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.     

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.     

Changes in students’ goal pursuits and motivational regulations toward healthy behaviors during the pandemic: A Self-Determination Theory perspective

ObjectivesIn this study, we examined how students’ perceptions of teachers and parents’ need-supportive and need-thwarting behaviors, related to their intrinsic and extrinsic goal pursuits, and in turn their motivational regulations toward physical activity in virtual physical education lessons over a semester during the Sars-COV2 pandemic.DesignShort-term longitudinal study.MethodsStudents (M_age = 14.43, SD = 0.99) completed the targeted questionnaires at the beginning (T1, N = 295) and the end (T2, N = 194) of a virtual semester.ResultsThe results of the autoregressive model indicated that all measures were relatively stable from T1 to T2. Neither teachers nor parents’ need-supportive and need-thwarting behaviors at T1 predicted students’ intrinsic goal pursuits at T2, except for teachers’ need-supportive behaviors at T1 negatively marginally predicted students’ extrinsic goal pursuits at T2. The results also showed that intrinsic goal pursuits at T2 positively and negatively related to autonomous motivation and amotivation at T2, respectively. Extrinsic goal at T2 positively related to controlled motivation and amotivation at T2.ConclusionsFindings suggested that teachers need-supportive behaviors are important for decreasing students’ extrinsic goal pursuits, while parents’ need-thwarting behaviors relate to students’ amotivation over time during the lockdown periods. Also, students’ intrinsic goal pursuits would contribute positively to autonomous motivation and negatively to amotivation over time.     

Timing of Stressful Life Events Affects Stability and Change of Neuroticism

Neuroticism is a predictor of many health problems. To study the determinants of within‐subject change in neuroticism, three hypotheses were tested: (i) subjects who experienced stressful life events (SLEs) show an increase in neuroticism; (ii) high baseline neuroticism moderated this effect; and (iii) recent SLEs had a greater impact on neuroticism than distant SLEs. Data came from the Finnish Twin Cohort. Neuroticism data were collected in 1975 and 1981 and SLEs data in 1981 (n = 21 085). By entering baseline neuroticism as a predictor for neuroticism at follow‐up, the outcome measure was change in neuroticism. Changes in neuroticism were predicted from SLE indices or their interaction with baseline neuroticism. Timing of SLEs was taken into account by distinguishing recent from distant SLEs. To control for confounding by shared genes and environments, both within‐twin pair and between‐twin pair effects were tested for monozygotic and dizygotic twin pairs separately. Neuroticism's six‐year stability was high (r = .58, p < .001). Exposure to SLEs modestly increased neuroticism (βs > .55, ps < .001), unconfounded by shared genes. This effect was not moderated by high baseline neuroticism. Recent SLEs (.09 < βs < .15) had more impact than distant SLEs (.03 < βs < .11; ps < .01). In conclusion, the findings strongly supported a model of environmentally driven SLEs causing dynamic fluctuations around a person's set point of neuroticism. Copyright © 2013 John Wiley & Sons, Ltd.     

药物治疗的风险及其处理

造成药物治疗风险的因素包括药物因素、病情因素、患者因素、用药因素及管理因素等。通过对药物进行严格监管,对医药从业人员加强培训和教育,对民众开展科普教学和用药指导,可以降低药物治疗的风险。风险事件主要表现为用药差错、药物不良反应或药物治疗无效。在药物治疗中,首先必须时刻警惕和及时发现风险;其次需要全面评估风险,还要对疾病风险和药物治疗风险进行比较。应尽可能避免药物治疗的风险,对于必须承受的风险,需采取相应措施,减少风险事件发生的概率和严重程度。如果存在较大风险,务必同时设计处理风险事件的预案,并与患者及其家属保持良好的交流和沟通。     

On the Decision to Explore New Alternatives: The Coexistence of Under‐ and Over‐exploration

The decision whether to explore new alternatives or to choose from familiar ones is implicit in many of our daily activities. How is this decision made? When will deviation from optimal exploration be observed? The current paper examines exploration decisions in the context of a multi‐alternative “decisions from experience” task. In each trial, participants could choose a familiar option (the status quo) or a new alternative (risky exploration). The observed exploration rates were more sensitive to the frequent outcome from choosing new alternatives than to the average outcome. That is, the implicit decision whether to explore a new alternative reflects underweighting of rare events: Over‐exploration was documented in “Rare Disasters” environments, and insufficient exploration was evident in “Rare Treasures” environments. In addition, the results reveal a decrease in exploration of new alternatives over time even when it is always optimal and some exploration even when it is never reinforcing. These results can be captured with models that share a distinction between “data collection” and “outcome‐driven” decision modes. Under the data collection mode, the decision maker collects information about the environment, to be used in future choices. Under the outcome‐driven mode, the decision maker relies on small samples of previous experiences with familiar versus unfamiliar alternatives, before the selection of a specific alternative. The predictive value of a two‐parameter “explorative sampler” quantification of these assumptions is demonstrated. Copyright © 2013 John Wiley & Sons, Ltd.     

Italian Adaptation and Confirmatory Factor Analysis of the Full and the Short Form of the Posttraumatic Growth Inventory

This study was designed to adapt and to assess the reliability and factor structure of an Italian translation of the full and short form of the Posttraumatic Growth Inventory. A sample of 1,244 Italian adults who had experienced a range of adverse life events participated in this study. Five models of the underlying structure of the Posttraumatic Growth Inventory were tested via confirmatory factor analyses. Analyses of both the short and full form of the PTGI provided support for the original correlated five-factor structure. Multigroup confirmatory factor analysis supported the invariance of the Posttraumatic Growth Inventory across gender.