Psychological predictors for depression and burnout among german junior elite athletes

There exists a strong need for research in clinical sport psychology which does not merely gather information on prevalence rates for psychological disorders and case studies of affected athletes. Rather, research should also uncover the underlying psychological variables which increase the risk for depression and burnout in elite athletes. Many studies gather general factors (e.g., gender, injury, sport discipline) and stay on a more descriptive level. Both constructs (burnout and depression) are based on a temporal, stress-related process model assuming the development of either syndrome results from unfavorable personal (e.g., dysfunctional attitudes, perfectionism, negative coping strategies) or environmental (e.g., cohesion) factors coexisting with severe stressors (i.e., chronic stress). Integrating this knowledge, we propose a shared model for depression and burnout in athletes: a sport specific diathesis-stress model. The present longitudinal study assesses data throughout one sporting season to analyze predictors for both constructs in junior elite athletes. Hierarchical multiple linear regression analyses resulted in six predictors for best model fit. The following factors demonstrated a significant impact on predicting (a) burnout or (b) depression scores at the end of the season: dysfunctional attitudes (a and b), coping strategies (a and b), perfectionism (a), recovery (b), stress (a) and the level of depression at onset (b). Variables such as cohesion or attributional style did not significantly predict depression or burnout. The study supports the structure of a process model (diathesis-stress model) for burnout and depression with the assumption of temporal progression. With some vulnerabilities and their temporal, developmental link identified, prevention can become athlete-specific, effective and economical

Plot of the alpha amplitudes at each electrode before, during and after contractions.

<p>A) For the left hand-block. B) For the right hand-block. Accompanying difference maps indicate the distribution of amplitude changes on the scalp when subtracting the baseline before contractions from the phases during and after contractions.</p

Spectral plot of the last second after contractions (black), first second after contractions (red), and their difference (gray).

<p>A) For the left hand-block. B) For the right hand-block. The gray rectangle highlights the upper alpha band. Accompanying difference maps illustrate the difference over the scalp when subtracting the last second of contractions, from the first second after contractions.</p

'Well-being paradox’ revisited: a cross-sectional study of quality of life in over 4000 adults with congenital heart disease

Objective The present cross-sectional study investigated quality of life (QOL) in a large cohort of German adults with congenital heart disease (ACHDs) in association with patient-related and clinical variables. Design Cross-sectional survey. Participants Between 2016 and 2019, a representative sample of 4014 adults with various forms of congenital heart defect (CHD) was retrospectively analysed. Inclusion criteria were confirmed diagnosis of CHD; participant aged 18 years and older; and necessary physical, cognitive and language capabilities to complete self-report questionnaires. Primary and secondary outcome measures QOL was assessed using the 5-level EQ-5D version (EQ-5D-5L). Sociodemographic and medical information was obtained by a self-devised questionnaire. Associations of QOL with patient-reported clinical and sociodemographic variables were quantified using multiple regression analysis and multiple ordinal logit models. Results Overall, ACHDs (41.8±17.2 years, 46.5% female) reported a good QOL comparable to German population norms. The most frequently reported complaints occurred in the dimensions pain/discomfort (mean: 16.3, SD: p<0.001) and anxiety/depression (mean: 14.3, p<0.001). QOL differed significantly within ACHD subgroups, with patients affected by pretricuspid shunt lesions indicating the most significant impairments (p<0.001). Older age, female sex, medication intake and the presence of comorbidities were associated with significant reductions in QOL (p<0.001). CHD severity was positively associated with QOL within the dimensions of self-care (OR 0.148, 95%CI 0.04 to 0.58) and mobility (OR 0.384, 95%CI 0.19 to 0.76). Conclusion Current findings temper widely held assumptions among clinicians and confirm that ACHDs experience a generally good QOL. However, specific subgroups may require additional support to cope with disease-related challenges. The negative correlation of QOL with age is especially alarming as the population of ACHDs is expected to grow older in the future. Trial registration number DRKS00017699; Results

An exploratory study of extreme sport athlete's nature interactions: from well-being to pro-environmental behavior

Traditionally, perceptions about extreme sport athletes being disconnected from nature and a risk-taking population have permeated the research literature. Drawing upon theoretical perspectives from environmental, sport, organizational and positive psychology, this qualitative study attempts to explore the lived experiences of four male and four female extreme sport athletes. The purpose of this study was to gain insight and understanding into the individuals’ attitudes toward the benefits of extreme sport activities for well-being, resilience and pro-environmental behavior. Eight participants (Mean age = 40.5 years; SD = 12.9) provided written informed consent to partake in semi-structured interviews. Each athlete provided written consented to allow the publication of their identifiable data and in order to facilitate sharing of their autobiographical account of their experiences. After conducting thematic analysis, meta-themes that emerged from the analyses were as follows: (a) early childhood experiences, (b) the challenge of the outdoors, (c) their emotional response to nature, (d) nature for coping, (e) restorative spaces, and (f) environmental concern. The findings convey great commonalities across the participants with regard to their mindset, their emotional well-being as well as their connectivity with nature and attitudes toward the natural environment. The cognitive-affective-social-behavioral linkage of the benefits of extreme sport participation for well-being, psychological recovery and proenvironmental behavior are highlighted. This study examining the lived experiences of extreme sportspeople provides a novel contribution to our contemporary understanding of extreme athletes’ relationship to nature and its commensurate impact upon well-being and pro-environmental attitudes. The findings suggest that extreme sport participation, while inherently risky has psychological benefits ranging from evoking positive emotions, developing resilience and life coping skills to cultivating strong affinity to and connection with nature and the natural environment

Editorial: human-nature interactions: perspectives on conceptual and methodological issues

Background: Three large trials of fluoxetine for stroke recovery (FOCUS (fluoxetine or control under supervision), AFFINITY (the Assessment oF FluoxetINe In sTroke recovery) and EFFECTS (Efficacy oF Fluoxetine—a randomisEd Controlled Trial in Stroke)) have been collaboratively designed with the same basic protocol to facilitate an individual patient data analysis (IPDM). The statistical analysis plan for the three individual trials has already been reported in Trials, including a brief description of the IPDM. In this protocol, we describe in detail how we will perform the IPDM. Methods/design: Data from EFFECTS and AFFINITY will be transferred securely to the FOCUS statistician, who will perform a one-stage IPDM and a two-stage IPDM. For the one-stage IPDM, data will be combined into a single data set and the same analyses performed as described for the individual trials. For the two-stage IPDM, the results for the three individual trials will be combined using fixed effects meta-analyses. The primary and secondary outcome domains for the IPDM are the same as for individual trials. We will also perform analyses according to several subgroups including country of recruitment, ethnicity and trial. We will also explore the effects of fluoxetine on our primary and secondary outcomes in subgroups defined by combinations of characteristics. We also describe additional research questions that will be addressed using the combined data set, and published subsequently, including predictors of important post-stroke problems such as seizures, low mood and bone fracture

Quality of life in patients with Marfan syndrome: a cross-sectional study of 102 adult patients

Background: Marfan syndrome (MFS) is a genetically determined multiorgan disease that leads to severe physiological and psychological impairments in adult life. Little consensus exists regarding quality of life (QOL) in individuals with MFS. The present study sought to investigate QOL in a representative cohort of adults with MFS. Methods: Patient-reported outcome measures from a representative sample of 102 adults with MFS (39.3±13.1 years of age; 40.2% female) were retrospectively analyzed and compared with those from adults with different congenital heart defects (CHD), at the German Heart Center Munich. QOL was assessed using the updated five-level version of the EQ-5D. Results: Differences between both populations were analyzed. Subjects affected by MFS reported an overall reduced QOL. Compared to CHD patients, individuals with MFS scored significantly lower in the dimensions of pain/discomfort, anxiety/depression, mobility and usual activities (P<0.05). Conclusions: Patients with MFS are at high risk for impaired QOL, especially in mental and physical domains. Psychosocial consequences of MFS cost resources for both, patients and professionals. Current findings highlight the great importance of additional psychological support to cope with disease-related challenges. Increased attention should be directed towards enhancing their subjective wellbeing to potentially improve their QOL and long-term health outcomes

Lessons from the short- and mid-term outcome of medical rehabilitation in adults with congenital heart disease

Background: The number of adults with congenital heart disease (ACHD) is steadily increasing. Over their life-time, many of the affected patients require medical rehabilitation after interventional or surgical treatment of residua, sequels or complications of their congenital heart defect (CHD). However, up to now only scarce data exist about indication, performance and outcomes of cardiac rehabilitation in ACHD. Methods: The course and outcome of rehabilitation after previous interventional or surgical treatment in ACHD was analyzed in a retrospective cohort study