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physical activity
any bodily movement produced by the contraction of skeletal muscles that results in an increase in caloric requirements over resting energy expenditure (raises energy cost)
benefits: decreases over 100 chronic diseases like depression, diabetes, COPD, arthritis, and reduces carbon emissions (walking instead of driving)
sport
a physical activity where people use skill and effort to compete, either for fun, well-being, or performance
benefits: increases social connection and increases fitness components
exercise
physical activity that is planned, structured, repetitive, and done to increase a component of physical fitness (ex: pushup)
benefits: reduces anxiety and increases brain size (cognition)
Health-related vs skill-related fitness components
Health
cardiorespiratory endurance
body composition
muscular strength
muscular endurance
flexibility
Skill
agility
coordination
balance
power
reaction time
speed
sedentary behaviour
any waking behaviour with an energy expendature less than 1.5 mets, in a seated, laying, or reclined position. standing doesnt count. you should be standing every 30-60 mins (ex: sitting at desk)
benefits of less sedentary behaviour: increases mood and decreases pain
what is a MET
a unit used to estimate the intensity of physical activity by comparing it to the body’s energy use at rest. 1 MET = 3.5 mL O2 per Kg^-1 per min^-1
higer MET values indicate higher activity intensity
benefits
the more the better
benefits plateau around 3-5 times guideline levels (150 hrs)
benefit is greater early on in the curve. going from no exercise to 10 mins will have larger benefits than 20 min to 30 min.
24 hour movement guidelines
4 S’s
Sweat: 150 mins of moderate to high intensity movement and 2 or more resistance training sessions per week
Step: several hours a day of light intensity movement (including standing)
Sleep: 7-9 hours of sleep plus consistent wake and bed times
Sit: less than 8 hours a day sitting. break up sessions of sitting. less than 3 hours of rec screen time
47% of Canadians are currently meeting the guideline
sport and exercise psychlogy
the branch of kinesiology that involves the scientific study of human behaviour in physical activity and the practical application of that knowledge in physical activity settings
Theory
structured approach for understanding and predicting physical activity behaviours (eg training for olympics)
kin subareas
exercise physiology, biomechanics, sport and exercise psychology, and sociocultural sport studies
a thorogh understanding of physical activity behaviour requires integrating information from ALL the kin subdisciplines
Psychology
the study of the mind and behaviour. has several branches
seeks to understand people’s thoughts, behaviours, and feelings within the dynamic context of the environment
ABCDEs of psychology
Affect (feelings, Behaviour, Cognition (thought), Dynamic (constantly changing), Environment (both our environment and individual characteristics determine our behaviour)
the interrelationships of the person, environment, and behaviour are complex and dynamic, changing over time.
Kinesiology
Discipline: the scientific study of human movement
Profession: work with people of all ages and abilities in many physical activity setting (eg clinics, courts, classrooms) to help them achieve their health, wellness, and performance goals. prevention, management, performance
complexity of behviour
B=f(P,E) ← lewin expressed the basic tenet of psychology as this. Behaviour is a function of the person and the environment
you are who you are (genes and personality affect behviour) and you are as the time is (physical and social environment affect behaviour)
P can have more influence in some situations, E can affect people different and the person affects the situation just as the situation affects the person
Personality
your unique individual psychological profile.
Individual differences in characteristic patterns of thinking, feeling, and behaving.
The stable configuration of characteristics and behaviour that comprises an individuals unque adjustment to life, including major traits, interests, drives, values, self-concept, abilities, and emotional patterns. (dont change that much, help explain behaviour)
Why focus on personality?
because it can influence physical activity participation and performance
Differences reflect…
confidence
intro vs extraverted
competitivness
all influences activity and pa type
we use personality assessments when..
we assess opponents
different ways of approaching sport settings (ex: otimistic or pestimistic)
assess own strengths
common myth
“athletes need a specific mix of personality traits to be successful in high performance sport.”
no specific mix of traits will garantee success in sports
Levels of personality
“Core” characteristics are formed early, are deeply ingrained. These are relatively stable but may gradually change over time. Ex: extraversion, optimism, competitiveness
“Superficial” characteristics and skills are more context-specific and may well change with the situation, over time, or with training. Ex: focus, motivation, emotional regulation. More responsive to context, good targets for change
Famous Canadian sport ‘personalities’
Mboko→ composed, mentally tough, resilient, coachable, calm, confident, humble
MacNeil→ emotionally aware, competitive, expressive
both different mixes but excellent athletes
explaining personality
Ancient Greeks: believed that 4 body fluids/humours determined personality (blood=sanguine, yellow bile=choleric. black bile=melancholic, phlegm=phlegmatic)
Modern(Galen’s prophecy): biology> temperament (eg: shy-bold in infancy)
“Grand theories” of personality
Psychodynamics (Frued 1920s); inner mind workings determined personality→ Id, ego, superego. Environment had no influence
Behaviourism (1950s): situation/reinforcement over behaviour. environment had all the influence, no person
Social learning: emphasis on active perceptions and cognitive processes over behaviour.
Focus on traits
Traits are relatively stable, highly consistent attributes that exert generalized casual effects on behaviour. Trait theories imply consistency and generalizability of behaviour. Once we identify traits, we can predict behaviour.
Eysenck’s two-dimensional (ie, trait) model (1770s):
Neuroticism: from calm and stable to anxious and moody
Extraversion: from very sociable and outgoing to very shy and introverted
Big five model of personality (current)
Neuroticism: nervousness, sensitive versus emotionally stable, relaxed
Extraversion: enthusiasm, sociable versus introverted, reserved
Openness: creative, curious versus cautious, resistant
Agreeableness: friendly, trusting versus suspicious, antagonistic
Conscientiousness: self-discipline, goal-directed versus disorganized
Integrative model
current psychology perspectives take an integrative approach.
McAdams and Pals (2006): incorporate biological and social perspectives emphasizing complex, dynamic relationships among traits, characteristic adaptations, and the continuing influence of culture.
Wagner and colleagues (2020): Typical patterns of thinking, feeling, striving, and behaving (personality) are both consistent and malleable with multiple interacting sources of both personality stability and change.
early physical activity research on personality
Griffith (1920)→ identified personality profiles of successful athletes. found similar traits in athletes and determined that there was a specific personality for athletes (not true)
Ogilvie (1960)→ identified similar profiles and developed the Athletic Motivation Inventory (AMI) to measure them (not a good way of measuring)
Morgan’s mental health model (1970)→ positive mental health is related to athletic success; psychopathology and success are inversely related.
morgans iceburg
measured that athletes have higher levels of vigor than average and lower levels of tension, depression, anger, fatigue, confusion. According to morgan, being at the tip of the iceburg, or having high vigor, causes better sport performance.
Mental health doesnt predict sport performance but can predict training over mood
clara hughes is a canadian olympian with the 2nd most medals in canadian history. open about having severe depression and anxiety, shows that an athlete can have many different personalities
NBA
The NBA used to use the Big 5 personality traits to screen athletes during recruitment process
dont anymore because there is no evidence that it works
considerations about the research process
Correlation (vs causation)→ correlation does not equal causation, relation doesnt mean its caused by one another
Effect size→ small impact, personality has small impact on sport behaviour, goes from 0 to 0.1 closer to 0 means larger effect
Over-generalization→ a lot of research was western-based and then applied to all over the world. (western, industrial, rich, and democratic) over-generalization of research in specific settings is common and inappropriate
lowest evidence quality is background info and expert opinion
highest qualities are meta-analysis, systematic reviews, and critically appraised literature
good news
caution warranted: physical activity psychologists must be cautious in using and interpreting global personality measures
Morgan’s offshoot: mood shifts reflect overtraining
sport specific personality measures - Anxiety
→ SCAT (Martens 1970s) and SAS (Smith 1990s)
both are sport-specific
SCAT: assess competitive trait anxiety defined as a tendency to perceive competitive situations as threatening and to respond to these situations with feelings of apprehension and tension. Predicts more spcific state anxiety in sport
SAS: similar to SCAT but multi-dimensional (cognitive [mwntal worry] and somatic [physical] anxiety scales)
Trait anxiety= all the time
state anxiety= specific situations or environments
sport specific personality measures - Mental Toughness
Jones (2000s)
mental toughness→ the natural or developing psychological edge that enables you to cope better than your opponents with the many demands that sport places on athletes
Gucciardi (2020s)
developed MTI tool
Focused on training→ recent focus on identifying mental toughness in athletes and related behaviours and developing them
global personality measure = overall poor predictors of sport and exercise behaviours
these are more useful
sport specific psychological skills
Early research successful athletes vs less successful
more self-confident, greater control of worry, better concentration with distraction, etc
Psychological skill measures
psychlogical skill inventory for sports (PSIS); wasnt very valid
athletic coping skills inventory (ACSI); outcomes focused
test of performance strategies (TOPS2); more skill focused, process oriented
Performance profiling
performance profiling→ not a personality measure. a technique to help individuals identify and assess psychological skills
steps in performance profiling
identify relevant skills
teams/individuals rate themselves on each skill
create the profile
key points from Nature’s video
going from nothing to something has the greatest psychological benefit
2 mins, 3 times a day of vigorous activity can reduce mortality rate by 33% (even walking up stairs counts)
New years motivation often fizzles out'
Break up sedentary time
Motivation
Internal processes, such as your psychological needs, thoughts, and emotions, that give your behaviour energy (strength, intensity, persistence) and direction (gives purpose, drives us to achieve goals)
It is not stable but influence by many things, often there is a spark of motivation which then dies off and the cycle repeats
What motivates you
personal factors, cognitive factors, and environmental factors. all coexist to influence physical activity motivation.
sources of physical activity enjoyment/motivation:
mastery accomplishments (success)
Social affiliation (connection)
Movement sensations (feeling strong or more energized)
alll can lead to enjoyment then commitment then the phys activity behaviour
Motives can differ
things that motivate people vary greatly.
ex: first nations student in uni may have culturally-relevant activities that draw from history or lived experiences to motivate them while prince harry created the Invictus games for a challenge of competition.
motives for stopping PA also differs:
kids often stop because of negative experiences, lack of fun, coach issues, overtraining and burnout, while adults typically stop because motivation changes, unrealistic expectations, lack of social support or lack of time.
Behavioural approaches
focus on the E in B=f(P,E) specifically:
antecedents (cues/conditions that prompt or deter behaviour)- before behaviour
Consequences (outcomes that strengthen or weaken behaviour) - after behaviour but influence it
Conditioning from environment: behaviour strengthened when reinforced, weakened when punished.
Reinforcement : positive (provide smth good), Negative (remove smth bad)
Punishmment: positive (add smth bad), Negative (remove smth good)
ABC model
A= Antecedents→ occur before the behaviour (triggers)
B= The target behaviour
C= consequences→ occur after the behaviour (reinforcers or punishments)
SMART goals
create solid goals related to solid behaviour changes, self-monitoring and most efficient
Specific→ goal is concrete and tangible, everyone knows what it looks like
Measurable→ goal has an objective measure of success that everyone can understand
Attainable→ goal is challenging but should be achievable with resources available
Relevant→ goal meaningfully contributes to larger objectives like the overall mission.
Timely→ goal has a deadline or better yet, a timeline of progress milestones
Cognitive approaches
assume that people are active perceivers and interpreters of information, and cognitive processes (evaluation, beliefs, values) are key to understanding motivation and behaviour. How you respond to what happens, interpretation of environment
Rational thought and logic to reform cognitive patterns.. Automatic thought patterns/cognitive errors can impact motivation but can be identified and altered
Social cognitive theory
reciprocal relationship between:
Personal←→environmental←→behavioural (results from interaction from personal and environmental)
Self-efficacy: one’s confidence in their ability to do smth; another potent predictor of physical activity (scale out of 10)
Integrative approach
physical activity behaviour is complex
approaches to understanding motivated behaviour are useful but do not fully explain when, why, how much activity one will do. Additional factors thus, must be at play here. Curren research incorporates both behavioural and cognitive approaches by drawing from multiple theories
Behaviour change theory
a structured approach for understanding and predicting behaviour
Behaviour change model
a visual presentation that illustrates a behaviour change phenomena or theory
Dual processing theories
most suitable for context-sensitive tweaks
Fast thinking vs slow thinking
fast→ reflexive (habits formed unconciously), fast, emotional, automatic, limited, important for bahviour regulation over time
Slow→ reflective, day to day decisions, slow, controllable, smart, rational, important for initiating behaviour change
classic duel processing theory experiment: cafeteria experiment, put regular milk at eye level, then chocolate milk at eye level on shelves. regular milk at eye level lowered chocolate milk purchases. Proves that environment can determine our health choices
duel-processing real life example
Carrot fitness app
gave people daily step goals and points as a reward. the rewards tip the decisional balance that gets people to move initially (slow thinking). the more they do it, the more automatic it becomes and reward matters less (fast thinking)
Trans-theoretical Model
aka stages of change model
most suitable when behaviour change is gradual and voluntary
increases understanding of individual readiness and actual exercise behaviour.
Decisional balance refers to the process of weighing perceived relative costs and benefits of engaging in exercise. Favours costs in first two stages, crosses over in preparation stage and favours benefits in last two stages.
self-efficacy: positive relationship between self-efficacy and greater readiness for change.
Precontemplation→contemplation→preparation→action→maintenance→relapse
constantly relapsing
the CSEP-PATH is a stages of change questionnaire that asks people to describe their current level of physical activity and decides which stage they are at
Social Ecological Model
shifts focus away from individual and towards environment for PA motivation
best suitable for bigger population level problems
intrapersonal (motivation)→ interpersonal (support from others) → Institutional (walkable campus) → Community (live next to a gym or walkable sidewalks) → Policy (taxes back for signing kids up for sports)
social ecological model example
looking at common kid pa barriers
rising screen time
fewer active transport oppertunities
limited access to green spaces
costs and financial commitments
over-programming and burnout
global warming(rising temps causing kids to stay inside)
key point 1 of emotions
emotion is a complex biopsychoosocial process. emotions cannot easily be defined. simply, emotions are subjective feeling states that occur in response to events, but emotions are not so simple.
Most psychologists recognize both physiological and psychological components if emotion and consider emotion to be a process rather than a static state.
key point 2 of emotions
“Affect” is the general umbrella term for feeling states, includes both emotions and moods.
Emotions are short-lived feeling states in response to events
Moods are also feeling states, but in contrast to emotions, moods are more diffuse and less intense, do not have identifiable causes and do not prompt specific behaviours or actions.
Key point 3
Arousal is defined as a general state of excitement ranging on a continuum from deep sleep to extreme excitement. It is related to emotion but without direction or cognition, arousal is not an emotion.
Anxiety, which is a feeling state characterized by high arousal and cognitive worry, is the most widely studied emotion.
positive and negative emotions
Negative emotions→ anxiety, fear, envy. narrow options (fight or flight)
Positive emotions→ joy, love, gratitude. Broaden options, build enduring resources (any actions possible)
research supports the key point that positive emotions are good for physical health and mental health. In practice, we should spend as much time fostering positive emotions as we do controlling negative ones. A 3:1 ratio is recommended.
Flow in sport
Flow occurs when perceived challenges are in balance with perceived skills
when challenges are too high, anxiety results
when they are too low, boredom results
Challenges and skills are also high and low
flow… when perceived challenges and perceived skills are both above average
Apathy is experienced when both are below average
Anxiety is experience with high challenge and low skill
Relaxation is experienced with low challenge and high skill
Key point #5
Flow occurs when the performer is totally connected to activity in a situation in which skills equal challenges, and both perceived challenges and perceived skills are above average. Flow is perhaps the ultimate positive emotional state.
James-Lange Theory
bodily sensations stem directly from perceptions, and our awareness of the physiological changes is emotion.
Schachter and Singer (1962)
proposed an interaction of cognition with physiological state
Lazarus’ Encompassing Model
approaches emotion as a multidimensional, dynamic process rather than an easily identifiable state.
sport and exercise psychology scholars have moved to similar multidimensional models that better fit the complexities of emotion.
Emotions and performance
Emotions (two components):
Arousal/activation (physiological/somatic)
Cognition (thought)
Anxiety (an emotion)
High arousal/activation
cognitive worry
Drive Theory
proposes that as drive increases (as when one is facing competition), learned responses are more likely to occur. As arousal increases, performance improves only if the dominant response is correct performance.
Inverted-U Theory
proposes that performance is optimal at a moderate level of arousal and declines as arousal increases or decreases from that optimal level.
IZOF
Individualized Zones of Optimal Functioning
similar to inverted-U but unique to the individual
why new models were needed
early theories assumed:
performance changes gradually
anxiety is always negative
the same relationship applies to everyone
however in sport we often see:
athletes performing better under pressure
athletes suddenly choking
athletes reacting differently to the same pressures
Reversal Theory
multidimensional models consider cognitive and somatic anxiety separately.
reversal theory:
performance depends on how athletes interpret arousal
high arousal can be interpreted as: excitement→improves performance or anxiety→ impairs performance
both have the same physical symptoms: increased heart rate, sweating, muscle tension
But interpretation determines the outcome
Facilitative vs debilitative anxiety
Facilitative:
increases focus
increases motivation
improves performance
Debilitative:
causes distraction
reduces concentration
increases mistakes
The key factor is how the athlete interprets the arousal
Catastrophe Theory
depends on the interaction between physiological arousal (somatic) and cognitive anxiety
when cognitive anxiety is low→ performance follows inverted-U
when cognitive anxiety is high→ performance may drop suddenly aka choking under pressure
**recovery after a catastrophe: after a sudden performance collapse, simply lowering arousal slightly does not restore performance. The athlete must significantly reduce anxiety and arousal and gradually rebuild optimal activation. This process is called Hysteresis
Multidimensional anxiety models
2 main components of anxiety:
cognitive (worry, negative thoughts, fear)
Somatic (increased HR, sweating, muscle tenion)
research suggests that these two follow different patterns. Often, somatic anxiety increases as competition approaches while cognitive anxiety may remain more stable
Classic research: parachute jumpers
Walter Fenz studied parachute jumpers. He measured anxiety at different times:
day before jump
1 hour before jump
during jump
landing
Goal was to understand how anxiety changes before performance
Key findings
both novice and experienced jumpers experienced anxiety however, the pattern over time was different
Novice jumpers: anxiety increased steadily, peaks at the moment of jump
Experienced jumpers: anxiety increased earlier, decreased before the jump
this means, netter performers tend to control anxiety ealier and bring arousal to moderate levels before performance whereas poor performers allow anxiety to build until performance.
The ability to control anxiety timing is an important performance skill
why study parachuters
parachuting creates
very high anxiety and arousal
clear performance stakes
a well-defined moment of performance (the jump)
bc the anxiety is so intense, the performance patterns are easier to observe
These help us understand:
how anxiety develops before performance
how experienced performers regulate anxiety
how these processes apply to other sports and performance settings
Emotional control
Research suggests experienced performers are better at:
regulating emotions
controlling anxiety
focusing attention on the task
Example:
Instead of thinking: “I might fail” They shift attention to: “Focus on technique.”
group definition
A group is a collection of 2 or more individuals who:
posses a common fate (shared outcome)
show interpersonal attraction and mutual benefit (enjoy being together)
have a stable social structure and relationship patterns
rely on each other (interdependence)
share common goals or objectives
have structured patterns of interaction and communication (unique communication style)
has a common identity and self-categorization (each member identifies as part of the group)
Group norms and roles
Norms→ informal standards of accepted, appropriate, or valued behaviour. ex: communication styles
Roles→ behaviours expected of those in specific positions within a group. Formal roles like captain or positions and Informal roles like the goon
Role elements→ clarity, acceptance, efficacy, conflict, overload, satisfaction, performance
Group performance
Steiner’s model of individual-group performance
actual performance = potential productivity - process losses
potential productivity→ combination of resources (individual talent) and task demands (tasks for each person)
process losses→ two types: Coordination losses; poor timing or strategy (ex: poor exchanges in a relay), and Motivational losses; less than best effort (ex: social loafing)
we want to limit losses as much as possible
Reducing social loafing
is reduced when individuals:
believe that others can evaluate their collective performance
work in smaller groups
percieve their contributions as unique
have a standard to which they can compare their groups performance
work on interesting, meaningful, important, or high in personal involvement tasks
work with people they respect
expect their teammates to perform poorly
have a tendency to view favourable collective outcomes as important
Ringleman effect→ average individual effort goes down as group size increases
Leadership definition
The behavioural process of influencing individuals and groups toward set goals
leader emotional intellegence= self-regulation, empathy, and social skills
leadership matters in sports and life, it doesnt just come from one place/person.
Chelladurai’s multidimensional model of leadership
Congruence hypothesis→ optimal performance is realized when the leaders’ required behaviour, preferred behaviour, and actual behaviour are congruent.
The more the leader’s actual behaviours match the preferences of group members and situation requirements, the better the group’s performance and the greater the group members’ satisfaction improves
Transformational Leadership
involves motivating and encouraging others
four components:
Idealized influence: role model, leaders practice what they preach
Inspirational motivation: give clear vision, create confidence in members
Intellectual stimulation: engaging team members in decisions
Individualized consideration: attending to individual needs
These components lead to better performance, more confidence in coaching, and more team cohesion
Morton (2014) Transformational Leadership tips for coaches
treat players with respect to earn their respect
Lead by example
Remain optimistic and enthusiastic about what athletes can accomplish
Articulate a compelling vision
Encourage athletes to provide input and feedback
Try to understand each individual player and that player’s specific strengths and weaknesses, and support their personaldevelopment
Ammary and Janssen (2021) Athlete leadership development tips for coaches
Select athlete leaders
Develop partnerships to avoid dictatorship relationships
Teach athletes about leadership
Provide opportunities to lead
Encourage athlete reflection
Cohesion in sport and exercise groups
"A dynamic process which is reflected in the tendency for a group to stick together and remain united in the pursuit of its own instrumental objectives and/or the satisfaction of member affective needs.” - multidimensional• dynamic, instrumental(Performance based) affective (thoughts and feeling important)
Group cohesion
Basis for sport psych idea on cohesion
Group integration → task and social
Individual attraction to group → task and social
Carron’s (1985) model
Group integration-task (GI-T): the degree to which the group is united around task objectives
Group integration-social (GI-S): the degree to which the group is united around social objectives
Individual attractions to the group -task (ATG-T): group members’ perceptions of their personal involvement with the task aspects of the group
Individual attractions to the group-social (ATG-S): group members’ perceptions of their personal involvement with the social aspects of the group
Correlates of cohesion
Environmental factors (proximity and distinctiveness)
Personal factors (individual abilities, attitudes, and commitment)
Leadership factors (coach’s leadership style)
Team factors (group structure-norms, processes-goals, and outcomes-performance)
performance and cohesion have a bilateral relationship of satisfaction (stronger for women)
these boost communication and performance success aswell
cohesion-performance relationship
the most recent reviews of the evidence conclude that the cohesion-performance relationship is positive and bidirectional; greater cohesion leads to better performance and better performance leads to cohesion. Cohesion also facilitates exercise adherence (fitness class, boot camp, cardiac rehab)
Team-building in sport
“Team enhancement for both task and social purposes”
Carron and Spink’s framework:
Team-building→ improves cohesion → improves group performance
Team building involves:
group environment (distinctivness)
group structure (norms and positions)
group process (interaction, communication, sacrifices)
Four stages:
Introductory (introduce benefits)
Conceptual (provide frame of reference)
Practical (brainstorm strategy)
Intervention (introduce and maintain strategies)
team building interventions
Eys et al (2021) strategy categories with egs:
Distinctiveness (sport=t-shirt, haircut ups distinctiveness, exercise=playlist)
Individual roles (sport=roles defined by coaches ie quarterback, exercise=lvl of intensity)
Group norms (sport=individual contributions, exercise=setting group goals)
Individual sacrifices (sport=individual sacrifice, exercise=regular exercise helping new ones)
Interaction and communication (sport=input, exercise=opportunities for input)
Social support
we are social creatures but the quality of our social connections is what matters not the quantity.
social support is an exchange of resources between at least two individuals to enhance the well-being of the recipient. It is perceived by the provider or the recipient. Sources of social support can be teachers, coaches, parents, friends, etc.
Types of social support
Tangible (instrumental→ involves tangible or direct assistance eg: someone spotting u at gym or getting a ride from a friend
Informational→ involves giving directions, suggestions, or advice eg: coach explains how to improve a technique or personal trainer giving a detailed workout
Emotional→ involves expressing encouragement, empathy, o concern eg: coach says they believe in you
diff types of support from diff people have diff impacts
social support benefits research
Rosenfeld (1989): student-athletes > parents and friends provided more emotional support while coaches and teammates provided info support
Duncan & McCauley (1993): sedentary adults> self-efficacy and exercise coherence was high
Gellert (2011): older adults> if exercise with spouse, they continued exercising longer
Loz (2014): socially supportive instructors> higher self-efficacy, enjoyment, and coherence
Katz (2008): Doctor advice> provided brief counselling to patients and they had an increase in exercise
Sabiston (2007): Breast Cancer> dragonboat team boosted feeling of social support by sharing common experiences and feelings