A qualitative analysis of Swedish sport psychology practitioners' experience of a continued professional development program.

Although sport psychology practitioners and researchers acknowledge the importance of continued professional development (CPD) for professional effectiveness and excellence, few studies have explored the influence of CPD activities on the practitioners' practice and thinking. This study examined qualified Swedish sport psychology practitioners' experiences of engaging in a CPD program and how it impacted their professional development. The Swedish Sports Confederation offers a CPD program that targets performance enhancement services and psychotherapy for sport psychology practitioners. We explored the influence of this CPD program on the professional development of 13 graduates (five females; age in years: M = 41.2, SD = 8.3) via semi-structured interviews. Our stance involved a realist ontology and constructionist epistemology. We followed the six-step Reflexive Thematic Analysis procedures to analyze data. We identified four themes of CPD: (1) Critique (participants decided to do the CPD program because of perceived gaps in their knowledge and skills), (2) Change (participants discussed several changes as a result of the CPD program), (3) Context (participants discussed the aspects of the CPD program that promoted change), and (4) Challenge (participants mentioned issues related to having completed the program). The study provides insights into the value of CPD activities for sport psychology practitioners, advances current knowledge on practitioner maturation, and illustrates how CPD fits within a practitioner's lifelong learning. Future research could investigate the professional development of mid-career sport psychology practitioners engaging in other CPD programs to confirm or extend this work.

Body Image in Athletes and Nonathletes With Low Back Pain: Avoidance-Endurance-Related Subgroups and Sports Status Play a Role.

CONTEXT: Low back pain (LBP) is a serious health problem, both in the general population as well as in athletes. Research has shown that psychosocial aspects, such as dysfunctional pain responses, play a significant role in the chronification of LBP. Recent research supports the relevance of the multidisciplinary concept of body image in the interpretation of LBP. OBJECTIVE: To examine the differences in 2 psychosocial aspects, body image and pain responses, between athletes and nonathletes with LBP. DESIGN: Cross-sectional design. SETTING: The questionnaires were distributed in the course of LBP treatment. PARTICIPANTS: Data from 163 athletes (mean age = 28.69 [9.6] y) and 75 nonathletes (mean age = 39.34 [12.63] y) were collected. INTERVENTIONS: Data were collected by questionnaires assessing body image, pain behavior, training activity, and LBP. MAIN OUTCOME MEASURES: To examine group differences between athletes and nonathletes regarding body image and pain behavior, the authors performed 2-way analyses of variance with Bonferroni post hoc tests. RESULTS: The results showed (1) a significant main effect regarding pain responses and body image, showing that participants with eustress endurance or adaptive pain behavior revealed a more positive body image in both groups compared with participants with distress endurance or fear-avoidance behavior, and (2) a significant main effect for the factor group in the body image dimension of physical efficacy, indicating a more positive body image for athletes. CONCLUSION: These results suggest that considering multiple risk factors for LBP, such as body image and dysfunctional pain behavior, as well as subgrouping, might be valuable for research and for broadening therapy options.

Examining the Presence of Back Pain in Competitive Athletes: A Focus on Stress and Recovery.

CONTEXT: Explanatory approaches for back pain (BP) in athletes focus on biomechanical factors while neglecting psychological perspectives. Psychological factors have gained importance in the prediction of injuries in athletes and BP in the general population, with stress and recovery emerging as central risk factors. However, scarce evidence exists regarding the role of these aspects for the prevalent burden of BP. OBJECTIVE: To investigate the association between stress and recovery parameters and the presence of BP. DESIGN: Cross-sectional design. SETTING: The questionnaires were distributed after the training sessions. PARTICIPANTS: A total of 345 competitive athletes (mean age = 18.31 y [SD = 5.40]) were investigated. The classification of the athletes' competitive status was based on performance level. INTERVENTIONS: Data were collected using questionnaires for the assessment of stress, recovery, and BP. MAIN OUTCOME MEASURES: The authors performed a multiple logistic regression to obtain odds ratios for stress and recovery parameters with regard to the outcome variable BP status. RESULTS: For stress, the dimension "overall stress" (odds ratio = 1.83; 95% confidence interval, 1.30-2.59; P = .001) and the scale "physical complaints" (odds ratio = 1.68; 95% confidence interval, 1.25-2.25; P = .001) of the general version of the Recovery-Stress Questionnaire resulted to be significantly associated with BP. None of the recovery-related scales displayed a statistically significant relationship with BP. CONCLUSION: The outcomes of this study imply a modest association between stress and the presence of BP in competitive athletes. Practitioners may take these findings into account regarding the conception of training and for monitoring purposes.

Body image is more negative in patients with chronic low back pain than in patients with subacute low back pain and healthy controls.

Background and aims Body image as an increasing research field has been integrated into pain research within the last years. However, research on cognitive-affective dimensions of body image dependent on different pain groups like acute/subacute and chronic pain patients, and healthy controls is still lacking. Therefore, this study aims to explore three dimensions of body image, namely self-acceptance, physical efficacy, and health in patients with low back pain and healthy controls. The present study is the first to distinguish between patients with low back pain in different stages of pain with regard to the concept of body image. In a second step we investigated the differences in exercise frequency between the three groups. Methods Seventy seven patients (53.2% female) suffering from low back pain and 57 healthy controls (42.1% female) filled in a battery of questionnaires in terms of body image, pain parameters and exercise frequency. Results Main results indicate first that patients suffering from chronic low back pain revealed a more negative body image in all three body image-dimensions than healthy controls. Second, patients suffering from subacute pain revealed a more negative body image of physical efficacy compared to the healthy controls. Conclusions Our results suggest that body image is relevant for the treatment of low back pain, because patients suffering from low back pain revealed a more negative body image than healthy controls. Implications To investigate the cognitive-affective dimensions of body image in different patient groups suffering from low back pain seems to be an important aspect for future research to improve therapy options and prevention of low back pain. Future research should also focus on improvements or on positive aspects of body image in patients with low back pain.

Stress and risk for depression in competitive athletes suffering from back pain - Do age and gender matter?

Back pain (BP), a prominent problem for competitive athletes, is a primary reason for limitations in athletic performance and daily life restrictions. As studies on the relationship between psychological variables and BP in athletes are scarce, the aim of this study was to investigate stress and depression in competitive athletes with BP. In a cross-sectional design, data of 154 competitive athletes (51% female; Mage = 18.81 years, SDage = 5.05 years) were collected, assessing Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being and the two BP parameters BP Intensity and Disability. Two multiple linear regressions were conducted to predict (1) BP Intensity and (2) Disability from Performance stress, Socio-emotional stress, Risk for depression and Psychological well-being. Multiple linear regressions demonstrated that Performance stress (ß = .21, p = .01) was the only significant predictor of BP Intensity (F1,142 = 6.68, p = .01, R2 = .05), whilst Risk for depression (ß = .24, p = .01) was the only significant predictor of Disability (F1,142 = 8.46, p = .01, R2 = .06). Neither gender nor age explained a significant amount of variance in the models. Study results showed that, as in the general population, the variables stress and depression are related to BP in competitive athletes. In particular, BP intensity was found to be associated with stress and BP-related disability was associated with depression, whereas age and gender showed no association with the BP parameters. A longitudinal investigation is warranted to determine the direction of the observed relationships.

Recovery-stress patterns and low back pain: Differences in pain intensity and disability.

BACKGROUND: Recovery describes a restoring process influencing the health conditions of individuals but a potential link to low back pain (LBP) has not been scrutinized so far. Psychological strategies to deal with LBP have been considered within the biopsychosocial approach but substantial evidence regarding specific psychological underpinnings remains elusive. The current study aimed to compare individuals with different recovery-stress patterns (i.e. specific combinations of recovery/stress) regarding their pain and disability in the lower back. METHODS: Cross-sectional data from 265 physically active individuals with non-specific LBP were collected via standardized questionnaires. The participants engaged in prescribed exercise therapy provided by a healthcare professional owing to their back burden. A k-means cluster analysis identified three clusters. RESULTS: Cluster 1 entailed individuals with high recovery and low stress values, Cluster 2 represented participants with medium scores on both dimensions and Cluster 3 included participants with low recovery and high stress values. The statistical analyses for pain intensity using analyses of covariance indicated significantly higher values for Cluster 3 compared with Clusters 1 and 2 for worst pain intensity (p < 0.001 and p = 0.003, respectively) and mean pain intensity (p < 0.001 and p = 0.001, respectively). The disability comparisons using non-parametric tests showed significantly higher LBP-related disability in Cluster 3 than Cluster 1 on two disability measures. CONCLUSIONS: The findings indicate an association between detrimental recovery-stress patterns and LBP. Examining the role of recovery has innovative practical relevance for LBP prevention and rehabilitation through the implementation of approaches to enhance recovery in relevant programmes.