A multi-design investigation of perfectionism risk profiles for traumatic injury in sport

Every year, many university athletes find themselves experiencing sports injuries while practicing their sport. Not all athletes are equal to each other, and some get injured more often. Individual differences in personality could explain these differences. This study focuses on how within-person combinations of perfectionistic strivings and perfectionistic concerns are associated with the risk of traumatic injury in university athletes. Two most prominent person-oriented approaches of perfectionism (the tripartite and 2x2 models) were tested in a retrospective (N=143) and a prospective (N=98) sample. Cluster analyses identified perfectionism profiles consistent with the two theoretical models in both samples. Furthermore, the profile with high levels of perfectionistic strivings and concerns was found to be the most at risk of experiencing a traumatic injury using both designs. This study supports the tripartite model of perfectionism in recognizing the exacerbating role of perfectionistic strivings on the maladaptive effect of perfectionistic concerns. Coaches and sports specialists will need to consider monitoring athletes' levels of PC, especially in conjunction with high PS levels, to reduce the risk of injury in athletes.

Modulatory role of sport factors on amateur and competitive athletes' aggressive and antisocial behaviors

Aggressiveness and unethical behaviors are an important problem in sports today. Understanding how to properly measure and manage an athlete's aggressive tendency is a crucial lesson to be learned within the rulesets of a sporting environment. This study aims at validating the Italian version of the Competitive Aggressiveness and Anger Scale (CAAS), specifically developed to measure aggressiveness and anger in athletes. The second aim is to investigate how aggressive and antisocial behaviors are modulated by sex, competitive level (i.e., amateur and competitive), sport contact (i.e., contact and no-contact), and sport type (i.e., team and individual). Two hundred and ninety-six athletes (mean age = 22.42 years, SD = 2.86) were asked to fill out a survey about sociodemographic variables, sport specific data, attitudes to moral decisions, past cheating behavior, and aggression. The Italian version of the CAAS presented a good fit of the data, adequate internal consistency and its construct validity was supported via convergent and discriminant validity. Both aggressiveness and anger dimensions of CAAS positively related with acceptance of cheating and gamesmanship, and past cheating behavior, while only the aggressiveness dimension of the CAAS negatively related with prosocial attitude. Competitive male athletes practicing contact sport showed the highest levels of aggressiveness, while competitive athletes practicing team sport showed the highest level of anger. This study represents the first empirical construct validity evidence of CAAS among Italian athletes and provides a deeper understanding of how athletes' aggressive tendencies and antisocial behavior differ across athlete populations.

"I Am on Top!": An Interactive Intervention Program to Promote Self-Regulation Processes in the Prevention of the Use of Doping in Sports High Schools

The use of substances to improve sports performance is a widespread phenomenon among adolescents. Several anti-doping programs have been developed, mainly based on knowledge-based evidence. The main aim of the present study was to implement an anti-doping intervention in sports high school students, based on a psychological framework, such as Socio-Cognitive Theory, through the development of a Serious Game (SG), i.e., digital learning based on the game. The experimental design included an intervention group (n = 167; F = 37.7%; Meanage = 17.5 years; SD = 0.58) and a control group (n = 112; F = 42%; Meanage = 17.6; SD = 1). Both of the groups completed the same questionnaire on two different occasions (i.e., time 1 and time 2) for measuring doping intention, self-regulatory efficacy to resist social pressure for the use of substances, moral disengagement, and doping knowledge. Data were analyzed through repeated measures of Group X Time ANOVA, demonstrating some degree of efficacy of the intervention, in particular in terms of the decrease in doping intention and the strengthening of doping knowledge. Moreover, the study demonstrated that the score obtained during the implementation of the SG could partially represent a coherent measure of the participants' beliefs regarding doping. These results could be considered a starting point for future research to better develop technological anti-doping interventions.

Identifying Determinants of Neuro-Enchancement Substance Use in Students

Abstract. Background: Use of Neuro-Enhancement Substances (NES) such as prescription drugs, illicit drugs, or alcohol to improve cognition, prosocial behavior, and performance is increasing among students. Aims: The study applied a multi-theory, integrated theoretical model to identify motivational and social cognition determinants of NES use among students. Methods: A prospective longitudinal design was adopted with 306 high school (66.8% female; Mage = 17.31 years, SD = 0.93) and 692 university (70.5% female; Mage = 24.97 years, SD = 6.64) students. They completed measures of motivation, social cognition constructs, and planning with respect to studying behavior and NES use. Results: Well-fitting structural equation models indicated the pervasive influence of autonomous motivation, attitudes, subjective norms, and perceived behavioral control for studying, as well as of attitudes, subjective norms, and perceived behavioral control for NES use. Inclusion of past NES use increased explained variance in NES use and attenuated model effects, but the pattern of effects remained. Multi-group analyses indicated consistency in the pattern model effects across high school and university students. Limitations: The study findings might not be generalizable, as student samples were not randomly recruited. Furthermore, NES use only relied on self-report, and its assessment did not consider different NES substances. Finally, there was no assessment of implicit attitudes and habits toward studying and NES use. Conclusions: Findings extend prior literature by demonstrating the integrated guiding view that students’ motivation and beliefs about studying influence their beliefs about and use of NES. Furthermore, the findings provide starting points for interventions targeting the reduction in NES use.

Analyzing the Perceived Utility of Covid-19 Countermeasures: The Role of Pronominalization, Moral Foundations, Moral Disengagement, Fake News Embracing, and Health Anxiety

An online survey (N = 210) is presented on how the perceived utility of correct and exaggerated countermeasures against Covid-19 is affected by different pronominalization strategies (impersonal form, you, we). In evaluating the pronominalization effect, we have statistically controlled for the roles of several personal characteristics: Moral Disengagement, Moral Foundations, Health Anxiety, and Embracing of Fake News. Results indicate that, net of personal proclivities, the you form decreases the perceived utility of exaggerated countermeasures, possibly due to simulation processes. As a second point, through a Structural Equation Model, we show that binding moral values (Authority, Ingroup, and Purity) positively predict both fake news embracing and perceived utility of exaggerated countermeasures, while individualizing moral values (Harm and Fairness) negatively predict fake news embracing and positively predict the perceived utility of correct countermeasures. Lastly, fake news embracing showed a doubly bad effect: not only does it lead people to judge exaggerated countermeasures as more useful; but, more dangerously, it brings them to consider correct countermeasures as less useful in the struggle against the pandemic.

Perfectionism and Eating Behavior in the COVID-19 Pandemic

The novel coronavirus disease 2019 (COVID-19) represents a massive global health crisis leading to different reactions in people. Those reactions may be adaptive or not depending on situational or psychological processes. Disordered eating attitudes and behaviors are likely to be exacerbated by the pandemic through multiple pathways as suggested by Rodgers et al. (2020). Among the psychological variables that may have increased dysfunctional eating attitudes and behaviors as a consequence of the social distancing and isolation, we looked at perfectionism. Perfectionism is a well-recognized risk and maintaining factor of eating-related symptoms and interact with stress increasing the probability of dysfunctional reactions (e.g., Wang and Li, 2017). The present study investigated the relationship between multidimensional perfectionism and eating behaviors by considering the mediating role of psychological distress. Data were collected from two countries (Italy and Spain) by means of an online survey. The samples included 465 (63.4% female) participants from Italy and 352 (68.5% female) from Spain. Participants completed the short form of the Hewitt and Flett Multidimensional Perfectionism Scale (Lombardo et al., 2021) to assess self-oriented, other-oriented and socially prescribed perfectionism, as well as the short form of Three Factors Eating Questionnaire (Karlsson et al., 2000) and the Italian version of Depression Anxiety and Stress Scale-21 (Bottesi et al., 2015), respectively used to assess restrictive, emotional and uncontrolled eating on one hand, and depression, anxiety and stress on the other. Multigroup analysis was performed to test the hypothesized model. Results showed that other-oriented and socially prescribed perfectionism were indirectly related to most of the dysfunctional eating aspects through the mediation of psychological distress, and the pattern obtained was consistent in both countries. These findings evidence that the psychological distress potentially related to the COVID-19 disease mediates the negative impact of interpersonal perfectionism and the tendency to eat in response to negative emotions.

Promoting Media Literacy Online: An Intervention on Performance and Appearance Enhancement Substances with Sport High School Students

The outbreak of coronavirus required adjustment regarding the delivery of interventions. Media literacy interventions are necessary to help people acquire relevant skills to navigate the complexities of media communications, and to encourage health-promoting behaviors. The present study aimed to promote a media literacy intervention regarding performance and appearance enhancement substances use in sports high school students. The COVID-19 contingency allowed us to evaluate whether online sessions can effectively promote greater awareness of media influence, a stronger sense of confidence in persuading others to deal with media messages, and healthier attitudes about PAES use among high school students. The study relied on an "intervention group" comprising 162 students (31.5% female) and a "control group" comprising 158 students (42% female). Data were analyzed through repeated measures of Group X Time MANOVA and ANOVA, demonstrating some degree of efficacy of the media literacy intervention. The "intervention group" reported higher awareness of potential newspapers' influence and a significant increase in their sense of confidence in dealing with media influence compared to the "control group". Findings support the efficacy of online media literacy programs to prevent doping consumption in adolescents.

One Does Not Fit All: European Study Shows Significant Differences in Value-Priorities in Clean Sport

Doping violates the Spirit of Sport and is thought to contradict the values which underpin this spirit. Values-based education (VBE) has been cited as a key element for creating a clean sport culture across age groups. Culturally relevant VBE requires understanding of the values that motivate athletes from different countries to practice their sport and uphold clean sport values. WADA's new International Standards for Education makes this study both needed and timely. Overall, 1,225 athletes from Germany, Greece, Italy, Russia, and the UK responded to measures assessing their general values, Spirit of Sport values, and their perceived importance of “clean sport”. MaxDiff analysis identified the most important values to participants based on their respective country of residence. Correlation analysis was conducted to assess the relationship between importance of clean sport and Spirit of Sport values. There were significant differences between participant nationality and their perceived importance of clean sport [F_{(4, 1,204)} = 797.060, p < 0.000], the most important general values (p < 0.05), and Spirit of Sport values (p < 0.05). Moderate positive correlations were observed between the perceived importance of clean sport and honesty and ethics (r = 0.538, p < 0.005) and respecting the rules of sport (r = 0.507, p < 0.005). When designing the values-based component of anti-doping education programs, athletes' different value-priorities across countries should be considered.

The Short Forms of the Hewitt and Flett's Multidimensional Perfectionism Scale: Which Factor Structure Better Fits Italian Data?

One of the most used instruments to assess perfectionism is Hewitt and Flett's Multidimensional Perfectionism Scale (HFMPS). This article reports result of two studies aimed at evaluating and comparing two short HFMPS versions provided by literature in Italian samples. In Study 1, two previously proposed short forms-Cox and colleagues' and Hewitt and colleagues'-were compared in terms of factor structure and concurrent validity in a community sample of 324 participants. In Study 2, validity and reliability of the two short scales in 102 university students and 58 patients with a primary diagnosis of Obsessive-Compulsive Disorder were examined. Results revealed mixed findings concerning which of the two short form should be preferred.

The Personal and Interpersonal Components of Perfectionism: The Italian Validation of "Multidimensional Inventory of Perfectionism in Sport"

The present research focused on the general theme of perfectionism in the sport domain, and it provided the first empirical validation of the original 72-item “Multidimensional Inventory of Perfectionism in Sport” (MIPS) among Italian athletes. The study, specifically, also focused on the relations linking personal and interpersonal components of perfectionism to athletes’ competitive anxiety. The research overall relied on data from 644 Italian sport science students and professional athletes and included both cross-sectional and longitudinal designs. Data analyses primarily focused on structural equation modeling, and the findings overall supported the psychometric and construct validity of the Italian version of the MIPS, also highlighting the key role of the personal components of perfectionism.

The Implementation and Evaluation of a Media Literacy Intervention About PAES Use in Sport Science Students

With respect to both competitive and amateur/fitness sports, media may strongly influence young people's opinions and behaviors concerning the use of PAES (Performance and Appearance Enhancing Substances). The present investigation addressed this topic by focusing on sport sciences students' beliefs concerning the possible role of media related to the implementation and evaluation of a PAES-focus media literacy intervention conducted with sport science students. This study relied on a sample of 521 students (attrition rate 10.3%) (45.1% female, mean age = 22.6, SD = 2.20), which provided baseline data on students' levels of media literacy concerning the use of PAES (i.e. "descriptive sample"), and a sample of 248 students, who participated in and provided data on the media literacy intervention. This latter sample included a group of 128 students (44.5% female, mean age = 23.03, SD = 3.76) who actively participated in the intervention (i.e. "intervention group"), and a group of 120 students who did not (i.e. "control group", 53.3% female, mean age = 22.25, SD = 2.47). All students filled out media literacy questionnaires targeting students' awareness of media influence, their views about the realism of media content, their sense of confidence in dealing with media messages, and their positive attitudes toward PAES use. Analyses of questionnaire data showed that students are relatively aware of media influence on people's views and behaviors with respect to PAES use. At the same time, students also believed that young people do not consider media as "realistic sources" of information; nonetheless, they also did not consider themselves entirely capable of dealing effectively with media messages. With respect to the intervention, students overall appreciated and greatly welcomed the educational program on media literacy, and the analyses of intervention data across intervention and control groups showed that key media literacy variables changed over time, attesting to the overall effectiveness of the intervention.

Actigraphic Sleep Pattern of Preschoolers With ADHD

Objective: To assess the features of sleep in preschoolers with ADHD by means of questionnaire and actigraphy. Method: Twenty-five ADHD and 21 age-matched typically developing (TD) preschool children underwent the Child Behavior Checklist (CBCL) for ages 1½ to 5 and Pre-School-Age Psychiatric Assessment interview. Sleep was assessed by means of a modified Sleep Disturbance Scale for Children and wrist actigraphy for at least 5 days. Results: Children with ADHD, compared with TD, showed higher scores in CBCL Withdrawal (58.83 vs. 51.15, p < .0001), Attention Problems (69.88 vs. 51.54, p < .0001), and Aggressive Behavior (59.46 vs. 51.08, p < .0001) dimensions; they also showed increased actigraphic nocturnal activity (activity index 31.57 vs. 25.74, p < .05); and night-to-night variability for sleep minutes (56.44 vs. 32.79, p < .01), mean wake episodes (1.34 vs. 0.98, p < .05), mean activity (2.64 vs. 1.71, p < .05), and activity index (5.15 vs. 3.77, p < .05). Conclusion: This pilot study in preschoolers with ADHD showed increased motor activity during sleep and night-to-night variability for sleep duration and motor activity.

Relations Between Sleep and Temperament in Preschool Children With ADHD

Objective: The objective of this study was to assess the links between temperament and sleep in a group of preschoolers with ADHD. Method: Twenty-five ADHD (M = 5.37 years, SD = 1.09) and 22 typically developing (TD; M = 5.10, SD = 1.18) preschoolers participated in the study. Sleep was assessed with the Sleep Disturbance Scale and wrist actigraphy. The Preschool Temperament and Character Inventory (PsTCI) was used to evaluate the child temperament. Results: ADHD children showed a temperamental profile characterized by higher novelty seeking, lower persistence, self-directness, and cooperativeness and marginally lower harm avoidance (HA) compared with controls. HA was associated negatively to wakefulness after sleep onset and sleep fragmentation and positively with sleep efficiency and sleep time. Reward dependence was negatively associated with wake episode length. Conclusion: Sleep and temperament are correlated in preschoolers with ADHD and temperament might represent an intermediate endophenotype underlying the relation between ADHD and sleep disorders.

Psychometric properties of the FertiQoL questionnaire in Italian infertile women in different stages of treatment

BACKGROUND

Reliable Fertility-specific QoL measures can be obtained through the FertiQoL, a questionnaire with six-subscales that consider different core aspects of the person's wellbeing and way of behaving during treatment.

OBJECTIVE

Examine the psychometric properties of all six-subscales of the Italian FertiQoL in a sample of infertile women and explore the effects of the ART treatment phases.

METHOD

323 women, in three different treatment stages (Diagnostic, Stimulation, Transfer), completed the FertiQoL. Raw data were subject to Confirmatory Factor Analysis (CFA), and a structural equation modelling (SEM) was used to validate the hypothesised model.

RESULTS

CFA shows a good fit of the data to the FertiQoL hierarchical model (chi-square/df = 1.989, CFI = 0.88, RMSEA = 0.055). After the deletion of 2 items, all FertiQoL scales have good internal consistency. SEM showed that the ART treatment phase was positively associated with fertility-related QoL scores both in the Relational (β = 0.14, p < 0.05) and in the Tolerability (β = 0.17, p < 0.05) subscales.

CONCLUSION

All scales of the Italian FertiQoL version maintain good psychometric characteristics; Tolerability and Relational subscales are sensitive to the treatment stage and thus providing relevant information for the medical staff.

Personality Traits and Attitudes Toward Traffic Safety Predict Risky Behavior Across Young, Adult, and Older Drivers

In the last few decades, several studies have investigated the role of personality traits and attitudes toward traffic safety in predicting driving behaviors in diverse types of drivers across several countries. However, to the best of our knowledge, no studies so far have investigated the possible moderating role played by age in relation to predictors of accident risk. Answering this open question would provide information about the generalizability of the model across different subpopulations and would make possible the tailoring of the interventions to specific target groups. The study involved 1,286 drivers from three different age groups (young: n = 435; adult: n = 412; old: n = 439) which completed a questionnaire measuring drivers’ personality traits (i.e., anxiety, hostility, excitement seeking, altruism, normlessness), positive attitudes toward traffic safety, risky driving behaviors (i.e., errors, lapses, and traffic violations), accident involvement and number of traffic fines issued in the last 12 months. Multi-group Variance Based Structural Equation Modeling (VB-SEM) across the three age groups showed that the hypothesized model had a good fit with the data in all the three age groups. However, some pattern of relationships between the variables varied across the three groups, for example, if considering the direct effects of personality traits on risky driving behaviors, anxiety, altruism, and normlessness predicted violations only in young and adult drivers, whereas excitement seeking was associated with lapses only in young drivers; anxiety was a positive predictor of drivers’ errors, both in adult and older drivers, whereas excitement seeking predicted errors in adult and young drivers. On the other hand, attitudes significantly and negatively predicted violations and errors in all the three age groups, whereas they significantly and negatively predicted lapses only in young and older drivers. The results of the present study provided empirical basis to develop evidence-based road safety interventions differently tailored to the specific life’s stage of the drivers.

Validating Driver Behavior and Attitude Measure for Older Italian Drivers and Investigating Their Link to Rare Collision Events

The present study aimed to: (a) validate the factor structures of three scales assessing driving behavior, attitudes toward traffic safety (ATTS) and self-regulation in driving, in a sample of Italian older adults, through confirmatory factor analyses and (b) to determine the effectiveness of these measures in predicting the likelihood and the frequency of collision involvements in the following year. A 28-item driver behavior questionnaire (DBQ), a 16-item ATTS, a 21-item extended driving mobility questionnaire (DMQ-A) were administered to 369 active Italian drivers, aged between 60 and 91 years. Results showed a four-factor structure for the DBQ, a five-factor structure for the ATTS and a two-factor structure for the Extended DMQ-A, as the best fitting models. Hurdle model analysis of count data with extra-zeros showed that all factors of DBQ predicted the likelihood of road collisions. Risky behavior, except for aggressive violations, self-regulation and attitudes toward traffic rules were associated with the frequency of collision involvement. The aforementioned three scales seemed to be a useful and concise suite of instruments assessing risky as well as protective factors of driving behavior in elderly.

Riding the Adolescence: Personality Subtypes in Young Moped Riders and Their Association With Risky Driving Attitudes and Behaviors

The aim of the present study was to identify sub-types of moped riders based on a cluster analysis of specific personality characteristics (i.e., driving anger, anxiety, angry hostility, excitement-seeking, altruism, normlessness, and driving locus of control) within a large sample of Italian adolescents. The study had also the aim to compare the emerged sub-types of moped riders on measures of attitudes toward safe driving, risky driving behaviors (e.g., rule's violations and speeding, not using helmet, drinking and driving, etc.), and self-reported tickets and accident involvement. One thousand two hundred seventy-three Italian high school students aged from 13 to 19 years (mean_age = 15.43, SD = 0.98) with a valid driving license for moped participated to the study. Results revealed three sub-types of moped riders (namely risky, worried and careful moped riders), which differ significantly for risky driving behaviors, attitudes toward traffic safety, risk perception, and self-reported accident involvement. Importantly, the results of the present study showed that the personality and behavioral characteristics of the three sub-groups of moped riders substantially resembled those identified by previous studies with vehicle drivers of different ages; thus, empirically supporting the notion that certain combinations of personality characteristics are associated with risk driving tendencies and behaviors in both young moped riders and car drivers. Safe driving interventions can tackle risky driving beliefs and behavioral tendencies in young moped riders and car drivers by tailoring their messages according to the personality sub-types of the target groups.

A study of quiet eye's phenomenon in the shooting section of "laser run" of modern pentathlon

The aim of the study was to evaluate the effects of the Quiet eye (QE) phenomenon on performances during the shooting section of "Laser Run" of Modern Pentathlon, in two samples of athletes (novices and experts). The "Laser Run" consists of running and shooting activities. The study involved 18 experienced athletes of the Italian National Team of Modern Pentathlon (i.e., "elite" group) and 18 young and nonexpert athletes of a local Pentathlon club (i.e., "novice" group). Participants performed, in ecological conditions, five trials of four series of shootings (as it occurs in the real competitions), for a total of 20 series. During the shooting trials, athletes wore a mobile Eye Tracking System to record eye movements (saccades, blinks, and fixations). Key measures of the study were QE parameters (QE Duration [QED], Relative QED [RQED], and QE Onset), as well as the performance (accuracy and time to perform the event). The results revealed that both groups of athletes had a longer QED, RQED, and an earlier onset during their best shots than during the worse ones. Furthermore, differences between the groups showed that elite athletes had an earlier onset and a shorter QED than the novice group of athletes. These results provide insightful information about different cognitive and perceptual processes involved in Modern Pentathlon's athletes' performances at both the elite and non-elite level.

Corrigendum: "I Want It All, and I Want It Now": Lifetime Prevalence and Reasons for Using and Abstaining from Controlled Performance and Appearance Enhancing Substances (PAES) among Young Exercisers and Amateur Athletes in Five European Countries

[This corrects the article DOI: 10.3389/fpsyg.2017.00717.].

Active lifestyles in older adults: an integrated predictive model of physical activity and exercise

Physical activity and exercise have been identified as behaviors to preserve physical and mental health in older adults. The aim of the present study was to test the Integrated Behavior Change model in exercise and physical activity behaviors. The study evaluated two different samples of older adults: the first engaged in exercise class, the second doing spontaneous physical activity. The key analyses relied on Variance-Based Structural Modeling, which were performed by means of WARP PLS 6.0 statistical software. The analyses estimated the Integrated Behavior Change model in predicting exercise and physical activity, in a longitudinal design across two months of assessment. The tested models exhibited a good fit with the observed data derived from the model focusing on exercise, as well as with those derived from the model focusing on physical activity. Results showed, also, some effects and relations specific to each behavioral context. Results may form a starting point for future experimental and intervention research.

Self-Efficacy for Coping with Cancer Enhances the Effect of Reiki Treatments During the Pre-Surgery Phase of Breast Cancer Patients

BACKGROUND/AIM

Self-efficacy for coping with cancer plays a critical role in influencing psychological cancer-related outcomes, some studies suggested its role in enhancing or reducing the effects of psychological interventions in cancer patients. Reiki has recently been included among the efficacious complementary therapeutic intervention for cancer patients.

PATIENTS AND METHODS

The present study evaluated the role of self-efficacy for coping with cancer as buffer of the Reiki treatment effects on cancer-related symptoms in a randomized controlled trial (intervention versus control group) of breast cancer patients (N=110) during the pre-surgery phase.

RESULTS

Results showed that self-efficacy for coping with cancer can influence the effect of a Reiki treatment. Higher efficacious patients showed a more powerful effect of the Reiki intervention on both anxiety and mood than the low efficacious patients.

CONCLUSION

From a practical perspective, the study provides insightful results for healthcare professionals.

"I Want It All, and I Want It Now": Lifetime Prevalence and Reasons for Using and Abstaining from Controlled Performance and Appearance Enhancing Substances (PAES) among Young Exercisers and Amateur Athletes in Five European Countries

Doping use in recreational sports is an emerging issue that has received limited attention so far in the psychological literature. The present study assessed the lifetime prevalence of controlled performance and appearance enhancing substances (PAES), and used behavioral reasoning theory to identify the reasons for using and for avoiding using controlled PAES in young exercisers across five European countries, in the context of the “SAFE YOU” Project. Participants were 800 young amateur athletes and exercisers (M = 21.56; SD = 2.69) from Cyprus, Germany, Greece, Italy, and UK who completed an anonymous questionnaire that included measures of self-reported use of controlled PAES, as well as reasons for using and not using controlled PAES. The results of the descriptive analyses demonstrated that almost one out five exercisers in the sample had a previous experience with controlled PAES. Higher prevalence rates were found in Greece and Cyprus and lower in Italy. The most frequently reported reasons for using controlled PAES included achieving the desired results faster; pushing the self to the (physical) limits; and recovering faster after exercise/training. Furthermore, the most frequently reported reasons for not using controlled PAES involved worry about any possible adverse health effects; not feeling the need for using them; and wanting to see what can be achieved naturally without using any controlled PAES. The findings of the present study indicate that the use of controlled PAES is fast becoming a crisis in amateur sports and exercise settings and highlight the need for preventive action and concerted anti-doping education efforts.

The Effectiveness of a New School-Based Media Literacy Intervention on Adolescents' Doping Attitudes and Supplements Use

The aim of the study was to evaluate the effectiveness of a media literacy intervention targeting, for the first time, the specific topic of Performance and Appearance Enhancing Substances (PAESs) use in high-school students. Overall, 389 students (52% male) aged between 13 and 19 years (mean = 16.56 year; SD = 1.26) participated to a media literacy intervention (i.e., “intervention group”) while 103 students aged between 14 and 19 year (mean = 16.10 year; SD = 1.38) were considered as the control group (i.e., “control group”). In two separate occasions over the course of six consecutive months, students in both groups filled out a set of questionnaires which included measures of social-cognitive beliefs (i.e., attitudes, subjective norms, intentions) and a self-reported measure of retrospective use of doping (Yes/No) and supplements (Yes/No). Compared to students in the control group (Mean_(time1) = 1.96; SD_(time1) = 0.85; and Mean_(time2) = 2.09; SD_(time2) = 0.94), intervention students on average expressed relatively stronger attitudes against doping use over time (Mean_(time1) = 2.2; SD_(time1) = 0.85; and Mean_(time2) = 2.05; SD_(time2) = 0.82). Students in the latter group also showed a statistically significant decrease in self-reported supplement use (Use_(time1) = 6.7%; Use_(time2) = 3.8%; p = 0.05, McNemar Test). Interestingly, albeit marginally significant, students in the control group showed a relative increment in the self-reported use of supplements over time (Use_(time1) = 4.9%; Use_(time2) = 8.7%; p = 0.22, McNemar Test). Overall, the media literacy intervention investigated in the present study was effective in decreasing adolescent student’s positive attitudes toward doping use and in reducing the use of legal PAES. These findings supported the generalizability and the usefulness of a media literacy approach in the specific field of PAES.

Moral Attitudes Predict Cheating and Gamesmanship Behaviors Among Competitive Tennis Players

Background: The present study tested Lee et al.’s (2008) model of moral attitudes and cheating behavior in sports in an Italian sample of young tennis players and extended it to predict behavior in actual match play. In the first phase of the study we proposed that moral, competence and status values would predict prosocial and antisocial moral attitudes directly, and indirectly through athletes’ goal orientations. In the second phase, we hypothesized that moral attitudes would directly predict actual cheating behavior observed during match play.

Method: Adolescent competitive tennis players (N = 314, 76.75% males, M age = 14.36 years, SD = 1.50) completed measures of values, goal orientations, and moral attitudes. A sub-sample (n = 90) was observed in 45 competitive tennis matches by trained observers who recorded their cheating and gamesmanship behaviors on a validated checklist.

Results: Consistent with hypotheses, athletes’ values predicted their moral attitudes through the effects of goal orientations. Anti-social attitudes directly predicted cheating behavior in actual match play providing support for a direct link between moral attitude and actual behavior.

Conclusion: The present study findings support key propositions of Lee and colleagues’ model, and extended its application to competitive athletes in actual match play.

(Mal)Adaptive Psychological Functioning of Students Utilizing University Counseling Services

Background: University students confront psychological difficulties that can negatively influence their academic performance. The present study aimed to assess several areas of adaptive and maladaptive psychological functioning among university students who request counseling services.

Method: One hundred eighty-four young female students seeking professional psychological help (Counseling seekers) and 185 young female students who have never asked for psychological help (Non-counseling seekers) were asked to complete the Adult Self-Report (ASR) to evaluate both their internalizing and externalizing problems through DSM-oriented scales as well as their adaptive functioning.

Results: ANOVA results indicated worse psychological functioning for the students who sought counseling. They reported lower score in ASR Adaptive Functioning Scales (i.e., friends, jobs, family, education), and higher scores in DSM-oriented scales (i.e., Depressive, Anxiety, Somatic, Avoidant Personality, Attention Deficit/Hyperactivity symptoms) than the students who never asked psychological help. Furthermore, discriminant analysis successfully discriminated between the two groups of students on the basis of the ASR’s adaptive and DSM-oriented scales.

Conclusion: The study findings could be useful to guide university counseling services in their screening activities as well as useful for clinical practice.

Psychosocial Outcomes of Quadrantectomy Versus Mastectomy in a Southern Italian Sample: Development and Needs of the Italian Derriford Appearance Scale 24

BACKGROUND/AIM

Breast cancer is associated with appearance concerns and issues of appearance identity, that require an appropriate and independent assessment. The Derriford Appearance Scale (DAS) has been widely used to this end, as has been shown in UK and other international samples. The aim of this study was to determine the extent to which an Italian translation of DAS24 is valid, reliable, and culturally appropriate, while remaining user friendly. The extent to which the statistical robustness of the scale is maintained was also assessed.

PATIENTS AND METHODS

Ninety-three female participants were recruited at a Breast Cancer Department in Southern Italy. According to the protocol designed by the original authors of the questionnaire, a booklet containing the DAS24ita and other scale was completed anonymously by participants.

CONCLUSION

The results of the statistical analysis confirmed the validity and reliability of the DAS24ita. The DAS24ita demonstrated significant correlations with the other measures of appearance sensitivity and quality of life. The translated scale was able to differentiate among patients with differential diagnoses, and was more sensitive to these differences than generic quality-of-life scales.

The Complexity of Neuroenhancement and the Adoption of a Social Cognitive Perspective

This contribution attempts to provide a broad perspective to the psychological study of neuroenhancement (NE). It departs from the assumption that, as the use of performance enhancing substances in sport, the use of substances with the aim of improving one's cognitive, motivational and affective functioning in academic domains is a goal-directed behavior. As such, its scientific study may very well benefit from an analysis taking into account the psychological processes regulating people's behavioral intentions and decisions. Within this broad framework, this contribution addresses several issues that currently seem to characterize the debate in the literature on neuroenhancement substances (NES) use. The first conceptual issue seeks to determine and define the "boundaries" of the phenomenon. The second issue concerns the empirical evidence on the prevalence of using certain substances for the purpose of NE. Finally, there is a debate around the ethical and moral implications of NE. Along these lines, the existing psychological research on NE has adopted mainly sociological and economic decision-making perspectives, greatly contributing to the psychological discourse about the phenomenon of NE. However, we argue that the existing psychological literature does not offer a common, explicit and integrated theoretical framework. Borrowing from the framework of doping research, we recommend the adoption of a social cognitive model for pursuing a systematic analysis of the psychological processes that dynamically regulate students' use of NES over time.

From perceived autonomy support to intentional behaviour: Testing an integrated model in three healthy-eating behaviours

A motivational model integrating self-determination theory, the theory of planned behaviour, and the health action process approach was tested in three samples in three behavioural contexts: fruit and vegetable, breakfast, and snack consumption. Perceived support for autonomous (self-determined) forms of motivation from parents and autonomous motivation from self-determination theory were hypothesised to predict intention and behaviour indirectly via the mediation of attitude and perceived behavioural control from the theory of planned behaviour. It was also expected that planning strategies would mediate the effect of intention on behaviour. Relations in the proposed models were expected to be similar across the behaviours. A two-wave prospective design was adopted. Three samples of high-school students (total N = 1041; 59.60% female; M age = 17.13 years ± 1.57) completed measures of perceived autonomy support, autonomous motivation, theory of planned behaviour constructs, planning strategies and behaviour for each of the three behavioural contexts. Three months later, 816 participants (62,24% female; M age: 17.13 years, SD = 1.58) of the initial sample self-reported their behaviour referred to the previous three months. Structural equation models provided support for the key hypothesised effects of the proposed model for the three health-related behaviours. Two direct effects were significantly different across the three behaviours: the effect of perceived autonomy support on perceived behavioural control and the effect of attitude on intention. In addition, planning strategies mediated the effect of intention on behaviour in fruit and vegetable sample only. Findings extend knowledge of the processes by which psychological antecedents from the theories affect energy-balance related behaviours.

Indicators of distress in newly diagnosed breast cancer patients

Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life.

Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment.

Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress.

Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68).

Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress.

Running away from stress: How regulatory modes prospectively affect athletes' stress through passion

A prospective field study conducted with runners training for an upcoming marathon (Marathon of Rome 2013) examined the relation between regulatory modes, locomotion and assessment, and stress. Integrating regulatory mode theory and the dualistic model of passion, we hypothesized that the relation between regulatory modes (evaluated 3 months before the race) and the experience of stress approaching the marathon, is mediated by the type of passion (harmonious vs obsessive) athletes experience with regard to marathoning. Results revealed that (a) locomotion positively predicted harmonious passion, which in turn reduced athletes' experience of stress; and (b) assessment positively predicted obsessive passion, which in turn enhanced athletes' experience of stress. Overall, the present results suggest that proximal psychological mechanisms such as basic regulatory mode orientations can predict distal outcomes such as stress indirectly through their relation with motivational phenomena such as passion.

Crash risk and aberrant driving behaviors among bus drivers: the role of personality and attitudes towards traffic safety

Several studies have shown that personality traits and attitudes toward traffic safety predict aberrant driving behaviors and crash involvement. However, this process has not been adequately investigated in professional drivers, such as bus drivers. The present study used a personality-attitudes model to assess whether personality traits predicted aberrant self-reported driving behaviors (driving violations, lapses, and errors) both directly and indirectly, through the effects of attitudes towards traffic safety in a large sample of bus drivers. Additionally, the relationship between aberrant self-reported driving behaviors and crash risk was also assessed. Three hundred and one bus drivers (mean age=39.1, SD=10.7 years) completed a structured and anonymous questionnaire measuring personality traits, attitudes toward traffic safety, self-reported aberrant driving behaviors (i.e., errors, lapses, and traffic violations), and accident risk in the last 12 months. Structural equation modeling analysis revealed that personality traits were associated to aberrant driving behaviors both directly and indirectly. In particular altruism, excitement seeking, and normlessness directly predicted bus drivers' attitudes toward traffic safety which, in turn, were negatively associated with the three types of self-reported aberrant driving behaviors. Personality traits relevant to emotionality directly predicted bus drivers' aberrant driving behaviors, without any mediation of attitudes. Finally, only self-reported violations were related to bus drivers' accident risk. The present findings suggest that the hypothesized personality-attitudes model accounts for aberrant driving behaviors in bus drivers, and provide the empirical basis for evidence-based road safety interventions in the context of public transport.

Personality and attitudes as predictors of risky driving among older drivers

Although there are several studies on the effects of personality and attitudes on risky driving among young drivers, related research in older drivers is scarce. The present study assessed a model of personality-attitudes-risky driving in a large sample of active older drivers. A cross-sectional design was used, and structured and anonymous questionnaires were completed by 485 older Italian drivers (Mean age=68.1, SD=6.2, 61.2% males). The measures included personality traits, attitudes toward traffic safety, risky driving (errors, lapses, and traffic violations), and self-reported crash involvement and number of issued traffic tickets in the last 12 months. Structural equation modeling showed that personality traits predicted both directly and indirectly traffic violations, errors, and lapses. More positive attitudes toward traffic safety negatively predicted risky driving. In turn, risky driving was positively related to self-reported crash involvement and higher number of issued traffic tickets. Our findings suggest that theoretical models developed to account for risky driving of younger drivers may also apply in the older drivers, and accordingly be used to inform safe driving interventions for this age group.

The contributions of sleep-related risk factors to diurnal car accidents

This study was intended to estimate the presence and number of individual sleep-related risk factors in a sample of diurnal car accidents and to analyze the extent to which these risk factors tended to be more represented in diurnal accidents involving only one vehicle, involving young drivers or occurring on non-urban roads. Two hundred fifty-three drivers involved in diurnal accidents were interviewed immediately after the accidents to assess their sleepiness-related personal conditions and the circumstances prior to the accident (i.e., individual sleep-related risk factors), such as poor sleep, changes in habitual sleeping patterns, prolonged wakefulness, self-reported acute sleepiness and daytime sleepiness, night-shift jobs and insomnia. A total of 12.3% of the drivers were classified as having at least one of the seven risk factors assessed in the study, supporting the general notion that drivers' sleepiness conditions are crucial, even in diurnal driving circumstances in which they are less likely to depend on chrono-biological processes. Furthermore, consistent with the guiding hypotheses, specific sleep-related risk factors were more evident in single (vs. multiple) car accidents, among young drivers and in car accidents occurring on non-urban roads. In summary, sleep-related risk factors seemed to have a negative impact on drivers' safety in circumstances of diurnal driving, especially when the accidents involved young individuals and occurred on non-urban roads.

Complementary therapy and support services for formal and informal caregivers in Italian palliative care hospices: an exploratory and descriptive study

PURPOSE

The present study is aimed to assess the availability and use of complementary medicine (CM) therapies in Italian palliative care hospices, and the support services available to caregivers and hospice staff.

METHODS

A national sample of 30 hospices meeting study criteria provided data by means of telephone interviews.

RESULTS

All hospices offered spiritual assistance and at least one other form of CM, with the most common being massage therapy (n = 24) and relaxation therapy (n = 10). When offered complementary therapies, 65% or more of the patients accepted them. Twenty-nine hospices provided spiritual and psychological support to caregivers during patient stays, but only 12 offered support at home. All hospices offered support services to their staff, both in individual and group formats.

CONCLUSIONS

Despite limited empirical support, CM has become an important part of palliative care for end-of-life patients in Italy, as in many other countries.

Young novice driver subtypes: relationship to driving violations, errors and lapses

The present study aimed to identify, in a large Italian sample of young, novice drivers, specific subtypes of drivers on the basis of combinations of self-reported personality traits (i.e., driving anger, anxiety, angry hostility, excitement-seeking, altruism, normlessness and driving locus of control) and to evaluate their high-risk driving behaviors not only in terms of traffic rule violations and risk-taking behaviors, but also in terms of driving errors and lapses as measured by the Manchester Driver Behavior Questionnaire. Participants were 1008 high school students between the ages of 18 and 23 years, with valid driver's licenses. On the basis of a cluster analysis of the personality variables, three easily interpretable driver subgroups were identified (risky drivers, worried drivers and careful drivers) that differed on self-reported accident involvement, attitudes toward traffic safety and risk perception, as well as on driving violations, errors, and lapses. The inclusion of internal and external driving locus of control, variables not previously considered in similar cluster studies, provided a relevant contribution to the final cluster solution. Further, the use of the Driving Behavior Questionnaire permitted the differentiation between deliberate deviations from safe driving practices and mistakes due to misjudgments or lapses in attention. This distinction was critical for understanding the behavior of each of the three identified subgroups of drivers, and for planning interventions to promote safe driving.

Sleep-related car crashes: risk perception and decision-making processes in young drivers

The aim of the present study is to analyse factors affecting worries, coping strategies and decisions of young drivers regarding the risk of sleep-related car crashes. Furthermore, the study also analyses whether framing the same information about sleepiness in two different linguistic forms influences: (1) the evaluation of the level of risk associated to a specific level of drowsiness (Attribute Framing problem); (2) the willingness to enact strategies to "prevent" sleepiness before night-time driving (Goal Framing problem); (3) the choice between two different ways, both of equal expected efficacy, of lowering drowsiness (Risky decision-making Framing problem). Six hundred and ninety-five young drivers [(57.6% females, 42.4% males); mean age 20.85 years (S.D.=1.2)] answered questions on drive risk perception and sleepiness, on nocturnal driving experience and on the strategies to deal with driver sleepiness, responding to one of the two different versions of the framed problems. A sub-sample of 130 participants completed the framed problems in both versions. The results show that experiences of sleep attacks and nocturnal driving frequency in the past 6 months affect both risk perception and the preventive strategies adopted. Furthermore, the manipulation on two out of the three problems (attribute and risky decision-making frames) significantly affected the respondents' evaluation.