Trevor Thompson

EEG applications for sport and performance

One approach to understanding processes that underlie skilled performing has been to study electrical brain activity using electroencephalography (EEG). A notorious problem with EEG is that genuine cerebral data is often contaminated by artifacts of non-cerebral origin. Unfortunately, such artifacts tend to be exacerbated when the subject is in motion, meaning that obtaining reliable data during exercise is inherently problematic. These problems may explain the limited number of studies using EEG as a methodological tool in the sports sciences. This paper discusses how empirical studies have generally tackled the problem of movement artifact by adopting alternative paradigms which avoid recording during actual physical exertion. Moreover, the specific challenges that motion presents to obtaining reliable EEG data are discussed along with practical and computational techniques to confront these challenges. Finally, as EEG recording in sports is often underpinned by a desire to optimise performance, a brief review of EEG-biofeedback and peak performance studies is also presented. A knowledge of practical aspects of EEG recording along with the advent of new technology and increasingly sophisticated processing models offer a promising approach to minimising, if perhaps not entirely circumventing, the problem of obtaining reliable EEG data during motion.

Anxiety sensitivity and pain: Generalisability across noxious stimuli

&NA; Anxiety sensitivity, a fear of anxiety‐related symptoms, has been associated with a heightened experience of pain, especially within women. The majority of experimental studies investigating this association have relied heavily on the cold pressor technique as a means of pain induction, limiting the generalisability of results. The aim of the current study was to extend previous research by using two types of pain stimuli (cold and heat) to determine whether the link between anxiety sensitivity and pain generalises beyond cold pressor pain. The pain experience of 125 participants in response to these stimuli was assessed using threshold and tolerance readings, as well as subjective pain ratings. Results indicated a positive association between anxiety sensitivity and subjective pain, with this association observed primarily in females. Although analysis also indicated a basic generalisability of results across pain stimuli, anxiety sensitivity effects appeared to be especially pronounced during heat stimulation. These findings suggest that those high in anxiety sensitivity may respond more negatively to specific types of pain. Possible implications along with suggestions for future research are discussed.

Selective attentional bias, conscious awareness and the fear of pain

&NA; It has been suggested that healthy individuals with a high fear of pain possess a selective attentional bias in favour of pain‐related material. However, evidence is limited since only a few studies have been conducted to date. In addition, these studies have not yet examined whether such attentional biases are relatively automatic, and so are outside conscious control. We, therefore, conducted a study with unmasked (conscious) and masked (preconscious) versions of the visual dot‐probe task, and examined the effect of pain fearfulness on performance. In the masked trials, we confirmed that individuals with a low fear of pain seem to orient away from pain‐related material. Furthermore, we also found that when stimuli were masked, this bias was reversed. Neither effect was found amongst participants high in the fear of pain. Together, these findings suggest that the ability to orient away from pain‐related stimuli may be under conscious control in low fearful people, whereas such a mechanism does not seem to exist in those high in the fear of pain.

Application of alpha/theta neurofeedback and heart rate variability training to young contemporary dancers: State anxiety and creativity

As one in a series on the impact of EEG-neurofeedback in the performing arts, we set out to replicate a previous dance study in which alpha/theta (A/T) neurofeedback and heart rate variability (HRV) biofeedback enhanced performance in competitive ballroom dancers compared with controls. First year contemporary dance conservatoire students were randomised to the same two psychophysiological interventions or a choreology instruction comparison group or a no-training control group. While there was demonstrable neurofeedback learning, there was no impact of the three interventions on dance performance as assessed by four experts. However, HRV training reduced anxiety and the reduction correlated with improved technique and artistry in performance; the anxiety scale items focussed on autonomic functions, especially cardiovascular activity. In line with the putative impact of hypnogogic training on creativity A/T training increased cognitive creativity with the test of unusual uses, but not insight problems. Methodological and theoretical implications are considered.

Relationship between depression and frailty in older adults: A systematic review and meta-analysis

AIM Depression and frailty are prevalent and burdensome in older age. However, the relationships between these entities are unclear and no quantitative meta- analysis exists. We conducted a systematic review and meta-analysis to investigate the associations between depression and frailty. METHODS Two authors searched major electronic databases from inception until November-2016 for cross-sectional/longitudinal studies investigating depression and frailty. The strength of the reciprocal associations between frailty and depression was assessed through odds ratios (ORs) adjusted for potential confounders. RESULTS From 2306 non duplicated hits, 24 studies were included. The overall prevalence of depression in 8023 people with frailty was 38.60% (95% CI 30.07-47.10, I2=94%). Those with frailty were at increased odds of having depression (OR adjusted for publication bias 4.42, 95%CI 2.66-7.35, k=11), also after adjusting for potential confounders (OR=2.64; 95%CI: 1.59-4.37, I2=55%, k=4). The prevalence of frailty in 2167 people with depression was 40.40% (95%CI 27.00-55.30, I2=97%). People with depression were at increased odds of having frailty (OR=4.07, 95%CI 1.93-8.55, k=8). The pooled OR for incident frailty, adjusted for a median of 7 confounders, was 3.72 (95%CI 1.95-7.08, I2=98%, k=4), whilst in two studies frailty increased the risk of incident depression with an OR=1.90 (95%CI 1.55-2.32, I2=0%). CONCLUSION This meta-analysis points to a reciprocal interaction between depression and frailty in older adults. Specifically, each condition is associated with an increased prevalence and incidence of the other, and may be a risk factor for the development of the other. However, further prospective investigations are warranted.

Osteoarthritis and mortality: A prospective cohort study and systematic review with meta-analysis

OBJECTIVES Osteoarthritis (OA) is a leading cause of disability, but the relationship with premature mortality remains uncertain. We aimed to investigate the relationship between OA and mortality from any cause and from cardiovascular disease (CVD). METHODS Electronic literature databases searches were conducted to identify prospective studies comparing mortality in a sample of people with and without OA. Risk of all-cause and CVD mortality were summarized using adjusted hazard ratios (HRs) for joint specific (hand, hip, and knee) and joint non-specific OA. New data from the Progetto Veneto Anziani (PRO.V.A.) study were also included. RESULTS From the PRO.V.A. study (N = 2927), there was no significant increase in mortality risk for participants with any joint OA (N = 1858) compared to non-OA (all-cause, HR = 0.95, 95% CI: 0.77-1.15 and CVD, HR = 1.12, 95% CI: 0.82-1.54). On meta-analysis, seven studies (OA = 10,018/non-OA = 18,541), with a median 12-year follow-up, reported no increased risk of any-cause mortality in those with OA (HR = 1.10, 95% CI: 0.97-1.25). After removing data on hand OA, a significant association between OA and mortality was observed (HR = 1.18, 95% CI: 1.08-1.28). There was a significant higher risk of overall mortality for (1) studies conducted in Europe, (2) patients with multi-joint OA; and (3) a radiological diagnosis of OA. OA was associated with significantly higher CVD mortality (HR = 1.21, 95% CI: 1.10-1.34). CONCLUSIONS People with OA are at increased risk of death due to CVD. The relationship with overall mortality is less clear and may be moderated by the presence of hand OA.

The epidemiology of back pain and its relationship with depression, psychosis, anxiety, sleep disturbances, and stress sensitivity: Data from 43 low- and middle-income countries

BACKGROUND Back pain (BP) is a leading cause of global disability. However, population-based studies investigating its impact on mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). Thus, the primary aims of this study were to: (1) determine the epidemiology of BP in 43 LMICs; (2) explore the relationship between BP and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress). METHODS Data on 190,593 community-dwelling adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past-12 month psychotic symptoms and depression was established using questions from the Composite International Diagnostic Interview. Anxiety, sleep problems, stress sensitivity, and any BP or chronic BP (CBP) during the previous 30 days were also self-reported. Multivariable logistic regression analyses were undertaken. RESULTS The overall prevalence of any BP and CBP were 35.1% and 6.9% respectively. Significant associations with any BP were observed for subsyndromal depression [OR (odds ratio)=2.21], brief depressive episode (OR=2.64), depressive episode (OR=2.88), psychosis diagnosis with symptoms (OR=2.05), anxiety (OR=2.12), sleep disturbance (OR=2.37) and the continuous variable of stress sensitivity. Associations were generally more pronounced for chronic BP. CONCLUSION Our data establish that BP is associated with elevated mental health comorbidity in LMICs. Integrated interventions that address back pain and metal health comorbidities might be an important next step to tackle this considerable burden.

High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies

Erectile dysfunction may be common among men with diabetes, but its prevalence is still debated. We aimed to assess the relative prevalence of erectile dysfunction in diabetes searching major databases from inception to November 2016 for studies reporting erectile dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta‐analysis of the prevalence [and 95% confidence intervals (95% CIs)] of erectile dysfunction in diabetes compared with healthy controls, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initial hits, 145 studies were included representing 88 577 men (age: 55.8 ± 7.9 years). The prevalence of erectile dysfunction in diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and 57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of erectile dysfunction was highest in studies using the Sexual Health Inventory for Men (82.2%, 17 studies, P for interaction < 0.0001). Studies with a higher percentage of people with hypertension moderated our results (beta = 0.03; 95% CI, 0.008 to 0.040; P = 0.003; R2 = 0.00). Compared to healthy controls (n = 5385) men with diabetes (n = 863) were at increased odds of having erectile dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I2 = 67%, k = 8). Erectile dysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds of approximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for men with erectile dysfunction is warranted.

Happiness and age in European adults: The moderating role of gross domestic product per capita.

Studies of happiness levels across the life span have found support for two rival hypotheses. The positivity effect states that as people get older, they increasingly attend to positive information, which implies that happiness remains stable or increases with age, whereas the U-shaped hypothesis posits a curvilinear shape resulting from a dip during midlife. Both have been presented as potentially universal hypotheses that relate to cognitive and/or biological causes. The current study examined the happiness-age relationship across 29 European nations (N = 46,301) to explore whether it is moderated by national wealth, as indexed by Gross Domestic Product (GDP) per capita. It was found that eudaimonic and hedonic happiness remained relatively stable across the life span only in the most affluent nations; in poorer nations, there was either a fluctuating or steady age-associated decline. These findings challenge the cultural universality of the happiness-age relationship and suggest that models of how age relates to happiness should include the socioeconomic level of analysis.

Sensory Focusing Versus Distraction and Pain: Moderating Effects of Anxiety Sensitivity in Males and Females

UNLABELLED Although previous research has examined whether the relative effects of distraction and sensory focusing on pain are dependent upon anxiety sensitivity, such research has concentrated primarily on females. Given the increasing emergence of sex differences in pain processing, the current study aimed to examine whether any influence of anxiety sensitivity on coping effectiveness differs for males and females. The sample consisted of 76 healthy adults (41 males and 35 females), all of whom received distraction and sensory-focusing instructions and underwent noxious thermal testing (cold and heat). Results showed that anxiety sensitivity was positively associated with the emotional qualities of cold pain, and that males exhibited significantly greater heat pain tolerance than females. In addition, within males, a significant coping × anxiety sensitivity effect was found for cold tolerance, with distraction superior to sensory focusing only when anxiety sensitivity was high. In females, however, distraction was a superior strategy irrespective of anxiety sensitivity. PERSPECTIVE This study highlights the importance of considering anxiety sensitivity and sex when examining the relative effectiveness of attentional pain coping strategies. This finding may be potentially beneficial to clinicians considering pain management interventions that include a cognitive or attentional component.