The Efficacy of a Mental Skills Training Course for Collegiate Athletes.

CONTEXT: Psychological skills training improves performance in athletes. However, few studies have looked at the efficacy and satisfaction of mental skills training programs for collegiate athletes. OBJECTIVE: We aimed to evaluate satisfaction of collegiate athletes with a 6-session mental skills course, and to assess changes in mental toughness and coping skills before and after the course. DESIGN: Prospective cohort study following collegiate female athletes through a 6-session mental skills course. SETTING: Division 1 collegiate athletic teams. PATIENTS/PARTICIPANTS: 54 Division I female athletes (mean age =19.8) participated in the program and 42 (77.7 %) completed pre-course assessments, which subsequent evaluations were matched to. MAIN OUTCOME MEASURES: The Athletic Coping Skills Inventory (ACSI, range=0-84) and Mental Toughness Index (MTI, range=8-56) assessed coping skills and mental toughness pre-course, immediate post-course and 4-month post course. Satisfaction was assessed on a 10-point scale. RESULTS: For participants with paired pre- and immediate post-course data (n=37, 68.5%), MTI scores improved by a mean 2.6 points (95% CI=1.1-4.1; p=0.001) and ACSI scores improved by a mean 4.0 points (95% CI=0.6-7.4; p=0.02). At four-month follow-up (n=25, 46.2%), no change was detected from pre-course in mean MTI score (p=0.72), but there was a significant increase of 3.4 points in mean ACSI (95% CI=0.4-6.4; p=0.03). Overall satisfaction had a median score of 9/10 (IQR, 8-10) at post-course, and eighteen participants (48.6%) shared positive free-text comments regarding course delivery, content, and impact. No negative feedback was reported. CONCLUSIONS: Mental toughness and coping skills scores significantly improved at post-course assessment, with coping skills scores maintaining their effect at four months. The improvements identified spark the question of the potential impact of mental skills training programs when studied in larger athlete populations or over more sustained periods of time. Athletes reported being highly satisfied with course content and reported overall positive experiences.

Skills to Enhance Positivity in adolescents at risk for suicide: Protocol for a randomized controlled trial.

BACKGROUND: Suicide and suicidal behavior during adolescence have been steadily increasing over the past two decades. The preponderance of interventions focuses on crisis intervention, underlying psychiatric disorders, regulating negative affect, and reducing cognitive distortions. However, low positive affectivity may be a mechanism that contributes to adolescent suicidal ideation and behaviors independent of other risk factors. Skills to Enhance Positivity (STEP) is an acceptance-based intervention, designed to increase attention to, and awareness of, positive affect and positive experiences. Results from a pilot RCT demonstrated engagement of the target (positive affect) and a decrease in clinical outcomes (suicidal events; i.e., either a suicide attempt or an emergency intervention for an acute suicidal crisis), providing support to test the clinical effectiveness of STEP in a larger clinical trial with clinical staff implementing the intervention. OBJECTIVE: To test the effectiveness of STEP, compared to Enhanced Treatment as Usual (ETAU), in reducing suicidal events and ideation in adolescents admitted to inpatient psychiatric care due to suicide risk. We hypothesize that those randomized to STEP, compared to ETAU, will have lower rates of suicide events, active suicidal ideation (SI), and depressed mood over the 6-month follow-up period. We hypothesize that those randomized to STEP, compared to ETAU, will demonstrate greater improvement in the hypothesized mechanisms of attention to positive affect stimuli and gratitude and satisfaction with life. METHODS: Participants will be randomized to either STEP or ETAU. STEP consists of four in-person sessions focused on psychoeducation regarding positive and negative affect, mindfulness meditation, gratitude, and savoring. Mood monitoring prompts and skill reminders will be sent via text messaging daily for the first month post-discharge and every other day for the following two months. The ETAU condition will receive text-delivered reminders to use a safety plan provided at discharge from the hospital and healthy habits messages, matched in frequency to the STEP group. This trial was registered on 6 August 2021 (ClinicalTrials.gov NCT04994873). RESULTS: The STEP protocol was approved by the National Institute of Mental Health (NIMH) Data and Safety Monitoring Board on March 4, 2022. The RCT is currently in progress. DISCUSSION: The STEP protocol is an innovative, adjunctive treatment that has the potential to have positive effects on adolescent suicidal ideation and attempts beyond that found for standard treatment alone.

COVID-Delayed Elective Surgery Has a Negative Effect on Young Sports Medicine Patients.

Purpose: The purpose of this study was to evaluate the physical and psychological effects of COVID-related elective surgery delays on young sports medicine patients. Methods: We conducted a cross-sectional study of patients (10-25 years old) who had elective sports medicine surgery delayed due to the COVID crisis. Electronic surveys were sent to patients and included the 12-item Short Form Health Survey (SF-12), which yields a physical component score (SF12-PCS) and a mental component score (SF12-MCS), the PROMIS Psychological Stress Experience survey (PROMIS-PSE), and self-designed questions about patient concerns regarding the COVID crisis and delayed surgery. Results: Of the 194 eligible patients with delayed elective sports surgeries, 107 patients (55%) elected to participate (mean age 17.6 ± 3.09 years, 30% male). The mean surgical delay was 76 days (CI 57-98). Delayed surgery patients scored significantly lower than population norms on the SF12-PCS (mean 39.3, CI 37.0-41.7; P < .001). Males scored significantly higher than females on the SF12-MCS (52.8 vs 45.7; P = .002), but the overall SF12-MCS mean was not significantly different from the general population (47.4; P =.07). The mean PSE score was significantly higher than population norms (57.7, CI 56.1-59.3; P < .001), but they did not differ by age or gender. Patients who reported higher levels of concern about their surgical delay endorsed significantly lower scores on the SF-MCS (P = .006) and higher scores on the PROMIS-PSE (P < .001), indicating greater emotional symptoms. The biggest concern with COVID-related surgical delays was a concern about not being back in time for a sports season. Conclusions: Young sports medicine patients reported significant physical and emotional symptoms associated with COVID-related surgical delays. Patients were most concerned about delays resulting in missed sport seasons. Those who reported greater levels of concern with surgical delays reported more emotional symptoms and higher levels of psychological stress. Clinical Relevance: It is important to understand the impact of delayed elective surgical treatment on young patients due to COVID. This study will allow us to make more informed choices for patients during the pandemic.