Matthew P. Martens
Issues associated with athletics, alcohol abuse, and drug use continue to be salient aspects of popular culture. These issues include high-profile athletes experiencing public incidents as a direct or indirect result of alcohol and/or drug use, the role that performance-enhancing drugs play in impacting outcomes across a variety of professional and amateur contests, and the public-health effects alcohol abuse and drug use can have among athletes at all competitive levels. For some substances, like alcohol abuse, certain groups of athletes may be particularly at-risk relative to peers who are not athletes. For other substances, participating in athletics may serve as a protective factor. Unique considerations are associated with understanding alcohol abuse and drug use in sport. These include performance considerations (e.g., choosing to use or not use a certain substance due to concerns about its impact on athletic ability), the cultural context of different types of sporting environments that might facilitate or inhibit alcohol and/or drug use, and various internal personality characteristics and traits that may draw one toward both athletic activity and substance use. Fortunately, there are several effective strategies for preventing and reducing alcohol abuse and drug use, some of which have been tested specifically among athlete populations. If such strategies were widely disseminated, they would have the potential to make a significant impact on problems associated with alcohol abuse and drug use in sport and athletics.
Benjamin Gardner and Amanda L. Rebar
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Psychology. Please check back later for the full article.
Within psychology, the term habit is most often used to refer to a process whereby situations prompt action automatically, through activation of mental situation-action associations acquired through prior performances. Unlike consciously intended behavior, which proceeds via a cognitively effortful reflective processing system, behavior that is directed by habit is regulated by an impulsive processing system, and so can be elicited with minimal cognitive effort, awareness, control, or intention. The habit formation process involves a gradual transferral of action initiation from the conscious attentional or motivational processes involved in reflective processing, to external cuing mechanisms characteristic of impulsive processing. Behavior thus becomes detached from motivational or volitional control, freeing finite cognitive resources for unfamiliar or otherwise more demanding tasks. Upon encountering associated situations, habitual tendencies dominate action regulation, and alternative actions become less readily accessible.
By virtue of these characteristics, habit theory proposes that habit strength will predict the likelihood of enactment of habitual behavior, and that strong habitual tendencies will dominate over motivational tendencies. Evidence of these effects, albeit predominantly observational and correlational, has been found for many everyday socially significant and health-relevant behaviors, such as physical activity, healthy eating, alcohol consumption, TV viewing, and travel mode choice. Such findings have stimulated interest in habit formation as a behavior change mechanism—commentators have argued that adding habit formation components into behavior change interventions should sustain what are otherwise typically only short-term effects, by shielding new behaviors against potential motivational lapses. Habit-based interventions differ from non-habit-based interventions in that they include elements that promote context-dependent repetition, with the explicit aim of developing situation-action associations, and thus, situationally cued automatic behavioral responses. A wealth of habit-based behavior change interventions have been studied in clinical trials and have mostly shown positive effects on behavior. However, due to the methodological limitations of these trials, the longevity of such effects, and the unique impact on behavior of habit-focused components are not yet known. As an intervention strategy, habit formation has been shown to be acceptable to intervention recipients, who report that, through repetition, behaviors gradually become routinized and “second nature.” Whether habit formation interventions truly offer a route to long-lasting behavior change, however, remains unclear.
Philip Sayegh, David J. Moore, and Pariya Fazeli Wheeler
Since the first cluster of people with HIV was identified in 1981, significant biomedical advances, most notably the development of antiretroviral therapy (ART), have led to considerably increased life expectancy as well as a reduction in the morbidity and mortality associated with HIV/AIDS. As a result, HIV/AIDS is no longer considered a terminal illness, but rather a chronic illness, and many persons living with HIV/AIDS are beginning to enter or have already reached later life. In fact, Americans ages 50 years and older comprise approximately half of all individuals with HIV/AIDS and represent the most rapidly growing subpopulation of persons living with HIV/AIDS in the United States.
Despite significant advances in HIV/AIDS treatment and prognosis, older adults living with HIV (OALH) face a number of unique challenges and circumstances that can lead to exacerbated symptoms and poorer outcomes, despite demonstrating generally better ART adherence than their younger counterparts. These detrimental outcomes are due to both chronological aging and cohort effects as well as social and behavioral factors and long-term ART use. For instance, neurocognitive deficits and neuropsychiatric symptoms, including depression, anxiety, apathy, and fatigue, are often observed among OALH, which can result in feelings of loneliness, social isolation, and reduced social support. Taken together, these factors can lead to elevated levels of problems with everyday functioning (e.g., activities of daily living) among OALH. In addition, sociocultural factors such as race/ethnicity, ageism, sexism, homophobia, transphobia, geographic region, socioeconomic status and financial well-being, systemic barriers and disparities, and cultural values and beliefs play an influential role in determining outcomes.
Notwithstanding the challenges associated with living with HIV/AIDS in later life, many persons living with HIV/AIDS are aging successfully. HIV/AIDS survivor and community mobilization efforts, as well as integrated care models, have resulted in some significant improvements in overall HIV/AIDS patient care. In addition, interventions aimed at improving successful aging outcomes among OALH are being developed in an attempt to effectively reduce the psychological and physical morbidity associated with HIV disease.
Ildiko Tombor and Susan Michie
People’s behavior influences health, for example, in the prevention, early detection, and treatment of disease, the management of illness, and the optimization of healthcare professionals’ behaviors. Behaviors are part of a system of behaviors within and between people in that any one behavior is influenced by others. Methods for changing behavior may be aimed at individuals, organizations, communities, and/or populations and at changing different influences on behavior, e.g., motivation, capability, and the environment. A framework that encapsulates these influences is the Behavior Change Wheel, which links an understanding of behavior in its context with methods to change behavior. Within this framework, methods are conceptualized at three levels: policies that represent high-level societal and organizational decisions, interventions that are more direct methods to change behavior, and behavior change techniques that are the smallest components that on their own have the potential to change behavior. In order to provide intervention designers with a systematic method to select the policies, interventions, and/or techniques relevant for their context, a set of criteria can be used to help select intervention methods that are likely to be implemented and effective. One such set is the “APEASE” criteria: affordability, practicability, effectiveness, acceptability, safety, and equity.
Britton W. Brewer
In addition to the disruptive impact of sport injury on physical functioning, injury can have psychological effects on athletes. Consistent with contemporary models of psychological response to sport injury, aspects of psychological functioning that can be affected by sport injury include pain, cognition, emotion, and behavior. Part of the fabric of sport and ubiquitous even among “healthy” athletes, pain is a common consequence of sport injury. Postinjury pain is typically of the acute variety and can be exacerbated, at least temporarily, by surgery and some rehabilitation activities. Cognitive responses to sport injury include appraising the implications of the injury for one’s well-being and ability to manage the injury, making attributions for injury occurrence, using cognitive coping strategies, perceiving benefits of injury, and experiencing intrusive injury-related thoughts and images, increased perception of injury risk, reduced self-esteem and self-confidence, and diminished neurocognitive performance. Emotional responses to sport injury tend to progress from a preponderance of negative emotions (e.g., anger, confusion, depression, disappointment, fear, frustration) shortly after injury occurrence to a more positive emotional profile over the course of rehabilitation. A wide variety of personal and situational factors have been found to predict postinjury emotions. In terms of postinjury behavior, athletes have reported initiating coping strategies such as living their lives as normally as possible, distracting themselves, seeking social support, isolating themselves from others, learning about their injuries, adhering to the rehabilitation program, pursuing interests outside sport, consuming alcohol, taking recreational and/or performance-enhancing substances, and, in rare cases, attempting suicide. Psychological readiness to return to sport after injury is an emerging concept that cuts across cognitive, emotional, and behavioral responses to sport injury.