Psychological skills training and a mindfulness-based intervention to enhance functional athletic performance: design of a randomized controlled trial using ambulatory assessment

Philipp Röthlin, Daniel Birrer, Stephan Horvath, Martin Grosse Holtforth, Philipp Röthlin, Daniel Birrer, Stephan Horvath, Martin Grosse Holtforth

Abstract

Background: Struggling to deliver performance in competitions is one of the main reasons why athletes seek the advice of sport psychologists. Psychologists apply a variety of intervention techniques, many of which are not evidence-based. Evidence-based techniques promote quality management and could help athletes, for example, to increase and maintain functional athletic behavior in competitions/games (i.e., being focused on task relevant cues and executing movements and actions in high quality). However, well-designed trials investigating the effectiveness of sport psychological interventions for performance enhancement are scarce. The planed study is founded by the Swiss National Science Foundation and examines the effectiveness of two interventions with elite and sub-elite athletes. A psychological skills training (PST) and a mindfulness-based intervention (MI), administered as group-program, will be compared to a waiting-list control group concerning how they enhance functional athletic behavior - which is a prerequisite for optimal performance. Furthermore, we will investigate underlying mechanisms (mediators) and moderators (e.g., task difficulty, individual characteristics, intervention-expectancy and intervention-integrity).

Methods/design: The presented trial uses a randomized controlled design with three groups, comparing PST, MI and a waiting list control condition. Both group interventions will last 5 weeks, consist of four 2 h sessions and will be administered by a trained sport psychologist. Primary outcome is functional athletic behavior assessed using ambulatory assessment in a competition/game. As secondary outcomes competition anxiety, cognitive interference and negative outcome expectations will be assessed. Assessments are held at pre- and post-intervention as well as at 2 months follow up. The study has been approved by the ethical committee of the Swiss Federal Institute of Sport.

Discussion: Both PST and MI are expected to help improve functional behavior in athletes. By examining potential mechanisms of change and moderators of outcome we will not only be able to answer the question whether the interventions work, but also how, under what conditions, and for whom. This study may also fill a gap in sport psychology research, considering the current lack of randomized controlled trials. In the future, researchers could use the presented study protocol as template to investigate similar topics in sport psychology.

Trial registration: ISRCTN11147748 , date of registration: 11 July 2016.

Keywords: Ambulatory assessment; Athletic performance; Elite sport; Intervention; Mindfulness; Performance enhancement; Psychological skills training; Randomized controlled trial; Sport psychology.

Figures

Fig. 1
Fig. 1
Participant recruitment and flow through the study

References

    1. Acharya J, Morris T. Psyching up and psyching down. In: Papaioannou AG, Hackfort D, editors. Routledge companion to sport and exercise psychology: Global perspectives and fundamental concepts. London: Routledge; 2014. pp. 386–401.
    1. Aherne C, Aidan PM, Lonsdale C. The effect of mindfulness training on athletes’ flow: An initial investigation. Sport Psychol. 2011;25:177–89.
    1. Baltzell AL. Self-compassion, distress tolerance, and minfulness in performance. In: Baltzell AL, editor. Mindfulness and Performance. Cambridge: University Press; 2016. pp. 53–77.
    1. Berking M, Znoj H. Entwicklung und Validierung eines Fragebogens zur standardisierten Selbsteinschätzung emotionaler Kompetenzen. Z Psychiatr Psychol Psychother. 2008;56:141–52.
    1. Birrer D, Morgan G. Psychological skills training as a way to enhance an athlete’s performance in high-intensity sports. Scand J Med Sci Sports. 2010;20:78–87. doi: 10.1111/j.1600-0838.2010.01188.x.
    1. Birrer D and Röthlin P. Riding the 3rd wave: Working with CBT and Mindfulness-based interventions in sport. In Andersen MB and Sizzi S, editors. In preparation.
    1. Birrer D, Röthlin P, Morgan G. Mindfulness to enhance athletic performance: Theoretical considerations and possible impact mechanisms. Mindfulness. 2012;3:235–46. doi: 10.1007/s12671-012-0109-2.
    1. Bohlmeijer E, Peter M, Fledderus M, Veehof M, Baer R. Psychometric properties of the Five Facet Mindfulness Questionnaire in depressed adults and development of a short form. Assessment. 2011;18:308–20. doi: 10.1177/1073191111408231.
    1. Bond FW, Hayes SC, Baer RA, Carpenter K, Orcutt HK, Waltz T, Zettle RD. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological flexibility and acceptance. Behav Ther. 2011;42:676–88. doi: 10.1016/j.beth.2011.03.007.
    1. Boot WR, Simons DJ, Stothart C, Stutts C. The pervasive problem with placebos in psychology why active control groups are not sufficient to rule out placebo effects. Perspect Psychol Sci. 2013;8:445–54. doi: 10.1177/1745691613491271.
    1. Brand R, Ehrlenspiel F, Graf K. Wettkampf-Angst-Inventar (WAI) Bonn: Bundesinstitut für Sportwissenschaft; 2009.
    1. Chiesa A, Calati R, Serretti A. Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clin Psychol Rev. 2011;31:449–64. doi: 10.1016/j.cpr.2010.11.003.
    1. Collani G, Herzberg PY. Eine revidierte Fassung der deutschsprachigen Skala zum Selbstwertgefühl von Rosenberg. Zeitschrift für Differentielle und Diagnostische Psychologie. 2003;24:3–7. doi: 10.1024//0170-1789.24.1.3.
    1. DeWitt DJ. Cognitive and biofeedback training for stress reduction with university athletes. J Sport Psychol. 1980;2:288–94.
    1. Eberspächer H. Mentales Training. Ein Handbuch für Trainier und Sportler. München: Copress Sportinform; 2004.
    1. Elferink-Gemser MT, Roos ID, Torenbeek M, Fokkema T, Jonker L, Visscher C. The importance of psychological constructs for training volume and performance improvement. A structural equation model for youth speed skaters. Int J Sport Psychol. 2016;47:726–44.
    1. Fan J, McCandliss BD, Sommer T, Raz A, Posner MI. Testing the efficiency and independence of attentional networks. J Cogn Neurosci. 2002;14:340–7. doi: 10.1162/089892902317361886.
    1. Feldman G, Greeson J, Senville J. Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts. Behav Res Ther. 2010;48:1002–11. doi: 10.1016/j.brat.2010.06.006.
    1. Ferguson LJ, Kowalski KC, Mack DE, Sabiston CM. Exploring self-compassion and eudaimonic well-being in young women athletes. J Sport Exerc Psychol. 2014;36:203–16. doi: 10.1123/jsep.2013-0096.
    1. Fresco DM, Moore MT, van Dulmen MH, Segal ZV, Ma SH, Teasdale JD, Williams JMG. Initial psychometric properties of the experiences questionnaire: Validation of a self-report measure of decentering. Behav Ther. 2007;38:234–46. doi: 10.1016/j.beth.2006.08.003.
    1. Frewen P, Evans E, Maraj N, Dozois D, Partridge K. Letting go: Mindfulness and negative automatic thinking. Cogn Ther Res. 2008;32:758–74. doi: 10.1007/s10608-007-9142-1.
    1. Gardner FL. Scientific advancements of mindfulness- and acceptance-based models in sport psychology: A decade in time, a seismic shift in philosophy and practice. In: Baltzell AL, editor. Mindfulness and Performance. Cambridge: University Press; 2016. pp. 127–52.
    1. Gardner FL, Moore ZE. A mindfulness-acceptance-commitment-based approach to athletic performance enhancement: Theoretical considerations. Behav Ther. 2004;35:707–23. doi: 10.1016/S0005-7894(04)80016-9.
    1. Gardner FL, Moore ZE. Clinical Sport Psychology. Champain, IL: Human Kinetics; 2006.
    1. Gardner FL, Moore ZE. The Psychology of Enhancing Human Performance. The Mindfulness-Acceptance-Commitment Approach (MAC) New York: Springer; 2007.
    1. Gardner FL, Moore ZE. Mindfulness and acceptance models in sport psychology: A decade of basic and applied scientific advancements. Can Psychol. 2012;53:309–18. doi: 10.1037/a0030220.
    1. Gould D, Voelker DK, Damarjian N, Greenleaf C. Imagery training for peak performance. In: Van Raalte JL, Brewer BW, editors. Exploring sport and exercise psychology. Washington, DC: American Psychological Association; 2014. pp. 55–82.
    1. Grawe K. Psychologische Therapie. Göttingen: Hogrefe; 1998.
    1. grosse Holtforth M, Krieger T, Bochsler K, Maule B. The prediction of psychotherapy success by outcome expectations in inpatient psychotherapy. Psychother Psychosom. 2011;80:321–2. doi: 10.1159/000324171.
    1. Grote M, Benthien O, Brand R. Sportpsychologischer Betreuung im Spitzensport: Eine empirische Bestandsaufnahme aus 5 Jahren Landesteam Sportpsychologie [Sport psychological services in elite sport: An empirical report after 5 years of the Landesteam Sportpsychologie). Leistungssport. 2015;45(6):5–11.
    1. Hardy L. A catastrophe model of performance in sport. In: Jones G, Hardy L, editors. Stress and performance in sport. Chichester: Wiley; 1990. pp. 81–106.
    1. Hardy J. Speaking clearly: A critical review of the self-talk literature. Psychol Sport Exerc. 2006;7:81–97. doi: 10.1016/j.psychsport.2005.04.002.
    1. Hardy L, Jones G, Gould D. Understanding Psychological Preparation for Sport: Theory and Practice of Elite Performers. New York: Wiley; 1996.
    1. Hargus E, Crane C, Barnhofer T, Williams JMG. Effects of mindfulness on meta-awareness and specificity of describing prodromal symptoms in suicidal depression. Emotion. 2010;10:34–42. doi: 10.1037/a0016825.
    1. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther. 2004;35:639–65. doi: 10.1016/S0005-7894(04)80013-3.
    1. Hayes AF. Mediation, moderation, and conditional process analysis. New York, NY: The Guilford Press; 2013.
    1. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behav Res Ther. 2006;44:1–25. doi: 10.1016/j.brat.2005.06.006.
    1. Hayes SC, Strosahl K, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford; 1999.
    1. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78:169–83. doi: 10.1037/a0018555.
    1. Howard WL, Reardon JP. Changes in the self concept and athletic performance of weight lifters through a cognitive-hypnotic approach: An empirical study. Am J Clin Hypn. 1986;28:248–57. doi: 10.1080/00029157.1986.10402661.
    1. Hupfeld J, Ruffieux N. Validierung einer deutschen version der Self-Compassion Scale (SCS-D) Z Klin Psychol Psychother. 2011;40:115–23. doi: 10.1026/1616-3443/a000088.
    1. Janelle CM. Ironic mental processes in sport: Implications for sport psychologists. Sport Psychol. 1999;13:201–20.
    1. John S, Verma SK, Khanna GL. The effect of mindfulness meditation on HPA-Axis in pre-competition stress in sports performance of elite shooters. Nat J Integr Res Med. 2011;2:15–21.
    1. Jones G, Hanton S. Pre-competitive feeling states and directional anxiety interpretations. J Sports Sci. 2001;19:385–95. doi: 10.1080/026404101300149348.
    1. Kabat-Zinn J. An outpatient program in behavioural medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33–42. doi: 10.1016/0163-8343(82)90026-3.
    1. Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clin Psychol-Sci Pract. 2003;10:144–56. doi: 10.1093/clipsy.bpg016.
    1. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: A review of empirical studies. Clin Psychol Rev. 2011;31:1041–56. doi: 10.1016/j.cpr.2011.04.006.
    1. Locke EA, Shaw KN, Saari LM, Latham GP. Goal setting and task performance: 1969–1980. Psychol Bull. 1981;90:125–52. doi: 10.1037/0033-2909.90.1.125.
    1. Madden G, Mc Gown C. The effect of hemisphericity, imagery, and relaxation on volleyball performance. J Hum Mov Stud. 1988;14:197–204.
    1. Masmoudi J, Trigui D, Feki I, Bâati I, Jaoua A. Athletic performance, self-esteem and temperamental profile: Which relationship? Tunis Med. 2015;93:175–80.
    1. Mehl MR, Conner TS. Handbook of research methods for studying daily life. New York: Guilford Press; 2013.
    1. Moghadam MS, Sayadi E, Samimifar M, Moharer A. Impact assessment of mindfulness techniques education on anxiety and sports performance in Badminton players Isfahan. Int Res J Appl Basic Sci. 2013;4:1170–5.
    1. Morris T, Spittle M, Watt AP. Imagery in sport. Champaign: Human Kinetics; 2005.
    1. Mosewich AD, Crocker PR, Kowalski KC, DeLongis A. Applying self-compassion in sport: An intervention with women athletes. J Sport Exerc Psychol. 2013;35:514–24.
    1. Noble LM, Douglas BC, Newman SP. What do patients expect of psychiatric services? A systematic and critical review of empirical studies. Soc Sci Med. 2001;52:985–98. doi: 10.1016/S0277-9536(00)00210-0.
    1. Noel RC. The effect of visuo-motor behavior rehearsal on tennis performance. J Sport Psychol. 1980;2:221–6.
    1. Posner MI, Rothbart MK. Research on attention networks as a model for the integration of psychological science. Annu Rev Psychol. 2007;58:1–23. doi: 10.1146/annurev.psych.58.110405.085516.
    1. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother. 2011;18:250–5. doi: 10.1002/cpp.702.
    1. Rethorst S and Wehrmann R. Der TEOSQ-D zur Messung der Zielorientierung im Sport. Sportpsychologische Diagnostik, Prognostik, Intervention.1998:57–63.
    1. Roberts R, Woodman T, Hardy L, Davis LW, Wallace HM. Psychological skills do not always help performance: The moderating role of narcissism. J Appl Sport Psychol. 2013;25:316–25. doi: 10.1080/10413200.2012.731472.
    1. Röthlin P, Horvath S, Birrer D, Güttinger L, and grosse Holtforth M. Kognitive Interferenz im Sport - Validierung einer deutschsprachigen Version des “Thoughts Occurence Questionnaires Sport” (TOQS); Cognitive interference in sports - validation of a German version of the “Thoughts Occurence Questionnaire Sport” (TOQS). Diagnostica. In press
    1. Röthlin P, Horvath S, Birrer D, grosse Holtforth M. Mindfulness promotes the ability to deliver performance in highly demanding situations. Mindfulness. 2016;7:727–33. doi: 10.1007/s12671-016-0512-1.
    1. Sappington R, Longshore K. Systematically reviewing the efficacy of mindfulness-based interventions for enhanced athletic performance. J Clin Sport Psychol. 2015;9:232–62. doi: 10.1123/jcsp.2014-0017.
    1. Sarason IG, Sarason BR, Pierce GR. Anxiety, cognitive interference, and performance. J Soc Behav Personal. 1990;5:1–18.
    1. Schmid J, Birrer D, Kaiser U, Seiler R. Psychometrische Eigenschaften einer deutschsprachigen Adaptation des Test of Performance Strategies (TOPS) Z Sportpsychol. 2010;17:50–62. doi: 10.1026/1612-5010/a000008.
    1. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;3:18–26. doi: 10.1186/1741-7015-8-18.
    1. Scott‐Hamilton J, Schutte NS, Brown RF. Effects of a mindfulness intervention on sports‐anxiety, pessimism, and flow in competitive cyclists. Appl Psychol Health Well‐Being. 2016;8:85–103. doi: 10.1111/aphw.12063.
    1. Spitzer C, Hammer S, Löwe B, Grabe HJ, Barnow S, Rose M, Franke GH. Die Kurzform des Brief Symptom Inventory (BSI-18): Erste Befunde zu den psychometrischen Kennwerten der deutschen Version. Fortschritte der Neurologie. 2011;79:517–23. doi: 10.1055/s-0031-1281602.
    1. Stoeber J, Stoll O, Pescheck E, Otto K. Perfectionism and achievement goals in athletes: Relations with approach and avoidance orientations in mastery and performance goals. Psychol Sport Exerc. 2008;9:102–21. doi: 10.1016/j.psychsport.2007.02.002.
    1. Tang YY, Hölzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015;16:213–25. doi: 10.1038/nrn3916.
    1. Thelwell RC, Maynard IW. The effects of a mental skills package on ‘repeatable good performance’in cricketers. Psychol Sport Exerc. 2003;4:377–96. doi: 10.1016/S1469-0292(02)00036-5.
    1. Trull TJ, Ebner-Priemer U. Ambulatory assessment. Annu Rev Clin Psychol. 2013;9:151–76. doi: 10.1146/annurev-clinpsy-050212-185510.
    1. Van Raalte JL, Vincent A, Brewer BW. Self-talk: Review and sport-specific model. Psychol Sport Exerc. 2016;22:139–48. doi: 10.1016/j.psychsport.2015.08.004.
    1. Vealey SR. Mental skills training in sport. In: Tenenbaum G, Eklund R, Singer R, editors. Handbook of Sport Psychology. New Jersey: Wiley; 2007.
    1. von Haaren B, Haertel S, Stumpp J, Hey S, Ebner-Priemer U. Reduced emotional stress reactivity to a real-life academic examination stressor in students participating in a 20-week aerobic exercise training: A randomised controlled trial using Ambulatory Assessment. Psychol Sport Exerc. 2015;20:67–75. doi: 10.1016/j.psychsport.2015.04.004.
    1. Wegner DM. Ironic processes of mental control. Psychol Rev. 1994;101:34–52. doi: 10.1037/0033-295X.101.1.34.
    1. Weinberg R, Butt J. Goal-setting and sport performance. In: Papaioannou AG, Hackfort D, editors. Routledge companion to sport and exercise psychology: Global perspectives and fundamental concepts. London: Routledge; 2014. pp. 343–55.
    1. White M, Sheldon K. The contract year syndrome in the NBA and MLB: A classic undermining pattern. Motivation Emotion. 2014;38:196–205. doi: 10.1007/s11031-013-9389-7.
    1. Zhang CQ, Chung PK, Si G, Gucciardi DF. Measuring decentering as a unidimensional construct: The development and initial validation of the Decentering Scale for Sport. Psychol Sport Exerc. 2016;24:147–58. doi: 10.1016/j.psychsport.2016.02.006.
    1. Zhang CQ, Chung PK, Si G. Assessing acceptance in mindfulness with direct-worded items: The development and initial validation of the athlete mindfulness questionnaire. J Sport Health Sci. 2015

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel