Helping athletes flourish using mindfulness and acceptance approaches: an introduction and mini review

Mindfulness and acceptance are core concepts of the third wave of cognitive and behavioral psychotherapies. Their aim is not to overpower thoughts and emotions by suppression and using control techniques but to change the relationships with them. This article focuses on mindfulness- and acceptance-based approaches in sports. It briefly outlines these approaches and concludes that they are characterized by promoting three processes, which are present-moment attention, metacognitive awareness, and acceptance. Subsequently, the paper describes one approach particularly suitable for sports in detail – Acceptance and Commitment Therapy – with a special focus on how athletes can promote psychological flexibility and thrive in their effort to perform. This paper further addresses the question of whether mindfulness- and acceptance-based approaches are effective in sports by summarizing research from the past five years in the form of a mini-review. Findings from 19 reviewed studies, including 15 controlled or randomized controlled studies, suggest that different athlete populations can benefit from mindfulness- and acceptance-based approaches in terms of athletic performance and well-being. Positive effects on performance and well-being could be mediated by other psychological processes, e.g., enhanced emotion regulation. Further research is needed, especially regarding the mechanisms that impact mindfulness- and acceptance-based interventions in sports

Laparoscopic wedge resection for benign gastric tumors

Background: Both laparoscopic wedge resection and formal laparoscopic resection are used in the treatment of benign and malignant gastric diseases. Methods: We performed totally laparoscopic wedge resection using stapling devices and three or four trocars. Patients: Four patients were treated with this technique. All four suffered from gastrointestinal stromal tumors (GIST), and one presented with an additional gastric adenoma. Two were morbidly obese, and two had additional operations performed at the same time. Two patients were admitted for acute upper GI bleeding. Results: All of the tumors were removed successfully. Operating time ranged from 135 to 215 min. Oral feeding commenced on days 2-4. Postoperative hospital stay ranged from 5 to 11 days. Conclusion: Laparoscopic wedge resection of benign gastric tumors is a safe, reliable method that should be further investigated and used on a broader scal

Mindfulness to Enhance Athletic Performance: Theoretical Considerations and Possible Impact Mechanism

Top athletes face various challenges in their career on and off the sports field. Sport psychologists teach techniques to help athletes to cope with these challenges. Over the last 30 years, the techniques used stem mainly from psychological skills training (PST), which is influenced mainly from cognitive-behavioral theories. Recently, interest in mindfulness-based interventions has increased in sport psychology. This article identifies the limits of PST and presents theoretical considerations how mindfulness-based interventions can amend PST. Further, it addresses in what form and by what mechanisms athletes could benefit. In reviewing current mindfulness literature, we conclude that it is important to distinguish between mindfulness practice and dispositional mindfulness. Mindfulness practice means the methods through which mindfulness is fostered, whereas dispositional mindfulness describes the tendency to be mindful in everyday life. In our conceptualization, we differ between three interwoven facets of mindfulness practice (intention, attention, and attitude), which are associated with six components of dispositional mindfulness. We consider that athletes with a higher degree in mindfulness practice and dispositional mindfulness will enhance the level of several required psychological skills through various impact mechanisms. Based on theoretical considerations, we suggest bare attention, experiential acceptance, values clarifications, self-regulation/negative emotion regulation, clarity about one’s internal life, exposure, flexibility, non-attachment, and rumination as possible impact mechanisms. A greater knowledge of the conceptualization of mindfulness and its impact on psychological skills could develop and improve the effectiveness of mindfulness based interventions in sports

Factors Contributing to Elite Athletes' Mental Health in the Junior-to-Senior Transition: A Mixed Methods Study.

The goals of this study were to examine factors that may affect the mental health of elite athletes during their junior-to-senior transition and to explore the types and frequency of facilitators and challenges athletes encounter during this transition. Using a cross-sectional, embedded QUAN(qual) mixed methods study design, we surveyed two samples for the study goals. All participants completed demographic data (e.g., gender, age, sports). Sample one (N = 394, Mage = 18.46 years, SD = 2.2) consisted of current transitioning athletes which completed questionnaires on stress, anxiety, depression, well-being, self-compassion, and social support. Mediation and moderation analyses revealed that stress leads to resource depletion, and that self-compassion can be an important resource for young athletes to draw upon to maintain their mental health. Regarding social support results were less conclusive. Sample two (N = 371, Mage = 27.70 years, SD = 8.3) consisted of athletes that have passed the transition. They responded to open questions about helpful strategies and challenges faced during their junior-to-senior transition, which were analyzed using thematic content analysis. Results showed that during the junior-to-senior transition, external resources were more frequently mentioned than internal resources when it came to facilitators. Furthermore, external challenges were perceived as hindering more frequently than internal challenges. These findings can guide practitioners by providing potential starting points for improving the mental health of transitioning elite athletes, as well as information on helpful strategies and barriers during the transition

Dispositional Mindfulness and Injury Time Loss in Soccer

Soccer injuries have a low prevalence, albeit prompting detrimental effects for individuals and teams, particularly with prolonged convalescence periods. Age and injury severity appear as the most robust correlates with recovery duration. The role of dispositional mindfulness remains unknown, however, despite considerable evidence that highlights positive effects of mindfulness on injury rehabilitation. This study sought to examine whether dispositional mindfulness explained additional variability in injury time loss in an elite sample of soccer players (N = 207). A series of moderated regression analyses examined whether dispositional mindfulness interacted with either age or injury severity in explaining the length of recovery from an injury. The main findings suggest that dispositional mindfulness was unrelated with length of recovery. In contrast, age and injury severity related robustly with the length of lesion recovery, which was even longer for the older players with very severe injuries. The current findings constitute a novelty in the study of injuries in soccer and open new research lines to determine whether mindfulness interventions are likely to contribute to shorten objective rehabilitation length for a more sustainable approach to sports injury

Effects of Mindfulness Practice on Performance-Relevant Parameters and Performance Outcomes in Sports: A Meta-Analytical Review

Mindfulness as a present-oriented form of mental training affects cognitive processes and is increasingly considered meaningful for sport psychological training approaches. However, few intervention studies have examined the effects of mindfulness practice on physiological and psychological performance surrogates or on performance outcomes in sports.; The aim of the present meta-analytical review was to examine the effects of mindfulness practice or mindfulness-based interventions on physiological and psychological performance surrogates and on performance outcomes in sports in athletes over 15 years of age.; A structured literature search was conducted in six electronic databases (CINAHL, EMBASE, ISI Web of Knowledge, PsycINFO, MEDLINE and SPORTDiscus). The following search terms were used with Boolean conjunction: (mindful* OR meditat* OR yoga) AND (sport* OR train* OR exercis* OR intervent* OR perform* OR capacity OR skill*) AND (health* OR adult* OR athlete*).; Randomized and non-randomized controlled studies that compared mindfulness practice techniques as an intervention with an inactive control or a control that followed another psychological training program in healthy sportive participants were screened for eligibility.; Eligibility and study quality [Physiotherapy Evidence Database (PEDro)] scales were independently assessed by two researchers. A third independent researcher was consulted to achieve final consensus in case of disagreement between both researchers. Standardized mean differences (SMDs) were calculated as weighted Hedges' g and served as the main outcomes in comparing mindfulness practice versus control. Statistical analyses were conducted using a random-effects inverse-variance model.; Nine trials of fair study quality (mean PEDro score 5.4, standard deviation 1.1) with 290 healthy sportive participants (athletics, cyclists, dart throwers, hammer throwers, hockey players, hurdlers, judo fighters, rugby players, middle-distance runners, long-distance runners, shooters, sprinters, volleyball players) were included. Intervention time varied from 4 weeks to over 2 years. The practice frequency lasted from twice daily to just once a week, and the mean session time covered 50-60 min. In favor of mindfulness practice compared with the control condition, large effects with narrow confidence limits and low heterogeneity were found for mindfulness scores [SMD 1.03, 90% confidence interval (CI) 0.67-1.40, p < 0.001, I 2 = 17%]. Physiological performance indices depicted wide confidence limits accompanied with very large heterogeneity. However, the effect sizes remained very large, with confidence limits that did not overlap zero (SMD 3.62, 90% CI 0.03-7.21, p = 0.10, I 2 = 98%). Moderate to large effects were observed for both psychological performance surrogates (SMD 0.72, 90% CI 0.46-0.98, p < 0.001, I 2 = 14%) and performance outcomes in shooting and dart throwing (SMD 1.35, 90% CI 0.61-2.09, p = 0.003, I 2 = 82%).; Mindfulness practice consistently and beneficially modulates mindfulness scores. Furthermore, physiological and psychological surrogates improved to a meaningful extent following mindfulness practice, as well as performance outcomes in shooting and dart throwing. It seems reasonable to consider mindfulness practice strategies as a regular complementary mental skills training approach for athletes, at least in precision sports; however, more high-quality, randomized, controlled trials on mindfulness practice and performance improvements in diverse sport settings are needed

Prevalence of non-functional overreaching and the overtraining syndrome in Swiss elite athletes

Objectives: Fatigue and unaccountable underperformance are common for athletes, but there is a lack of empirical data regarding the prevalence of non-functional overreaching (NFOR) and the overtraining syndrome (OTS). Using the overtraining definition of the European College of Sport Science (ECSS), the present study aimed to explore the prevalence, symptoms and associated factors of NFOR/OTS across Swiss elite athletes in various sports. Method: 139 Swiss elite athletes (63 males and 76 females, Mage = 23.6, SDage = 5.6 y) from 26 different sports completed a1 7-item online survey about underperformance and symptoms of NFOR/OTS. 95% of the sample represented Switzerland in their sport. Athletes were classified as NFOR/ OTS by according to the overtraining definition of the ECSS. Data were analysed using Mann-Whitney U nonparametric tests and ANOVAs. Results: 9% of the athletes were classified as OTS and 21% as NFOR at least once in their career. The prevalence was significantly higher in medium-physical demand sports than in low-physical demand sports (p = .02). There were no significant differences in the NFOR/OTS prevalence between individual and team sports and female and male athletes. Competition level and training load had also no significant influence on the NFOR/OTS prevalence, although low-physical demand sports trained significantly less than medium- and high-physical demand sports. Injury/illness, loss of weight and sleep disturbance rates were significantly higher in the NFOR/OTS group. More than 70% of the NFOR/OTS athletes reported loss of motivation and emotional disturbances. Conclusions: The NFOR/OTS career prevalence rate of Swiss elite athletes can be estimated at approximately 30%. NFOR/ OTS is accompanied by biopsychosocial signs of maladjustment, e.g., emotional disturbances, loss of motivation, sleep disturbances, injury/illness and weight loss, but training load is not a predictor of NFOR/OT