Feasibility,Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design

Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation.Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client’s therapist.Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern.The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.     

Physiological indicators of driver workload during car-following scenarios and takeovers in highly automated driving

This driving simulator study, conducted as a part of Horizon2020-funded L3Pilot project, investigated how different car-following situations affected driver workload, within the context of vehicle automation. Electrocardiogram (ECG) and electrodermal activity (EDA)-based physiological metrics were used as objective indicators of workload, along with self-reported workload ratings. A total of 32 drivers were divided into two equal groups, based on whether they engaged in a non-driving related task (NDRT) during automation (SAE Level 3) or monitored the drive (SAE Level 2). Drivers in both groups were exposed to two counterbalanced experimental drives, lasting ∼ 18 min each, of Short (0.5 s) and Long (1.5 s) Time Headway conditions during automated car-following (ACF), which was followed by a takeover that happened with or without a lead vehicle. Results showed that driver workload due to the NDRT was significantly higher than both monitoring the drive during ACF and manual car-following (MCF). Furthermore, the results indicated that a lead vehicle maintain a shorter THW can significantly increase driver workload during takeover scenarios, potentially affecting driver safety. This warrants further research into understanding safe time headway thresholds to be maintained by automated vehicles, without placing additional cognitive or attentional demands on the driver. Our results indicated that ECG and EDA signals are sensitive to variations in workload, which warrants further investigation on the value of combining these two signals to assess driver workload in real-time, to help future driver monitoring systems respond appropriately to the limitations of the driver, and predict their performance in the driving task, if and when they have to resume manual control of the vehicle after a period of automated driving.     

The interplay of actual and perceived physical fitness in children: Effects on motivation and physical activity

From a sport and exercise psychology perspective, both the actual and perceived physical fitness become important for motivation towards physical activity and persistent physical activity in children no later than middle childhood (Stodden et al., 2008). To date, the effects of actual and perceived physical fitness have been investigated from a variable-centered approach (Jekauc et al., 2017). However, within this approach, the accuracy of the perceived physical fitness remains unconsidered. As actual and perceived physical fitness levels can be divergent, especially in children due to greater egocentricity and hence less comparison processes (Harter, 2006), also the accuracy of perceived physical fitness should be considered.In total, 462 children from 3rd and, approximately nine months later, from 4th grade participated in this study (M_age = 8.79 years). Third-grade students were assessed on their actual physical fitness, perceived physical fitness, and physical activity. In fourth grade, students were asked to fill out questionnaires that assess motivational regulations and physical activity. Polynomial regressions with response surface analyses were conducted to analyze main effects and accuracy effects of actual and perceived physical fitness on motivation and physical activity. Analyses revealed that children with higher actual and perceived physical fitness levels show greater autonomous motivation, higher current physical activity levels and higher physical activity levels nine months later. In addition, children who perceive their physical fitness more accurately show more current physical activity. Results indicate that the interplay between actual and perceived physical fitness does not only have an effect on physical activity but also on autonomous motivation, which is a predictor for long-term physical activity. Therefore, intervention should focus on the promotion of actual and perceived physical fitness. In addition, the ability to accurately assess fitness should be promoted in this age group.     

Reorganization of personal identity in the context of motivational dynamics and internal dialogical activity

Identity is constantly constructed and reconstructed. It may be assumed that there are six fundamental motivational goals according to which it is organized: self‐esteem, self‐efficacy, continuity, distinctiveness, belonging, and meaning (Vignoles, 2011 ). Moreover, identity is shaped by its dialogical nature (Hermans, 2003 ; van Halen & Janssen, 2004 ). The longitudinal study was conducted to examine both the motivational and the dialogical basis of identity structure dynamics. The results showed that the more the identity element was connected with a sense of continuity and the more dialogical it was, the greater the perceived centrality of this element was after two months. Furthermore, the more the identity element satisfied the self‐esteem and belonging motives, the more positive was the affect ascribed to it. In the behavioral domain of identity, participants more strongly manifested those identity aspects that were earlier rated as more dialogical and satisfying the motive of belonging. The results showed that the motivational underpinnings of identity along with its dialogical nature explain changes in identity structure.     

Short report: correlates of functional disability with disease activity in elderly patients with rheumatoid arthritis

Rheumatoid arthritis (RA) prevalence increases with age and old people are special patient population. The recognition of functional disability related to RA could be challenging in elderly patients because aging itself and potential co-morbid disease may also cause functional disability. In this study, we aimed to look at the correlation between disease activity and functional disability in elderly RA patients. Elderly RA patients, ≥65 years old at their routine visits were included in the study. The composite ‘disease activity score’ in 28 joints (DAS-28) was used to determine disease activity groups. Health assessment questionnaire (HAQ) scores were calculated to describe the functional disability and compared across the disease activity groups. Two hundred and fifty-eight RA patients with the mean age of 71 ± 5 (65–90) and a total disease duration of 8.4 ± 8.5 (.5–50) years were recruited. The proportion of patients with high and moderate disease activity was 70%. HAQ scores were significantly correlated with disease activity (p < .05). Functional disability estimated by HAQ was correlated with disease activity in elderly patients with RA     

Stress perçu et santé physique des doctorants dans les universités françaises

Few studies have focused on PhD students in France despite the fact that this population appears to be particularly vulnerable to stress and often faces precariousness. This research investigated associations between socio-demographic factors, health behaviours, perceived stress and physical health in a wide sample of PhD students (n = 1923) in order to have a better understanding of this population's specificities. Our results indicated that stress is a critical issue among PhD candidates. Predictors of perceived stress were: gender, age, satisfaction with supervision, sleep quality and sports practice. Findings from this study confirm the relevance of the transactional model to investigate students’ health issues and suggest that physical activity and stress management should be encouraged through health promotion programs.     

Girls’ Perspectives of Barriers to Outdoor Physical Activity Through Photovoice: A Call for Counselor Advocacy

Physical inactivity and limited time spent in nature are major societal concerns that affect the mental and emotional health of youth in the United States. As such, this study explored girls’ perspectives of barriers to outdoor physical activity using a qualitative participatory action research method called photovoice. Six themes emerged from data representing the girls’ perspectives of barriers to outdoor physical activity through photovoice: Very Busy Schedule, Social Media, Health Concerns, Indoor Activity Instead of Outdoor Activity, Electronic Devices, and Way of Life. Researchers address how counselors can use these findings to advocate on this issue, given that counselors are called to advocate at multiple levels to address barriers that inhibit the growth and development of clients.     

Self-reported stress and psychophysiological reactivity in paramedics

Background: As an important group of health care professionals, paramedics accomplish sophisticated and frequently stressful tasks.

Design: The study investigated self-reported stress burden, self-reported health status, coping strategies, personality traits and psychophysiological reactivity in paramedics.

Methods: 30 paramedics were compared with 30 professionals from other disciplines, in terms of self-reported stress, physical complaints, coping strategies, personality traits and psychophysiological reactivity during aversive visual and acoustic stimuli, and cognitive challenge. Regression analyses were performed for the prediction of stress burden and physical complaints in paramedics according to coping and personality factors.

Results: Paramedics reported lower stress and less somatic complaints, and exhibited reduced electrodermal activity and heart rate responses to experimental stimuli, as well as higher respiratory sinus arrhythmia. They indicated less negative coping strategies, reduced empathy, and higher conscientiousness and sensation seeking. Higher self-reported stress burden and more physical symptoms were associated inter alia with more negative coping strategies, less conscientiousness and lower empathy.

Conclusion: The findings support the notion of reduced self-reported stress burden, and improved general health and stress resistance in paramedics. In addition to health benefits, stress tolerance may contribute to the prevention of performance decline during situations in which health and life are at stake.