Stress, Sport Anxiety, Neuroticism, and Coping in Student-Athletes: Implications for Patient Mental Health.

CONTEXT: Patients' mental health has been recognized as important in providing patient-centered care in athletic training. OBJECTIVE: To evaluate stress, sport anxiety, neuroticism, and coping in student-athletes. DESIGN: Cross-sectional study. SETTING: University athletics. PATIENTS OR OTHER PARTICIPANTS: The sample comprised 86 student-athletes competing in National Collegiate Athletic Association (NCAA) Division III. MAIN OUTCOME MEASURE(S): The Perceived Stress Scale, Sport Anxiety Scale-2, neuroticism scale of the Big Five Inventory, and Brief COPE were used to measure stress, sport anxiety, neuroticism, and coping, respectively. RESULTS: Sport anxiety was positively related to stress (r = 0.446, P < .001) and neuroticism (r = 0.311, P < .01) and not related to emotion-focused coping (r = 0.270, P = .804). Neuroticism was a negative predictor of emotion-focused coping (b = -0.373, P < .001), and sport anxiety and stress were predictors of dysfunctional coping (b = 0.120, P < .05; b = 0.037, P < .05). Stress, sport anxiety, and neuroticism were not predictors of problem-focused coping. CONCLUSIONS: Support was evident for the relationship among stress, sport anxiety, neuroticism, and coping in NCAA Division III student-athletes. Such results warrant future exploration to inform behavioral interventions targeting student-athlete psychosocial factors to promote improved performance, reduce injury risk factors (eg, stress, personality, coping), and enhance student-athlete mental health and well-being.

Understanding drift in the treatment of eating disorders using a mixed-methods approach.

Despite strong empirical support for treatments of eating disorders, research has demonstrated a trend of clinicians deviating from protocols outlined in empirically supported manuals. The present study used a convergent mixed-methods design to understand clinicians' use of and drift from empirically supported treatments in a sample of 114 licensed clinicians in the US who had substantial experience (i.e. one-third of caseload) working with patients with eating disorders and training in cognitive-behavioral therapy (CBT), family-based therapy (FBT), and/or interpersonal therapy (IPT) for eating disorders. Results revealed that 63.7-76.3% of clinicians drift from empirically supported treatments and 71.8% were aware they deviated from empirically supported treatments. Qualitative analyses identified client differences (57.2%) to be the primary reason why clinicians drift, with less participants describing therapist factors (20.4%), treatment shortcomings (12.6%), treatment setting (11.7%), logistic constraints (4.9%) and family factors (4.9%) as reasons why they drift. These findings suggest that drift for most clinicians may be better explained under the umbrella of evidence-based practice. Clinicians also identified a number of ways in which treatment and access to treatment can be improved. This broadened understanding of the use of empirically supported treatments within evidence-based practice may serve to help bridge the gap between research and practice.

Control Balance, Personality Traits, Attachment, and Communication Styles Associated with Stalking.

Stalking is associated with negative occupational, physical, social, and psychological consequences, yet little is known about who is at risk of being stalked. The purpose of the current study was to determine if individuals with experiences of being stalked have unique personality traits, attachment, and communication styles. Participants (N = 180; 78% female, mean age = 24, SD = 8.18) completed an online, self-report survey utilizing a cross-sectional, correlational design. Results indicated that 21% (N = 38) of participants reported experiences of being stalked. Those who had experienced stalking had a higher control deficit (t = 3.99, p = .000), higher control surplus (t = 2.14, p = .03), and lower general health scores (t = -2.50, p = .01), as compared to participants who had not experienced stalking. Results also showed that those who had experienced stalking possessed higher scores of openness (F = 5.41, p = .021), neuroticism (F = 5.29, p = .023), and motivation to defer to a dominant partner (F = 46.79, p = .000). A logistic regression revealed that higher scores on neuroticism, motivation to defer to a dominant partner, and extroversion were associated with an increased risk of being stalked, whereas higher scores on interpersonal deference, disequilibrium, and agreeableness decreased college students' risk of being stalked (χ2 (11, N = 180) = 67.34, p < .001). Findings provide information that may be used to decrease the prevalence of stalking victimization and inform clinical treatment for victims of this crime.

Positive Affect Moderates the Relationship Between Salivary Testosterone and a Health Behavior Composite in University Females.

BACKGROUND: Testosterone is released in both men and women and plays an important role in social functioning and motivation. Greater testosterone in women has been associated with negative physical health outcomes, while lower testosterone has been associated with psychological disorders. The following cross-sectional study examined the contribution of salivary testosterone, positive and negative affect, and demographic variables in predicting a composite health behavior score (cigarette use, hours of sleep, fruit/vegetable intake, following an exercise routine). METHOD: The sample (mean age 21.17, SD = 6.13) consisted of 87 female university students asked to complete a demographic and lifestyle behavior questionnaire, the Positive and Negative Affect Schedule, and provide a saliva sample. Participants self-identified as Latina (37.9%), European American (32.2%), Asian American (5.7%), African American (4.6%), or Mixed/other (19.5%). Hierarchical regression analyses were used to examine whether positive and negative affect served as a moderator between salivary testosterone and a health behavior composite. RESULTS: Results indicated that positive affect moderated the relationship between salivary testosterone and the composite health behavior score (t = - 2.42, p = .018, Adj. R2 = .21, F (5, 81) = 5.07, p < .001) such that the healthiest behaviors were observed in participants with high positive affect and low salivary testosterone. Findings remained after adjusting for oral contraceptive use, income level, relationship status, and ethnicity. CONCLUSIONS: These results provide a preliminary foundation for future research examining the interplay of neuroendocrine function, psychological factors (i.e., positive affect), and behavior. Further empirical studies can focus on expanding this research in larger, representative samples.

Adverse childhood experiences, self-care, and compassion outcomes in mental health providers working with trauma.

OBJECTIVE: This study examined the moderating effects of self-care on various compassion outcomes among mental health providers. METHOD: Mental health providers (n = 371; 94.1% female; mean age = 47.12) were surveyed regarding their level of self-care, history of adverse childhood experiences, and the degree of burnout, secondary traumatic stress, and compassion satisfaction experienced. RESULTS: Results indicated that providers who endorsed a history of adverse childhood experiences (82.5%) also endorsed greater negative compassion outcomes than those who did not have such a history. Endorsement of self-care activities was a significant predictor of compassion satisfaction and burnout in the expected directions. Self-care served as a moderator between adverse childhood experiences and burnout. CONCLUSIONS: Self-care is an effective method for decreasing negative compassion outcomes among mental health providers who work with trauma. It is important to develop effective training programs that promote self-care in personal and professional settings.

Cardiovascular risk: gender differences in lifestyle behaviors and coping strategies.

BACKGROUND: Although cardiovascular disease (CVD) does not occur until mid to late life for most adults, the presence of risk factors, such as high blood pressure (BP) and cholesterol, has increased dramatically in young adults. PURPOSE: The present study examined the relationships between gender and coping strategies, lifestyle behaviors, and cardiovascular risks. METHOD: The sample consisted of 297 (71% female) university students. Participants completed a survey to assess demographics, lifestyle behaviors, and coping strategies, and a physiological assessment including lipid and blood pressure (BP) measurements. Data collection occurred from January 2007 to May 2008. RESULTS: Analyses revealed that age, ethnicity, greater body mass index (BMI), greater use of social support, and less frequent exercise were associated with higher cholesterol, while gender, age, greater BMI, and less frequent exercise were associated with higher systolic BP. There were two significant interactions: one between gender and avoidant coping and the other between gender and exercise on systolic BP, such that for men greater use of avoidant coping or exercise was associated with lower systolic BP. CONCLUSION: Understanding how young adults manage their demands and cope with stress sets the stage for understanding the developmental process of CVD. Both coping strategies and lifestyle behaviors must be considered in appraising gender-related cardiovascular risk at an early age before the disease process has begun.

Attachment, forgiveness, and physical health quality of life in HIV + adults.

Research aims to help HIV + individuals improve and maintain a healthy quality of life, while managing a chronic illness. Using Lazarus and Folkman's model of stress and coping, we examined the main and interactive effects of attachment style and forgiveness on physical health quality of life of HIV + adults. Participants (n=288, 49% women) were recruited in Dallas/Fort Worth and self-identified as African-American (52%), European-American (32%), Latino(a) (12%), and other (4%), with an average age of 41.7 (SD=8.6). The average number of years participants reported being HIV + was 7.6 (SD=5.4). Participants completed medical and demographic information, measures assessing attachment anxiety and avoidance, forgiveness of self and others, and five quality of life scales (physical functioning, pain, role functioning, social functioning, and health perceptions). Significant correlations revealed that attachment anxiety was inversely related to physical health quality of life, while forgiveness of self was associated with greater quality of life. Hierarchical multiple regression analyses revealed that attachment anxiety and avoidance, forgiveness of self and others, as well as interactions between attachment style and forgiveness, were related to the physical health quality of life of HIV + adults. Interpretation of the interactions identified that for individuals who endorsed greater attachment anxiety, forgiveness of others was associated with greater pain, while forgiveness of self was associated with a greater perception of health. Research has indicated that forgiveness interventions lead to positive health outcomes for most individuals; however, in HIV + adults, whether an outcome is health promoting may be dependent on attachment style.

Mindfulness and its Role in Physical and Psychological Health.

This study examined the relationships of mindfulness, a form of focused self-awareness, with physical and psychological health. Mindfulness was measured in terms of four stable forms of awareness: Observe, an awareness of internal and external stimuli; Describe, an ability to verbally express thoughts clearly and easily; Act with Awareness, the tendency to focus on present tasks with undivided attention; and Accept without Judgment, the tendency to take a nonjudgmental attitude toward one's own thoughts and emotions. These aspects of mindfulness were explored in relation to both physical health, which consisted of heart rate variability, a measure of overall cardiovascular health, and psychological health, which consisted of flourishing, existential well-being, negative affect, and social well-being in a sample of 506 undergraduate students. Individuals high in mindfulness showed better cardiovascular health and psychological health.

Ethnicity and Type D personality as predictors of heart rate variability.

This study examined the relationship between Type D personality and heart rate variability (HRV) during three guided imagery experiences (baseline, stressful, and uplifting) in a non-medical sample. The interaction between African-American ethnicity and Type D personality was predictive of both low and high frequency HRV during stressful imagery experiences. The importance of identifying group influences when assessing psychological and cardiovascular health was discussed.

Gender differences in HIV-related coping and depression.

Our study examined differences in HIV-related coping in relation to depression in men and women. Ethnically diverse participants (n = 247, 46% women) were recruited in Dallas/Fort Worth and completed medical and demographic information, the Coping with HIV Scale (CHIV), and the Center for Epidemiological Studies-Depression scale (CES-D). Multiple regression analyses revealed that in men, depression was associated with symptoms, higher use of distraction, blame, expression and lower use of positive growth. In women, depression was associated with symptoms and higher use of blame. These results shed light on the ways in which each gender copes with HIV and may help researchers develop interventions tailored to the needs of the HIV-positive population.

Gender differences, anger expression, and cardiovascular risk.

Research has established the influence of serum cholesterol and anger management style as cardiovascular risk factors. However, mixed and sometimes contradictory results have created uncertainty with respect to contributions of anger. Some incongruities may be accounted for on the basis of gender differences since a number of studies have employed male samples rather than female samples or mixed samples. The present study examined both gender and anger management style in relation to cardiovascular risk. One hundred three (72 men and 31 women) midlevel executives completed questionnaires and a blood draw during a week long, succession training program within a large international organization. Gender, anger expression, and anger expressed outward were significant predictors for levels of high-density lipids, low-density lipids/very low-density lipids, and triglycerides, and cardiovascular risk ratios. Results replicate and extend previous research. Anger held inward and anger control were significant for men but not women, contrary to earlier gender-specific findings.

Effects of intraperitoneal lipopolysaccharide on Morris maze performance in year-old and 2-month-old female C57BL/6J mice.

Several studies have shown that systemic lipopolysaccharide (LPS) or interleukin-1beta (IL-1beta) may affect performance in various learning tasks, including the Morris water maze. In the current study, female C57BL/6J mice, either 2 months or 1 year of age, were given 5 days of testing followed by 3 days of rest, and then three additional days of testing. Mice either received a single LPS injection on day 1 and saline on days 2-5, LPS injections on days 1-5, or saline injections on days 1-5. Daily LPS administration significantly prolonged latency for the animals to find the platform, and decreased their swimming speed. Year-old mice treated with LPS each day also exhibited significantly higher levels of thigmotaxis in the maze. Despite effects on latency and swim speed, no effect of LPS treatment was observed for distance traveled to the platform or other measures that clearly indicate disruption of learning in the maze. On the other hand, age was a significant factor affecting both latency and distance, with older animals swimming greater distances to find the platform. Additionally, older animals were more adversely affected by daily LPS treatment. In this study, although LPS-induced performance impairments in the Morris water maze were noted, particularly in older animals, these effects were not clearly indicative of learning impairment per se.