Lecture 8 - Performance impairemtn 1 - Anxiety Flashcards
What are the three classifications of stuff in Performance impairment 1?
- anxiety disorders
- eating disorders
- depression (last week)
What are the symptoms of panic attacks?
- Palpitations, pounding heart, or accelerated heart rate •Sweating
- Trembling or shaking
- shortness of breath
- Feeling of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint •Derealization or depersonalization (feeling detached from oneself)
- Fear of losing control or going crazy
- Fear of dying
- Numbness or tingling sensations
- Chills or hot flushes
How many panic attacks do you need to have to be classed as having PAD
4 in 4 weeks
- or just 1, but the continual anxiety of having another one
What is the prevalence of PAD?
2-6% of general population
What is usually the cause of PAD
72% is caused by a significant life stressor
What are the characteristics of panic disorder? **
phsycial…..
- Unexpected - leads to continual worry and behavioural avoidance
- intense physical discomfort - often misintepreted as cardiac emergency
- Athletes find it hard to distinguish a panic attack from the rush of finishing a performance
What does the psychologist have to do when deciding it is panic disorder? - Social eval
******
- rule out any cardiac problems
- rule out drug abuse
- What situations does it occur in? - if its in sports contexts, it may just be social evaluation anxiety not PAD
Outline the treatment of panic disorder
- Cog
15 structured sessions, 2/3 on each of these:
- educates the person about anxiety and panic attacks
- Cognitive restructuring - they usually overestimate the threat, if it happened here before, it will happen again - but make them see thats not the case
- Controlled exposure to physiological stress - you can cope with this
- Controlled exposure to avoided situations
- Along the way - give them coping skills (breathing)
Define Anorexia
A) A restriction of energy intake leading to a significantly low body weight, in context of age, sex, developmental trajectory and physical health
B) Intense fear of gaining weight and becoming fat, or persistant behaviour that interfers weight gain, even though they are at a significantly low weight. Potentially denying this fear exists
C) Disturbance in the way in which ones body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistant lack of recognition of the seriousness of the current low body weight
What’s a limitation of this definition of Anorexia?
- If a psychologist had no knowledge of sport, he may diagnose loads of sports people for the amount of weight loss they have done. E.g. Lee Selby. But that was done in a controlled manner so it is okay
- Used to be female specific as you had to have a loss of menstruation for 3 months
Define Bulimia Nervosa
***** time periods. When can it not co-occur with other stuff
A) Recurrent episodes of binge eating, and a lack of control over these episodes
B) Recurrent inappropriate compensatory behaviour to prevent weight gain (purging)
C) Binging and Purging must happen at least once a week for 3 months
D) Self-evaluation unduly influenced by body shape and weight
E) This doesnt occur within periods of anorexia, it’s seperate
What characterises an episode of Binge eating?
Characterised by these 2 things:
1. Eating in a given period of time (e.g. 2 hours) an amount of food that is definitely larger than what most people would eat during a smiliar period of time, under similar circumstances.
- Lack of control over eating during an episode, e.g. feeling that they cannot stop or control how much they eat
What is OFSED?
Mix of anorexia and bulimia symptoms
- Other specified eating disorder
What is FED-NEC
Feeding and eating disorders not elsewhere classified
What is EDNOS?
Eating disorder not otherwise specified
What did Sundgot-Borgen & Torstveit, 2004 find about the prevalence of eating disorders?
Son got an eating disorder, but women do more
They are more prevelant in elite athletes, than non-elites.
They are more prevelant in women- had more cases of Anorexia, Bulimia and OFSED
1 in 5 female athletes have an eating disorder
What did Sundgot-Borgen & Torstveit, 2004 say about eating disorders in Skaters? **
Eating disorders in sport are very secretive. It’s very hard to spot those skaters who have an eating disorder and those that do not. About 85% of skaters have suffered from disordered eating in some way.
What did Papathomas & Lavallee, 2006 do?
*****
Studied an academy footballer (Mike), argued as a kid, playing football is just for fun. But when you enter adult/ elite sport, there is a focus on fitness, but as a kid its never about fitness. There is suddenly so much focus on diet and eating habits. He was also a perfectionist and compared himself to others
What was the triangle about eating disorders outlined by Papathomas & Lavallee (2006)?
Combination of:
- Focus on fitness in the team
- perfectionism
- Comparing to others - if he is the best, and he is lean, i must be lean to be the best.
All these things interacted with each other and combined to cause bulimia
What did Francisco et al (2012) argue were the sport related risk factors for eating disorders
Aesthetic sports, like gymnastics and ballet were more at risk.
Body dissatisfaction is more common in aesthetic sports. As opposed to like weightlifting or something, where it is less common.
The certain area they are dissatisfied with relates specifically to their sport.
What did Jones et al (2005) argue was a significant risk factor? Self-determination??? ****
Coaches, and what they say.
- but interventions know are focused around educating the coaches, so they dont say the wrong things
- they can have such an impact due to self-determination theory - when you internalise things, and think someones doing something cos it’s your fault.
What has been found about the effects coaches can have?
**
- Over 50% of NCAA coaches see (ammenhoureaa) menstruation cessation as normal
- Gymnastics coaches often promote unhealthy weight loss plans
- Coaches make decisions about weight loss from appearance only
Which sports can be dodgy for weight loss?
*** cycling?
- Aesthetic sports
- Taekwondo, if you are 80kg, you could be fighting a 130kg, so you have to get under 80kg
- Endurance sports - power to weight ratio is the golden ticket zone to get into - light but powerful, tricky to achieve healthily
- Humans make judgements quickly, and in some sports, this judgement comes quicker/ more easily spotted than in others
What are the treatments for Bulimia?
- Behavioural, schemas, IPP
- Behavioural
•self-monitoring
•scheduled eating - often know when and where it happens - Modify dysfunctional attitudes/ schemas
•need strong therapeutic relationships
•Cognitive restructuring - Interpersonal psychotherapy
•Problematic relationships and circumstances
•if the bulimia is a result of interpersonal disputes/ early experiences
- Early response to treatment is a good predictor of success
What are the treatments for anorexia
2 things
harder to treat
- Inpatient treatments - not always aware they have it
- Family-based interventions - especially if family are always involved in the problematic meal times. They need to be changed.
- May have to stop them performing for some time
In general, what are the treatments for Performance Impairement
- PST techniques may not work at all, because often you have to stop performing to be treated.
- Intensive, full time psychological treatment necessary
- Medication may be necessary
