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Darren Dale
Health & Fitness Section Editor

By Josh Muller,  California State University, Fresno

When one wins or loses, reasons or explanations are given by the performer regarding the outcome. In fact, in most situations, people make attributions to explain events. The focus of this editorial is in the exercise setting. The aim is to examine exercise, not the actual physical actions, but instead, the reasons made for exercising or not. Primary concern is on the explanations of exercise non-adherers. When it all comes down to it, it may be the reasons we give for exercise adherence or non-adherence that determine if healthy exercise behavior will be achieved and maintained. Many of us have been educated on the benefits of exercise. Exercise is good for us physically, psychologically, and emotionally. However, even with this education, many of us do not exercise. Probably as you are reading this you are giving an explanation, or maybe a few explanations, for why you do not exercise as you should. The underlying key to success in exercise is motivation. As the famous Nike slogan goes, “just do it.” This is easier said than done. Getting motivated to exercise is one of the biggest challenges for people today. A life of work schedules, fast-food, and a "time is money" philosophy, leaves exercise at the bottom of many people’s priority lists.

Seligman (1998) has devised a theoretical concept which is directly related to attributions (explanations) given for events. His term is “learned optimism;” a concept which gives hope to those who negatively attribute failures in exercise. All of us know what being optimistic means: to have a positive attitude even in the face of adversity. Some believe that this cannot be taught – one is either born optimistic, or not (i.e., pessimistic). Seligman (1998), however, has proven that optimism can be learned.

Three Dimensions of Attributions

After years of research, Seligman (1998) has shown that people can learn to be more optimistic regarding events. Specifically, three major dimensions are identified to help people explain events. The first is personalization, which focuses on how much personal blame or credit one gives for an outcome of an event. The second is permanence, which explains how stable an outcome is. Finally, pervasiveness addresses if the outcome is common in many areas of life; or how global or universal the outcome is. With analysis of these three dimensions, a rating of optimism is determined. Having relatively similar explanations for outcomes lends itself to an explanatory "style." Therefore, consistent explanations one provides for events displays a trait of their personality – an explanation trait.

Optimistic and Pessimistic Explanatory Styles

Those who make more internal, stable, and global attributions for negative events have a pessimistic explanatory style. What does this mean?  If you fail at a task and you blame your failure on yourself (internal), believe that you will always fail (stable), and think that you fail in many different areas (global), then you are pessimistic. The implications of having this type of explanatory style are that those who fail at a task, and are pessimistic, are more likely to fail in the future. In contrast, those who make more external, unstable, and specific attributions, those identified as having an optimistic explanatory style, are more likely to succeed in the future after initial failure at a task. For example, you fail at a task and you blame something outside of your control (external), believe that your failure was only temporary (unstable), and think that you only failed in this one area (specific); you are more optimistic.

An Optimistic Exercise Explanatory Style

How is this implemented into exercise? When we fail to exercise, we often make excuses or explain common barriers in our pursuit of getting in the gym. The attributions we make usually involve circumstances beyond our perceived control (e.g., work has drained me; time is against me; etc.). These are actually external attributions, a dimension that is usually classified for those with an optimistic explanatory style. However, simply shifting the blame does not help matters, especially in exercise. Seligman (1995) recognized this in children, who needed to make more internal attributions to take responsibility for their actions. The idea is to teach children to be "accurate optimists," who are guided to interact with the environment, yet to also be realistic and not fall into having false optimism when not appropriate. A perfect example of this is in the exercise domain. People need to take responsibility of their non-adherence and take action. This means making internal attributions.

However, this can still be accomplished without promoting exercise behavior. For example, one person may state that they don’t exercise because, “I’m lazy.” This is an internal attribution, but also an enduring personality trait according to the person. This is where the permanence dimension comes in. Optimists make more unstable attributions for failure. When failing to exercise, we should not direct our internal attributions toward our dispositional abilities, but rather to our fluctuating (unstable) effort. If we put in our minds that we didn’t exercise because we didn’t make the effort to do so, we then will be more likely to exercise in the future.

We also have to make specific attributions for failure. If we tell ourselves that we fail in many aspects of our lives, we are engaging in pessimistic, self-defeating thinking, which may even, in extreme cases, lead to depression. None of us wants this. When we fail, we must make attributions that are specific for the event in question. If we failed to exercise, we can state that the specific circumstances were the reason, which can later be changed. One "trap" that may be encountered within this dimension is making exercise the specific area of failure. For example, if a person states, "I am a very motivated person, just not when it comes to exercise," they are making a specific attribution that serves them no good. The major focus is to make the specific attribution changeable (i.e., unstable or temporary). Stating that one is not motivated in the domain of exercise implies that change cannot occur – but it can.

The trick is to change your perception of this specific domain. Exercise has been characterized with pain and intense labor. These characterizations need to be adjusted. Exercise can be fun and painless. This takes education, finding what is right for you, and prioritizing exercise into your life. The health benefits are tremendous. You feel better, look better, and are less susceptible to getting sickness and disease. Once exercise has been made a top priority, success and adherence will follow – but how does one accomplish this?

Success and Exercise Adherence

Education is the key. Understanding the benefits of exercise is the first step; the second is getting educated in how powerful the mind is. The explanations we make tremendously affect our actions (and inactions). Attributing lack of exercise to specific, unstable, and internal (to take responsibility) factors facilitates a thought process that can get you motivated. Making these types of attributions, alters your perceptions of exercise, and places the effort to exercise as a "psychological investment." You want to look and feel good? Of course, we all do. Find out about exercise routines or programs that interest and benefit you. Make exercising a top priority by gaining social support through family, friends, co-workers, and/or classmates. And most importantly, invest in your own mind adherence to exercise through the attributions you make, which in turn, benefits your behavior – and your life.

Quick-Reference Guidelines to Exercise Adherence

Here are a few helpful guidelines to increase exercise adherence, as well as getting motivated by making positive attributions.

1. Exercise Education
   • Benefits – Recognize the important health and performance benefits attained with working out.
   • Terminology – Don’t get lost in translation; speak and understand the vocabulary associated with exercise.
   • Fitness – Understand what fitness and exercise behavior consists of; knowing more increases confidence and interest.
2. Physical Education
• Your Unique Body – Learn your specific wants and needs, and how your body responds to exercise.
• Nutrition – Promote healthy eating practices that encourage physical activity.
• The Program – Know what exercises work for you; construct your program accordingly.
3. Psychological Education
   • Investment – Get a gym membership, buy equipment, and hold yourself accountable by setting goals.
   • Strategy – Recognize the realities of life and make a gameplan, which includes making time, mixing up workouts, and including interests into your physical activity.
   • Social Motivation – Gain support from others to enhance confidence and motivation.
4. Attributions
   • Personalization – Take responsibility to exercise, and give yourself credit for success.
   • Permanence – Realize that a setback is only temporary, and successful results can be maintained.
   • Pervasiveness – Lack of exercise can be attributed to specific, changeable reasons; success in exercise can be carried over into other areas of your life.

By Sarah McCord, NSCA-CPT

California State University, Fresno

According to the National Institute for Mental Health, approximately 19 million Americans have an anxiety disorder.  Affecting almost just as many people as depression (with approximately 20 million diagnosed cases), anxiety disorders are widely ignored and even frequently misdiagnosed.  Modern medicine and better access to health care have led to improved diagnostics but access to information is limited, especially for the average sufferer.

The Anxiety/Activity Relationship

The 19 million sufferers of anxiety disorders experience a variety of different disorders that range from obsessive-compulsive disorder to post-traumatic stress disorder to generalized anxiety. The main differences are the causes or ‘triggers’.  For example, post-traumatic stress disorder (PSTD) usually develops after a traumatizing event and episodes are triggered by things that remind you of the event.  On the other hand, most anxiety disorders are considered genetic in origin and episodes are triggered by a range of events, places, noises, or nothing at all.

Most anxiety episodes generate similar signs and symptoms that fall into two categories: mental and physical/physiological.  Mental symptoms are similar to depression and include sadness, hopelessness, changes in appetite or sleep, low energy, and difficulty concentrating.

The physiological stress response to anxiety begins in the brain where the hypothalamus, amygdala, and pituitary gland go on alert.  They communicate with each other to interpret the signal and then release hormones and nerve impulses to prepare the body for the flight-or-flight response.   The adrenal glands respond to this by releasing epinephrine which makes the heart beat faster and the lungs work harder to make oxygen more available to the body.  Simultaneously, the adrenal glands also release cortisol to help the body convert sugar into energy.  Nerve cells release norepinephrine to tense the muscles and sharpen the senses.

Both the physiological and mental responses to stress can cause significant damage to the body.  For example, the digestive system is shut down during each stress response.  But chronic stress, specifically the cortisol response, can cause damage to the arteries as well as weaken the immune system, cause bone loss, and suppress the reproductive system.  Attention-span and memory are adversely affected as well.

Exercise as Treatment

The good news is that there are a number of treatment options available to treat chronic (trait) anxiety.  Traditionally, psychiatrists will prescribe anti-depressants and talk therapy.  A new, and relatively unknown strategy for treating anxiety is aerobic exercise.  Researchers in both the exercise and psychology fields have discovered a direct connection between aerobic exercise and reduced anxiety.  Specifically, high-intensity aerobics will help decrease the physiological stress response.

In a recent study conducted at the University of Missouri, female participants (ages 18-20 and 35-45) completed three experimental sessions. Each session started with a test to determine the anxiety level of the participant. Following the test, the women either did not exercise (control condition) or exercised at a moderate or high-intensity level for 33 minutes. Anxiety levels were then measured at 5, 30, 60 and 90 minutes post-exercise. They found the high-intensity level experienced the sharpest decline in anxiety. 

Please note that self-directed exercise can be effective in treating anxiety.  However, anyone who suffers from anxiety that interferes with their daily lives should seek treatment from a medical professional such as a psychologist or psychiatrist.

The Anxiety/Performance Relationship

The relationship between anxiety and exercise is not just of importance to sufferers of chronic anxiety.  For anyone who participates in any form of physical activity, it is important to understand how anxiety affects performance.  Every one experiences anxiety at some point in their life.  The difference between an anxiety disorder and acute anxiety is state vs. trait.  Trait (chronic) anxiety exists as part of a person’s personality.  State (acute) anxiety refers to anxiety that develops in response to a specific state or situation.  In regards to athletics, participants usually experience state anxiety when faced with competition or a challenge that exceeds perceived ability.

Surprisingly, trait anxiety can actually improve athletic performance.  Every athlete performs best within an individual zone of optimal functioning (IZOF).  If the athlete is not aroused enough, they will be bored and unfocused.  If they are overly aroused, the athlete may give up.  When the athlete is aroused within their zone of optimal functioning, the athlete becomes physiologically prepared for the task.  As described earlier, the heart is beating faster, the lungs are working harder to make oxygen more available, cortisol is available to help the body convert sugar into energy, and norepinephrine tenses the muscles and sharpens the senses.  The stress response creates a physiological state of readiness for optimal performance.

Application

The ability to manage anxiety is considered one of the most important predictors for successful elite performance.  The most important factor for managing anxiety is achieving the optimal level of arousal.   If the athlete is not aroused enough, increase the demand from that athlete.  It may be that they do not feel challenged enough.  To decrease anxiety, try activities like deep breathing, biofeedback, or meditation. Terry Orlick’s book, In Pursuit of Excellence (2000) provides detailed descriptions and guidelines for these techniques. To learn to more about managing anxiety to facilitate performance, an athlete should consult with a sport psychologist.

Author Information:  Sarah McCord, NSCA-CPT is the Health & Fitness Director at a non-profit Sports/Arts Center in Fresno, CA.  She is also a graduate student at California State University, Fresno.  She can be reached at sarahm@csufresno.edu.

By Nancy A. Furcsik, ATC, California State University, Fresno

The goal of this article is to aid in educating parents, coaches and teachers who interact with physically active female adolescents about eating behaviors that can ensure a continued healthful participation in athletics or other physical activities.

"81% of 10 year olds are afraid of being fat"

The average weight of American youth has steadily increased over the past 10 years.   Physical activity has been the recommended solution to this problem.   Additional benefits associated with physical activity include decreased anxiety and stress, as well as increased self-esteem.   Young girls and women that engage in sport and physical activity benefit greatly, however some research suggests that the type of physical activity may affect their health and psychological outcomes in different ways.   While any athlete is more at risk than a non-athlete, participation in aesthetic activities create an increased risk.  

Yale University has released research that shows a direct correlation between food rules from childhood and adult eating behaviors.   A few examples are as follows:

• Kelly got into a fight at school and then was withheld dessert that evening by her parents.
• Tina received a good grade on an exam and was then taken out for pizza as a reward.
• Betty fell off her bike, skinned her knee, and her mother offers her ice cream to help her feel better.

These behaviors or others like them might encourage young girls to then turn to food as the solution to soothe themselves after an emotional or physical injury.   The studies suggest that with the solution to emotional or physical injury being tied to eating, promotion of disordered eating continue to occur into adulthood occurs.  

Additionally, a study released by York University presented information about anxiety and general family appearance as being factors that indicate a predisposition for eating disorders.   The results of the study concluded that people who show higher anxiety levels are more likely to have self-esteem and body-satisfaction issues.   It was also determined that when lower levels of anxiety were consistently present, it was less likely that if self-esteem and body images were present that they would be a strong contributing factor.   For example, a girl who is prone to anxiety or higher levels of stress is more likely to also suffer from a lower self-esteem and body image, whereas a girl who is not prone to anxiety is more likely to have a realistic (not distorted) view of themselves through their self-esteem and body image.   This study also concluded that females who are weight conscious might attribute these concerns in part toward a family preoccupation with weight.

A number of predisposing psychological issues has been briefly discussed including self-esteem, body image, family environment, and coping strategies.   The manifestation of eating disorders or disordered eating can result from any number of these predispositions.   The traditional signs and symptoms that are generally indicators of eating disorders are identified below specifically for Anorexia Nervosa and Bulimia Nervosa respectively:

Anorexia Nervosa

• Refusal to maintain body weight over a minimal normal weight for age and height
• Intense fear of gaining weight, even when underweight
• Inability to see one’s weight, size, or shape
• Absence of at least three consecutive menstrual cycles

Bulimia Nervosa

• Recurrent binge-eating
• Fear of not being able to stop eating during binges
• Regularly engage in either self-induced vomiting, misuse of laxatives, diuretics or enemas, rigorous dieting or fasting, or excessive exercise to get rid of the food or calories from the food eaten during the binge
• At least two binge-eating sessions followed by compensatory behavior (purging) each week for at least 3 months  
• Self-evaluation influenced by body shape and weight

Defining an eating disorder goes far beyond the typical clinical definitions associated with anorexia nervosa and bulimia nervosa and encompasses disordered eating.   Disordered eating can have a wide variety of problems falling beneath it such as eating taboo foods when one has been emotionally hurt or when one has succeeded or behaved.  Athletes might take successes or failures and attribute that to what they should/can eat.   In my experiences as an athletic trainer, many athletes display a wide variety of nutritional habits which varies from very healthful to those displaying irregular eating patterns and habits.   The gray area of disordered eating is vast, and should not be taken lightly.   

Recently a court case awarded a former high school athlete a large sum of money after verbal abuse caused the athlete to develop an eating disorder (as stated by the athlete).   This merely brings to light the important role that coaches play in the development of their high school athletes both on and off the playing fields.   While eating disorders/disordered eating can be noted as being higher in aesthetic sports, it is also becoming prominent in sports such as basketball, soccer, and softball.  A positive coaching model should be utilized when coaching these at risk sports.   As a result of promoting competition positively, the athlete’s self esteem and confidence will be boosted.   As was the case in the recent lawsuit, the student-athlete testified that repetitive references were made about her weight.   While the repetitive references made about the student-athlete’s weight were probably not the sole factor to her eating disorder, a positive coaching model might have aided the athlete in increasing her self-esteem, having the potential to prevent the disorder from becoming full circle.

In aesthetic sports/ activities, it is important to remember that a higher degree of incidence is present, and that in the event a participant is in need of nutritional counseling (for weight loss), it is best if it is presented from a nutritionist or other qualified healthcare provider (i.e. Athletic Trainer, Registered Nurse, etc).   Activities that can allow a coach or parent to assess a child’s eating behaviors start with revisiting healthy eating guidelines such as the food pyramid, which includes learning how to read and interpret nutritional labels.   Allowing access to healthy food choices is another way both parents and coaches can promote healthy eating.   For example, on a road trip, bringing water and fruit as a snack and stopping only at restaurants that provide healthy eating options is one way to promote healthy eating habits.   Additionally, boosting self-esteem by providing activities or drills in which the student is assured success.   Once some confidence is gained moving to a harder activity or drill will cause decreased anxiety if some level of self-confidence has been attained first.

With this information in mind, it is possible that a participant will still show some behavior that is indicative of an eating disorder.   Below are items that must be considered in order to aid that participant in a full recovery:       

Keys to Successfully Beginning an Intervention

• Document behaviors: Where, when, and who observed their, mood changes, behaviors, etc.
• Keep Confidential: only involve the needed parties, coaches, physicians, parents, athletic trainers, etc.
• Referral: many additional problems are associated with eating disorders. DO NOT attempt to handle without professional assistance.
• Stay POSITIVE: if the information is presented and handled negatively, the road to recovery will not be smooth.

Please remember this article is not a conclusive information guide.   This article is presented to help spark thoughts about how female adolescents are handled in sports and activities which place them at risk for these behaviors.   I encourage you to contact your school’s athletic trainer for additional information on what you as a coach or parent can do.   Most importantly, if you suspect that a person has an eating disorder or disordered eating, please seek help for this individual.   Below are several organizations that can be helpful in further research of this nature: 

• Anorexia Nervosa and Related Eating Disorders, Inc.
• The Renfrew Center
• National Eating Disorders Association
• Positive Coaching Alliance
• Food and Drug Administration-Nutrition

The author is currently working toward her Masters degree in Kinesiology while working as a Graduate Assistant Athletic Trainer at CSU, Fresno.   Feel free to contact her for further information or questions.  Nfurcsik@msn.com