Aminoacylase 1 deficiency: case report on three affected siblings

Background

Aminoacylase 1 (ACY1, EC 3.5.1.14) deficiency (ACY1D) is a very rare inherited metabolic disease (IMD) with autosomal recessive inheritance (OMIM #609924). Up to date, only 15 cases have been reported in the literature. It is diagnosed by detecting acetylated amino acids among the patient's urine organic acids by gas chromatography-mass spectrometry. Its clinical manifestations are highly variable, ranging from severe neurological symptoms to being asymptomatic.

Case Description

We present a 14-year-old boy with mild intellectual disability, speech sound disorder and non-alcoholic fatty liver disease who exhibited increased urinary excretion of N-acetylalanine, N-acetylmethionine and N-acetylglutamine during testing for inherited metabolic disorders. A suspected ACY1D was subsequently confirmed by targeted next generation sequencing, which revealed the presence of a homozygous pathogenic missense mutation in the ACY1 gene, c.1057C>T (p.Arg353Cys). The proband underwent speech education with good outcome. The same homozygous mutation in ACY1 gene was found in the boy's two brothers, who exhibited slightly varied intellectual abilities. Follow-up examinations of the siblings revealed no deterioration in their mental skills.

Conclusions

These results suggest that uneven mental abilities in pediatric patients with various disorders including autism spectrum disorder may be sufficient grounds to warrant metabolic testing for ACY1D. The acylglycines urine excretion could be a promising novel metabolic marker for ACY1D testing.

Grit, Athlete Burnout, and Well-Being in Female Collegiate Student-Athletes

CONTEXT

Collegiate student-athletes are faced with significant athletic and academic demands, causing a substantial amount of stress, which can lead to athlete burnout. Problematically, little research has been done to find ways to prevent or mitigate the effect of athlete burnout in collegiate student-athletes. Grit is one characteristic that they could use as a coping mechanism to reduce the effects of burnout and to improve overall well-being.

OBJECTIVE

To determine if grit had a main or buffering effect on well-being and athlete burnout in female collegiate student-athletes.

DESIGN

Cross-sectional study.

SETTING

National Collegiate Athletics Association Division I institution.

PATIENTS OR OTHER PARTICIPANTS

A total of 174 female collegiate student-athletes.

MAIN OUTCOME MEASURE(S)

The Grit Scale, Athlete Burnout Questionnaire, and Warwick Edinburgh Mental Well-Being Scale were used to assess grit, athlete burnout, and well-being.

RESULTS

Grit was a significant negative predictor for physical and emotional exhaustion (F1,172 = 28.25, P < .001), a reduced sense of accomplishment (F1,172 = 20.40, P < .001), and sport devaluation (F1,172 = 40.32, P < .001). Additionally, grit was a significant positive predictor of well-being (F1,172 = 29.68, P < .001). The moderated regression with grit did not reveal significant results.

CONCLUSIONS

We provide new information on considerations for reducing athlete burnout and improving well-being in female collegiate student-athletes. Athletic trainers and sports medicine stakeholders should consider intervention strategies for improving grit to mitigate athlete burnout and diminished well-being while continuing to explore their effectiveness.

Sharpening the tip of the spear: Tailoring performance psychology for Special Operation Forces

As performance psychology expands to address different environments, military settings are viewed as a natural extension. In certain cases, however, we suggest that a sub-optimal approach has been employed, due to a lack of specific knowledge of military culture and context, coupled with a diminished emphasis on conducting psychological research targeted directly on military performance. In this paper we explore the specific and importantly unique challenges encountered when researching and consulting with Special Operation Forces (SOF) within the North Atlantic Treaty Organization (NATO) alliance. To support both researchers and practitioners, we offer an overview of the current state of knowledge in this specific domain. We highlight key differences between SOF and conventional forces, then look at the specific requirements for developing performance psychology in the SOF context. Finally, we offer some perspectives on where opportunities might have been missed and offer some suggestions for more impactful (and accurate) research and practice.

The Effect of Halliwick Method on Aquatic Skills of Children with Autism Spectrum Disorder

BACKGROUND

Swimming and the skills associated with participation in the aquatic environment tend to be an integral part of the movement literacy complex. Non-participation then affects the safety of movement in the aquatic environment and may also be the reason for the limitation of movement, psychological, and social development compared to peers.

METHODS

This study is a single-subject research study. The aim of this study is to evaluate the effect of a seven-week intervention program of the Halliwick method in the development of aquatic skills, gross motor skills, and mental skills relevant for aquatic competence for children with autism spectrum disorder. Seven children with autism spectrum disorder participated in swimming classes for a two-week baseline period and a seven-week intervention program of the Halliwick method, one time per week. To measure the effect in the field of aquatic skills, we used the Alyn Water Orientation Test 1. To determine the level of gross motor skills, we used the Gross Motor Function Measure test.

RESULTS

There was an improvement in aquatic skills and gross motor skills in seven participants; two of them did not improve in mental adjustment oriented to the breathing control sections in the water.

Applying sport psychology in health professions education: A systematic review of performance mental skills training

INTRODUCTION

Health professionals are expected to consistently perform to a high standard during a variety of challenging clinical situations, which can provoke stress and impair their performance. There is increasing interest in applying sport psychology training using performance mental skills (PMS) immediately before and during performance.

METHODS

A systematic review of the main relevant databases was conducted with the aim to identify how PMS training (PMST) has been applied in health professions education and its outcomes.

RESULTS

The 20 selected studies noted the potential for PMST to improve performance, especially for simulated situations. The key implementation components were a multimodal approach that targeted several PMS in combination and delivered face-to-face delivery in a group by a trainer with expertise in PMS. The average number of sessions was 5 and of 57 min duration, with structured learner guidance, an opportunity for practice of the PMS and a focus on application for transfer to another context.

CONCLUSION

Future PMST can be informed by the key implementation components identified in the review but further design and development research is essential to close the gap in current understanding of the effectiveness of PMST and its key implementation components, especially in real-life situations.

Well-Being Perception during COVID-19 Pandemic in Healthy Adolescents: From the Avatar Study

The COVID-19 pandemic provided an extraordinary and naturalistic context to observe young people’s psychosocial profiles and to study how a condition of environmental deprivation and lack of direct social contact, affects the well-being and health status of adolescents. The study explored whether the COVID-19 outbreak changes, in the short term, the acute well-being perception in adolescents, as measured by a Personalized Well-Being Index (PWBI) and the four components affecting health (i.e., lifestyle habits, social context, emotional status, mental skills), in a sample of early adolescent students. Data from 10 schools were collected on 1019 adolescents (males 48.3%, mean age 12.53 ± 1.25 y). Measurements were obtained at two time points, in September/October 2019, (baseline condition, BC) as part of the “A new purpose for promotion and eVAluation of healTh and well-being Among healthy teenageRs” (AVATAR) project and during the Italian Lockdown Phase (mid–late April 2020, LP), with the same students using an online questionnaire. During COVID-19 quarantine, adolescents showed a lower PWBI (p < 0.001) as compared to the BC. Considering the four health-related well-being components, lifestyle habits (p < 0.001), social context (p < 0.001), and emotional status (p < 0.001), showed significantly lower values during LP than BC. However, mental skills, in LP, displayed a significant increase as compared to BC (p < 0.001). In this study, we have provided data on the personalized well-being index and the different components affecting health in adolescents during the COVID-19 lockdown, showing a general decrease in well-being perception, expressed in lifestyle habits, social, and emotional components, demonstrating detrimental effects in the first phase of quarantine on adolescents’ psychosocial profiles. Our results shed new light on adolescence as a crucial period of risk behavior, especially when social support is lacking.

Competitive Psychological Disposition and Perception of Performance in Young Female Soccer Players

The athletes' psychological disposition is a factor that is increasingly considered by researchers as a key to sports performance, even as a mediator between the physical, technical and tactical abilities of the athlete and their competitive performance, thus acquiring great relevance in training and in sports performance. The purpose of this study is to analyze the psychological characteristics of young soccer players and their relation to their performance perception, made both by the player herself and by their coaches. The sample is composed of 108 women (M age = 15.53, SD age = 1.05), with ages between 13 and 17 years (13 years, n = 1, 14 years, n = 18, 15 years, n = 36, 16 years, n = 29, 17 years, n = 24), and with a sport practice experience of 7.27 years on average (SD = 2.64). For to address this aim, we used the Psychological Characteristics related to the Sport Performance Questionnaire (CPRD) and the Psychological Skills Inventory for Sports (PSIS). In addition, regarding the evaluation of performance perception, an ad hoc short questionnaire was created, composed by one question addressed to the player and one directed to the coach. The results indicate that the group of players of the under-16 category obtained higher scores in all the psychological dimensions than the U-18 players, showing significant differences in Team Cohesion (p < 0.048). Regarding the degree of congruence between the player's psychological features, and the player's and coach's performance perceptions, the results show statistically significant and negative correlations between the Team Cohesion factor and the athlete's own outcome perception for the match #1 (rxy = -0.479; p < 0.001), and match #2 (rxy = -0.402; p < 0.01). The results of this study may contribute to establish the differences between different constellations of psychological characteristics according to the categories of competition and their relationship with the perception of performance. This knowledge can be used by sports professionals: coaches, psychologists, physical educators, etc., in order to help athletes to reach their maximum performance.

Validation of a French Version of the Psychological Characteristics of Developing Excellence Questionnaire (MacNamara & Collins, ): A Situated Approach to Talent Development

This study sought to validate the psychometric properties of a French-language version of the Psychological Characteristics of Developing Excellence Questionnaire (PCDEQ). Data were gathered from 305 athletes in French-speaking Switzerland (mean age: 16.6 yr, SD: 2.9). Translation of the PCDEQ followed established guidelines and included a standardized back-translation process. The psychometric properties were examined by descriptive statistics, Cronbach's alphas for internal reliability, confirmatory factor analysis, intraclass correlations and a paired t-test for test-retest reliability. The results provided evidence of validity of the French version of the PCDEQ. Two items were excluded for low factor loading, and the re-specified model was improved and confirmed the six-dimensional structure with acceptable fit using most criteria (χ²/df), RMSEA, SRMR, TFI, CFI). Cronbach's alpha also indicated that internal reliability was adequate for validation. Given the adequate psychometric properties, the French-version PCDEQ can be used with confidence for monitoring and designing interventions to enable aspiring athletes or artists to develop the psychological skills and characteristics that can act as important catalysts for their development.

Psychological Profiling of Triathlon and Road Cycling Athletes

Psychological characteristics of athletes play a key role in sport performance and may moderate and mediate the influence of technical, tactical, and physical abilities athletes show. Different authors have emphasized the special attention such psychological characteristics should receive considering the extent they can influence athletes' behavior either in training or in competition. This paper is aimed at describing the psychological profiles of two cycling sports: triathlon and road cycling. One hundred and twenty-nine male and female professional and amateur cycling athletes (35.74 years old average age ±12.79; 14.94 average number of years practicing cycling ±11.20) were assessed on different psychological characteristics. For that purpose, the Psychological Characteristics related to the Sport Performance (CPRD) Questionnaire and the Psychological Skills Inventory for Sports (PSIS) was used. Results showed significant differences among triathlon and road cyclists (Stress control = t₁₁₆ =-3.711, p = 0.000, d = 0.48 ; Influence of Performance Evaluation = t₁₁₅ =-3-115, p = 0.002, d = 0.49; Motivation = t₁₂₄ =-5.520, p = 0.000, d = 0.82; Mental Skills = t₁₁₉ =-4.985, p = 0.000, d = 1.02). There were no significant differences between men and women though there were differences among pros and amateur athletes. Triathlon professional, compared to amateurs, showed higher scores in all the psychological dimensions assessed (Stress control = t₈₅ = 3.005, p = 0.003, d = 1.07; Influence of Performance Evaluation = t₈₃ = 2.858, p = 0.005, 0.77; Motivation = t₉₁ = 2.721, p = 0.008, d = 0.26; Mental Skills = t₈₇ = 2.556, p = 0.012, d = 0.77). The results of this descriptive study contribute to establishing a model of optimal psychological profiling applied to the different cycling groups that can be used by sport psychologist, trainers, and coaches in order to promote peak performance of these athletes.

Historic notes on anatomic, physiologic, and clinical research on the cerebellum

This chapter is concerned with ideas on the function, structure, and pathology that shaped our present knowledge of the cerebellum. One of the main themes in its early history is its localization subtentorially, leading to misattributions due to clinical observations in trauma and lesion experiments that caused collateral damage to the brainstem. Improvement of techniques led to the insight that it plays a role in movement control (Rolando) or coordination (Flourens). Purkinje initiated the histology of the cerebellar cortex in 1837. Luciani's experiments in 1891 led him to conclude that the cerebellum has a tonic facilitating effect on central structures. Cajal identified the elements of the cortex and their circuitry (1888-1891). The inhibitory nature of the interneurons and the Purkinje cells, and the excitatory connections of the mossy and climbing afferents and the granule cells were established much later by Eccles and Ito. A functional localization for the coordinating action of the cerebellum of the motor system, based on local expansion of the folial chains, was devised by Bolk in 1906. Babinski and Holmes contributed to anatomoclinical insights. Magnus and coworkers showed the cerebellum does not play an essential role in body posture. The heterogeneity of the Purkinje cells with respect to their connections and histochemistry found its expression in the zonal organization of the cerebellar cortex. The roots of modern developments, like cerebellar learning and its involvement in cognition and emotion, can be traced to the theories of Marr and Albus and the pioneering work of the Leiners and Dow.

Making Champs and Super-Champs-Current Views, Contradictions, and Future Directions

In our 2016 paper (Collins et al., 2016a), we proposed that superchamps (athletes who have achieved the highest level in their sport) were differentiated from their less successful counterparts by their use of positive proactive coping and a “learn from it” approach to challenge. This skill-based focus to talent development (TD) is supported extensively in the literature (e.g., MacNamara et al., 2010a,b) and suggests that the differences between levels of adult achievement relate more to what performers bring to the challenges than what they experience (Collins et al., 2016a). In this focused review we present and discuss a number of key concepts related to this paper and other parallel research in TD. We begin by presenting our pragmatic objectives and the importance of considering how we evaluate the research with an emphasis on its application to the applied setting. We then consider commonalities and differences in recent psychological approaches to TD, namely the experiential, attitudinal, and skill-based. The paper then provides further exploration of the Psychological Characteristics of Developing Excellence and their role in TD processes. We conclude with a consideration of future research and the application of research in TD. Reflecting our pragmatic stance as researchers, we hope that this focused review provides suggestions for progress and stimulates critical debate amongst practitioners, researchers and policy makers.

Application of Mental Skills Training in Surgery: A Review of Its Effectiveness and Proposed Next Steps

INTRODUCTION

Mental skills training, which refers to the teaching of performance enhancement and stress management psychological strategies, may benefit surgeons. Our objective was to review the application of mental skills training in surgery and contrast it to other domains, examine the effectiveness of this approach in enhancing surgical performance and reducing stress, and provide future directions for mental skills training in surgery.

MATERIALS AND METHODS

A systematic literature search of MEDLINE, PubMed, PsycINFO, and ClinicalKey was performed between 1996 and 2016. Keywords included were mental readiness, mental competency, mental skill, mental practice, imagery, mental imagery, mental rehearsal, stress management training, stress coping, mental training, performance enhancement, and surgery. Reviews of mental skills interventions in sport and well-regarded sport psychology textbooks were also reviewed. Primary outcome of interest was the effect of mental skills on surgical performance in the simulated or clinical environment.

RESULTS

Of 490 identified abstracts, 28 articles met inclusion criteria and were reviewed. The majority of the literature provides evidence that mental imagery and stress management training programs are effective at enhancing surgical performance and reducing stress. Studies from other disciplines suggest that comprehensive mental skills programs may be more effective than imagery and stress management techniques alone.

CONCLUSIONS

Given the demonstrated efficacy of mental imagery and stress management training in surgery and the incremental value of comprehensive mental skills curricula used in other domains, a concerted effort should be made to apply comprehensive mental skills curricula during surgical training.

Self-Reported Responses to Player Profile Questions Show Consistency with the Use of Complex Attentional Strategies by Expert Horseshoe Pitchers

The advantages on an external focus of attention have been demonstrated for a variety of sport tasks. The constrained action hypothesis (Wulf et al., 2001) argues that focusing externally on the movement effect results in the use of automated processes for movement control. In contrast, focusing internally in an attempt to control the movements of the body disrupts normally automated processes and degrades performance. Research on experts, however, suggests that they may adopt more complex attentional strategies. The present study provided a unique opportunity to examine expert horseshoe players' attentional strategies as indicated by their self-reported responses to questions included in a National Horseshoe Pitchers Association (NHPA) player profile questionnaire. Responses submitted by 83 top NHPA players were examined to determine the frequency of references to the use of internal and external focus points and identify categories related to attentional strategies. Results indicated that the large majority of players reported using focus points that are consistent with an external focus of attention and that their thoughts corresponded to one or more categories related to technique, mental focus or concentration, general success, use of external focus cues, and emotional control. The findings are consistent with the view that experts may adopt complex attentional strategies that encompass both an external focus and thoughts about a variety of other performance related factors.

The Effects of Mental Imagery with Video-Modeling on Self-Efficacy and Maximal Front Squat Ability

This study was designed to assess the effectiveness of mental imagery supplemented with video-modeling on self-efficacy and front squat strength (three repetition maximum; 3RM). Subjects (13 male, 7 female) who had at least 6 months of front squat experience were assigned to either an experimental (n = 10) or a control (n = 10) group. Subjects′ 3RM and self-efficacy for the 3RM were measured at baseline. Following this, subjects in the experimental group followed a structured imagery protocol, incorporating video recordings of both their own 3RM performance and a model lifter with excellent technique, twice a day for three days. Subjects in the control group spent the same amount of time viewing a placebo video. Following three days with no physical training, measurements of front squat 3RM and self-efficacy for the 3RM were repeated. Subjects in the experimental group increased in self-efficacy following the intervention, and showed greater 3RM improvement than those in the control group. Self-efficacy was found to significantly mediate the relationship between imagery and front squat 3RM. These findings point to the importance of mental skills training for the enhancement of self-efficacy and front squat performance.

The role of psychological factors in the career of the independent dancer

Previous research indicates that psychological factors such as motivation and mental skills play an important role in relation to performance and to negotiating talent development stages. However, little is known about these factors in dance, particularly with regard to the independent dancer whose career may involve multiple roles, varied work patterns, and periods of instability. The aim of this study was to explore dancers’ motivation to work in an independent capacity, and the extent to which dancers’ psychological characteristics and skills enabled them to navigate a career in this demanding sector. In-depth semi-structured interviews were conducted with 14 dancers at different stages of their careers. Interviews were transcribed verbatim and content analyzed. Analysis revealed that the dancers were intrinsically motivated and highly committed to the profession. Working in the independent sector offered dancers opportunities for growth and fulfillment; they appreciated the autonomy, flexibility and freedom that the independent career afforded, as well as working with new people across roles and disciplines. In order to overcome the various challenges associated with the independent role, optimism, self-belief, social support, and career management skills were crucial. The mental skills reported by the participants had developed gradually in response to the demands that they faced. Therefore, mental skills training could be invaluable for dancers to help them successfully negotiate the independent sector.

The relationship between imagery type and collective efficacy in elite and non elite athletes

This study investigated the relationship between imagery function and individual perceptions of collective efficacy as a function of skill level. Elite (n = 70) and non elite (n = 71) athletes from a number of interactive team sports completed the Sport Imagery Questionnaire (SIQ) and the Collective Efficacy Inventory (CEI). Multiple hierarchical regression analysis was then used to examine which SIQ sub-scales predicted individual perceptions of collective efficacy. For the elite sample, Motivational General-Mastery (MG-M) imagery accounted for approximately 17% of the variance in collective efficacy scores. No significant predictions were observed in the non elite sample. The findings suggest MG-M imagery as a potential technique to improve levels of collective efficacy although competitive level may moderate the effectiveness of such interventions. Key pointsAs imagery is an individual intervention, an examination of individual perceptions of collective efficacy was most appropriate.Elite athletes who use more MG-M imagery also have higher individual perceptions of collective efficacy.For non-elite athletes, none of the imagery functions tested predicted individual perceptions of collective efficacy.Performance accomplishments provided by MG-M imagery may increase individual perceptions of collective efficacy.Future research should investigate further the effects of imagery intervention programmes on collective efficacy beliefs.

Perceptions of the contribution of psychology to success in elite kickboxing

The study used semi-structured interviews to explore the views of three high performance kickboxers regarding the contribution of psychology to the development and maintenance of expert performance within kickboxing. The results provide a useful insight into the experiences of high performance kickboxers, identifying those mental skills and psychological attributes that are perceived to contribute to success. Participants identified seven mental skills that they believed to be linked to success in kickboxing; 1) effective use of self-talk, 2) relaxation, 3) heightened concentration, 4) self-regulation of arousal, 5) goal setting, 6) coping with being hit, and 7) imagery. Three psychological characteristics were identified by all participants as contributing to success, 1) high self-efficacy, 2) highly motivated and 3) mental toughness. Although not specifically identified by participants, it is suggested that a fourth psychological characteristic was also apparent. Participants demonstrated varying degrees of emotional intelligence thorough their ability to monitor and manipulate their emotional states prior to and during competition. Martial artists used a number of long and short-term psychological strategies in preparing for competition. Furthermore, whilst mental skills were not systematically practiced, all participants endeavored to integrate some form of mental training within physical training. It is recommended that sport psychologists help martial artists develop and refine individualized mental training routines, assisting with the formal integration of psychological training into physical training. Martial artists spend the majority of their time practicing as opposed to competing. As such, the integration of mental skills training within physical training may help ensure quality practice, and facilitate the effective transfer of mental skills into competition. Key PointsPerceptions of the contribution of psychology to success in high performance kickboxing was explored using semi-structured interviews.Seven mental skills and three psychological attributes were collectively identified by participants, which they perceived as being linked to success.The need to integrate mental skills training into physical training was identified. This is necessary to optimise training effectiveness, and as such should be a key objective of applied sport psychologists.

Do Not Pay Any Attention to the Umpires: Thought Suppression and Task-Relevant Focusing Strategies

Two studies grounded in ironic-cognitive-processing theory were conducted to determine (a) whether ironic errors may be associated with efforts to exert mental control that typically occur in sport settings and (b) whether these potential ironic effects could be negated through the use of a task-relevant cue word to refocus one's thoughts during suppression. Participants were asked to watch a videotape of a series of clips of Australian Rules Football players, coaches, and umpires. Study 1 revealed that participants were more aware of umpires when instructed not to pay attention to them. Contrary to expectations, however, ironic effects were not significantly magnified by the combination of high cognitive load and the instruction not to pay attention to the umpires. Results from Study 2 indicated that potential ironic effects could be negated when individuals were given a task-relevant cue word to focus on when suppressing unwanted or negative thoughts. Overall, support for ironic processing theory was found in Studies 1 and 2 in this investigation.