Tobacco and cannabis use as moderators of the association between physical activity and alcohol use across the adult lifespan in the United States: NHANES, 2005-2016.

Physically-active adults are more likely to consume alcohol, but this association may vary if adults also use other substances (i.e., tobacco and/or cannabis), which could increase substance-use related harms. This study examined whether tobacco and/or cannabis use moderated the associations between physical activity, odds of drinking and alcohol drinks/week. We used cross-sectional 2005-2016 National Health and Nutrition Examination Survey data (United States of America). Physical activity was assessed using device-based and self-reported moderate-to-vigorous physical activity (MVPA) and total physical activity hours/week. Individuals were categorized into one of four (poly)substance use categories, no tobacco/no cannabis, tobacco, cannabis, or tobacco/cannabis use. Regression models examined substance use as a moderator of the association between physical activity and the odds of drinking versus not drinking and alcohol drinks/week among light/moderate/heavy drinkers (≥12 drinks/year). Using cannabis or tobacco weakened the significant positive associations between total physical activity and self-reported recreational MVPA hours/week on odds of drinking (ORs = 0.978 and 0.967, respectively), such that the effect was negative or null when using cannabis or tobacco, respectively. Greater total physical activity and device-based MVPA hours/week was associated with consuming greater drinks/week (IRRs = 1.003 and 1.035, respectively). Using tobacco weakened the association between device-based MVPA and alcohol drinks/week (IRR = 0.934, 95% CI: [0.888, 0.982]). Cannabis and tobacco use weakened the association between physical activity and alcohol use. The positive association between physical activity and alcohol use may be limited to single substance users of alcohol and could reflect shared reasons for engaging in these behaviors, such as stress management or social motives.

Validity and factorial invariance of the Social Physique Anxiety Scale.

PURPOSE: The present study 1) tested whether the two-factor model to the 12-item Social Physique Anxiety Scale (SPAS) was substantively meaningful or a methodological artifact representing positively and negatively worded items, 2) assessed the factorial validity of the nine-item unidimensional model to the SPAS, 3) examined whether modifying the number of SPAS items would improve the factorial validity. 4) evaluated the factorial invariance of the SPAS across gender, and 5) explored the construct validity of SPAS scores. METHODS: Female (N = 146) and male (N = 166) college students (22.2 +/- 4.0 yr) in lecture (N = 103) and physical activity (N = 209) courses completed the SPAS, Physical Self-Efficacy Scale (PSES), Surveillance subscale of the Objectified Body Consciousness Scale (S-OBCS), and short form of the Marlowe-Crowne Social Desirability Scale (SDS-C). RESULTS: Confirmatory factor analyses (CFA) revealed that the two-factor model to the 12-item SPAS was a methodological artifact representing positively and negatively worded items. CFA indicated that the nine-item unidimensional model represented an acceptable fit to the SPAS, but it also could be improved. Modifications based on standardized residuals and item content led to the removal of two items and a seven-item unidimensional solution to the SPAS. The nine- and seven-item models demonstrated factorial invariance across gender. Correlation analyses between nine- and seven-item SPAS scores to PSES, S-OBCS, and SDS-C provided support for the construct validity. CONCLUSIONS: The nine- and seven-item unidimensional models to the SPAS demonstrated evidence of factorial validity, factorial invariance, and construct validity; the two-factor model to the SPAS represented a methodological artifact.

The Social Physique Anxiety Scale: an example of the potential consequence of negatively worded items in factorial validity studies.

Social physique anxiety (SPA) based on Hart, Leary, and Rejeski's (1989) Social Physique Anxiety Scale (SPAS) was originally conceptualized to be a unidimensional construct. Empirical evidence on the factorial validity of the SPAS has been contradictory, yielding both one- and two-factor models. The two-factor model, which consists of separate factors associated with positively and negatively worded items, has stimulated an ongoing debate about the dimensionality and content of the SPAS. The present study employed confirmatory factor analysis (CFA) to examine whether the two-factor solution to the 12-item SPAS was substantively meaningful or a methodological artifact. Results of the CFAs, which were performed on responses from four different samples (Eklund, Kelley, and Wilson, 1997; Eklund, Mack, and Hart, 1996), supported the existence of a single substantive SPA factor underlying responses to the 12-item SPAS. There were, in addition, method effects associated with the negatively worded items that could be modeled to achieve good fit. Therefore, it was concluded that a single substantive factor and a non-substantive method effect primarily related to the negatively worded items best represented the 12-item SPAS.

The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome.

Primary shoulder impingement syndrome is a common shoulder problem which, if treated ineffectively, can lead to more serious pathology and expensive treatment. This study examined whether subjects receiving joint mobilization and comprehensive treatment (hot packs, active range of motion, physiologic stretching, muscle strengthening, soft tissue mobilization, and patient education) would have improved pain, mobility, and function compared with similar patients receiving comprehensive treatment alone. Subjects were eight men and six women (mean age = 52.9 years) with primary shoulder impingement syndrome (superolateral shoulder pain, decreased active humeral elevation, limited overhead function). Following random assignment to experimental (N = 7) and control groups (N = 7), three blinded evaluators tested 24-hour pain (visual analog scale), pain with subacromial compression test (visual analog scale), active range of motion (goniometry), and function (reaching forward, behind the head, and across the body in an overhead position) before and after nine treatments. One-tailed analyses of covariance (baseline values as covariates) showed that the experimental group had less 24-hour pain and pain with subacromial compression test but no differences in range of motion and function (Mann-Whitney U) compared with controls. The experimental group improved on all variables, while the control group improved only on mobility and function (one-tailed, paired t tests; Wilcoxon matched pairs). Age, side of dominance, duration of symptoms, treatment attendance, exercise quality, and adherence had no effect on the outcomes. Results may be affected by inadequate sample size, minimal capsular tightness, insensitive functional scale, nonspecific motion measurements, position at which mobilization treatment was given, or a strong effect of comprehensive treatment. Mobilization decreased 24-hour pain and pain with subacromial compression test in patients with primary shoulder impingement syndrome, but larger replication studies are needed to assess more clearly mobilization's influence on motion and function.

Comprehending role conflicts in the coaching of children, adolescents, and young adults. Transference, countertransference, and achievement by proxy distortion paradigms.

Relationship violations have been documented in all service professions, particularly those involving a power differential in the relationship. Although the coach-athlete relationship is not a typical therapeutic interaction, there should be professional and ethical boundaries. Boundary violations, including sexual abuse of a minor, do occur. Five clinical cases of relationship disturbances are presented. The authors use the paradigms of transference, countertransference, and achievement by proxy distortion to discuss these worrisome vignettes. Colleagues are encouraged to collaborate in an effort to develop awareness and prevention programs through research and education. Developing an enlarged workbook of similar case studies for use as a stimulus for seminars and discussions in training environments is an immediate goal.