Promoting positive development: Coaches as trainers in sports-based resilience programs.

OBJECTIVE: To assess the efficacy of a train-the-trainer model for sporting coaches delivering a youth sports-based resilience program. DESIGN: A quasi-experimental design was applied, with a pre-post comparison, utilising purposive sampling to take advantage of an existing naturally formed group. SETTING AND PARTICIPANTS: A total of 11 coaches and 86 athletes involved in a community rowing program. MAIN OUTCOME MEASURE(S): Coaches responded to paper-based measures of resilience and knowledge/attitudes pre- and post-completion of a training workshop. Athletes responded to online measures of stress, efficacy and life satisfaction pre- and post-completion of a resilience program. RESULTS: Following the completion of the train-the-trainer workshop, coaches reported significant increases in general knowledge and confidence in teaching resilience skills. Following the delivery of the resilience program, athlete self-efficacy and satisfaction with life scores were significantly higher, with significant reductions in reported stress for athletes trained by the varsity-level coaches. CONCLUSION: There is support for investing in a train-the-trainer model for the delivery of a resilience skills program within a sports context. Caution is given to investing in the training and support of the coaches, particularly coaches with less coaching experience. These results are consistent with previous research and demonstrate support for coach-led resilience programs being effective in community settings, with implications for rural and remote locations.

Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention.

BACKGROUND: Acceptance and commitment therapy has shown to be effective in chronic pain rehabilitation, and acceptance has been shown to be a key process of change. The influence of treatment dose on acceptance is not clear, and in particular, the effectiveness of a non-intensive treatment (<20 h) in a tertiary pain clinic is required. PURPOSE: The purpose of the study was to assess the effectiveness of a low-intensity, acceptance and commitment therapy (ACT) group program for chronic pain. The study sought to compare, at both groups and individual patient levels, changes in acceptance with changes observed in previous ACT studies. METHODS: Seventy-one individuals with chronic pain commenced a 9-week ACT-based group program at an outpatient chronic pain service. In addition to acceptance, outcomes included the following: pain catastrophizing, depression, anxiety, quality of life, and pain-related anxiety. To compare the current findings with previous research, effect sizes from seven studies were aggregated using the random-effects model to calculate benchmarks. Reliable change indices (RCIs) were applied to assess change on an individual patient-level. RESULTS: The ACT intervention achieved a statistically significant increase in acceptance and medium effect size (d = 0.54) at a group level. Change in acceptance was of a similar magnitude to that found in previous ACT studies that examined interventions with similar treatment hours (<20 h). Results across other outcome measures demonstrated small to medium effect sizes (d = 0.01 to 0.48, mean = 0.26). Reliable improvement in acceptance occurred in approximately one-third (37.2, 90% CI) of patients. Approximately three-quarters (74.3, 90% CI) demonstrated reliable change in at least one of the outcome measures. CONCLUSIONS: The low-intensity, group-based ACT intervention was effective at a group level and showed a similar magnitude of change in acceptance to previous ACT studies employing low-intensity interventions. Three-quarters of patients reported reliable change on at least one outcome measure.

The roles of acceptance and catastrophizing in rehabilitation following anterior cruciate ligament reconstruction.

OBJECTIVES: The purpose of this study was to determine if pain catastrophizing and experiential acceptance predicted depression, pain intensity, and maladaptive behaviour following anterior cruciate ligament reconstruction. DESIGN: Patients who had undergone anterior cruciate ligament surgery completed assessment within 2 weeks of surgery (N=44) and again 6 months post-surgery (N=26). METHODS: Predictor measures were the Pain Catastrophizing Scale and the Acceptance and Action Questionnaire. Outcome measures included the depression scale of the Depression Anxiety and Stress Scale, numerical rating scale of pain intensity, and the alcohol and substance misuse subscale of the Brief Coping Orientations to the Problem Experience inventory. Demographic variables and athletic identity were also measured. RESULTS: Higher pain catastrophizing scores were associated with greater pain intensity and depressive symptoms in the 2-week post-operative period. Lower acceptance scores in the 2-week post-operative period were predictive of more severe depression scores at 6 months, even after controlling for early post-operative depression and athletic identity. Lower acceptance was also associated with greater use of alcohol and other substances, reportedly to cope with the stress of being injured. CONCLUSIONS: This study highlights the importance of acceptance in an athletic population undergoing rehabilitation after ACL reconstruction.

Validation of the Chronic Pain Acceptance Questionnaire-8 in an Australian pain clinic sample.

BACKGROUND: Recently, an 8-item short-form version of the Chronic Pain Acceptance Questionnaire (CPAQ-8) was developed predominantly in an internet sample. Further investigation of the factor structure in a multidisciplinary pain clinic sample is required. Investigation of the concurrent validity of the CPAQ-8 after accounting for the effects of variables commonly measured in the pain clinic setting is also necessary. PURPOSE: This study examines the factor structure and concurrent validity of the CPAQ-8 in a sample of treatment-seeking patients who attended a multidisciplinary pain clinic. METHODS: Participants were 334 patients who attended an Australian multidisciplinary pain service. Participants completed the CPAQ, a demographic questionnaire, and measures of patient adjustment and functioning. RESULTS: Confirmatory factor analysis identified a two-factor 8-item model consisting of Activity Engagement and Pain Willingness factors (SRMR = 0.039, RMSEA = 0.063, CFI = 0.973, TLI = 0.960) was superior to both the CPAQ and CPAQ with an item removed. The CPAQ and CPAQ-8 total scores were highly correlated (r = 0.93). After accounting for pain intensity, the CPAQ-8 was a significant predictor of depression, anxiety, stress, and disability. The subscales of the CPAQ-8 were both unique contributors to depression and disability in regression analyses, after accounting for pain intensity and kinesiophobia, and after accounting for pain intensity and catastrophizing. CONCLUSIONS: The CPAQ-8 has a sound factor structure and similar psychometric properties to the CPAQ; it may have clinical utility as a measure of pain acceptance in treatment-seeking, chronic pain patients.

Six month post-treatment deterioration in acceptance (CPAQ-8) and cognitions following multidisciplinary pain treatment.

Pain acceptance contributes significantly to the effectiveness of pain treatment outcomes. Nevertheless, little research has been conducted to examine whether a decrease in acceptance contributes to a deterioration in post treatment functioning. The aim of this study was to assess the role of pain acceptance in relation to process and outcome variables in the six-months following the conclusion of a pain program. Adults with chronic pain (N = 120) completed assessments at the completion of a 3-week multidisciplinary treatment program and 6-months post-treatment. Process measures included the Chronic Pain Acceptance Questionnaire-8 (CPAQ-8); the catastrophizing scale of the Pain Response Self-Statement Scale; the coping cognitions scale of the Pain Response Self-Statement Scale; and the Tampa Scale of Kinesiophobia. Outcome measures included the Roland Morris Disability Questionnaire; the depression scale of the Depression Anxiety and Stress Scale; and two measures of physical functioning. Deterioration in acceptance of pain was significantly associated with deterioration in depression and disability, even when catastrophizing cognitions and kinesiophobia were accounted for. Decrease in acceptance was the strongest predictor of reliable deterioration in depression and disability. Results indicated the CPAQ-8 has utility as a measure for monitoring patient functioning post-treatment.

Activation of self-focus and self-presentation traits under private, mixed, and public pressure.

Trait activation theorists suggest that situational demands activate traits in (pressure) situations. In a comparison of situational demands of private (monetary incentive, cover story), mixed (monetary incentive, small audience), and public (large audience, video taping) high-pressure situations, we hypothesized that situational demands of private and mixed high-pressure conditions would activate self-focus traits and those of a public high-pressure condition would activate self-presentation traits. Female handball players (N = 120) completed personality questionnaires and then performed a throwing task in a low-pressure condition and one of three high-pressure conditions (n = 40). Increased anxiety levels from low to high pressure indicated successful pressure manipulations. A self-focus trait negatively predicted performance in private and mixed high-pressure conditions, and self-presentation traits positively predicted performance in the public high-pressure condition. Thus, pressure situations differed in their trait-activating situational demands. Experimental research investigating the trait-performance relationship should therefore use simulations of real competitions over laboratory-based scenarios.

Gender, level of participation, and type of sport: differences in achievement goal orientation and attributional style.

Findings regarding gender differences in achievement goal orientations and attributional style have been somewhat inconsistent. One possible explanation for varied findings is that potentially confounding variables such as level of participation and type of sport have not been considered. Athletes (108 males and 164 females) from team and individual sports, competing at recreational and competitive levels, completed the Task and Ego Orientation in Sport Questionnaire, the Sport Attributional Style Scale, and a demographic questionnaire. Athletes competing in individual sports had a higher ego orientation than those from team sports, and females scored higher in task orientation than males. Individual sport athletes made more internal, stable, and global, and less externally controllable attributions for positive events, and more internal attributions for negative events than team sport athletes. Competitive female athletes made less global attributions for positive events than did recreational female athletes. This difference was not observed in male athletes. Competitive individual, but not team, athletes made less global attributions than recreational individual athletes. The significant interactions regarding globality suggest that the tradition in sport psychology attribution research to focus solely on internality, stability, and controllability may be inadequate. From an applied perspective, sport psychologists and coaches may find it beneficial to target individual sport athletes and males for interventions designed to enhance task orientation. Similarly, team sport athletes may be appropriate as a focus for attribution retraining programs.

Dancing in pain: pain appraisal and coping in dancers.

This study investigated the relationships between the type of pain experienced (performance pain and injury pain), the cognitive appraisal of pain and pain coping styles in dancers. Fifty-one professional ballet and contemporary dancers (17 males and 34 females), with the mean age of 25.9 years, completed a general pain questionnaire, the Pain Appraisal Inventory, the Survey of Pain Attitudes Control Subscale, and the Sports Inventory for Pain. Multivariate analyses of variance indicated that both the cognitive appraisal of the pain and pain coping styles did not differ according to the type of pain experienced or the pain severity. However, it was found that dancers with performance pain of either low or high severity were more likely to dance in pain than dancers experiencing injury pain. Multiple regression analyses indicated that the appraisal of pain as threatening was predictive of the use of avoidance and catastrophizing pain coping styles. Overall, results indicated that dancers may not differentiate between performance pain and injury pain, or modify their appraisal and coping strategies according to the characteristics of the pain experienced. The study highlighted an opportunity for increased education for dancers in recognizing the difference between pain considered to be a routine aspect of training and pain which is a signal of serious injury.