Perfectionistic Environments and Irrational Beliefs on the Transition to Elite Athletic Performance: A Longitudinal Study.

This study aimed to longitudinally evaluate talented athletes' levels of perfectionism, irrational beliefs, and motivations with regard to their athletic careers. A total of 390 athletes from U14, U16, and junior categories (MageT1 = 15.42) answered shortened versions of the Sport-MPS2, iPBI, and BRSQ during two consecutive seasons, along with questions referring to their current and predicted prioritization of sports and education. Participants reported high levels of perfectionistic strivings and medium to low levels of socially prescribed perfectionism and concern over mistakes decreasing from T1 to T2. A decrease was also found for demandingness and awfulizing, but increased levels were found for depreciation in T2. Participants report very high intrinsic motivation with low levels of external regulation and amotivation, but intrinsic motivation decreased from season to season. This general profile varied depending upon future expectancies toward dedication to sports and education. Those who foresaw a prioritized dedication to sports presented significantly higher levels of socially prescribed perfectionism, perfectionistic strivings, and intrinsic motivation, while those who considered that sports would not be prioritized in the following 5 years reported higher levels of demandingness, awfulizing, depreciation, and amotivation. Additionally, while current levels of motivation (T2) seemed to be predicted mainly by previous motivation levels (T1), significant predictive capacity was also detected for socially prescribed perfectionism positively predicting external regulations and amotivation, perfectionistic strivings negatively predicting amotivation, and depreciation negatively predicting intrinsic motivation and positively predicting both extrinsic regulation and amotivation. We discuss the potential perils of developing extremely demanding environments, as they could potentially result in poor motivational profiles of athletes in their talent development stage during the junior to senior transition.

Influencia del feedback de entrenadoras/es sobre el refinamiento de destrezas motrices en deportistas experimentados/as: Una revisión sistemática / Influência do feedback dos treinadores no aperfeiçoamento das capacidades motoras em atletas experientes: Uma revisão sistemática / Influence of coaches' feedback on motor skill refinement in experienced athletes: Asystematic review

Los y las entrenadoras pueden utilizar el feedback para mejorar el rendimiento de las y los deportistas. Sin embargo, dicha evidencia no ha sido aún revisada en deportistas experimentados/as. Por ello, el objetivo del presente estudio es realizar una revisión sistemática para examinar la influencia de las diversas características del feedback que proporcionan las y los entrenadores sobre el refinamiento de destrezas motrices en deportistas experimentadas/os, así como observar si el nivel de experiencia y el tipo de destreza motriz tienen influencia sobre esta relación. Siguiendo las directrices PRISMA, se buscaron estudios experimentales y cuasiexperimentales en Web of Science, Scopus, PsycInfo y Dialnet en español, inglés y portugués. Se obtuvieron 19 estudios. La mayoría mostraron una mejora del rendimiento motor con valores similares en casi todas las características del feedback: después de la destreza motriz, valencia neutra, frecuente, constante, controlado por el investigador/a, comparado con ellos/as mismos/as, veraz, sobre el resultado y/o rendimiento de modo visual y/o verbal. No se obtuvo evidencia de que los resultados estuvieran influidos por el tipo de destreza motriz o el nivel de experiencia. Como conclusión, los estudios analizados mostraron como, cuando se proporciona feedback, se realiza mediante algún valor de cada una de las características de este. Además, se debe tener en consideración si el objetivo final de su proporción es refinar una destreza motriz para la mejora de la condición física o promover cambios en la realización de esta. En ambos casos, el uso de la tecnología podría ser útil para proporcionar el tipo de feedback expuesto anteriormente. (AU)

Coaches can use feedback to improve athletes’performance. Therefore, the aim of the present study is to conduct a systematic review to examine the influence of various characteristics of feedback on the refinement of motor skills in experienced athletes, as well as to observe whether the level of experience and the type of motor skill have an influence on this relationship. Following PRISMA, we searched for studies in Web of Science, Scopus, PsycInfo and Dialnet in Spanish, English and Portuguese. 19studies were obtained. The results show that feedback after the motor skill, with neutral valence, frequent and constant, controlled by the researcher or the coach, compared with the same athletes, truthful, about the result and/or performance in a visualand/or verbal way, improves, although not in a great magnitude, the motor performance. In conclusion, the studies analysed showed the extensive richness of feedback and the different values of each of its characteristics. In addition, it should be taken into consideration whether the goalof its proportion is to refine a motor skill for the improvement of physical fitness or to promote changes in the performance of the skill. In both cases, the use of technology could be useful to provide the type of feedback outlined above. (AU)

Os treinadores podem utilizar o feedback para melhorar o desempenho dos atletas. Por conseguinte, o objectivo do presente estudo é conduzir uma revisão sistemática para examinar a influência de várias características do feedback no aperfeiçoamento das capacidades motoras em atletas experientes, bem como para observar se o nível de experiência e o tipo de capacidades motoras têm influência nestarelação. Na sequência do PRISMA, procurámos estudos em Web of Science, Scopus, PsycInfo e Dialnet em espanhol, inglês e português. Foram obtidos dezanove estudos. Os resultados mostram que o feedback após a perícia motora, com valência neutra, frequente econstante, controlada pelo investigador ou pelo treinador, em comparação com os mesmos atletas, verdadeiro, sobre o resultado e/ou desempenho de forma visual e/ou verbal, melhora, embora não de grande magnitude, o desempenho motor. Em conclusão, os estudos analisados mostraram a extensa riqueza do feedback e os diferentes valores de cada uma das suas características.Além disso, deve ser tido em consideração se o objectivo final da sua proporção é aperfeiçoar uma habilidade motora para a melhoria da aptidão física ou promover mudanças no desempenho da habilidade. Em ambos os casos, a utilização da tecnologia poderia ser útil para fornecer o tipo de feedback acima delineado. (AU)

Measuring optimal psychological states: Proposal of two brief versions to measure flow and clutch in athletes.

Background: The study of sports experiences with high levels of performance has led to the observation of two psychological states categorized as optimal, denominated flow and clutch. The objective of this study is to design and validate two brief scales version to measure flow and clutch. Methods: Following the MIMO (Maximum Information, Minimum Discomfort) protocol, three studies are carried out: In Study 1, we developed the short versions of the questionnaires based on theory-driven and data-driven criteria; in Study 2, we used quantitative criteria to validate the short versions; and in Study 3, we checked the final version of each scale to observe their statistical validity and their relation to other variables. Results: The new short flow scale is made up of seven items, while the clutch scale is made up of five items. Throughout the three studies, evidence is provided of the internal consistency, invariance of the measurement models and content validity, validity related to the responding process and validity in relation to other variables. Conclusion: This study provides two short versions to evaluate flow and clutch, which will help to continue advancing in the study of optimal psychological states in sport.

Del césped al banquillo: trayectorias de futbolistas semiprofesionales en su transición de jugar a entrenar / From pitch to bench: Trajectories of semi-professional soccer players in their transition from playing to coaching

El objetivo de este trabajo es explorar de manera retrospectiva el proceso de transición y las trayectorias de futbolistas semiprofesionales hacia el rol de entrenador/a. Se realizaron nueve entrevistas semiestructuradas con entrenadores/as de fútbol. Con el propósito de dar una visión global del proceso de transición, el guion de entrevista y el posterior análisis temático tuvieron en cuenta los seis niveles de desarrollo del modelo holístico de carrera deportiva (Wylleman et al., 2013). Los resultados muestran la existencia de tres etapas en esta transición: (a) el sueño se aleja, (b) la llamada, (c) el banquillo; y un tema central más estructural el cuál aparece a lo largo de las tres etapas: (d) trayectoria multidimensional. Los y las participantes siguen modelos de trayectoria poco llamativas, pero seguras y adaptativas, en cuanto a tener otras opciones profesionales o dedicarse a otras esferas vitales como la familia. Hacer visibles estas trayectorias podrá ayudar a que clubes, sindicatos, federaciones e instituciones políticas puedan proporcionar los recursos formativos necesarios para facilitar la compaginación en esta vía (AU)

The aim of this paper is to explore retrospectively the transition process and trajectories of semi-professional soccer players into the role of coach. Nine semi-structured interviews were conducted with soccer coaches. In order to provide a more global view of such transition process, the interview guide and the subsequent thematic analysis were based on the six levels of the holistic developmental career model (Wylleman et al., 2013). Our results show the existence of three stages in this transition: (a) the dream drifts away, (b) the call, (c) the bench; and a more structural central theme that appears throughout the three stages: (d) multidimensional trajectory. Participants follow trajectory that are unremarkable, but safe and adaptive, and report that it allows them to have more vocational options or to devote themselves to other spheres of life such as family. Making these trajectories visible may help clubs, unions, federations and political institutions to provide the necessary educational resources to facilitate reconciliation during this transition (AU)

Fuelling the passion: Psychological needs and behavioural regulations as antecedents of passion for football.

The purpose of the present study was to examine the motivational antecedents of passion for sport by testing a model where players' satisfaction of the three basic psychological needs was expected to predict their harmonious and obsessive passions through the mediation of autonomous and controlled motivations. Four-hundred eighty-seven elite U18 male football players (Mage = 17.43, SD = 0.71) completed measures of psychological need satisfaction, behavioural regulations and passion for sport. Measurement models were defined using exploratory structural equation models. The results support the model where autonomous and controlled regulations partially mediate the relationship between psychological needs and passion. In this model, the need for relatedness positively and directly predicts harmonious passion and indirectly predicts obsessive passion, which supports its key role in discriminating between the two types of passion. Moreover, autonomy and competence satisfaction present direct and indirect effects on both types of passions. Finally, autonomous regulations positively predict obsessive and harmonious passion, although the strength of the relationship was stronger for the latter. In sum, our results highlight that (a) satisfaction of each need is crucial to promote harmonious passion and (b) both autonomous and controlled regulations contribute to the understanding of how passion is developed in football.

Factors associated with the absence of cocaine craving in treatment-seeking individuals during inpatient cocaine detoxification.

BACKGROUND: Anecdotal evidence suggests a substantial proportion of individuals with cocaine use disorder do not report craving during inpatient detoxification. OBJECTIVE: To examine prevalence and clinical correlates of consistent absence of cocaine craving among inpatients during detoxification. We hypothesized that craving absence would be associated with less severity of cocaine use, depression, and anxiety. Alternative explanations were also explored. METHODS: Craving absence (i.e., non-cravers) was defined as a daily score of zero across two separate craving visual analogue scales in each of the inpatient days. Participants scoring ≥1 on ≥1 day were considered cravers. Severity of cocaine use disorder as well as in-treatment depression and anxiety were assessed. Alternative contributors included presence of cocaine and other substances in urine at admission, in-treatment prescription of psychotropic medications, treatment motivation, executive function, interoception, and social desirability. RESULTS: Eighty-seven participants (78.2% males) met criteria as either non-cravers (n = 29; 33.3%) or cravers (n = 58; 66.7%). Mean length of admission in non-cravers and cravers was, respectively, 10.83 and 13.16 days. Binary logistic regression model showed that non-cravers scored significantly lower than cravers on cocaine use during last month before treatment (OR, 95% CI; 0.902, 0.839-0.970), in-treatment depression (OR, 95% CI; 0.794, 0.659-0.956), and in-treatment prescribing of antipsychotics (OR, 95% CI; 0.109, 0.014-0.823). Model prediction accuracy was 88.9%. CONCLUSIONS: One in three patients undergoing inpatient detoxification experienced absence of craving, linked to less pretreatment cocaine use, better mood, and decreased administration of antipsychotics. Findings may inform pretreatment strategies and improve treatment cost-effectiveness.

Where Did All the Sport Go? Negative Impact of COVID-19 Lockdown on Life-Spheres and Mental Health of Spanish Young Athletes.

During the 2020, the pandemic caused by the massive spread of the SARS-CoV-2 coronavirus (COVID-19) resulted in a global crisis. In Spain, the COVID-19 pandemic caused a lockdown for almost 100 days and forced the sudden stop of sport practices and competitions. This interruption had a negative impact on high-level athletes' mental health. However, its impact on young athletes, who are intrinsically developing a high-demanding dual career, remains unclear. Therefore, this study aimed at (1) describing and characterizing the general impact that COVID-19 lockdown had on Spanish young athletes' life-spheres and mental health, and (2) identifying different profiles of athletes regarding life-conditions and sport-related variables. A sample of 544 young athletes (M = 15.9; SD = 1.51) participated in this study. Measures included life-conditions and sport-related information along with the Holistic Monitoring Questionnaire (HMQ) and the General Health Questionnaire (GHQ-12). After the screening and description of the data, profiles were defined using a two-level cluster analysis using HMQ and GHQ-12 subscales. We explored differences in demographic and sports information between profiles using MANOVA and subsequent ANOVA. Results suggest a general negative impact of COVID-19 on young athletes' life-spheres and mental health, but with three different clusters regarding the degree of such impact. Cluster 1 grouped the 54.78% of the sample and exhibited a low negative impact of COVID-19 lockdown on life-spheres and few mental health issues. Cluster 2 grouped a 29.96% of the participants who reported a medium negative impact on life-spheres and moderate mental health issues. Cluster 3 represented 15.26% of the sample including participants who showed a high negative impact of the COVID-19 lockdown with high mental health issues. The paradigmatic participant in this third group would be a female student-athlete from a medium or low socioeconomic status with high academic demands and poor or inexistent training conditions during lockdown. Current findings emphasize the need to pay attention to young athletes' mental health and suggest possible influencing contextual variables. We suggest some applied recommendations aimed at helping clubs and sports institutions to mitigate the negative effects of such difficult circumstances on athletes' mental health.

Experiencias del entorno deportivo de origen al asesorar a esgrimistas migrantes / Supporting Migrant Fencers in a Sporting Environment / Experiências do entorno esportivo de origem ao assessorar a esgrimistas migrantes

Resumen Objetivo. Explorar las experiencias de entrenadores y profesionales de la salud, al asesorar la transición cultural y la carrera deportiva transnacional de esgrimistas colombianos migrantes. Método. Se conformaron dos grupos focales en los que participaron nueve personas (seis hombres y tres mujeres), de un equipo multidisciplinario de alto rendimiento en esgrima: cinco entrenadores y cuatro profesionales de la salud. Los datos se analizaron por medio del análisis temático reflexivo. Resultados. Se evidencia que acompañar la transición cultural de esgrimistas migrantes impacta en el bienestar y las dinámicas de asesoramiento de entrenadores y profesionales de la salud. Se generaron dos temas centrales: (a) en guardia y (b) marchar y romper. En el primero comentaron haber experimentado sorpresa, dilemas y la sensación de pasar a un segundo plano respecto a su rol como asesores técnicos y de la salud. En el segundo, se evidenció el cambio en las dinámicas de asesoramiento (comunicación virtual) y el carácter reactivo de las relaciones a distancia. Conclusión. La migración en el deporte genera nuevos desafíos para el equipo multidisciplinario que acompaña y asesora a los deportistas, tanto mujeres como hombres. Se proponen recomendaciones prácticas para entrenadores y profesionales de la salud, basadas en la praxis cultural de la Psicología Cultural aplicada al deporte.

Abstract Objective. To explore the experiences of coaches and health science professionals while supporting the cultural transition and the transnational sports career of migrant Colombian fencers. Method. Two focus groups were conducted with the participation of nine people of the top-class, multidisciplinary team in fencing (men = 6 and women = 3), coaches (n = 5) and health sciences professionals (n = 4). A reflexive thematic analysis was performed. Results. Supporting the cultural transition of migrant fencers impacts the well-being and supporting dynamics of coaches and health professionals. Two main issues were generated: (a) En garde; and (b) Marche and retraite. Regarding En garde, participants expressed that they faced dilemmas, surprise and the feeling of fading into the background regarding their role as technical and health support providers. In Marche and retraite, the change in the counseling dynamics (e.g. virtual communication) and the reactive nature of distance relationships was clear. Conclusion. The sport migration create new challenges for the multidisciplinary team that supports and assists athletes' transnational careers. Hence, practical recommendations for coaches and health professionals based on the cultural praxis of Cultural Sport Psychology are suggested.

Resumo Escopo. Explorar as experiências de treinadores e profissionais da saúde, ao assessorar a transição cultural e a carreira esportiva de esgrimistas colombianos migrantes. Metodologia. Foram conformados dois grupos focais nos que participaram nove pessoas (seis homens e três mulheres), da equipe multidisciplinar de alto rendimento em esgrima: cinco treinadores e quatro profissionais da saúde. Os dados foram analisados por meio da análise temática reflexiva. Resultados. Foi evidenciado que acompanhar a transição cultural de esgrimistas migrantes impacta no bem-estar e as dinâmicas de assessorar de treinadores e profissionais da saúde. Foram gerados dois temas centrais: (a) em guarda e (b) marchar e quebrar. No primeiro comentaram ter experimentado surpresa, dilemas e a sensação de passar a um segundo plano respeito a seu controle como assessores técnicos e da saúde. No segundo, foi evidenciada a mudança nas dinâmicas de assessorar (comunicação virtual) e o caráter reativo das relações a distancia. Conclusão. A migraçao esportiva gera novos desafios para a equipe multidisciplinar que acompanha e assessora aos atletas, tanto mulheres como homens. São propostas recomendações práticas para treinadores e profissionais da saúde, baseadas na práxis cultural da Psicologia Cultural ao esporte.

Towards a common metric for assessing heroin-dependent patient satisfaction with medications: Testing methadone and buprenorphine-naloxone.

BACKGROUND: Patient satisfaction with methadone or buprenorphine-naloxone can be multidimensionally and specifically assessed by using, respectively, the Scale to Assess Satisfaction with Medications for Addiction Treatment-Methadone for Heroin addiction (SASMAT-METHER) or the SASMAT-Buprenorphine-Naloxone for Heroin addiction (SASMAT-BUNHER). The factor structures of the SASMAT-METHER and SASMAT-BUNHER show substantial commonalities. The objective of the present study is to evaluate the replicability of the SASMAT-METHER factor structure using data from the SASMAT-BUNHER development study in order to obtain an instrument that can be used to compare patient satisfaction with methadone vs. buprenorphine-naloxone. METHOD: Secondary analysis of SASMAT-BUNHER data provided by 205 participants in the original validation study of that scale (Pérez de los Cobos et al., 2018). Using the SASMAT-METHER component solution (17 items, 3 factors) as the target structure, a principal component analysis was performed on the data set comprised of the corresponding 17 SASMAT-BUNHER items using an oblique semi-specified Procrustean rotation. Additionally, Tucker congruence coefficients were computed to examine the correspondence between the two solutions. RESULT: The factor structures of SASMAT-METHER and the 17-item version of the SASMAT-BUNHER can be considered equal given that the overall Tucker's congruence coefficient of factorial similarity was 0.972, with individual component congruencies ranging from 0.960 to 0.995. CONCLUSIONS: The SASMAT-METHER component solution can serve as a single common tool to compare methadone vs. buprenorphine-naloxone in terms of patient satisfaction. This finding supports the feasibility of using a common metric to specifically assess satisfaction with medications to treat heroin dependence.

Quality of life and well-being from the perspective of patients on opioid agonist maintenance treatment: study protocol for a systematic review of qualitative research and a scoping review of measures.

BACKGROUND: Opioid agonist maintenance treatment (OAMT) is a first-line treatment for heroin dependence, but its effectiveness has been assessed primarily through clinical outcomes with a limited attention to patient perspectives. Despite the increased use of patient reported outcome measures their patient-centeredness is highly questionable. This is the protocol of a systematic review of qualitative research on how OAMT users construct the meaning of their quality of life and well-being and a scoping review of instruments that measure these domains. METHODS: We will conduct a systematic review of qualitative research exploring the views of quality of life of patients on OAMT (registration number CRD42018086490). According pre-specified eligibility criteria, we will include studies from a comprehensive search of bibliographical databases from their inception. We will extract data from included studies and assess their risk of bias with the CASP appraisal criteria, and will implement a thematic analysis to generate a set of interpretative analytical themes ascertaining their confidence using the CERQual approach. We will implement similar methods to conduct a scoping review to assess to what extent the existing measures of these domains were focused on user's views, assessing their validity using the COSMIN methodology, and summarizing their characteristics and level of patient centeredness. CONCLUSION: The findings from the reviews will contribute to obtain a genuine understanding of the perspective from users on OAMT regarding their perception of well-being and quality of life and will likely lead to greater patient centeredness when assessing such variables, which in turn may contribute to a more patient-centered care.

Heroin-dependent patient satisfaction with methadone as a medication influences satisfaction with basic interventions delivered by staff to implement methadone maintenance treatment.

PURPOSE: The aim of the present study was to test a structural equation model of patient satisfaction with different key facets of methadone maintenance treatment (MMT). In this model, the three dimensions of patient satisfaction with methadone as a medication (ie, personal functioning and well-being, anti-addictive effect on heroin, and anti-addictive effect on non-opioid substances) were expected to predict satisfaction with the basic interventions delivered by the staff of treatment centers to implement MMT. PATIENTS AND METHODS: A sample of 210 heroin-dependent patients, resistant to MMT treatment (mean age =41.66 years, SD =6.50; 75.7% male), participated voluntarily in this study. Preliminary analysis based on exploratory structural equation modeling supported the expected three-factor measurement model of the scale to assess satisfaction with medications for addiction treatment - methadone for heroin addiction. Moreover, the 15 items measuring staff's basic interventions were shown to be compatible with the expected single-factor measurement model. Then, both measurement models were included in a structural model. RESULTS: Results of this model show that patient satisfaction with the compatibility of methadone with personal functioning and well-being, as well as with the anti-addictive effects of methadone on non-opioid substances, predicts satisfaction with basic interventions conducted at methadone treatment centers (ß=0.191 and ß=0.152, respectively). CONCLUSION: Our results provide further understanding regarding patient satisfaction with MMT, which could help professionals to better understand patient perspective and experience during MMT.

Development and validation of the scale to assess satisfaction with medications for addiction treatment - Buprenorphine-naloxone for heroin addiction (SASMAT-BUNHER).

BACKGROUND: Until now, no specific tool has been available to measure heroin-dependent patient satisfaction with buprenorphine-naloxone as a medication. The purpose of the present study was to develop the Scale to Assess Satisfaction with Medications for Addiction Treatment-Buprenorphine-Naloxone for Heroin addiction (SASMAT-BUNHER) and to examine its validity and reliability. METHODS: The SASMAT-BUNHER was developed from a pool of 44 self-administered items grouped into nine theoretical domains, as follows: Overall Satisfaction, Pharmacotherapy, Initiation, Anti-Addictive Effect on Heroin, Mental State, Physical State, Personal Functioning, Acceptability, and Anti-Addictive Effect on Secondary Substances. The Treatment Satisfaction Questionnaire for Medication 1.4 version (TSQM 1.4) was used for convergent validation. Participants were 316 heroin-dependent patients in maintenance treatment with buprenorphine-naloxone sublingual tablets at 16 different treatment centres. RESULTS: Principal component analysis of the SASMAT-BUNHER revealed a 5-factor structure that accounted for 65.1% of total variance. Based on similarities between empirically-obtained factors and theoretical domains, Factors 1 through 5 were named 'Mental and Physical State' (10 items), 'Anti-Addictive Effect on Other Substances' (5 items), 'Anti-Addictive Effect on Heroin' (4 items), 'Personal Functioning' (3 items), and 'Acceptability' (4 items). All factors showed acceptable internal consistency (Cronbach's alpha coefficients: 0.744-0.925) and test-retest reliability (intraclass correlation coefficients: 0.704-0.895). Correlation between SASMAT-BUNHER and TSQM 1.4 total scores was moderate (Pearson r = 0.552). Moreover, SASMAT-BUNHER total scores of patients reporting absence of buprenorphine-naloxone side effects were higher than those of their counterparts. CONCLUSION: These results support the validity and reliability of the SASMAT-BUNHER.

A cluster-analytic profiling of heroin-dependent patients based on level, clinical adequacy, and patient-desired adjustment of buprenorphine dosage during buprenorphine-naloxone maintenance treatment in sixteen Spanish centers.

BACKGROUND: Buprenorphine dosage is a crucial factor influencing outcomes of buprenorphine treatment for heroin use disorders. Therefore, the aim of the present study is to identify naturally occurring profiles of heroin-dependent patients regarding individualized management of buprenorphine dosage in clinical practice of buprenorphine-naloxone maintenance treatment. METHODS: 316 patients receiving buprenorphine-naloxone maintenance treatment were surveyed at 16 Spanish centers during the stabilization phase of this treatment. Patients were grouped using cluster analysis based on three key indicators of buprenorphine dosage management: dose, adequacy according to physician, and adjustment according to patient. The clusters obtained were compared regarding different facets of patient clinical condition. RESULTS: Four clusters were identified and labeled as follows (buprenorphine average dose and percentage of participants in each cluster are given in brackets): "Clinically Adequate and Adjusted to Patient Desired Low Dosage" (2.60 mg/d, 37.05%); "Clinically Adequate and Adjusted to Patient Desired High Dosage" (10.71 mg/d, 29.18%); "Clinically Adequate and Patient Desired Reduction of Low Dosage" (3.38 mg/d, 20.0%); and "Clinically Inadequate and Adjusted to Patient Desired Moderate Dosage" (7.55 mg/d, 13.77%). Compared to patients from the other three clusters, participants in the latter cluster reported more frequent use of heroin and cocaine during last week, lower satisfaction with buprenorphine-naloxone as a medication, higher prevalence of buprenorphine-naloxone adverse effects and poorer psychological adjustment. CONCLUSIONS: Our results show notable differences between clusters of heroin-dependent patients regarding buprenorphine dosage management. We also identified a group of patients receiving clinically inadequate buprenorphine dosage, which was related to poorer clinical condition.

Evidence of validity and reliability of the Opiate Dosage Adequacy Scale (ODAS) in a sample of heroin addicted patients in buprenorphine/naloxone maintenance treatment.

OBJECTIVE: The Opiate Dosage Adequacy Scale (ODAS) is a clinical tool to individually measure the "adequacy" of opioid doses in patients on maintenance treatment. The aim of this paper is to provide evidence for the validity and reliability of the ODAS in a sample of patients in buprenorphine/naloxone (B/N) maintenance treatment. METHOD: Cross-sectional study of a convenience sample of B/N-treated patients (n = 316) from four Autonomous Communities in Spain. Participants completed a battery of instruments to assess the following: buprenorphine dose adequacy; heroin dependence severity; psychological adjustment; and patient-desired adjustment of buprenorphine dose. RESULTS: Exploratory Factor Analysis identified four factors from the ODAS that together account for 85.4% of the total variance: "Heroin craving and use"; "Overmedication"; "Objective opiate withdrawal symptoms (OWS)" and 'Subjective OWS'. Compared to patients with an "inadequate" B/N dose (ODAS), patients with "adequate" doses had less heroin use in the last week (0.01 vs. 0.40; t = -2.73; p < 0.01, 95% CI: -0.67, -0.10), less severe heroin dependence (2.20 vs. 5.26, t = -5.14, p < 0.001; 95% CI: -4.23, -1.88), less psychological distress (3.00 vs. 6.31, t = -4.37, p < 0.001; 95% CI: -4.80, -1.81), and greater satisfaction with their doses (42.1% vs. 13.6%, χ2 = 14.44, p < 0.01). Cronbach's alpha coefficient was 0.76 (0.81, 0.92, 0.94, and 0.93, respectively, for the four factor dimensions). CONCLUSION: These findings support the validity and reliability of the ODAS as a tool to measure and assess buprenorphine dose adequacy in the context of an opioid dependency treatment program.

Patient perception of methadone dose adequacy in methadone maintenance treatment: The role of perceived participation in dosage decisions.

OBJECTIVE: In clinical practice, methadone maintenance treatment (MMT) entails tailoring the methadone dose to the patient's specific needs, thereby individualizing treatment. The aim of this study was to identify the independent factors that may significantly explain methadone dose adequacy from the patient's perspective. METHOD: Secondary analysis of data collected in a treatment satisfaction survey carried out among a representative sample of MMT patients (n=122) from the region of La Rioja (Spain). As part of the original study protocol, participants completed a comprehensive battery to assess satisfaction with MMT, psychological distress, opinion of methadone as a medication, participation in dosage decisions, and perception of dose adequacy. RESULTS: Multivariate binary logistic regression showed that the only variable independently associated with the likelihood of a patient perceiving methadone dose as inadequate was the variable perceived-participation in methadone dosage decisions (OR=0.538, 95% CI=0.349-0.828). CONCLUSION: Patient participation in methadone dosage decisions was predictive of perceived adequacy of methadone dose beyond the contribution of other socio-demographic, clinical, and MMT variables. PRACTICE IMPLICATIONS: Patient participation in methadone dosage decision-making is valuable for developing a genuinely patient-centred MMT.

Intervenciones para la promoción de actividad física basadas en la teoría de la autodeterminación: Una revisión narrativa (2011-2016) / Lessons from self-determination interventions to promote physical activity: A Narrative review (2011-2016)

El objetivo del presente estudio es revisar intervenciones recientes orientadas a la promoción de la actividad física mediante un enfoque basado en la Teoría de la Autodeterminación (SDT). Así, presentamos ideas apoyadas por la evidencia que los investigadores pueden utilizar para desarrollar sus futuros programas. Nuestro estudio incluye artículos publicados entre 2011 y 2016 que cumplen los siguientes criterios de inclusión: (a) SDT como principal marco teórico, (b) participantes sanos con edades ≥ 12 años, y (c) foco en la promoción de la actividad física y/o variables relacionadas. Presentamos los resultados en tres categorías: (a) estructura, enfoque teórico y aspectos generales, (b) desarrollo, y (c) evaluación. En relación con la estructura, encontramos dos tipos de intervención: aquellas desarrolladas en un contexto existente, donde los profesionales responsables reciben una formación específica que puede influir indirectamente en los estudiantes/pacientes, e intervenciones desarrolladas desde cero, dónde los participantes reciben la formación o información directamente. Los resultados muestran que el enfoque más habitual para desarrollar la intervención es el apoyo y la satisfacción de la autonomía. En cuanto al desarrollo de la intervención, es crucial entender las necesidades de la población diana y aplicar intervenciones hechas a medida que incluyan la SDT no solo como conceptos a explicar sino también como una manera de guiar el desarrollo de la intervención. Por último, para la evaluación de la intervención destacamos: (a) utilizar métodos mixtos, (b) evaluar medidas objetivas y autopercepciones, y (c) medir la satisfacción de los participantes con la intervención (AU)

The purpose of the present study is to review recent interventions aimed at promoting physical activity using self-determination theory (SDT) framework. We present evidence-based proposals that researchers could find useful to develop their own interventions. Our narrative review includes journal articles published between 2011 that meet the following inclusion criteria: (a) using SDT as reference framework, (b) targeting healthy participants with age ≥ 12 years old, and (c) pursuing a main goal of promoting physical activity or related variables. Results are presented in three categories: (a) structure, theoretical approach and general aspects of the intervention, (b) development, and (c) assessment. Regarding the structure, two types of interventions emerged: those conducted within an existing setting, where professionals in charge receive specific training that is expected to indirectly affect their students/patients; and interventions developed from zero, where participants receive direct training or information. Results showed that the most common background to develop SDT interventions is autonomy support and autonomy satisfaction. Concerning the development of the intervention, it appears essential to understand the needs of the target population and to develop tailored interventions that consider SDT not only as concepts to explain but also as a way of thinking that guides the development of the interventions. Regarding the assessment of the intervention, researchers could consider (a) using mixed-methods approach, (b) including objective and self-reported measures and (c) measuring participants’ satisfaction with the intervention (AU)

Stop&Go - Promoting healthy lifestyles during inpatient detoxification treatment: rationale, intervention design, methodology / Stop&Go - Promoviendo vidas saludables durante el tratamiento de desintoxicación. Justificación, diseño, metodología

Exercise could help in the treatment of substance addictions. However, there is a lack of programs promoting a healthy and physically active lifestyle for patients requiring inpatient detoxification treatment. We present the protocol of an intervention program with such characteristics, namely Stop&Go. Stop&Go includes two different phases. Phase I is aimed at understanding the variables related with adherence to healthy lifestyle interventions. Patients with substance use disorders will be invited to participate in focus groups (Study1) and to respond to questionnaires assessing variables related to exercise and healthy habits (Study2). Phase II will use the knowledge obtained in Phase I to develop and evaluate an intervention to promote healthy and physically active lifestyles for patients admitted to an inpatient detoxification center. The intervention will also be based on Self-determination theory postulates. Patients will participate in four practically-oriented training sessions, focused on (1) physical activity and exercise, (2) nutrition and oral hygiene, (3) sleep habits and self-care, and (4) smoking cessation. In addition, the entire inpatient detoxification center will be adapted to encourage autonomous physical activity/exercise and to reinforce the ideas presented in the psychoeducational sessions. It is expected that, compared to a control group, patients engaged in the Stop&Go intervention will show: (a) higher scores in exercise-related variables (e.g., autonomous motivation), (b) better mental health status, and (c) greater knowledge regarding healthy and physically active lifestyles (AU)

El ejercicio puede ayudar a tratar las adicciones a sustancias. Sin embargo, se detecta una falta de programas que promuevan los estilos de vida activa y saludable para pacientes que requieran tratamiento de desintoxicación hospitalaria. Por ello, presentamos el protocolo de un programa de intervención, llamado Stop&Go. Stop&Go incluye dos fases: La Fase I tiene como propósito comprender qué variables se relacionan con la adherencia de estos pacientes a intervenciones que promuevan el estilo de vida saludable. Pacientes con trastornos por uso de sustancias serán invitados a participar en grupos focales (Estudio 1) y a contestar cuestionarios que evalúan variables relacionadas con el ejercicio físico y los hábitos saludables (Estudio 2). La Fase II utilizará el conocimiento obtenido en la Fase I para desarrollar y evaluar una intervención que promueva los hábitos de vida activa y saludable de pacientes ingresados en una unidad hospitalaria de desintoxicación (UHD). Esta intervención se basará también en los postulados de la Teoría de la Autodeterminación. Los pacientes participarán en cuatro sesiones psicoeducativas: (1) actividad física y ejercicio físico, (2) alimentación e higiene bucal, (3) higiene del sueño y autocuidado, y (4) cesación tabáquica. Además, la UHD será adaptada para estimular la práctica autónoma de actividad física, y para reforzar las ideas presentadas en los grupos psicoeducativos. Se espera que, en comparación con el grupo control, los pacientes de la intervención Stop&Go mostrarán: (a) mayores puntuaciones en variables relacionadas con el ejercicio físico, (b) mejor salud mental, y (c) mayor conocimiento sobre los hábitos de vida saludable (AU)

Effects of an Individualized Program on Coaches’ Observed and Perceived Behavior / Effectos de un programa personalizado sobre loscomportamientos observados y percibidos de los entrenadores / Efeitos de um programa personalizado nos comportamentos observados e percebidos dos treinadores

The purpose of the present study is to evaluate an individualized intervention based on Coach Effectiveness Training (CET) principles, using a case study. Two basketball coaches selected 3 target behaviors to improve. Behavioral assessment revealed that Coach 1 achieved positive changes in all his 3 target behaviors. In turn, Coach 2 improved on 2 of his 3 target behaviors. Changes in coaches’ behaviors were mostly perceived by players in the evaluation stage. Specifically, players’ perceptions of Coach 1 showed an increase of General Encouragement and Mistake-Contingent Encouragement, and players of Coach 2 perceived a clear increase of General Encouragement, Reinforcement and Mistake-Contingent Technical Instruction. Results are discussed in line with CET principles and potential applications of our program are presented

El objetivo del presente estudio es evaluar una intervención individualizada basada en los principios del Coach Effectiveness Training (CET) mediante un enfoque de estudio de caso. Dos entrenadores de baloncesto seleccionaron 3 conductas objetivo a mejorar. La evaluación conductual reveló que el Entrenador 1 consiguió cambios positivos en sus 3 conductas objetivo. Por su parte, el Entrenador 2 mejoró en 2 de sus 3 conductas objetivo. Estos cambios en la conducta de los entrenadores fueron mayoritariamente percibidos por sus jugadores en la fase de evaluación. Concretamente, las percepciones de los jugadores del Entrenador 1 mostraron un claro aumento de Ánimo General y Ánimo Contingente al Error, y las de los jugadores del Entrenador 2 una clara mejoría de Ánimo General, Refuerzo e Instrucción Técnica al Error. Los resultados se discuten en base a los principios del CET y se proponen potenciales aplicaciones de nuestro programa

O objetivo do presente estudo é avaliar uma intervenção baseada nos princípios do Coach Effectiveness Training(CET) através de doisestudos de caso. Dois treinadores de basquetebol selecionaram 3 comportamentos - objetivo a melhorar. A avaliação comportamental revelou que o Trei-nador 1 conseguiu mudanças positivas nos 3 comportamentos - objetivo. O Treinador 2 melhorou em dois dos 3 comportamentos que definiu como ob-jetivo. Estas mudanças nos comportamentos dos treinadores foram, na sua maioria, percebidos pelos seus jogadores na fase de avaliação. Concretamente,as perceções dos jogadores do Treinador 1 indicam um aumento evidente de Animo Geral e Animo após o Erro, e as perceções dos jogadores do Treinador2 indicam uma clara melhoria de Animo Geral, Reforço e Instrução Técnica ao Erro. Os resultados são discutidos com base nos princípios do CET e sãoapresentadas propostas de potenciais aplicações do nosso programa de intervenção