the interactions between (1) somatic trait anxiety, somatic situational stress (i.e. threat of electric shock), and effort, and (2) cognitive trait anxiety, cognitive situational stress (i.e. ego-threat instructions), and effort, on inhibitory processes using a Go-No-Go paradigm. Trait anxiety was operationalised using questionnaire scores and effort was operationalised using a visual analogue scale. Performance effectiveness was measured using the d' parameter from signal detection theory and processing efficiency was indexed by the ratio of d' to response time on correct trials. Results indicated that somatic trait anxiety and stress did not predict effectiveness or efficiency. Cognitive trait anxiety and stress were associated with both inhibitory effectiveness and efficiency deficits; however, contrary to expectations these deficits were evident at higher rather than lower mental effort. Results suggest a distinction between how somatic and cognitive anxiety manifest on tasks involving inhibitory control.

Depression Moderates the Relationship between Trait Anxiety, Worry and Attentional Control in Melanoma Survivors.

Cancer survivors commonly contend with concurrent cognitive difficulties such as problems with attention and concentration, and psychological distress, including anxiety and depression. However, the associations between attentional and emotional difficulties within the specific context of melanoma survivors remain relatively unexplored. Premised on attentional control theory, the current study employed a cross-sectional design to explore the interplay among trait anxiety (dispositional) and situational anxiety (cancer-related worry), depression and attentional control (ability to inhibit distractors and flexibly shift within and between tasks) in a sample of 187 melanoma survivors aged 18 to 58 years (Mage = 36.83 years, SDage = 5.44 years; 93% female). Data were analyzed using a moderated multiple regression, with anxiety, cancer worry and depression as predictors, and attentional control as the criterion variable. After statistically controlling for the variance of chemotherapy, we found that individuals with higher trait anxiety and higher cancer-related worry reported greater attentional control at low levels of depression, yet poorer attentional control at high depression, relative to individuals with low anxiety. Our findings suggest that anxiety and depression are differentially related to attentional control in melanoma survivors. The results provide a marker for clinicians addressing anxiety and depression in this population. Implications for primary healthcare are discussed.

Examining the Association between Sports Participation and Mental Health of Adolescents.

Sports participation has been linked to various health outcomes; however, there is scant literature exploring this relationship in developing countries. We used a mixed method approach to examine the association between sports participation and mental health of Bangladeshi adolescents (n = 320; 13-17 years; 59% boys) and to explore sports preferences and barriers to sports participation across genders. A survey collected team and non-team sports participation, depression, and life satisfaction. Focus groups (16 boys, 16 girls) explored preferences for, and barriers to, sports participation. Regression analysis showed that higher team and non-team sports participation were associated with lower depressive symptoms in boys (ß = -1.22, 95% CI:-2.55 to -0.10; ß = -2.50, 95% CI:-3.83 to -1.16, respectively), while greater participation in team sports was associated with less depression in girls (ß = -2.44, 95% CI:-4.63 to -0.24). Participation in team and non-team sports was positively associated with life satisfaction for boys and girls. Boys reported preferences for playing football and cricket, while girls favored skipping and running. Prolonged time on electronic devices was reported as barriers to sports participation in both genders. Furthermore, household chores, family restrictions, and unsafe environment were reported by girls. Participation in team sports may provide mental health benefits for both genders, while non-team sports may be more beneficial to boys than girls.

Teaching brief motivational interviewing to medical students using a pedagogical framework.

OBJECTIVE: Medical schools are charged with assisting medical students to acquire the confidence, knowledge and skills for behavior change conversations in primary healthcare. The present study evaluated teaching brief motivational interviewing (MI) to pre-clinical medical students. METHODS: Forty-six students participated in an educational intervention premised on the Learn, See, Practice, Prove, Do, Maintain pedagogical framework, comprising 2 × 2-h lectures, a 2-h role-play triad session, and 3 × 2-h small group simulated patient encounters supported by scaffolding strategies. Measures of brief MI knowledge (MI Knowledge and Attitudes Test & Multiple-Choice Knowledge Test) and confidence (MI Confidence Scale) were taken at baseline, post-training, and 3-month follow-up, and skills (Behavior Change Counseling Index) were assessed at three intervals during simulated patient encounters. RESULTS: Students who received brief MI training improved in knowledge and confidence from baseline to post-training and gains remained at 3-months. Brief MI skills improved across the simulation sessions. CONCLUSION: Pre-clinical medical students can attain knowledge, confidence and skills in brief MI after participation in a short intervention and improvements are sustainable. PRACTICE IMPLICATIONS: Our results support the use of an evidence-based pedagogical framework for teaching brief MI in pre-clinical years of medical curricula and our scaffolding strategy affords promise.

Cognitive control training for children with anxiety and depression: A systematic review.

Cognitive control training has gained traction as an intervention for reducing anxiety and depression vulnerability in adults. There are, however, a limited number of studies investigating such training interventions for reducing symptomology of anxiety and depression in children and adolescents. Thus, we aimed to provide a robust review and qualitative synthesis of the available research in young people. Twelve articles met the inclusion criteria, and all were randomised control trials. Evidence of the efficacy of cognitive control training for relief of symptoms are reported separately for anxiety, depression, and other related psychological factors, and on the basis of type of cognitive control training paradigm. A lack of standardisation in relation to type of intervention, duration and context, outcome measures and population was observed. Results are discussed in terms of these variations and recommendations for future research are provided.

Reflection-impulsivity in athletes: A cross-sectional and longitudinal investigation.

Reflection-impulsivity is a dimension of cognitive or decision-making style. We conducted two quasi-experimental studies to examine reflection-impulsivity in athletes using an information sampling task. In Study 1 (n = 108; Mage = 22.7 ± SDage = 1.42; 50% female), we used a cross-sectional design to compare performance across athletic expertise (super-elite, elite, amateur, novice or non-athlete) and sport type (external-paced or self-paced). In Study 2 (Time 1 n = 106; Mage = 21.32 ± SDage = 5.77; 53% female and Time 2 n = 64; Mage = 21.19 ± SDage = 5.12; 44% female), we examined changes in reflection-impulsivity across a 16-week playing season. Study 1 showed more accurate and more efficient performance as athletic expertise increased. Study 2 revealed better effectiveness and efficiency following sport participation, a 16-week playing season, most notably in elite-level performers. No sport-type differences were noted. Taken together, the studies demonstrate an association between reflection-impulsivity and athletic expertise, while also providing evidence that competitive sports participation leads to efficient decisions based on reflection, without sacrificing accuracy, which is often a consequence of impulsive decision-making.

Mental Health Measurement in a Post Covid-19 World: Psychometric Properties and Invariance of the DASS-21 in Athletes and Non-athletes.

Psychological science faces a call to action researching the implications of the corona virus disease 2019 (Covid-19) pandemic. Rapid reviews have reported that maintaining rigorous research standards is a priority for the field, such as ensuring reliable and valid measurement, when investigating people's experience of Covid-19 (O'Connor et al., 2020). However, no research to date has validated a measure mental health symptomology for an athlete population. The current research addresses this gap by examining the internal consistency, factor structure, invariance, and convergent validity of the Depression Anxiety and Stress Scale (DASS-21; Lovibond and Lovibond, 1995) in two athlete samples. Participants completed the DASS-21 and sport-specific measures of mental health such as the Profile of Mood States - Depression subscale (POMS-D), Sport Anxiety Scale-2 (SAS-2), Athlete Burnout Questionnaire (ABQ), and Athlete Psychological Strain Questionnaire (APSQ). In sample one (n = 894), results of exploratory structural equation modeling indicated that a three-factor model provided good fit to the data, but a bifactor model provided better fit. Factor loadings indicated minimal misspecification and higher loadings on the general-factor. Invariance testing suggested equivalence across gender, athletic expertise, sport type, and injury status. Further, latent mean differences analyses indicated that females and injured athletes scored higher than male and non-injured athletes on all DASS-21 factors reporting higher mental health symptomology, those with more expertise scored higher on the general-factor and depression and those with less expertise scored higher on anxiety and stress, and no differences between team and individual athletes. In sample two (n = 589), the bifactor structure was replicated. Results largely supported the scales convergent validity with depression predicting POMS-D scores, whereas all three subscales predicted the SAS-2, ABQ, and APSQ scores. Internal consistency was acceptable in both samples. The current work provides initial support for use of the DASS-21 as an operationalisation of mental health symptomology in athletes. Theoretical and practical implications of these results are discussed.

Interrelationships between trait anxiety, situational stress and mental effort predict phonological processing efficiency, but not effectiveness.

Attentional control theory (ACT) describes the mechanisms associated with the relationship between anxiety and cognitive performance. We investigated the relationship between cognitive trait anxiety, situational stress and mental effort on phonological performance using a simple (forward-) and complex (backward-) word span task. Ninety undergraduate students participated in the study. Predictor variables were cognitive trait anxiety, indexed using questionnaire scores; situational stress, manipulated using ego threat instructions; and perceived level of mental effort, measured using a visual analogue scale. Criterion variables (a) performance effectiveness (accuracy) and (b) processing efficiency (accuracy divided by response time) were analyzed in separate multiple moderated-regression analyses. The results revealed (a) no relationship between the predictors and performance effectiveness, and (b) a significant 3-way interaction on processing efficiency for both the simple and complex tasks, such that at higher effort, trait anxiety and situational stress did not predict processing efficiency, whereas at lower effort, higher trait anxiety was associated with lower efficiency at high situational stress, but not at low situational stress. Our results were in full support of the assumptions of ACT and implications for future research are discussed. (PsycINFO Database Record

Cognitive trait anxiety, situational stress, and mental effort predict shifting efficiency: Implications for attentional control theory.

Attentional control theory (ACT) predicts that trait anxiety and situational stress interact to impair performance on tasks that involve attentional shifting. The theory suggests that anxious individuals recruit additional effort to prevent shortfalls in performance effectiveness (accuracy), with deficits becoming evident in processing efficiency (the relationship between accuracy and time taken to perform the task). These assumptions, however, have not been systematically tested. The relationship between cognitive trait anxiety, situational stress, and mental effort in a shifting task (Wisconsin Card Sorting Task) was investigated in 90 participants. Cognitive trait anxiety was operationalized using questionnaire scores, situational stress was manipulated through ego threat instructions, and mental effort was measured using a visual analogue scale. Dependent variables were performance effectiveness (an inverse proportion of perseverative errors) and processing efficiency (an inverse proportion of perseverative errors divided by response time on perseverative error trials). The predictors were not associated with performance effectiveness; however, we observed a significant 3-way interaction on processing efficiency. At higher mental effort (+1 SD), higher cognitive trait anxiety was associated with poorer efficiency independently of situational stress, whereas at lower effort (-1 SD), this relationship was highly significant and most pronounced for those in the high-stress condition. These results are important because they provide the first systematic test of the relationship between trait anxiety, situational stress, and mental effort on shifting performance. The data are also consistent with the notion that effort moderates the relationship between anxiety and shifting efficiency, but not effectiveness.

Building skills, knowledge and confidence in eating and exercise behavior change: brief motivational interviewing training for healthcare providers.

OBJECTIVE: Obesity related health problems affect individuals, families, communities and the broader health care system, however few healthcare providers (e.g., doctors, nurses, social workers, psychologists, counselors) receive formal training in obesity prevention interventions. We examined the effectiveness of training healthcare providers in brief motivational interviewing (brief MI) targeting eating and exercise behavior change. METHODS: 163 healthcare providers participated. 128 participants completed a one-day experiential brief MI training workshop followed by electronic peer-support and a further 35 matched controls did not receive the training. RESULTS: Participant's knowledge of brief MI and confidence in their ability to counsel patients using brief MI significantly improved following training (p<0.05) and remained at 3 and 6-month follow-up (p<0.05). Brief MI skills assessed during the simulated patient interactions indicated a significant improvement across two practical training blocks (p<0.05). CONCLUSION: Healthcare providers can learn brief MI skills and knowledge quickly and confidence in their counseling abilities improves and is sustained. PRACTICE IMPLICATIONS: Healthcare providers may consider brief MI as an obesity prevention intervention.

Effects of trait anxiety and situational stress on attentional shifting are buffered by working memory capacity.

BACKGROUND AND OBJECTIVES: Attentional Control Theory (ACT) predicts that trait anxiety and situation stress combine to reduce performance efficiency on tasks requiring rapid shifts in attention. Recent evidence has also suggested that working memory capacity (WMC) might moderate this relationship. We controlled for methodological difficulties in the existing literature to investigate the relationships between trait anxiety, situational stress, and WMC on attentional shifting. DESIGN AND METHOD: Seventy undergraduate students participated in the study. Trait anxiety was operationalized using questionnaire scores, situational stress was manipulated through a pressured counting task, and WMC was based on performance on the Automated Operation Span Task (AOSPAN). The shifting task involved a modified version of the Sternberg paradigm as the primary task and an oddball tone-discrimination task as the secondary task. Dependent variables were performance effectiveness (accuracy) and processing efficiency (accuracy divided by response time) on the secondary task. RESULTS: There was no effect of anxiety, stress, or WMC in predicting performance effectiveness; however, a significant three-way interaction on processing efficiency was observed. At higher WMC, anxiety and situational stress were not associated with processing efficiency. Conversely, at lower WMC, higher trait anxiety was associated with poorer efficiency but only for those who reported higher situational stress; for those who reported lower situational stress higher trait anxiety predicted facilitated efficiency. CONCLUSIONS: Results are interpreted with respect to ACT and directions for future research are discussed.