Exploring adversity and the potential for growth among elite female athletes

ObjectivesThe purposes of this study were to (a) explore experiences of adversity and (b) to examine perceptions of growth following adversity among elite female athletes.MethodsSemi-structured interviews were conducted with five elite female athletes (ages 18–23 years) who competed internationally in track and field, swimming, long-distance running, and basketball. Interviews were analyzed using an interpretative phenomenological approach (Smith, Flowers, & Larkin, 2009).ResultsIncidents of performance slumps, coach conflicts, bullying, eating disorders, sexual abuse, and injuries were reported. The shared ‘essential’ features of participants’ experiences of adversity were isolation/withdrawal, emotional disruption, questioning identity as an athlete, and understanding experiences within a context of perceived expectations. It appeared that as participants sought and found meaning in their experiences, they identified opportunities for growth associated with social support and also as they realized the role of sport in their lives. Aspects of growth include realizing strength, gaining perspective of their problems, and gaining a desire to help others. Athletes’ experiences with adversity were seen as part of an ongoing journey through elite sport.ConclusionsAthletes’ experiences of adversity may have initiated a process of questioning their identities and searching for meaning in their experiences. Findings highlighted the complexity associated with social support and athletes’ growth following adversity. Growth following adversity appears to be a valuable area of research among elite athletes.     

Gunther von Hagens' BODY WORLDS: Selling Beautiful Education

In the BODY WORLDS exhibitions currently touring the United States, Gunther von Hagens displays human cadavers preserved through plastination. Whole bodies are playfully posed and exposed to educate the public. However, the educational aims are ambiguous, and some aspects of the exhibit violate human dignity. In particular, the signature cards attached to the whole-body plastinates that bear the title, the signature of Gunther von Hagens, and the date of creation mark the plastinates as artwork and von Hagens as the artist in a gesture that strips the personal dignity from the donors. I conclude that the educational use of cadavers is compatible with respect for dignity if: 1) the utility of such use is great enough; 2) there are no other ways of achieving these ends; and 3) every effort is made to honor the dignity of the donors.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Repeated retrieval practice and item difficulty: Does criterion learning eliminate item difficulty effects?

A wealth of previous research has established that retrieval practice promotes memory, particularly when retrieval is successful. Although successful retrieval promotes memory, it remains unclear whether successful retrieval promotes memory equally well for items of varying difficulty. Will easy items still outperform difficult items on a final test if all items have been correctly recalled equal numbers of times during practice? In two experiments, normatively difficult and easy Lithuanian–English word pairs were learned via test–restudy practice until each item had been correctly recalled a preassigned number of times (from 1 to 11 correct recalls). Despite equating the numbers of successful recalls during practice, performance on a delayed final cued-recall test was lower for difficult than for easy items. Experiment 2 was designed to diagnose whether the disadvantage for difficult items was due to deficits in cue memory, target memory, and/or associative memory. The results revealed a disadvantage for the difficult versus the easy items only on the associative recognition test, with no differences on cue recognition, and even an advantage on target recognition. Although successful retrieval enhanced memory for both difficult and easy items, equating retrieval success during practice did not eliminate normative item difficulty differences.     

Training Addiction Counselors to Implement an Evidence-Based Intervention: Strategies for Increasing Organizational and Provider Acceptance

One barrier to widespread public access to empirically supported treatments (ESTs) is the limited availability and high cost of professionals trained to deliver them. Our earlier work from 2 clinical trials demonstrated that front-line addiction counselors could be trained to deliver a manualized, group-based cognitive behavioral therapy (GCBT) for depression, a prototypic example of an EST, with a high level of adherence and competence. This follow-up article provides specific recommendations for the selection and initial training of counselors, and for the structure and process of their ongoing clinical supervision. We highlight unique challenges in working with counselors unaccustomed to traditional clinical supervision. The recommendations are based on comprehensive feedback derived from clinician notes taken throughout the clinical trials, a focus group with counselors conducted 1 year following implementation, and interviews with key organization executives and administrators.     

EPISTEMOLOGICAL ORIGINS–EPISTEMOLOGICAL AIMS: RETHINKING POSTMODERN THERAPY IN RESPONSE TO HELD

There has been a great deal of controversy over Barbara Held's use of the term "antirealism" in her now popular critique of postmodern therapy. Many of her respondents have rejected this label, claiming that it restricts the debate and oversimplifies their position. Recognizing that this is so, I nevertheless accept Held's term as a useful signifier of the epistemological framework of postmodern therapy, and, thus, challenge her critique on its own grounds. I argue that Held's critique of this epistemological approach, in fact, misses the epistemological point, targeting ontological issues where there are none, and misinterpreting the original aim behind the shift to epistemological antirealism. It is Held's contention that the antirealist turn aimed at "maximizing individuality" in therapy - a goal which can and should be achieved through realism. Her justification for the latter is a supposed "oscillation" between realism and antirealism in the theory of this movement. To the contrary, l suggest that the aim of this epistemological shift was the resolution of strictly epistemological problems, and that the oscillation that Held identifies is the product of her own conflation of epistemological and ontological issues.     

Deliberate Self-Harm and State Dissociation: An Experimental Investigation

The purpose of this study was to test the relation between deliberate self-harm (DSH) and state dissociation. Participants (N = 85) were randomly assigned to self-administer either a very mild electric shock below their pain threshold (a no-self-harm control condition) or an electric shock they were told could “cause minor tissue damage that would heal quickly,” but which was in fact equal to a predetermined pain threshold (a DSH condition). After task completion, 42 participants rated the extent of their dissociation before the shock and 43 rated the extent of their dissociation after the shock. Results indicated that women in the DSH group experienced more dissociation compared to men, but only after the shock. Potential reasons for this gender effect are discussed.     

Effects of religious stigma and harm on perceived psychopathology

Prior research suggests that assessment of the pathology of religious beliefs is influenced by conventionality and harm, with less conventional and more harmful beliefs resulting in higher pathology ratings. This study, involving 313 participants, investigated levels of pathology assigned to religious beliefs when the beliefs were either helpful or less severely harmful than those used in prior research, and when the associated religion was either stigmatised (Islam) or non-stigmatised (Christianity). Results indicate that an attenuated form of harm results in elevated pathology ratings. Furthermore, religious stigma impacts these perceptions when beliefs are harmful but not when beliefs are helpful. Ratings in the harm condition were higher for Christianity than for Islam, suggesting that perceived pathology of religious beliefs may depend less on general stigma assumptions and more on perceived consistency between harmful beliefs and assumed religious schemata.     

Positive and negative affect,depression, and cognitive processes in the Cognition in the Study of Tamoxifen and Raloxifene (Co-STAR) Trial

ABSTRACT

Objectives: This study examined the relationship between positive and negative affect, depressive symptoms, and cognitive performance. Methods: The sample consisted of 1479 non-demented, postmenopausal women (mean age = 67 years) at increased risk of breast cancer enrolled in the National Surgical Adjuvant Breast and Bowel Project’s Study of Tamoxifen and Raloxifene. At each annual visit, women completed a standardized neuropsychological battery and self-report measures of affect and depression. Data from three visits were used in linear mixed models for repeated measures using likelihood ratio tests. Separate analyses were performed to relate positive/negative affect and depression to each cognitive measure. Results: Higher positive affect was associated with better letter fluency (p = .006) and category fluency (p < .0001). Higher negative affect was associated with worse global cognitive function (p < .0001), verbal memory (CVLT List B; p = .002), and spatial ability (p < .0001). Depressive symptoms were negatively associated with verbal knowledge (p = .004), figural memory (p < .0001), and verbal memory (p’s ≤ .0001). Discussion: Findings are consistent with some prior research demonstrating a link between positive affect and increased verbal fluency and between depressive symptoms and decreased memory. The most novel finding shows that negative affect is related to decreased global cognition and visuospatial ability. Overall, this research in a large, longitudinal sample supports the notion that positive affect is related to increases and negative affect to decreases in performance on distinct cognitive measures.     

The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

Introduction

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

Methods

We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.

Results

1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).

Conclusions

Moral intuitions shed light on variation in physician judgments about cost issues in health care.