MHT FInal Flashcards
What is Solution Focused Brief Counseling?
Focus on solutions, ask what would you do about something rather than what you would avoid, imagine problem is gone
In Solution Focused Brief Counseling, what do you identify?
the exceptions, or when the problem is NOT present. What is it that they are doing during these exceptions that they’re not doing during yips
In Solution Focused Brief Counseling one should focus on and celebrate:
small changes
Treatment for Yips (Bell et al (2009))
experienced male golfers, used solution focused imagery as intervention, yips consistently decreased after intervention, improvements maintained, all golfers saw reduction in number of yips during intervention phase
What is the point of telling someone a miracle happened and they don’t have the yips anymore?
builds self-efficacy
The study by Bell et al (2009) used a Multiple Baseline Design. Why/When should this study type be used?
when you don’t have enough people for a control group, takes away other factors that could cause participants to be better, being more comfortable and having less of an audience influences people’s improvement
What do the findings in Bell et al (2009) tell us about the Yips?
people get into a bad self-fulfilling prophecy and continuously worry about yipping, so they do it; yipping may be less neurological; athletes have ability to reduce their yips; focusing less on the yips and technique is the cure
What were the main takeaways of A-C, Sossin, & Quatromoni (2016)
treating EDs need to be different for athletes and non-athletes, since they are caused by different issues; if one person has an ED on a team, the whole team should be looked at, not just the individual athlete; EDs spread easily on teams
What were the results of A-C, Sossin, & Quatromoni (2016)?
many factors were similar for both athletes and non-athletes; EDs in athletes were more caused by sport performance pressure, and peer modeling
According to A-C, Sossin, & Quatromoni (2016) what is consistent between both athletes and non-athletes, and unique to each in developing an ED?
Consistent: low self worth
Unique to NA: family negative comments
Unique to A: performance pressure
Are EDs heritable?
Yes, EDs run in families, your risk for developing an ED is higher if someone in your family has or had an ED; could be genetic but could also be diet culture norms in your family; linked to a certain personality trait
What makes Anorexia Nervosa heritable?
if you have perfectionism, which is heritable, you are more likely to develop AN
What makes Bulimia Nervosa appear heritable?
if you have impulsivity, which is heritable, you are more likely to develop BN
How does social media influence EDs?
you see people with perfect body types who are constantly working out and eating right, when social media use goes up, ED risk and depression go up
Sport Specific Weight Pressures:
increased publicity, physicality in contact sports, making weight class, aesthetic/judged sports, uniforms, team modeling, modeling after athletes they look up to, competitive thinness w teammates, coaches comments, wanting to be biggest/strongest, power/weight metrics, lack of time, injury, RED-S
Using what you know about cognitive behavior therapy for depression, how would you treat an athlete with AN?
get rid of cognitive distortions
Cognitive Behavioral Therapy (CBT) for Anorexia
challenge cognitive distortions, perfectionism; counter thoughts: who told you that? point out other successful athletes that don’t fit the norm; rope technique, tangible evidence that their thought isn’t based on reality; change “i ate a cookie so i’m getting fat” to “eating one cookie does not equal 3500 calories”; reduce body checking/weighing
CBT for Bulimia/BED
Build awareness of triggers to binge/purge; identify cycle of restricting/binging/purging; build coping skills for stress, replace binging with “incompatible behaviors”; challenge cognitive distortions; add snacks between meals; mindful eating
Are athletes at a higher ED risk?
higher risk in athletes in “weight sensitive sports”
ED prevention with athletes
coaches/trainers should de-emphasize weight, eliminate public weigh-ins; reduce unsafe sport weight-loss behaviors, wrestling starting weighing right before matches; educate athletes/coaches on nutrition and EDs; critically examine body ideals in media and openly discuss “dual pressures” athletes face; create adaptive team norms, address “body bashing” on teams
Causes of substance abuse:
use = environmental influences; disorders = diathesis stress model
How does the Diathesis-Stress Model influence substance abuse?
diathesis: some people have more sensitive pleasure centers in the brain; genetic predisposition to experience more pleasure from alcohol with fewer lows afterward (some ppl don’t get hangovers)
Stress: people use drinking as a coping mechanism; cultural norms/expectations
What are some psychological dimensions to substance abuse?
positive reinforcement: your teammates could be reinforcing it, could be less consequences
negative reinforcement: escape from stress (removes anxiety by increased GABA neurotransmitter); self medication (often comorbid with anxiety, depression, bipolar, and bulimia
What are the 5 principles of motivational interviewing?
READS:
Roll with resistance
Express empathy
Avoid argumentation
develop discrepancy
support self-efficacy
Roll with resistance
“dance instead of wrestle”; when you get resistance, focus on building the relationship and understanding the person; show them that you get there’s a reason they must be drinking
Express empathy
ambivalence (being unsure) about change is normal
avoid argumentation
dont argue for change “listen as much as tell”; resist the “righting reflex” (trying to be right)
develop discrepancy
how is behavior interfering with goals/values? create cognitive dissonance about continued substance abuse; want to hear them say something that can’t be true at the same time
support self efficacy
help a person see small achievements on their way to the bigger goal
big picture lessons for substance abuse case
timing of each intervention has to be at appropriate phase (transtheoretical model); non-linear progression; empathy with mandated clients; resist judgement; personal safety of sport psychologist; give autonomy to client
Background info on EDs
more common in female identified populations; more in gay and bi men than straight men; most common in higher wealth groups (high SES); less common in people of color; EDs found in other cultures (used to think it was only in developed countries)
Anorexia Nervosa
Eating disorder most coaches know about and see
Anorexia nervosa DSM-5 criteria:
restriction of food leading to significantly low body weight (less than minimally normal BMI); intense fear of gaining weight or attempting to lose more; disturbance in experience of weight or denial of low weight
Can people with AN die?
yes, 10% with AN die, 20% of that is due to suicide; deaths are also due to heart failure
What is typically comorbid with AN?
depression, anxiety, and OCD
Anorexia statistics
- 0.5-2% of general population
- 1-3.5% of athletes
- 90% female (reported)
- typical onset age: 14-18
- due to puberty and body change
- highest mortality rate
- heart failure and suicide
Bulimia Nervosa DSM-5
- Recurrent “Binge Eating”
- eating past point of being full
- out of control; more than typical (2hr period)
- Regular methods to compensate for binges
- vomiting
- laxatives
- excessive exercise
- Self-evaluation based heavily on weight or shape
- Binge/purge occurs 1x a week for 3 months
- severe = 8-13; extreme = >14 per week
- could be many times per day
Bulimia Nervosa Statistics
- 1-3% of general population
- 2-5% of athletes
- 80-90% female
- typical onset in late adolescence (18-22 years)
- due to a lot of stress
- Die due to dehydration and change in sodium/potassium levels in heart
Bulimia Nervosa
- Often average or above average weight-why?
- purging is ineffective (only getting rid of 25-50% of calories)
- Why binge if you want to be thin?
- restrict food between meals (binges)
- hunger leads to overeating/binge
- purge reduces anxiety/shame
- binge leads to restriction next day
- one big cycle
- Dehydration, death
- gastrointestinal issues
- destruction of throat, teeth
- fatigue
Binge Eating Disorder DSM-5
- Recurrent “Binge Eating Episodes”
- three or more of the following:
- eating much more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts when not physically hungry
- eating alone due to embarrassment
- feel disgusted or depressed afterward
- Marked distress about the binge eating
- no compensatory “purging” behavior
- 1x week for 3 months (severity: extreme = > 14; severe = 8-13)
BED statistics
- 0.5-3% of population; athletes unknown
- higher % of males have BED than BN or AN
- Responds well to treatment
- easiest of 3 to treat
Social Physique Anxiety and ___ are positively correlated
BMI
SPA and Body Image Disturbance increase risk for:
EDs, excessive exercise, depression, anxiety
What were the findings of the Zhou et al (2015) study?
team sport players reported significantly greater rates of alcohol consumption, as well as scoring higher than individual sports players on measures of athlete identity and happiness.
What were the main findings of the Barry (2015) study?
IM athletes drank most often, then club, varsity, and nonathletes. IM athletes consumed most drinks during last drinking episode, then varsity, club, and NAs. Club athletes reached highest BAC, then varsity, IMs, and NAs. IMs experienced greatest number of alc-related consequences, then club, varsity, NAs.
Levels of substance involvement:
substance use (moderate amount) and alcohol use disorder (maladaptive)
DSM-5 Diagnostic criteria for alcohol use disorder (must have at least 2)
- consuming more alcohol than originally planned
- consistently failed efforts to control one’s use
- spending a large amount of time using or obtaining alcohol
- “craving” alcohol
- Use results in failure to fulfill obligations at home, work, or school
- continuing use despite social problems caused or worsened by it
- giving up activities because of alcohol use
- repeated use of alcohol in situations that are physically hazardous (ex: DUIs)
- continued use despite physical or psychological problems caused or worsened by alcohol
- tolerance
- withdrawal symptoms after stopping use
Are most adults light drinkers or abstainers?
yes
what percentage of adults binge drink?
20-25%
how many adults have alcohol use disorder?
17 million adults (7.2%)
males are about how many more times likely to have alcohol use disorder than females?
2x
do athletes report higher or lower alcohol use than non-athletes?
higher
what division is the largest gender difference for drinking at?
division 3: 52% male, 41% female
Zhou et al (2015) found that this percentage of college athletes in england had “hazardous drinking”
86.8%
What did Zhou et al (2015) find were the highest use groups for alcohol?
males and team sport athletes
Zhou et al (2015) found that higher athlete identity was related to…
lower use for indiv. sport athletes
How to address suspected ED?
- approach in private, one-on-one
- person who addresses issue should have good relationship
- express concern, don’t accuse
- use “I” statements, not “you” statements
- focus on changes in mood, performance, not eating/weight
- avoid giving simple solutions like “just eat”
- listen… then refer to professional help
What are the yips?
- long-term involuntary movements (jerks, tremors, freezing) during a motor behavior
- long-term breakdown of a skill previously executed at a high level
- not one bad performance, keeps getting worse
- athletes might just give up
Are the yips a psychological disorder?
could be
Yips are compared to:
- choking =
- failure or unexpected poor performance in one specific moment
- usually high pressure situation
- slump =
- sequence of performances that are significantly lower than typical/expected
Who is affected by the yips?
- more individual sport athletes
- primarily sports involving closed skill (aiming tasks) or fine motor skills
- golf, cricket, serves, darts
are there any known gender differences for the yips?
no
What causes the yips? (smith et al, 2020)
- type 1 = focal dystonia (involuntary muscle contractions)
- finding: higher peak EMG activity in forearms
- type 2: choking due to performance anxiety
Compared to non-yippers, yippers have:
higher HR; more activity in wrist flexor/extensors; more grip force
What psychological variables are associated with the yips?
- obsessive thinking, embarassment
- social anxiety and self-consciousness
- low confidence
- sport/life stress or events
- maladaptive perfectionism
According to Phillippen and Lobinger (2012), what thoughts and feelings do golfers have during the yips?
dread, hyper-focus, over analysis, helplessness
During the Phillippen and Lobinger (2012) study, when were yips most severe for participants?
during games or tournaments
Do yips occur during practice?
no
What theories explain the yips?
- self-fulfilling prophecy
- I am going to mess up/yip > anxious/shame > yips/twitch
- ironic processing
- don’t mess up, don’t yip > anxious/shame > yips/twitch.
- Overall, may be fueled by maladaptive perfectionism
