When not hitting your sales target is 'the end of the world': Examining the effects of rational emotive behaviour therapy on the irrational beliefs and emotional reactivity of UK-based sales professionals

Against the backdrop of the COVID-19 pandemic, workplace wellbeing is a key priority for employers. Severe market and health conditions continue to bring inevitable problems that could be reduced with the application of psychological interventions to prevent mental and physical health issues, making this study a highly pertinent and valuable contribution to the field. This paper reports the effects of a rational emotive behaviour therapy (REBT) programme on the irrational beliefs and emotional reactivity of 56 office-based sales professionals located in the northwest region of the UK. A pre-test, post-test experimental design was utilised, and a mixed model ANOVA (repeated measures) was adopted to assess changes in mean differences concerning irrational beliefs and emotional reactivity at pre and post-test stages for the intervention group, in comparison to a control group. Results indicate that those in the REBT group reported significant reductions in irrational beliefs and emotional reactivity, whilst those in the control group reported no such changes. It is recommended that future research studies consider utilizing a mixed methods design and focus on a strategic collaboration of organisational and individual level interventions for improving the psychological wellbeing and performance of sales personnel.

University makes me angry: Investigating stimulus-response (S-R) and cognitive-mediation (C-M) emotion beliefs in undergraduate students

Emotion regulation through cognitive reappraisal is well-studied, but less so are the predispositional and superordinate beliefs that influence reappraisal. Recently, researchers developed the cognitive mediation beliefs questionnaire (CMBQ), which measures two emotion beliefs, namely stimulus-response (S-R) generation beliefs and cognitive mediation (C-M) change beliefs. In working populations S-R generation beliefs are inversely related to cognitive reappraisal tendencies and positive mental health, and positively related to emotion reactivity. C-M change beliefs are positively related to cognitive reappraisal tendencies, and inversely related to emotion reactivity and positive mental health. As yet, there is no evidence for the validity of the CMBQ within student samples, or for the associations between its subscales and cognitive reappraisal, emotion reactivity, and positive mental health. Therefore, in the present study the CMBQ is tested for factorial, convergent (associations with cognitive reappraisal), and concurrent (associations with emotion reactivity and positive mental health) validity in a cohort of 621 undergraduate students in the United Kingdom (U.K.). Results indicate support for the factorial and convergent validity of the CMBQ, with mixed evidence for the concurrent validity of the CMBQ. A CM-SR discrepancy score appeared to provide a promising variable when associated with emotion reactivity and positive mental health. The findings are discussed in terms of practical and research implications of the findings.

Examination of cognitive appraisals, irrational beliefs, and challenge and threat evaluations in the prediction of tournament affective states and performance of competitive elite Indian golfers

Researchers have intimated that cognitions and emotions can change in the lead up to important events. However, previous research has adopted atemporal cross-sectional designs, making it challenging to understand how cognitions and emotions unfold in the lead up to a competition. In the current study, we extended previous research by examining the temporal patterns of cognitive appraisals, irrational beliefs, and challenge and threat evaluations in predicting pre-competitive affective states (hedonic balance and anxiety) in the lead up to an actual competition, among competitive elite Indian golfers (N = 107). We adopted a within-subjects repeated-measures design and collected data in the lead up to an actual golf tournament, at three timepoints; 1 week before (T1), the night before (T2), and an hour prior (T3). Self-reported measures of cognitive appraisals, irrational beliefs, challenge and threat evaluations, affect, and anxiety were completed. Also, objective golf performance was collected from participants. Crossed-lagged path analysis did not find a causal effect for irrational beliefs on any of the variables across the three time points. On the other hand, hierarchical multiple regression analysis determined that changes in irrational beliefs predicted changes in cognitive appraisals, threat evaluation, cognitive and somatic anxiety, and the directional interpretation of anxiety. The findings of temporal patterns in the current research indicated that sport psychologists should consider the dynamic nature of antecedent cognitions and affective states in the lead up to competition, and accordingly provide adequate support to the athletes. Further, limitations and future research is discussed with reference to the results.

The mediating role of proactive coping in the relationships between stress mindset, challenge appraisal tendencies, and psychological wellbeing

Objective

Stress is ubiquitous and how individuals view the nature of stress can influence psychological wellbeing. The present study aimed to investigate the mediating role of proactive coping on the relationships between stress mindset and challenge appraisal tendencies and examine how this in turn related to psychological wellbeing. A secondary aim was to investigate if there were any differences in stress mindset between athletes and non-athletes. It was hypothesised that stress mindset would be indirectly positively associated with challenge appraisal tendencies through proactive coping, that a challenge appraisal tendency would positively relate to vitality, and that vitality would negatively relate to depressive symptoms. It was also hypothesised that athletes would possess more facilitative views of stress compared with non-athletes.

Methods

Two hundred and seven individuals (n = 101 athletes, n = 106 non-athletes, Mage = 22.76 years, SD = 4.94) completed an online questionnaire pack assessing stress mindset, proactive coping, challenge appraisal tendencies, vitality, and depressive symptoms.

Results

Using path analysis, the hypothesised model demonstrated a good fit to the data and the positive relationship between stress mindset and challenge appraisal tendencies was mediated by proactive coping. Challenge appraisal tendencies were positively associated with vitality, which was negatively associated with depressive symptoms. Athletes reported a significantly greater 'stress-is-enhancing' mindset, greater vitality, and fewer depressive symptoms than non-athletes.

Conclusion

Findings offer support for the role that stress mindset has in potentially influencing psychological wellbeing and offer the novel suggestion that this mechanism may operate through proactive coping and challenge appraisal tendencies.

The role of social support and social identification on challenge and threat cognitive appraisals, perceived stress, and life satisfaction in workplace employees

There is an emergent literature highlighting the positive role of social support and social identification in buffering against the deleterious effects of psychological stressors. Yet, we have limited understanding of how exactly these social factors fit within contemporary stress and coping theory. To advance and gain a greater understanding of these social factors, we explore the associations of social support and social identification on individuals' challenge and threat cognitive appraisals and how this then relates to perceived stress, life satisfaction, turnover intentions, and job performance. A total of 412 workplace employees from private and public sector occupations completed state measures around a recent most stressful experience at work. Results revealed atemporal associations between cognitive resource appraisals with both social support and social identification. Specifically, greater identification with colleagues and lower threat were related to less perceived stress, while having greater social identification (with colleagues and organisation), social support, and lower threat, were related to greater life satisfaction. Greater perceived stress, and lower social identification and life satisfaction, were also related to greater turnover intentions. While greater identification with the organisation and life satisfaction, along with lower perceived stress were related to greater job performance. Taken together, this research provides evidence that social support and social identification play a positive role when trying to promote more adaptive responses to stressful situations.

Understanding the influence of irrational beliefs and body image inflexibility on exercise dependence and psychological well-being: A latent profile analysis approach

Irrational beliefs are a risk factor for mental ill-health and exercise dependence. In addition to this, researchers have also proposed that body image inflexibility can determine mental health and behavioural outcomes. However, research is yet to explore whether and to what extent irrational beliefs and body image inflexibility align to influence mental health and exercise dependence. We examined the latent profile structure of irrational beliefs and body image inflexibility, and how these latent profiles relate to mental health and exercise dependence in exercise active adults. Results indicate a two class profile, whereby class 1 is characterized by high irrational beliefs and body image inflexibility, and class 2 is characterized by low irrational beliefs and body image inflexibility. Those in class 1 reported significantly greater depression, anxiety, stress, and exercise dependence than those in class 2 (p ≤ .02). The findings are discussed in relation to the implications for practitioners in the mental health of exercise participants.

Using Personal-Disclosure Mutual-Sharing (PDMS) with first-year undergraduate students transitioning to higher education

BACKGROUND

Using Personal-Disclosure Mutual-Sharing (PDMS) with students transitioning to Higher Education (HE) has yet to be researched in education.

AIMS

In two studies, we aimed to explore the immediate effects of a Coping Oriented Personal-Disclosure Mutual-Sharing (COPDMS) intervention on first-year undergraduate students' relational and organizational identification, perceived social support availability, and self-efficacy for learning and performance. In our second study, we also aimed to examine student-perceptions of participating in a COPDMS intervention.

SAMPLE AND METHODS

At the beginning of induction week in both studies, first-year undergraduate students on the same degree programme at a HE provider in England received an education session where COPDMS was introduced. Students participated in a COPDMS session a few days later. During COPDMS sessions, students mutually-shared and disclosed personal information and/or stories relating to transitional experiences.

RESULTS

Across both studies, students' relational identification with staff and perceived emotional, esteemed, and informational support availability from others on the degree programme significantly increased from pre- to post-COPDMS phases. Findings relating to relational identification with other Year 1 students and perceived availability of tangible support were mixed. No significant changes occurred for organizational identification with the university and self-efficacy for learning and performance. In Study 2, five higher-order themes relating to students' perceptions of COPDMS were found: (1) emotionality; (2) personal development; (3) storytelling; (4) enhanced group processes; and (5) task appropriateness and value.

CONCLUSIONS

Study findings provide evidence that COPDMS is a useful psychological intervention to deliver to students transitioning to HE. Practical considerations, limitations, and future research suggestions are provided.

"I must be perfect": The role of irrational beliefs and perfectionism on the competitive anxiety of Hungarian athletes

In this study the influence of irrational beliefs and perfectionism on the emergence of competitive anxiety was investigated. While previous studies indicate that higher irrational beliefs predict greater competitive anxiety, in the present study it is hypothesized that this relationship is mediated by perfectionism. A serial atemporal multiple mediation analysis revealed that both adaptive and maladaptive perfectionism were significant partial mediators between irrational beliefs and competitive anxiety. The total score and all four subscale scores on irrational beliefs had both direct and indirect effects on cognitive competitive anxiety, the latter effects mediated by both forms of perfectionism. Depreciation beliefs had a direct effect, and demandingness and awfulizing had indirect effects, on somatic competitive anxiety when both forms of perfectionism were entered as mediators. These findings suggest that both irrational beliefs and perfectionism influence the emergence of competitive anxiety, therefore rational emotive behavioral therapy with a focus upon perfectionism may be an effective means of reducing competitive anxiety in athletes.

Air Pollution Levels Outside the Capital's Maternity Hospitals

Introduction The World Health Organisation has identified air pollution as the single biggest environmental threat to human health. There is growing evidence in the literature that air pollution is associated with negative outcomes in pregnancy. The purpose of this study was to measure pollution levels in the immediate surroundings of the three Dublin maternity hospitals by measuring fine particulate matter <2.5 micrometres (PM2.5). Methods Data pertaining to levels of PM2.5 at the three Dublin maternity hospitals were obtained from Pollutrack's records for the time period 25/6/2021-2/12/2021. Results were compared to the 2021 WHO Air Quality Guidelines. Results Average PM2.5 levels were 9μg/m³ around the National Maternity Hospital, 10μg/m³ around the Coombe Hospital and 13μg/m³ around the Rotunda Hospital. Levels were higher during the day, weekdays and in December. No matter when the PM2.5 levels were measured, results were higher than those recommended by the World Health Organisation's Air Quality Guideline. Discussion Air pollution levels across Ireland's capital city are higher than recommended by the WHO. This is concerning for the public and in particular for the pregnant population. Going forward, further research is required on the relationship between levels of air pollutants and adverse pregnancy outcomes in Dublin.

Implementing Medical Student Teaching on Gynaecological Healthcare of Transgender Patients

Introduction Transgender people have specific healthcare needs and experience difficulty in accessing health services. Medical students should receive teaching on general and gynaecological healthcare issues in this population. Our aim was to assess medical students' knowledge of healthcare needs of transgender people before and after a newly implemented teaching session on transgender healthcare. Method A mixed-method study was carried out over a three month period in a university obstetric and gynaecology hospital in Dublin. A one-hour teaching session was developed and delivered to final year medical students. Students completed a survey before and after receiving the lecture. Results Seventy-one students completed the pre-lecture survey and forty-three completed the post-lecture survey. Pre-lecture, 64 students (90%) reported some-to-no understanding of healthcare issues of transgender people, and only 13 (18%) reported understanding gynaecological issues faced by transgender people. Post-lecture, 41 (95%) had a better understanding of health issues faced by this population and 40 (93%) had a better understanding of gynaecological health issues faced. Most students (81%) wanted further teaching on the topic. Conclusion A one-hour teaching session was effective at improving student knowledge of care of transgender people. This teaching could be expanded to all Irish medical schools. Going forward, the teaching could be adapted for post-graduate obstetric and gynaecology teaching.

Adolescent Soccer Athletes’ Irrational Beliefs About Basic Psychological Needs are Related to Their Emotional Intelligence and Mental Health

There has been a scarcity of research regarding the unique mental health risk factors that adolescent athletes face. The recently proposed Rational Emotive Self Determination Scale for Adolescents (RESD-A) has been suggested to understand some of the antecedent and associative factors of adolescent athlete mental health. The principal aim of this study is to examine the structural and criterion validity of the RESD-A in an athlete sample for the first time. To achieve this aim, two hundred and forty-two club level soccer athletes participated in the study. Confirmatory factor analysis (CFA) was conducted to test the validity of the RESD-A’s factor structure. Partial correlation analyses with the subscales of RESD-A, emotional intelligence, and mental health scores were used to examine criterion validity. Initial results for the structural and criterion validity of the RESD-A with an athlete population are promising. The potential importance, limitations and directions for future research are discussed.

Link Between Irrational Beliefs and Important Markers of Mental Health in a German Sample of Athletes: Differences Between Gender, Sport-Type, and Performance Level

In this article, we conducted the first meaningful study of irrational beliefs (IBs) in a German sample of athletes. Moreover, we investigated associations between IBs and potential general as well as sport-specific markers of mental health in German athletes. As general markers, we considered psychological distress and wellbeing in addition to IBs, and as sport-specific markers, we considered anxiety, perfectionism, and athletic identity. To achieve this, our first step was to translate and validate a specific measure of irrational beliefs, namely the Irrational Performance Beliefs Inventory (iPBI). The iPBI is a performance-relevant measure that captures specific IB, taking into account the situational circumstances of the target population, namely operators in different performance context (academia, sports, business, medicine, etc.). Its theoretical basis is largely Ellis' work on rational and irrational beliefs. We developed a short and a long version of the iPBI, which both capture four core IBs (i.e., demandingness, awfulization, low frustration tolerance, and depreciation). Factorial validity was confirmed by a confirmatory factor analysis (comparative fit index = 0.92) with data from 234 athletes. Both versions of the newly developed iPBI showed good internal consistency (Cronbach's alpha > 0.77) and retest reliability (intra-class correlation coefficients >0.71). Results of the correlational analyses indicated low positive relationships between IBs and athletes' psychological distress, and low negative relations between IBs and wellbeing. In terms of sport-specific markers, there were low to moderate correlations with IBs. This study also examined the differences in IBs between females and males, individual and team sport athletes, and across three different performance levels. Implications of these findings are discussed along with approaches for future research and applied work.

Knowing your ABCs: Extending the assessment of stimulus-response (S-R) and cognitive-mediation (C-M) beliefs

Recently, researchers have proposed four superordinate emotion beliefs that supposedly influence emotion regulation and emotion reactivity. Two of these proposed emotion beliefs are captured in the cognitive mediation beliefs questionnaire (CMBQa), namely stimulus-response (S-R) generation beliefs and cognitive mediation (C-M) change beliefs. The remaining two proposed emotion beliefs, C-M generation beliefs and S-R change beliefs, are yet to be operationalised in psychometric form. It is important to validate measurement for all four emotion beliefs in order for them to be used in research and practice. The current paper reports the development and initial validity testing of the CMBQb (studies 1–3), which concerns only C-M generation beliefs and S-R change beliefs, and then tests the four-factor structure of the combined CMBQa (S-R generation, C-M change) and CMBQb (C-M generation, S-R change): the CMBQc (study 4). Some support was found for the four-factor structure of the CMBQc, with factor analyses revealing good fit to the data with a four-factor solution. Also, scores indicating greater C-M generation and change beliefs, and lower S-R generation and change beliefs, were related to more adaptive, and less maladaptive, emotion regulation tendencies. In addition, there was some evidence that greater C-M change beliefs, and lower S-R generation and change belief, were related to better affective and emotion reactivity outcomes. Implications of the CMBQc for research and practice are discussed within the context and emotion regulation science, and cognitive behavioural psychotherapy.

At the Coalface: Practitioner Perspectives on Applying Rational Emotive Behaviour Therapy (REBT) in High Performance Sport

The reported usage of rational emotive behaviour therapy (REBT) in high performance sport is becoming more common in research literature. This research indicates that REBT is a useful and effective approach to performance psychology. However, applied professional practice reflections and insights remain sparse. The current paper brings together REBT practitioners who work predominantly in performance settings (i.e., sport) to answer three questions pertaining to their application of REBT. Practitioners were asked to respond to the following questions: (1) What do you consider to be among the main irrational beliefs that interfere with performance? (2) In your experience, which irrational beliefs impair one’s ability to recover from a significant injury or major setback? (3) Can you describe the role of cognitive restructuring/change/reappraisal/disputation in applied work as it relates to performance? In the present paper, the practitioners’ responses are collected and presented, following which common themes are drawn from the responses to form guidance for practitioners wishing to apply REBT in performance settings. It is hoped that the experiences of the included practitioners will be useful for those wishing to take an REBT approach to their performance psychology consultancy.

Assessing beliefs about emotion generation and change: The conceptualisation, development, and validation of the Cognitive Mediation Beliefs Questionnaire (CMBQ)

The ability to regulate emotions is important for human function and health. That emotion regulation can be achieved through cognitive change is predicated on the notion of cognitive mediation. However, the extent to which individuals believe that their emotions are cognitively mediated (C-M), or in contrast, that their emotions occur via stimulus-response (S-R), is underexplored, and whether C-M and S-R beliefs shape emotion reactivity is not yet known. Research that addresses these empirical needs could inform emotion regulation interventions such as cognitive behavioural therapies (CBTs). The current paper reports the development and initial validity testing of the cognitive mediation beliefs questionnaire (CMBQ). Five studies report the factor structure, the construct and criterion validity, and the test-retest reliability of the CMBQ. The CMBQ was found to have a correlated two-factor structure (C-M change beliefs, and S-R generation beliefs). Higher C-M change beliefs and lower S-R generation beliefs were related to greater emotion regulation, greater thought control ability, higher positive mental health, and lower emotion reactivity. The CMBQ also demonstrated acceptable test-retest reliability. Initial testing indicates that the CMBQ is a valid and reliable questionnaire for psychometric use in adult populations, including those with a diagnosed mental health condition.

A web-based dietary intervention in early pregnancy and neonatal outcomes: a randomized controlled trial

BACKGROUND

Maternal nutrition is a determinant of pregnancy outcomes. Few studies have evaluated the potential of online nutrition resources to modify behaviour. This randomized controlled trial aimed to determine whether access to a customized evidence-based nutrition website in pregnancy improved neonatal outcomes.

METHODS

Women <18 weeks gestation were recruited at their convenience. The control group received standard care. In addition to standard care, the intervention group received access to an evidence-based nutrition website, customized to the preferences of pregnant women.

RESULTS

Of the 250 women, there were no differences in characteristics between the two groups. Of the women, 91.0% reported they make a conscious effort currently to eat a healthy diet. However, only 19.6% met dietary requirements for calcium, 13.2% for iron, 2.7% for folate and 2.3% for iodine. The most popular website section was pregnancy nutrition advice but engagement was not sustained. Access to the website was not associated with any improvement in clinical outcomes (P > 0.05).

CONCLUSIONS

We found that provision of a customized website providing nutrition information, did not improve neonatal outcomes. Future studies should explore whether redesign with website interactivity or embedding information on popular digital platforms sustains women's engagement and modifies dietary behaviour.

The effects of REBT on irrational beliefs, self-determined motivation, and self-efficacy in American Football

It has been suggested in recent research that rational beliefs as conceptualized within rational-emotive behaviour therapy (REBT) can be operationalized as strategic self-talk, but this has yet to be meaningfully investigated. The current study examines the effects of five one-to-one REBT sessions with three amateur American Football athletes to foster rational self-talk. The purpose of the intervention was to reduce the irrational beliefs, but also in line with recent applied REBT research, to increase the self-determined motivation and self-efficacy of the athletes. Using an idiographic single-case, staggered multiple-baseline across participants design, visual analyses revealed meaningful increases in self-determined motivation and self-efficacy, adjunct to decreases in total irrational beliefs across all participants. Social validation data supported these outcomes. These findings add to the growing research indicating that REBT can influence motivational approaches in athletes, such as self-determined motivation and self-efficacy. Results are discussed in relation to processes underlying the mechanisms of change, while also reporting the limitations of the study. The robustness of the research design increases the extent to which target variable changes can be attributed to REBT, but critical reflections are undertaken to assess the veracity of the findings.

More positive group memberships are associated with greater resilience in Royal Air Force (RAF) personnel

In the current project, we examined how perceived group memberships (number, and characteristics, of), social and relational identification, and social identity leadership are associated with resilience in Royal Air Force (RAF) personnel. Based on social identity theorizing, we hypothesized positive associations between the number of groups, perceptions of their characteristics (e.g., positivity), and how they relate to each other (i.e., compatibility) and resilience (H1). We also hypothesized positive associations between both social identity leadership (H2) and resilience, and social and relational identification (H3) and resilience. Two hundred and forty-three personnel from 18 RAF bases completed an identity mapping exercise and measures of leadership, social and relational identification, and resilience. Our findings highlighted the importance of the association between positive group memberships and resilience, and social identification and resilience. Counter to our hypothesis, belonging to more groups was negatively associated with resilience, and there were non-significant relationships between three principles of social identity leadership and resilience, with embedding identity being significantly negatively associated with resilience. In support of social identity theorizing, the number of positive groups was positively associated with resilience, as was social identification. These findings indicate that, for RAF personnel, it is belonging to positive groups, both within and outside work, along with social identification, that is positively associated with resilience.

The diagnosis of gestational diabetes mellitus (GDM) using a 75 g oral glucose tolerance test: A prospective observational study

AIMS

Screening for Gestational Diabetes Mellitus (GDM) is controversial. This prospectivestudy compared different sets of diagnostic cut-off points for plasma glucose measurements following a 75 g Oral Glucose Tolerance Test (OGTT).

METHODS

Women who had maternal risk factors for GDM were recruited at their convenience attheir first prenatal visit and consented to a one-step OGTT at 26-28 weeks gestation.All women fulfilling the World Health Organization (WHO) 2013 diagnostic criteriareceived standard care for GDM.

RESULTS

Of the 202 women, 139 (69%) had one risk factor for GDM and 63 (31%) had > 1.Using the WHO criteria, 53% (n = 108) had GDM compared with 35% (n = 71) usingCanadian criteria and 18% (n=36) using National Institute for Health Care Excellencecriteria (NICE) criteria (both p<0.001). Of the 108 women, 50% (n = 54) requiredpharmacological treatment to control hyperglycaemia. If the Canadian criteria wereapplied, 11/54 (20.4%) women would not have received hypoglycaemics. If the NICEcriteria were applied, 36/54 (66.7%) women would not have received hypoglycaemics.Maternal insulin, HOMA-IR and C-peptide measured at the time of the OGTT showed evidence of increased insulin resistance in women who had GDM based on the WHOcriteria but who had a normal OGTT based on the Canadian or NICE criteria.

CONCLUSIONS

Under stringent research conditions, our study suggeststhat the Canadian and, in particular, the NICE criteria are not identifying women who may benefit fromimproved glycaemic control. These findings support the need for the planned review of the NICE guidelines on GDM in 2020.

Cognitive appraisals and team performance under stress: A simulation study

OBJECTIVES

The present study explored how challenge and threat responses to stress relate to performance, anxiety, confidence, team identity and team characteristics (time spent in training and postgraduate experience) in a medical simulation-based team competition.

METHODS

The study was conducted during a national simulation-based training event for residents, the SIMCUP Italia 2018. The SIMCUP is a simulation competition in which teams of four compete in simulated medical emergency scenarios. Cross-sectional data were collected prior to the 3 days of the competition. Subjects included 95 participants on 24 teams. Before the competition on each day, participants completed brief self-report measures that assessed demands and resources (which underpin challenge and threat responses to stress), cognitive and somatic anxiety, self-confidence and team identification. Participants also reported time (hours) spent practising as a team and years of postgraduate experience. A team of referees judged each scenario for performance and assigned a score. A linear mixed model using demands and resources was built to model performance.

RESULTS

The data showed that both demands and resources have positive effects on performance (31 [11-50.3] [P < .01] and 54 [25-83.3] [P < .01] percentage points increase for unitary increases in demands and resources, respectively); however, this is balanced by a negative interaction between the two (demands * resources interaction coefficient = -10 [-16 to -4.2]). A high level of resources is associated with better performance until demands become very high. Cognitive and somatic anxieties were found to be correlated with demands (Pearson's r = .51 [P < .01] and Pearson's r = .48 [P < .01], respectively). Time spent training was associated with greater perceptions of resources (Pearson's r = .36 [P < .01]).

CONCLUSIONS

We describe a model of challenge and threat that allows for the estimation of performance according to perceived demands and resources, and the interaction between the two. Higher levels of resources and lower demands were associated with better performance.

A longitudinal, observational study of women who persisted in smoking in successive pregnancies

BACKGROUND

This longitudinal study examined the profile and pregnancy-related behaviours of women who reported smoking in two successive pregnancies when they presented for prenatal care in a large maternity hospital.

METHODS

Using the hospital electronic medical records, women who delivered two successive singleton pregnancies during the years 2011-15 were analyzed. Standardized data were computerized by a midwife at the first prenatal visit, following delivery and before discharge.

RESULTS

Over the 5 years, 6647 women delivered twice. Overall 5754 (86.6%) were persistent non-smokers in both pregnancies, 609 (9.2%) were persistent smokers in both pregnancies and between pregnancies 202 (3.0%) quit and 82 (1.2%) started smoking. Compared with persistent non-smokers, persistent smokers had higher rates of reported illicit drug use, alcohol consumption and psychological problems and lower rates of planned pregnancy, folic acid supplementation and breastfeeding in both pregnancies (all P < 0.001). In persistent smokers, folic acid supplementation practices deteriorated and illicit drug use increased in the subsequent pregnancy.

CONCLUSIONS

We found that approximately one in 10 women smoked in two consecutive pregnancies. Furthermore, compared with non-smokers, persistent smokers were more likely to report other health behaviours associated with adverse pregnancy outcomes and may require additional multidisciplinary support.

The relationship between early pregnancy dietary intakes and subsequent birthweight and neonatal adiposity

Background

Maternal nutrition intakes may influence neonatal birthweight and adiposity; however, inconsistencies within the literature exist. The relationships between maternal dietary intakes in early pregnancy and both birthweight and neonatal adiposity requires elucidation. This study examined the relationship between early pregnancy dietary intakes and subsequent birthweight and neonatal adiposity.

Methods

Women were recruited at their convenience after sonographic confirmation of a singleton pregnancy. Women completed a Willet food frequency questionnaire evaluating habitual food and nutrient intakes at their first antenatal visit. Neonatal body composition was measured using air-displacement plethysmography.

Results

Of the 385 mother-neonate dyads, mean maternal age was 30.8 ± 5.3 years, mean Body Mass Index (BMI) was 24.5 ± 4.8 kg/m2 and 41.8% (n = 161) were nulliparous. There were no relationships between maternal food intakes and birthweight (P > 0.05) (n = 385). On multivariable analysis there was a positive relationship between polyunsaturated fat and neonatal fat mass index (FMI) (beta = 0.015, 95% CI = 0.002-0.028, P = 0.04) (n = 80).

Conclusion

Dietary intakes of polyunsaturated fat in early pregnancy are positively associated with neonatal FMI at birth on multivariable analysis. Further longitudinal studies need to explore this association and the long-term implications for the neonate.

Investigating Irrational Beliefs, Cognitive Appraisals, Challenge and Threat, and Affective States in Golfers Approaching Competitive Situations

On approach to competitive situations, affective states (emotions and anxiety) occur through the complex interaction of cognitive antecedents. Researchers have intimated that irrational beliefs might play an important role in the relationship between cognitive appraisals and affective states, but has ignored challenge and threat. In the current research, we examine the interaction between cognitive appraisals, irrational beliefs, and challenge and threat to predict golfers' pre-competitive affective states. We adopted a cross-sectional atemporal design to examine how golfers approached two different competitive situations: imagined imminent golf competition (phase 1), and actual future golf competition (phase 2). Path analysis revealed how cognitive appraisals, irrational beliefs, and challenge and threat interact to predict affective states among golfers. Serial atemporal multiple mediation analysis indicated that the relationships between cognitive appraisals and affective states were mediated by irrational beliefs and challenge and threat. Further, some differences were revealed between phase 1 and phase 2 in the serial multiple atemporal mediation results with regard to challenge. That is, at phase 1 no significant serial mediation was found for any affective outcomes, but at phase 2 significant serial mediation was found for all affective states, showing that irrational beliefs and challenge serial mediated the associations between cognitive appraisals and affective states. The finding that mediation and bivariate associations differed across phase 1 and phase 2 is echoed in the phase 1-phase 2 tests of differences. The current research makes a theoretical advancement by elucidating in more detail the complex interaction between cognitive antecedents and mediators of affective states. Specifically, the inclusion of challenge and threat alongside irrational beliefs and cognitive appraisals is an important theoretical advancement that builds on work inside of sport literature (e.g., Dixon et al., 2016) and outside of sport literature (e.g., David et al., 2002, 2005), as this constellation of theoretically related antecedents of affective states has not been examined together in the extant research.

Sonographic markers of fetal adiposity and risk of Cesarean delivery

OBJECTIVE

Increased fetal size is associated with shoulder dystocia during labor and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically in late pregnancy is associated with increased risk of operative delivery.

METHODS

This secondary analysis of the Genesis Study recruited 2392 nulliparous women with singleton pregnancy in cephalic presentation, in a prospective, multicenter study, to examine prenatal and intrapartum predictors of Cesarean delivery. Participants underwent ultrasound and clinical evaluation between 39 + 0 and 40 + 6 weeks' gestation. Data on fetal biometry were not revealed to patients or to their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal wall thickness was compiled for each infant in order to determine whether fetal adiposity > 90^th centile was associated with an increased risk of Cesarean or operative vaginal delivery.

RESULTS

After exclusions, data were available for 2330 patients. Patients with a fetal adiposity composite > 90^th centile had a higher maternal body mass index (BMI) (25 ± 5 kg/m² vs 24 ± 4 kg/m² ; P = 0.005), birth weight (3872 ± 417 g vs 3585 ± 401 g; P < 0.0001) and rate of induction of labor (47% (108/232) vs 40% (834/2098); P = 0.048) than did those with an adiposity composite ≤ 90^th centile. Fetuses with adiposity composite > 90^th centile were more likely to require Cesarean delivery than were those with adiposity composite ≤ 90^th centile (P < 0.0001). After adjusting for birth weight, maternal BMI and need for induction of labor, fetal adiposity > 90^th centile remained a risk factor for Cesarean delivery (P < 0.0001). A fetal adiposity composite > 90^th centile was more predictive of the need for unplanned Cesarean delivery than was an estimated fetal weight > 90^th centile (odds ratio, 2.20 (95% CI, 1.65-2.94; P < 0.001) vs 1.74 (95% CI, 1.29-2.35; P < 0.001). Having an adiposity composite > 90^th centile was not associated with an increased likelihood of operative vaginal delivery when compared with having an adiposity composite ≤ 90^th centile (P = 0.37).

CONCLUSIONS

Fetuses with increased adipose deposition are more likely to require Cesarean delivery than are those without increased adiposity. Consideration should, therefore, be given to adding fetal thigh adiposity and abdominal wall thickness to fetal sonographic assessment in late pregnancy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

The benefits of a challenge approach on match day: Investigating cardiovascular reactivity in professional academy soccer players

This study assessed physiological (cardiovascular) and psychological (confidence, control, and approach focus) data in professional academy soccer players prior to performance in competitive matches. A challenge state is characterised by an increase in cardiac output (CO), and a decrease in total peripheral vascular resistance (TPR). Data were collected from 37 participants, with 19 of these providing data on two separate occasions. Performance was measured using coach and player self-ratings. Challenge reactivity was positively, and significantly, associated with performance. Participants who demonstrated blunted cardiovascular (CV) responses performed significantly worse than participants who displayed either challenge or threat reactivity. There was mixed consistency in CV reactivity for those participants whose data were collected on more than one occasion, suggesting that some participants responded differently across the competitive matches. The association between self-report data and CV responses was weak. This study supports previous research demonstrating that challenge reactivity is associated with superior performance.

Maternal anaemia and folate intake in early pregnancy

Background

The World Health Organization recommends that women take 400 µg of folate supplementation daily throughout pregnancy. We examined the relationship between total folate intake from the diet and supplements at the first prenatal visit and haematological indices at this visit and subsequently.

Methods

Women were recruited at their convenience and in addition to clinical and sociodemographic details, detailed questionnaires on dietary intakes and supplementation consumption were completed under supervision. A full blood count and serum and red blood cell (RBC) folate levels were taken.

Results

Of the 502 women studied, 97.5% had inadequate total dietary folate intake at the first visit, but, 98.2% were taking folic acid (FA) supplementation. Only 1.8% (n = 9) had anaemia at their first visit (with no case of macrocytosis). Subsequently, 212 women had a further Hb sample in the third trimester and 8.5% (n = 18) were anaemic and 43.4% (89/205) were anaemic postnatally. There was a relationship between the development of anaemia postnatally and lower RBC folate levels at the first visit (P = 0.02).

Conclusions

In a country where FA food fortification remains voluntary, these findings support the recommendation that women should start FA supplementation before pregnancy and continue FA after the first trimester.

Screening For Gestational Diabetes Mellitus Selectively in a University Maternity Hospital

Aims Screening for gestational diabetes mellitus (GDM) may be universal or selective based on risk factors. We audited selective screening with an Oral Glucose Tolerance Test (OGTT). Methods Clinical and laboratory details of the first 200 women who delivered a baby in 2017 were analysed. Results Based on national recommendations, 46.5% (n=93) had maternal risk factors (RF) and an additional 6.5% (n=13) had fetal RF. Nine women with RF, for unexplained reasons did not have their OGTT. Of the 95 who had their OGTT, the diagnosis of GDM was made in 27.4% (n=26). The diagnosis of GDM was made in an additional 8 women outside selective screening giving an overall incidence of 17.0%. Discussion More than half of the women needed to be screened selectively for GDM. Compliance with the national recommendations was incomplete and thus the diagnosis of GDM may be missed even in an academic setting.

The Development and Initial Validation of the Irrational Performance Beliefs Inventory (iPBI)

Abstract. The growing use of Rational Emotive Behavior Therapy (REBT) in performance contexts (e.g., business, sport) has highlighted the absence of a contextually valid and reliable measure of irrational beliefs. This paper reports the development and initial validation of the Irrational Performance Beliefs Inventory (iPBI). The iPBI was developed to provide a validated measure of the four core irrational beliefs of REBT theory. Item development was completed in three stages comprising two expert panels and one novice panel, reducing and refining 176 items to 133. Then, exploratory and confirmatory factor analyses were used to refine the measure and reduce the number of items. A total of 665 business professionals completed the 133-item scale, alongside an established measure of irrational beliefs and a measure of negative emotion. A 28-item measure was developed (the iPBI) that showed an acceptable fit to the four-factor REBT structure. The iPBI correlated well with the established irrational beliefs measure, and with anxiety, depression, and anger, demonstrating concurrent and predictive validity. Further validation efforts are required to assess the validity and reliability of the iPBI in alternative samples in other performance-related contexts.

An Audit of Neural Tube Defects in the Republic Of Ireland for 2012-2015

Neural tube defects (NTD) are potentially preventable in two-thirds of cases by periconceptional maternal Folic Acid (FA) supplementation. A national audit for the years 2009-11 showed no decline in NTD rates over twenty years. The aim of this national audit was to determine trends/rates and inform revision of national FA supplementation and food fortification strategies. Of 274,732 live and stillbirths there were 121(42.0%) cases of anencephaly, 136(47.2%) cases of spina bifida and 31(10.8%) cases of encephalocoele giving a total of 288 and overall rate of 1.05/1000 compared with 1.04/1000 in 2009-11(NS). In the 184 women where the information was available, only 29.9%(n=55) reported starting FA before pregnancy. The number of cases diagnosed antenatally was 91%(n=262) and 53%(n=154) were live-born. This audit confirms that over a generation, healthcare interventions have not succeeded in decreasing the number of pregnancies in Ireland complicated by NTD, and that revised strategies need to be developed and implemented.

Test-retest reliability of the irrational performance beliefs inventory

The irrational performance beliefs inventory (iPBI) was developed to measure irrational beliefs within performance domains such as sport, academia, business, and the military. Past research indicates that the iPBI has good construct, concurrent, and predictive validity, but the test-retest reliability of the iPBI has not yet been examined. Therefore, in the present study the iPBI was administered to university sport and exercise students (n = 160) and academy soccer athletes (n = 75) at three-time points. Time point two occurred 7 days after time point one, and time point three occurred 21 days after time point two. In addition, social desirability was also measured. Repeated-measures MANCOVAs, intra-class coefficients, and Pearson's (r) correlations demonstrate that the iPBI has good test-retest reliability, with iPBI scores remaining stable across the three-time points. Pearson's correlation coefficients revealed no relationships between the iPBI and social desirability, indicating that the iPBI is not highly susceptible to response bias. The results are discussed with reference to the continued usage and development of the iPBI, and future research recommendations relating to the investigation of irrational performance beliefs are proposed.

A National Audit of Smoking Cessation Services in Irish Maternity Units

There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.

Tinzaparin thromboprophylaxis prescribing practice after caesarean delivery 2009-2014

BACKGROUND

National guidelines have been developed to ensure correct dosing of tinzaparin for women delivered by caesarean delivery (CD) to reduce the risk of venous thromboembolism.

AIMS

The aim of this study is to examine the impact of implementation of national guidelines on thromboprophylaxis prescribing practice for women undergoing CD in a university maternity hospital.

METHODS

Details of tinzaparin usage were obtained from the Hospital pharmacy for the years 2009-2014. Information on CD and pulmonary embolism (PE) were obtained from the Hospital's annual clinical reports.

RESULTS

Following guideline recommendations on weight-based tinzaparin for all women undergoing CD, the usage of syringes prefilled with tinzaparin 4500 IU increased from 526 to 8502 (P < 0.001) and usage of syringes prefilled with tinzaparin 10,000 IU increased from 36 to 910 (P < 0.001). Usage of syringes prefilled with tinzaparin 3500 IU decreased from 8216 in 2009 to 39 in 2014 (P < 0.001). During 2008-2010, there were two cases of PE after CD, both of whom received an inadequate dose of prophylactic tinzaparin. During 2011-2014 there were no cases of PE diagnosed after a total of 9427 CDs.

CONCLUSIONS

The development of national guidelines on thromboprophylaxis after CD was followed by a significant change in weight-based prescribing of tinzaparin. Following implementation, there have been no cases of PE after CD.

Pilot evaluation of an online weight management programme

This intervention examined the efficacy of a six-week online weight loss programme. Students and staff of a third level institution (n=183) were recruited to the programme which provided individualised dietary advice for weight loss. Eighty-five participants (mean age 29.7 years, mean BMI 28.9kg/m2, 33% male) met the minimum inclusion criterion of logging on to the study website at least twice. All participants who completed the full six-week programme lost weight (n=31), with significant reductions in mean weight (2.8kg), BMI (0.9kg/m2) and waist circumference (4.1cm) observed between the start and end of the programme (all P<0.001). Among "completers", males lost more weight than females (4.2kg vs. 1.9kg, P=0.004). One in four completers lost >5% of their bodyweight, with reductions in biscuit and alcohol consumption being most predictive of weight loss. These findings suggest that individualised online dietary advice is effective in achieving short-term weight loss, especially in males.

Examining the relationships between challenge and threat cognitive appraisals and coaching behaviours in football coaches

Previous research demonstrates that sports coaching is a stressful activity. This article investigates coaches' challenge and threat cognitive appraisals of stressful situations and their impact on coaching behaviour, using Blascovich and Mendes' (2000) biopsychosocial model as a theoretical framework. A cross-sectional correlational design was utilised to examine the relationships between irrational beliefs (Shortened general attitude and belief scale), challenge and threat appraisals (Appraisal of life events scale), and coaching behaviours (Leadership scale for sports) of 105 professional football academy coaches. Findings reveal significant positive associations between challenge appraisals and social support, and between threat appraisals and autocratic behaviour, and a significant negative association between threat appraisals and positive feedback. Results also show that higher irrational beliefs are associated with greater threat, and lesser challenge cognitive appraisals. However, no associations were revealed between irrational beliefs and challenge cognitive appraisals. Additionally, findings demonstrate a positive relationship between age and training and instruction. Results suggest that practitioners should help coaches to appraise stressful situations as a challenge to promote positive coaching behaviours.

Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes

In this article Rational Emotive Behavior Therapy (REBT) is proposed as a potentially important framework for the understanding and promotion of mental health in athletes. Cognitive-behavioral approaches predominate in the provision of sport psychology, and often form the backbone of psychological skills training for performance enhancement and maintenance. But far from being solely performance-focused, the cognitive-behavioral approach to sport psychology can restore, promote, and maintain mental health. This review article presents REBT (Ellis, 1957), the original cognitive behavioral therapy, as a valuable approach to addressing mental health issues in sport. REBT holds that it is not events that directly cause emotions and behaviors. Rather, it is one's beliefs about the events that lead to emotional and behavioral reactivity. Further, REBT distinguishes between rational and irrational beliefs, and suggests that in response to failure, maltreatment, and misfortune, people can react with either healthy or unhealthy emotional and behavioral responses. The extant research indicates that irrational beliefs lead to unhealthy negative emotions, a range of pathological conditions, and a host of maladaptive behaviors that undermine mental health. Therefore, REBT proposes a process for the reduction of irrational beliefs and the promotion of rational beliefs. The use of REBT in sport is seldom reported in literature, but research is growing. This review article proposes three important areas of investigation that will aid the understanding of irrational beliefs and the application of REBT within sport. These areas are: (1) the influence of irrational beliefs and REBT on the mental health of athletes, (2) the influence of irrational beliefs and REBT on athletic performance, (3) the origins and development of irrational beliefs in athletes. Each area is discussed in turn, offering a critical and progressive review of the literature as well as highlighting research deficits, and recommendations to address each of the three areas of investigation.