Changing behaviour 'more or less'-do theories of behaviour inform strategies for implementation and de-implementation? A critical interpretive synthesis

BACKGROUND: Implementing evidence-based care requires healthcare practitioners to do less of some things (de-implementation) and more of others (implementation). Variations in effectiveness of behaviour change interventions may result from failure to consider a distinction between approaches by which behaviour increases and decreases in frequency. The distinction is not well represented in methods for designing interventions. This review aimed to identify whether there is a theoretical rationale to support this distinction. METHODS: Using Critical Interpretative Synthesis, this conceptual review included papers from a broad range of fields (biology, psychology, education, business) likely to report approaches for increasing or decreasing behaviour. Articles were identified from databases using search terms related to theory and behaviour change. Articles reporting changes in frequency of behaviour and explicit use of theory were included. Data extracted were direction of behaviour change, how theory was operationalised, and theory-based recommendations for behaviour change. Analyses of extracted data were conducted iteratively and involved inductive coding and critical exploration of ideas and purposive sampling of additional papers to explore theoretical concepts in greater detail. RESULTS: Critical analysis of 66 papers and their theoretical sources identified three key findings: (1) 9 of the 15 behavioural theories identified do not distinguish between implementation and de-implementation (5 theories were applied to only implementation or de-implementation, not both); (2) a common strategy for decreasing frequency was substituting one behaviour with another. No theoretical basis for this strategy was articulated, nor were methods proposed for selecting appropriate substitute behaviours; (3) Operant Learning Theory makes an explicit distinction between techniques for increasing and decreasing frequency. DISCUSSION: Behavioural theories provide little insight into the distinction between implementation and de-implementation. Operant Learning Theory identified different strategies for implementation and de-implementation, but these strategies may not be acceptable in health systems. Additionally, if behaviour substitution is an approach for de-implementation, further investigation may inform methods or rationale for selecting the substitute behaviour

Eating disorders in sport : current status and future directions in the study of the psychological factors

Este trabalho procura atingir dois objetivos. Em primeiro lugar, apresenta-se a situação atual da investigação sobre desordens alimentares no desporto. Neste caso, salientam-se as linhas de investigação dedicadas ao estudo da prevalência destes problemas no desporto e analisam-se as diferenças entre atletas e modalidades desportivas. Dadas as dificuldades destas linhas de investigação na compreensão dos comportamentos alimentares de risco nos atletas, são avançadas outras possibilidades de desenvolvimento da investigação. Assim, e enquanto segundo objetivo deste artigo, salientamos a necessidade dos estudos se dirigirem para a compreensão dos fatores psicológicos associados aos comportamentos alimentares de risco e implicados no desenvolvimento das desordens alimentares. Esta abordagem tem como vantagem adicional ajudar a prevenir estes problemas através da promoção das competências mentais dos atletas no sentido de resistirem melhor aos possíveis efeitos nocivos da prática desportiva, onde se inserem os problemas com a alimentação.This paper focuses on two main goals. In first place, we present the current status on the research about eating disorders in sport contexts. In this case, we point out studies dedicated to the analysis of the incidence of eating disorders in sport and studies that observe the differences between athletes and different sports in the tendency for these problems. Second, we proposed new research directions on this subject, namely the need of analysing the psychological factors that are related with the development of eating disorders on athletes. This research approach has the advantage of helping the prevention of eating disorders on athletes through the promotion of psychological skills that protect athletes from the negative effects of sport practicing, where are included maladaptive eating behaviors.(undefined

Positive conceptions of perfectionism: Approaches, evidence, challenges.

Almost 30 years ago, Hamachek (1978) suggested that 2 forms of perfectionism be distinguished, a positive form labeled "normal perfectionism" and a negative form labeled "neurotic perfectionism." Focusing on the positive, we present an overview of the different empirical conceptions of the 2 forms of perfectionism and a common framework for the 2 basic approaches: the dimensional approach differentiating 2 dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns) and the group-based approach differentiating 2 groups of perfectionists (healthy perfectionists and unhealthy perfectionists). Moreover, we review the evidence demonstrating that (a) perfectionistic strivings are associated with positive characteristics and (b) healthy perfectionists show higher levels of positive characteristics compared to unhealthy perfectionists and nonperfectionists. Although questions on core facets, positive effects, and developmental antecedents of positive forms of perfectionism remain, our findings suggest that self-oriented perfectionistic strivings are positive, if perfectionists are not overly concerned about mistakes and negative evaluations by others

Positive conceptions of perfectionism: Approaches, evidence, challenges.

Almost 30 years ago, Hamachek (1978) suggested that 2 forms of perfectionism be distinguished, a positive form labeled "normal perfectionism" and a negative form labeled "neurotic perfectionism." Focusing on the positive, we present an overview of the different empirical conceptions of the 2 forms of perfectionism and a common framework for the 2 basic approaches: the dimensional approach differentiating 2 dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns) and the group-based approach differentiating 2 groups of perfectionists (healthy perfectionists and unhealthy perfectionists). Moreover, we review the evidence demonstrating that (a) perfectionistic strivings are associated with positive characteristics and (b) healthy perfectionists show higher levels of positive characteristics compared to unhealthy perfectionists and nonperfectionists. Although questions on core facets, positive effects, and developmental antecedents of positive forms of perfectionism remain, our findings suggest that self-oriented perfectionistic strivings are positive, if perfectionists are not overly concerned about mistakes and negative evaluations by others