Emergency cesarean section is a risk factor for depressive symptoms when breastfeeding is limited.

OBJECTIVE: Previous studies indicated associations between cesarean section (CS), breastfeeding, and depressive symptoms. There is, however, little research integrating these variables into one model to analyze their interrelations. The aim of this observational prospective longitudinal study is to examine whether the effect of CS on postpartum depressive symptoms is mediated by difficulties with breastfeeding. METHODS: The participants were recruited in 5 maternity hospitals during their prenatal medical check-ups. Breastfeeding status was self-reported by the mothers six weeks postpartum. Screening for depressive symptoms was performed at six weeks (N = 404) and nine months (N = 234) postpartum using the Edinburgh Postnatal Depression Scale. Path analysis was used to model the relations between CS, breastfeeding, and depressive symptoms. RESULTS: No direct effects of CS on depressive symptoms at six weeks or nine months postpartum were found. CS was associated with a lower probability of exclusive breastfeeding, which was, in turn, associated with higher levels of depressive symptoms six weeks postpartum. The analysis stratified by type of CS revealed that the effect on breastfeeding only occurred with emergency, not planned, CS. The effect of CS on breastfeeding was noticeably stronger in women without versus with a history of depression. CONCLUSION: Emergency CS predicts breastfeeding difficulties, which are, in turn, associated with higher levels of depressive symptoms. Support should be provided to mothers with emergency CS and breastfeeding problems to reduce the risk of postpartum depressive symptoms in the early postpartum period.

Enhancing the Self: Amateur Bodybuilders Making Sense of Experiences With Appearance and Performance-Enhancing Drugs.

In this paper, we implemented a methodological framework of interpretative phenomenological analysis (IPA) and a theoretical conceptualization of multiple selves to explore the subjective accounts of six amateur bodybuilders using appearance- and performance-enhancing drugs (APEDs). The participants made sense of their bodybuilding careers and experiences with APEDs in a way that showed a multiplicity and complexity of reasons for using APEDs, which stemmed from tensions they perceived between the context of bodybuilding and other life domains. The participants' reasons for the use of APEDs included not only enhancing their body, appearance and performance but also enhancing other subjectively important psychological characteristics, such as agency and self-control, the development of knowledge and expertise, sense of meaning, well-being, and quality of life. In the analysis, we integrated these themes through the concept of the "extraordinary self," based on which our participants strived for self-actualization through bodybuilding and the use of APEDs. In the sense making of our participants, a potential "exit point" subverting their APED use emerged from a tension between such "extraordinary selves" and the "ordinary selves" through which they perceived APEDs as preventing them from living normal, balanced lives outside the context of bodybuilding. However, success in balancing the two selves also created the possibility of the future use of APEDs.

The Relationship between Physical Activity, Self-Perceived Health, and Cognitive Function in Older Adults.

There are consistent associations between physical activity and self-perceived health. However, it is not clear whether associations between self-perceived health and participation in physical activity could be accounted for by associations with cognitive function. In the present study, we examined whether associations between physical activity and cognitive functioning could explain the variability between physical activity and self-perceived health. A sample of 204 older adults performed three cognitive tests selected from the Vienna test system battery: The Determination, Cognitrone, and Visual Memory tests. These tests measure general processing speed, attention, and visual memory, respectively. Participants also completed the 12-item Short Form Health Questionnaire SF-12 to measure perceived health, and the Physical Activity Survey for the Elderly to measure physical activity. Linear regressions and the PROCESS macro for SPSS were used to test our hypotheses. Consistent with our hypotheses, processing speed accounted for significant variance in the relationship between physical activity and self-perceived health. This suggests that cognitive processing speed might be an indirect path by which physical activity relates to enhanced health perceptions. The results demonstrate that associations between physical activity and self-perceptions of health are related to a fundamental cognitive process.

The effects of pre- and post-partum depression on child behavior and psychological development from birth to pre-school age: a protocol for a systematic review and meta-analysis.

BACKGROUND: Pre- and post-partum depression is a common mood disorder with detrimental effects on both mother and child. The aim of the proposed review is to summarize evidence related to the effects of both pre- and post-partum depression on child behavior and development from birth to preschool age. In particular, our review will address mutual relations between pre- and post-partum depression in order to determine whether pre- and post-partum depression predict child psychological outcomes independently, whether there is an effect of timing of depression on child outcomes, whether pre- and post-partum depression interact to affect child outcomes, and whether the effect of pre-partum depression is mediated by depression after child's birth. METHODS: We will include prospective longitudinal studies that report data about the effects of both pre- and post-partum depression on child psychological outcomes as published in peer-reviewed academic journals since January 1998. We will search EMBASE, MEDLINE, PsycARTICLES, PsycINFO, ISI Web of Science, Scopus, and Wiley Online databases to identify original research articles written in English. Two independent reviewers will screen search results in two stages: (i) titles and abstracts and (ii) full text. The first one will extract data into tables, while the latter will verify whether the data extracted are correct. We will assess the risk of bias in the selected studies using the Critical Appraisal Skills Programme (CASP), Cohort Study Checklist. The results of the review will be reported in a narrative form. If there are sufficient data available, a meta-analysis will be conducted using metaSEM package in R. DISCUSSION: The proposed review will be the first systematic review summarizing the effects of both pre- and post-partum depression on child psychological development and behavior from birth to preschool age. The results of such a review may contribute to a better understanding of mutual relations between pre- and post-partum depression in their effects on child outcomes. They may also shed light on what periods in early human development are most vulnerable to the effects of maternal depression. TRIAL REGISTRATION: PROSPERO CRD42018106269.

Systemic Approach to the Development of Reading Literacy: Family Resources, School Grades, and Reading Motivation in Fourth-Grade Pupils.

The successful early acquisition of reading literacy represents a crucial learning process determining the further course of academic development (Stanovich, 2009). During this process, interactions between children and their proximal social environment are of utmost importance. Therefore, we introduce a systemic framework for the development of learning potential (e.g., Mudrak et al., 2019a, b; Ziegler and Stoeger, 2017) and explore the interactions between the social and motivational processes associated with reading literacy development in school-age children. We base our analysis on a representative Czech sample of fourth-grade pupils involved in the Progress in International Reading Literacy study (PIRLS, Martin et al., 2017). On the basis of the systemic framework, we hypothesized hierarchical relationships among family socioeconomic status, related developmental resources (including parental support, expectations, and reading resources), children's reading motivation (including reading engagement and reading confidence), and manifested learning outcomes (including school grades and reading competence). We implemented three structural equation models to test the hypothesized relationships. The first model tested the direct effect of developmental resources on reading competence. The second model included the motivational variables as mediators between resources and competence. The third model included school grades as mediators between resources and motivational variables. Our analyses indicated the good fit of the proposed models. The final model explained 37.8% of the variance in children's school grades and 46.5% of the variance in reading literacy test scores (compared to 34.8% in the first model). Moreover, parental socioeconomic status was strongly associated with parental expectations, which were associated with reading confidence, partially through the effect of parental expectations on children's school grades. Reading confidence was the main predictor of reading literacy within the model, followed by the direct effects of parental resources. The results illustrate complex processes through which the family environment affects the development of learning competencies such as reading literacy by providing children with the relevant social and material resources associated with their motivation and school outcomes. We discuss some of the reasons that these relationships may take place and consider their implications for educational practice.

Sport motivation and doping in adolescent athletes.

BACKGROUND: Although performance-enhancing drugs appear to be prevalent in adolescent sports, relatively little attention has been paid to why adolescent athletes decide to use these drugs. In this study, we examine doping among adolescents from a motivational perspective and explore how motivational variables, such as achievement goal orientations and the perceived self-determination of sports activities, may be related to moral attitudes, doping intentions and doping behavior in adolescents who participate in competitive sports. METHODOLOGY: The study included 1035 adolescents participating in competitive sports from all regions of the Czech Republic (mean age = 16.3 years). The respondents completed a battery of questionnaires assessing their achievement goal orientations (task, ego), sports motivation at various levels of self-determination (intrinsic motivation, external regulation, amotivation), moral attitudes toward sport competition (acceptance of cheating, keeping winning in proportion, attitudes toward doping), doping intentions and doping behavior. A structural equation model was used to test the relations among motivational variables, attitudes, intentions and doping behavior. PRINCIPAL RESULTS: Our analyses indicated a good fit with the proposed model, which explained 59% of the variance in doping intentions and 17.6% of the variance in doping behavior. Within the model, task orientation was positively associated with intrinsic motivation and lower amotivation, whereas ego orientation was positively associated with extrinsic regulation and amotivation. Furthermore, intrinsic motivation was positively associated with keeping winning in proportion and negatively associated with acceptance of cheating and attitudes toward doping; the less self-determined forms of motivation showed opposite relationships. However, only the acceptance of cheating and attitudes toward doping were related to doping intention, which subsequently predicted doping behavior. CONCLUSIONS/SIGNIFICANCE: The results provide further evidence that sports motivation represents a psychological variable that should be considered in anti-doping policies, programs, and interventions aimed at the adolescent population because motivation was linked to the doping-related attitudinal variables and also partially mediated the effect of achievement goal orientations in this regard. On the basis of these results, we may argue that the focus on intrinsic enjoyment, self-referenced criteria of success and self-improvement may be related to more negative attitudes toward doping and cheating, lower doping intentions and less frequent doping behavior, whereas the emphasis on competition, comparison with others and external motivation appear to be related to the opposite outcomes.

Social Cognitive Determinants of Physical Activity in Czech Older Adults.

We tested a social cognitive model of physical activity (PA) in the cultural context of the Czech Republic, a postcommunist central European country. In total, 546 older Czech adults (mean age = 68 years, data collected in 2013) completed a battery of questionnaires assessing indicators of PA and related social cognitive constructs, including self-efficacy, social support, and self-regulation strategies. Subsequently, a structural equation model was used to test the relationship between the social cognitive constructs and PA. Our analyses indicated an acceptable fit of the proposed model (CFI = .911; SRMR = .046; RMSEA = .073). Self-regulation was predicted by self-efficacy (ß = .67) and social support (ß = .23), which predicted PA (ß = .45). The model explained 60.4% of the variance in PA self-regulation and 20.5% of the variance in PA participation. The results provide further evidence for the role of self-efficacy and social support in enabling PA in older adults, and suggest that this relationship is partially mediated by self-regulation.

Physical activity, self-efficacy, and quality of life in older Czech adults.

Despite efforts to expand global physical activity (PA) surveillance data to include both low- and high-income countries worldwide, our understanding of the relationship between PA and quality of life (QOL) in older adults from culturally diverse backgrounds is limited. We tested McAuley's social-cognitive model of the PA-QOL relationship in the cultural context of the Czech Republic, a post-communist central European country. A total of 546 older Czech adults (mean age 68 years) completed a battery of questionnaires assessing indicators of PA, self-efficacy, health status, and global QOL. A structural equation model was used to test the relationship between PA and QOL. The model hypothesized an indirect relationship between PA and QOL: PA predicted self-efficacy, which in turn predicted global QOL through mental and physical health status. The analyses indicated an acceptable fit of the proposed model, albeit with different emphases than those of studies from Western countries. Above all, we observed a stronger effect of PA on self-efficacy and a weaker mediating effect of health status on the PA-QOL relationship. Our findings supported the validity of McAuley's PA-QOL social-cognitive model for a non-Western cultural context. However, it seems that self-efficacy and health status may influence the PA-QOL relationship in this population in a manner different from that proposed in McAuley's model.