A systematic review of psychoneuroimmunology-based interventions

Psychoneuroimmunology-based interventions are used to attenuated disease progression and/or side effects of pharmacological treatment. This systematic review evaluates the different therapeutic and/or clinical psychoneuroimmunology-based interventions associated to both psychological, neuroendocrine and immunological variables. The review was conducted for all English, Portuguese and Spanish language articles published between 2005 and 2015. Independent investigators analyzed 42 studies concerning human psychoneuroimmunology-based interventions. Decreased levels of cortisol, epinephrine and norepinephrine (stress-related hormones) were associated to interventions like yoga, meditation, tai chi, acupuncture, mindfulness, religious/spiritual practices, cognitive behavior therapy, coping and physical exercises. Moreover, those interventions were also associated to reductions in inflammatory processes and levels of pro-inflammatory cytokines in cancer, HIV, depression, anxiety, wound healing, sleep disorder, cardiovascular diseases and fibromyalgia. Despite the associations between PNI variables and clinical/therapeutic interventions, only one study evidenced significant effects on a disease progression.     

Life quality and rehabilitation after a road traffic crash: A literature review

Road traffic injuries continue to pose a worldwide threat to health and well-being of people. In European Union, for example, each year more than 25,000 people are killed and 1.4 million people are injured or disabled in road traffic crashes (RTCs). Additionally, families of RTC victims and their lives are affected emotionally, socially, psychologically, and economically. It should be noted that as in the beginning of 1990s, however, the majority of available literature is focused on the pre-RTC factors (e.g., prevention) rather than the post-RTCs (e.g., the rehabilitation of severely injured) period. As a result, disproportionally greater weight is attached on the pre-RTCs internationally whereas little is known about the psycho-social and economic burden of the post-RTCs period. In this paper, a literature review including the years 1990–2013 was conducted on the publications about post-RTCs period to investigate the possible problems that prevents studying the life quality and rehabilitation after RTCs. Trauma, traffic, injury, rehabilitation, and satisfaction (related to the services and process) were used as keywords and Scopus database (www.scopus.com) was used for searching. In the first step, 443 publications were obtained. Among 443 publications, 75 publications were recorded as relevant. In addition, three publications were suggested by co-authors and 37 publications were obtained by a book source suggested by the reviewer. A total number of 114 publications are presented and evaluated under different components or “stages” of the post-RTCs’ period related to rehabilitation as (a) service utilization indicators (e.g., length of care) and service satisfaction indicators (e.g. satisfaction from services), (b) morbidity indicators (e.g., injury patterns), (c) quality of life indicators (e.g., physical and psychological well-being indicators), (d) social network indicators (e.g., type and frequency of informal care provided by family members), and (e) cost indicators (e.g., overall expenditure). The overall evaluation of the publications in literature, possible implications, suggestions, and future directions were discussed.     

Performance slumps in sport: A systematic review

This systematic review explored the under-researched experience of performance slumps in sport with four objectives: (i) review definitions of a performance slump; (ii) identify known causes of a performance slump; (iii) identify the symptoms athletes present when in a performance slump; and (iv) review approaches used to combat a slump in performance. Literature searches into three databases (PsychARTICLES, PsychINFO and SPORTDiscus) resulted in the inclusion of quantitative (n = 14) and qualitative (n = 4) empirical research studies. The findings were thematically analysed and narratively synthesised. Results showed that: (i) definitions of a performance slump vary; (ii) perceived expectations for success and athletes attributing poor performance to something about themselves have been empirically verified as performance slump causes; (iii) during a slump, athletes might display a range of emotional and psychological symptoms and/or adopt skill-focused attention; and (iv) athletes reported several ways of coping with a performance slump, and research has offered succeeding under pressure as a potential route out of a slump. This systematic review highlights the need for an empirical investigation of the performance slump phenomenon. Future studies should be directed towards understanding the prominent symptoms athletes experience during the slump, so that cause, context, competitor and symptomatic dependant intervention strategies can be designed.     

A systematic review of interventions for adults who stutter

PurposeTo examine the effectiveness of (i) face to face interventions (ii) models of service delivery and (iii) psychological treatments combined with speech-focused interventions for adults who stutter.MethodsFive electronic databases and three clinical trial registries were searched. Systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with adults who stutter were included. Pharmaceutical interventions were excluded. Primary outcomes included a measure of stuttering severity. Risk of bias assessment was conducted on included studies and overall quality of the evidence was graded.ResultsFive RCTS, four registered trials and three systematic reviews met inclusion criteria. Intervention approaches included speech restructuring programs (e.g. Camperdown Program) and transcranial direct current stimulation (tDCS). One study investigated cognitive behaviour therapy (CBT) alongside speech restructuring. Overall, studies were classified low risk of bias and good quality. Speech restructuring was included in all but one study (tDCS study) and had the most evidence i.e. supported by the greatest number of RCTs. On average, stuttering frequency was reduced by 50–57 % using speech restructuring approaches. No study reduced stuttering to the same level as community controls who don’t stutter. The study on tDCS reduced stuttering frequency by 22–27 %. Speech restructuring delivered via telehealth was non-inferior to face-to-face intervention. One study reported CBT was an effective adjunct to speech restructuring interventions.ConclusionSpeech restructuring interventions were found to reduce stuttering in adults, however degree and maintenance of fluency varied. The body of evidence surrounding tDCS and psychological interventions is limited. Replication studies should be considered.     

Integrating technology in psychological skills training for performance optimization in elite athletes: A systematic review

ObjectivesThe aim of the current study was to systematically review the literature on the integration of technology in psychological skills training (PST) to optimize elite athletes’ performance.DesignSystematic review.MethodPublished English, Italian, and Russian language articles were identified using electronic databases. Eighteen articles (out of 3753 records) fulfilled the inclusion criteria, and their quality was assessed using the Mixed Method Appraisal Tool (MMAT). Six papers were judged to be excellent and four to be high quality. There were significant methodological inconsistencies across eight studies. An overall score of quality assessment ranged from 20% to 100%.ResultsThe included studies implemented various technologies, in combination with PST, to identify, monitor and/or have an intervention aimed at optimizing elite athletes' performance. The results suggested that the integration covered different meanings, i.e., functional integration, integration between technologies and measures, integration between technology, theoretical framework, and psychological skills training. There was no distinct consistency between the studies with regards to the theory or model used.ConclusionsTechnology and mental training should not be viewed as interchangeable facets of performance enhancement, but rather as complementary ones – where technology integrated in psychological skills training can lead to identify and monitor optimal performance and to implement more effective interventions.     

A systematic review of interventions for anxiety in people with HIV

People with human immunodeficiency virus (HIV) show elevated anxiety levels compared to the general population. Anxiety can predate HIV infection or be triggered by HIV diagnosis and the many stresses that emerge during the course of HIV disease. Many psychological and pharmacological therapies have been shown to treat anxiety in the general population but a systematic understanding of which interventions have been tested in and are effective with HIV-seropositive individuals is needed. This review examines all published intervention studies on anxiety and HIV from 1980 to 2009 covered by the databases MedLine (1980-2009) and PsycINFO (1980-2009) for a definitive account of effectiveness of interventions and an indication of prevalence of HIV-related anxiety and measurement within studies. Standard systematic research methods were used to gather quality published papers on HIV and anxiety, searching published data bases according to quality inclusion criteria. From the search, 492 papers were generated and hand searched resulting in 39 studies meeting adequacy inclusion criteria for analysis. Of these, 30 (76.9%) were implemented in North America (the USA and Canada), with little representation from developing countries. Thirty-three (84.6%) studies recruited only men or mostly men. A total of 50 interventions were investigated by the 39 studies; 13 targeted HIV, symptoms or associated outcomes/conditions, 20 directly targeted anxiety and another 17 indirectly targeted anxiety. Twenty-four (48%) interventions were effective in reducing anxiety (including 11 indirect interventions), 16 (32%) were ineffective and 10 (20%) had an unknown effect on anxiety. Sixty-five percent of interventions directly targeting anxiety were effective. Psychological interventions (especially cognitive behavioural stress management interventions and cognitive behavioural therapy) were generally more effective than pharmacological interventions. Only three studies provided prevalence rates - these ranged from 13% to 80%. Anxiety was measured using 16 different instruments. Our detailed data suggest that interventions are both effective and available, although further research into enhancing efficacy would be valuable. Also, the vast majority of studies were Western-based, no studies looked at children or adolescents and few looked specifically at women. An international effort to harmonise measurement of anxiety is also missing. There is a need to routinely log anxiety in those with HIV infection during the course of their disease, to provide specific data on women, young people and those in diverse geographic areas and incorporate management into care protocols.     

Family-based physical activity interventions and family functioning: A systematic review

Family physical activity (PA) can confer multiple health benefits, yet whether PA interventions affect general family functioning has not been appraised. The purpose of this review was to evaluate studies that have examined the effect of family PA interventions, where child PA was the focus of the intervention, on constructs of family functioning. Literature searches were concluded on January 11, 2022 using seven common databases. Eligible studies were in English, utilized a family PA intervention, and assessed a measure of family functioning as a study outcome. The initial search yielded 8413 hits, which was reduced to 20 independent PA interventions of mixed quality after screening for eligibility criteria. There was mixed evidence for whether family PA interventions affected overall family functioning; however, analyses of subdomains indicated that family cohesion is improved by PA interventions when children are in the early school years (aged 5–12). High-quality studies also showed an impact of family PA interventions on family organization. Targeted interventions at specific family subsystems (e.g., father–son, mother–daughter), characteristics (low-income, clinical populations, girls), and broad multibehavioral interventions may have the most reliable effects. Overall, the findings show that family PA interventions can promote family cohesion and organization, particularly among families with children in the early school years. Higher quality research, employing randomized trial designs and targeting specific intervention and sample characteristics (e.g., different clinical conditions, specific parent–child dyads), is recommended in order to better ascertain the effectiveness of these approaches.     

Drop-out from team sport among adolescents: A systematic review and meta-analysis of prospective studies

During the last decades, an increased drop-out rate in adolescents’ team sport participation is observed. Given the potential adverse consequences of drop-out from team sport more information about risk factors for drop-out is warranted. The objectives of this systematic review were to (1) synthesise the literature on factors associated with future drop-out from team sport among adolescents and (2) investigate the strength of associations between drop-out and related factors with meta-analysis. The databases Academic Search Elite, ERIC, PsycINFO, PubMed and SPORTDiscus were searched for relevant publications from the earliest reported date until October 8, 2021. Articles were included if: (1) data about drop-out was collected; (2) the focus was on adolescents; (3) the context was team sport and (4) studies were of prospective design. We used the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) to assess the risk of bias in included studies. A narrative synthesis was conducted according to the reporting guideline of synthesis without meta-analysis. Studies that presented statistical data necessary for the calculation of Hedge’s g effect sizes were included in the meta-analysis. In total, 16 studies met the inclusion criteria and were included in the narrative synthesis. The meta-analysis included 12 of the studies. Altogether, 6304 adolescent team sport players participated in the selected studies. Of those studies, most had a focus on intrapersonal factors relationship with drop-out. The results showed that constructs related to motivation as well as sport experience had the strongest relationships with drop-out. To prevent drop-out from adolescents’ team sport, organisations and clubs are recommended to focus on developing a high-quality motivation climate that facilitates motivation and enjoyment.     

Physical activity interventions in the school setting: A systematic review

Objectives

To review the effectiveness of school-based interventions with a physical activity component by measuring changes in psychological determinants, physical activity, and health outcomes.

Design

Systematic Review.

Method

We conducted a literature search of school-based controlled studies that involved a physical activity intervention targeting school students. Study design, methodological quality, and effectiveness of interventions on three target levels, ‘health and fitness’ (BMI and motor performance), ‘physical activity’, and ‘psychological determinants’ (knowledge of physical activity effects, self-concept, and attitudes towards physical activity), were analysed. Furthermore, we examined the influence of specific factors (e.g., age and gender) and mediator effects.

Results

The literature search identified 129 studies. The majority of the studies examining motor performance, physical activity, and knowledge of physical activity achieved significant results (69.7%, 56.8% and 87.5%, respectively). Significant effects on self-concept and attitudes were also found but to a smaller extent (in 30% and 43.8% of the studies, respectively). Only a few studies examining BMI (2.7%), physical activity (6.8%), and attitudes towards physical activity (12.5%) revealed negative effects, with better results observed for the control group. Intervention effects were influenced by the students’ age, intervention type, and frequency of the interventions. Self-efficacy was found to mediate the relationship between the program and the students’ physical activity.

Conclusions

Numerous school-based physical activity interventions achieved positive effects on three target levels. Further research is needed to clarify the mediator effects of psychological variables on physical activity and health and to increase our knowledge about the mechanisms that underlie behavioural change.     

The effects of mindfulness interventions on prenatal well-being: A systematic review

Objective: Low well-being during pregnancy can have significant adverse outcomes for mother and child. The effects of mindfulness interventions on prenatal maternal well-being are increasingly examined but outcomes have yet to be systematically evaluated. The aims of the current paper are to systematically evaluate intervention effects and current research approaches with pregnant groups.

Design: A systematic review of eight studies examining mindfulness intervention effects on prenatal well-being.

Results: Findings indicate potential benefits of mindfulness interventions for reducing levels of depression, anxiety and negative affect during pregnancy. There is also evidence for improved self-compassion and perceived childbirth self-efficacy. Further, these effects may be more pronounced for vulnerable groups, such as women currently experiencing low prenatal well-being. Less consistent findings were observed for stress, and positive affect. Variations in research design, gestational characteristics, timing of assessments and outcome measurement may explain some inconsistencies in the extant literature.

Conclusion: Mindfulness interventions present a potentially useful means to improve prenatal well-being but improved methodological quality is essential to rigorously examine intervention effects.     

The impact of sport and physical activity on the well-being of combat veterans: A systematic review

ObjectivesThis review examined the potential impact of sport and physical activity upon the subjective and psychological well-being of combat veterans in the aftermath of physical or psychological combat trauma.DesignA systematic review was conducted. The question guiding this review was ‘what is the impact of sport and physical activity on the well-being of combat veterans?’MethodsKey databases were searched for articles relating to the use of sport and/or physical activity in supporting combat veterans. 11 studies were identified as relevant for inclusion. Data from these studies were extracted by means of a directed content analysis, the results of which were reported in a narrative synthesis.ResultsSport and physical activity enhances subjective well-being in veterans through active coping and doing things again, PTSD symptom reduction, positive affective experience, activity in nature/ecotherapy, and quality of life. Impact on psychological well-being includes determination and inner strength, focus on ability and broadening of horizons, identity and self-concept, activity in nature/ecotherapy, sense of achievement/accomplishment, and social well-being. Participating in sport and/or physical activity can also enhance motivation for living.ConclusionsThe review advances knowledge by producing a synthesis of evidence that highlights the value of sport and physical activity for supporting the well-being and rehabilitation of disabled combat veterans and combat veterans diagnosed with Post-Traumatic Stress Disorder. It also develops knowledge by identifying the type of sports and physical activities used to promote well-being, offering the first definition of combat veterans in the sport literature, taking a critical approach, and highlighting the under researched role of nature-based physical activity.     

Altered stress responses in children exposed to early adversity: a systematic review of salivary cortisol studies

Pathological stress responses are implicated in numerous disorders. Hypothalamic-pituitary-adrenal axis function is influenced by gene-environment interaction, with early-life environmental adversity having long-lasting effects. We examine the evidence that, in humans, these effects are apparent from infancy. We systematically reviewed published findings on cortisol response to a stressor, in 0-5-year-olds already exposed to adversity. Adversity was defined as a negative environmental influence present post-conception. We searched Ovid MEDLINE (1950-May 2010), EMBASE (1980-May 2010) and PsychINFO (1806-May 2010). We included peer-reviewed, English language studies that analysed salivary cortisol before and after a standardised stressor. We identified 30 studies, of which 27 reported a significant effect of adversity on the cortisol response to stress. Six of these demonstrated an effect of prenatal substance exposure. Thirteen studies found that psychosocial adversity increased cortisol reactivity. Three studies reported that cortisol reactivity could be normalised by intervention programmes. The studies were heterogeneous, both in nature of adversity studied and in stressor used, precluding meta-analysis and assessment of publication bias. Our review presents evidence that adversity disrupts the stress response from an early age. Longitudinal studies are required to determine whether effects persist, alter with time, or are reversible with intervention.     

Unemployment as a chronic stressor: A systematic review of cortisol studies

Objective: Unemployment is a type of chronic stressor that impacts human health. The reasons for how the stress of unemployment affect health is still a matter of discussion. One of the pathways from chronic stress to ill health is mediated by cortisol, and so we set out to compile extant data on how its secretion is affected by unemployment.

Design: A systematic literature search was conducted to establish the cortisol dysregulatory effects of this stressor.

Main outcome measures: Only studies that specifically examined the effects of unemployment on cortisol excretion, and were written in English were included.

Results: Ten reports were obtained and synthesised to determine the severity and complexity of the effect of unemployment on cortisol secretion. The resulting combined evidence is mixed in terms of degree or dynamic of relationship.

Conclusions: The differences between the cumulate findings of the studies can be understood in the context of the lack of both standardised methodology and an absence of consensus on unemployment definition. We propose existing methodologies may be strengthened by acknowledging and accounting for the individual characteristics that may be relevant to the stress experience of unemployment.     

Burnout and its relations with basic psychological needs and motivation among athletes: A systematic review and meta-analysis

ObjectivesThe present study is a review on studies about the relationships between the three basic psychological needs/motivational regulations (i.e., amotivation, controlled regulation, extrinsic autonomous regulation, and intrinsic motivation) and burnout.DesignA systematic review and meta-analysis.MethodStudies were identified through five electronic databases and manual search using combinations of three groups of keywords. Three inclusion criteria were then used to screen the searched articles.ResultsEighteen studies met the inclusion criteria and these studies varied considerably in terms of their study characteristics (e.g., characteristics of participants, study designs, and outcome measures). The results also showed that the three basic psychological needs, intrinsic motivation, extrinsic autonomous regulation, and amotivation had small to large effects on predicting global burnout and its three dimensions. However, controlled regulation showed no or weak correlations with the burnout subscales.ConclusionsSelf-determination theory was generally supported in explaining athlete burnout.     

A systematic review and meta‐analysis of tertiary interventions in clinical burnout

Clinical burnout is one of the leading causes of work absenteeism in high‐ and middle‐income countries. There is hence a great need for the identification of effective intervention strategies to increase return‐to‐work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety. Four electronic databases (Ovid MEDLINE, PsychINFO, PubMed and CINAHL Plus) were searched in April 2016 for randomized and non‐randomized controlled trials of tertiary interventions in clinical burnout. Article screening and data extraction were conducted independently by two reviewers. Pooled odds ratios (ORs) and hazard ratios (HRs) were estimated with random‐effects meta‐analyses. Eight articles met the inclusion criteria. There was some evidence of publication bias. Included trials were of variable methodological quality. A significant effect of tertiary interventions compared with treatment as usual or wait‐list controls on time until RTW was found, HR = 4.5, 95% confidence interval (CI) = 2.15–9.45; however, considerable heterogeneity was detected. The effect of tertiary interventions on full RTW was not significant, OR = 1.33, 95% CI = 0.59–2.98. No significant effects on psychological symptoms of exhaustion, depression or anxiety were observed. In conclusion, tertiary interventions for individuals with clinically significant burnout may be effective in facilitating RTW. Successful interventions incorporated advice from labor experts and enabled patients to initiate a workplace dialogue with their employers.     

The use of heart rate variability in esports: A systematic review

Heart rate variability (HRV) is a psychophysiological measure of particular interest in esports due to its potential to monitor player self-regulation. This study aimed to systematically review the utilisation of HRV in esports. Consideration was given to the methodological and theoretical underpinnings of previous works to provide recommendations for future research. The protocol was made available on the Open Science Framework. Inclusion criteria were empirical studies, examining HRV in esports, using esports players, published in English. Exclusion criteria were non-peer-reviewed studies, populations with pre-existing clinical illness other than Internet Gaming Disorder (IGD), opinion pieces or review papers. In November 2022 a search of Web of Science, PubMed, and EBSCOHost identified seven studies using HRV in esports. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Narrative review identified two primary uses of HRV in esports; stress response and IGD. A lack of theoretical and methodological underpinning was identified as a major limitation of current literature. Further investigation is necessary before making recommendations regarding the use of HRV in esports. Future research should employ sound theoretical underpinning such as the use of vagally mediated HRV and the robust application of supporting methodological guidelines when investigating HRV in esports.     

Work engagement interventions can be effective: a systematic review

Work engagement is associated with important individual and organisational outcomes (e.g. employee health and well-being, performance). This narrative systematic review aims to synthesise the increasing number of work engagement interventions and inform future research by exploring: (1) the specific intervention foci, delivery methods and content of engagement interventions; (2) intervention effectiveness; and (3) underlying mediators and moderators. A systematic search for interventions employing a validated engagement measure revealed 40 studies. Five were personal resource building, twelve job resource building, three leadership training, eighteen health promotion, and two job and personal resource building. Twenty (50%) studies observed significant positive effects on work engagement, two (5%) had a negative effect, and eighteen (45%) had no effect. Job and personal resources, job demands and well-being were important mediators. Moderators included the specific intervention focus and delivery method, employee participation, manager support, and intervention level (top-down vs bottom-up). Bottom-up interventions, and job crafting and mindfulness interventions particularly, were most successful. Implementation difficulties were common, including poor response and attrition rates, and adverse factors (e.g. organisational restructuring, redundancy, economic downturn). We highlight implications for research and practice and stress the need to test underlying theories to build knowledge around how, why, and when interventions work.     

A review of behavioral interventions to enhance sports performance

Research on applied behavior analysis and sports performance has become an increasingly popular subject. It involves using behavioral measures to assess the utility of numerous interventions to enhance athletic performance. We identified 101 studies published since the late 1960s focusing on behavioral interventions to enhance sports performance. To determine the breadth of the current research, we identified each sport and the different interventions used to improve performance. Of the studies included in this review, research has investigated 23 interventions with 21 sports. The purpose of this paper is to review the current literature regarding what procedures have been evaluated, the results of this research, some of the limitations, and future directions of behavioral research on sports performance enhancement. In doing so, this review will allow readers to easily browse the current literature by the sport or intervention of interest.