This chapter addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. It provides Dr. Sachs’s honest and open remarks along with interspersed additions from the authors to introduce the field and its accompanying issues. In explaining his career trajectory, Dr. Sachs recalls earning his undergraduate degree in psychology and then applying to graduate programs in applied behavioral analysis. Dr. Sachs’s somewhat zigzagged trajectory in the field demonstrates the important sport and exercise psychology principle that explains the benefits of focusing on the process rather than the outcome when setting goals. Dr. Sachs added that the United States leads the way in research and writing with regard to sport and exercise psychology, while other countries may be more advanced in the application of that knowledge at the professional levels.

This chapter addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. The topic of decision making has been covered in psychology, economics, and motor learning but addressed very sparsely in sport, exercise, and performance psychology. Rational decision making requires defining the problem, identifying criteria, weighing those criteria, generating alternative solutions, and ultimately computing the optimal decision. The chapter introduces the literature on decision making and provides examples of factors that influence the choices people make. The decision to act, move, or what move to make is decided in the response selection stage, and the final stage is when one’s brain and muscles are organized to make the actual move. The key to improve the decision-making over time is to increase personal awareness of own limitations and keep learning and collecting information from reliable sources.

One of the most important findings from the original battered woman syndrome (BWS) research was the existence of a three-phase cycle of violence that could be described and measured through careful questioning of the battered woman. This chapter describes the cycle, updates it by adding information from the courtship period, and divides the third phase into several different sections where appropriate so that there may not be any loving contrition or even respites from the abuse at times during the relationship. Teaching the woman how her perception of tension and danger rises to an acute battering incident after which she experiences feelings of relief and then gets seduced back into the relationship by the batterer’s loving behavior, often similar to what she experienced during the courtship period, has been found to be helpful in breaking the cycle of violence that keeps the woman in the relationship.

This chapter aims to give the behavioral health specialist (BHS) a basic understanding of pain, knowledge about how to effectively evaluate chronic pain, and a description of effective pain management techniques. Knowledge of the biological and psychological basis of pain is important to understanding the experience of chronic pain. A biopsychosocial assessment is the foundation for providing behavioral health treatment to the chronic pain patient. Chronic pain is less responsive to treatments commonly used for acute pain such as opioid analgesia and avoiding physical activity. A multidisciplinary team approach can substantially improve outcomes in chronic pain treatment. Whatever the format of service provision, utilizing multiple interventions such as physical therapy/exercise, emotional management, pacing, and medication, rather than a single modality can substantially improve outcomes for chronic pain. Providing psychoeducation about chronic pain can be an important strategy.

This chapter discusses the assessment and laboratory findings, imaging, diagnosis and management of ascites. A common complication of cirrhosis is ascites, or the accumulation of fluid in the abdominal cavity. Ascites that develops from cirrhosis is associated with portal hypertension. The patient with cirrhosis and ascites may complain of increased weight gain, lower extremity edema, and abdominal bloating or distension. Physical examination findings may reveal a distended or even tense abdomen, positive fluid wave, dullness to abdominal percussion, and peripheral edema. Routine laboratory testing, such as complete blood count, complete metabolic panel, and liver function testing, should be performed with new-onset ascites and at routine return visits. Patients with cirrhosis and ascites can develop electrolyte imbalances and renal failure. Ultrasound is helpful to determine whether ascites is present if there is any uncertainty upon physical examination. Patients should abstain from alcohol consumption and avoid using nonsteroidal anti-inflammatory drugs.

The primary purpose of Module 3 of the MAC program is the understanding and exploration of values as a central orienting concept. In the context of understanding the important role of values in enhanced performance and quality of life, the functional and dysfunctional role of emotions is also considered. This chapter suggests to clients that their personal values will be the anchor point for all behavioral decisions that need to be made in the course of enhancing performance and achieving goals. The concepts of mindful awareness, mindful attention, and cognitive fusion and cognitive defusion become integrated with the concept of values-directed versus emotion-directed behavior. The Relevant Mindful Activity Exercise is intended to connect the mindfulness concept to a relevant performance situation in the client’s life. The question of personal values is particularly salient when confronted by the variety of emotions and internal rules that client confronts on a daily basis.

Inflammatory bowel disease (IBD) is a broad diagnosis that includes two major chronic diseases: ulcerative colitis (UC) and Crohn’s disease (CD). IBD is typically diagnosed in young adulthood. Smoking has been associated with a higher risk of developing CD. UC is an inflammatory disease of the mucosa of the colon and rectum. Typical symptoms include bowel movement urgency, tenesmus and bloody diarrhea. CD is a chronic inflammatory disorder of the alimentary tract. It is associated with high levels of proinflammatory cytokines. Referral to a gastroenterologist specializing in IBD may be needed. To confirm diagnosis, a flexible sigmoidoscopy is necessary in cases of UC and a colonoscopy is necessary in cases of CD. The goal for treatment of IBD is to suppress the immune system and help heal the bowel. Initial treatment for patients with mild to moderate UC includes 5-aminosalicyclic acid compounds.

Some drugs, like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), have been blamed for peptic ulcer formation. The most common peptic ulcers are duodenal ulcers. Risk factors for the development of peptic ulcer disease are chronic NSAID use, older age, Helicobacter pylori infection, use of anticoagulant or anti-platelet medications, history of prior ulcers, use of corticosteroids, alcohol use, and smoking. One of the goals of treatment for the patient with peptic ulcer disease is eradication of H. pylori infection. Complications that develop if peptic ulcer is untreated include gastrointestinal bleeding, gastric cancer and gastric outlet obstruction, with bleeding the most common. Most patients with peptic ulcer disease are asymptomatic. When symptoms do arise, dyspepsia is a common complaint. Sucralfate, a formula of aluminum hydroxide and sulfated sucrose, is given to patients with peptic ulcer disease to protect the gastric and duodenal mucosa.

The long-term use of benzodiazepines causes severe cognitive and neurological impairments, atrophy of the brain, and dementia, and the newer sleep aids should be considered a potential but unproven risk in this regard. Some of the most severe cases of chronic brain impairment (CBI) occur after years of exposure to benzodiazepines. This chapter examines the risk of increased mortality associated with benzodiazepines and closely-related sleep aids when given in relatively small doses for short periods of time in the treatment of insomnia. All of the benzodiazepines and the more common prescribed sleep aids are addictive. Opiate and opioid withdrawal tends to be more predictable than psychiatric drug withdrawal. Like the abuse of stimulants and benzodiazepines, abuse of opiates and opioids can result in unlawful acts. The chapter addresses legally used opioids, involving mild-to-moderate abuse or dependence as found in patients who can often be safely withdrawn in an outpatient setting.