Athletic trainers (ATs) are professionals who are most directly responsible for athletes’ health care in a sport environment. ATs work with athletes on prevention, diagnosis, and treatment of athletic injury; it is through these interactions that put ATs in an ideal position to recognize the psychological and emotional distress that athletes may suffer. Consequently, the National Athletic Trainer’s Association (NATA) has called for ATs to be competent in implementing psychosocial strategies and techniques (e.g., goal-setting, imagery, positive self-talk), recognizing basic symptoms of mental disorders, and identifying and referring athletes in need of psychological help. I explored ATs’ ability to recognize, diagnose, and provide a referral for collegiate athletes who were presenting with symptoms of depression across three different scenarios. The study examined factors that may impact ATs’ abilities in these areas, including AT gender, athlete gender, and type of presenting problem (e.g., athletic injury, romantic relationship, or sport performance issue). Overall, female ATs were better at recognizing depressive symptoms than male ATs, though both were equally proficient at diagnosing depression. Regardless of gender of the AT, gender of the athlete, and presenting problem, ATs were most likely to refer the athletes to a counselor/psychologist, and to a lesser extent sport psychology consultant (SPC). ATs viewed referrals to an SPC as most appropriate for presenting problems related to sport (i.e., performance problem or injury). The results highlight a possible bias in referrals to an SPC, in that SPCs may not be considered an appropriate referral source for romantic relationship problems. Implications for ATs and recommendations for future research are discussed.

Utilizing an analogue research design conducted via the Internet, this study assessed athletic trainers' abilities to recognize, diagnose, and intervene with a hypothetical athlete experiencing depression, and examined the impact of their gender, athlete gender, and athlete's presenting problem on their decisions. Athletic trainers' perceived competency in using psychosocial interventions with athletes, history of referring athletes to psychology professionals, and training backgrounds in psychology also were examined. Participants (270 male and 370 female certified athletic trainers) were randomly assigned to one of six conditions (Athlete Gender X Presenting Problem). After reading the appropriate vignette, they completed questions related to the athlete's psychological symptoms and diagnosis, referral recommendations, and use of psychosocial interventions if working with the athlete. The vignettes were identical except for the athlete's gender and problem. Overall, athletic trainers accurately identified the athlete's depressive symptoms/diagnosis and need for psychological referral. They rated the athlete significantly higher in Depressive Symptoms than in Anger/Agitation Symptoms and Compulsive Behavioral Symptoms, and as more likely to be experiencing a depressive disorder compared to an adjustment disorder, anxiety disorder, sleep disorder, or substance abuse disorder. Female athletic trainers provided significantly higher ratings of Depressive Symptoms than males and the injured athlete was rated significantly higher in Anger/Agitation than the performance problem athlete. Diagnosis ratings were not influenced by athlete gender, athletic trainer gender, or type of problem. Athletic trainers were most likely to refer the athlete to a psychology professional compared to an allied health professional, treating the athlete themselves, or doing nothing. Presenting problem significantly impacted referral recommendations. If treating the athlete themselves, athletic trainers were significantly more likely to use supportive interventions than cognitive-behavioral techniques; they felt significantly more competent in providing supportive interventions. Competency in both interventions was significantly enhanced if athletic trainers completed psychology coursework. Findings suggest that athletic trainers are able to accurately identify and intervene with athletes experiencing psychological problems.

Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean levels of endorsement for apathy varied by diagnosis. Further research is warranted to investigate this relationship and the GDS endorsement patterns for caregivers regarding their impression of the demented individual.

University of Macau / Institute of Chinese Medical Sciences

This study was an investigation into the clinical judgments made by counseling psychologists when faced with a patient who had major depression and AIDS. Two hundred and eighty one counseling psychologists evaluated one of four vignettes depicting an individual with major depression. In three of the vignettes the individual also had AIDS but the vignette varied on how the virus was contracted (unprotected gay sex, IV drug abuse, hemophilia). In the fourth vignette (the control group) the individual did not have AIDS. Results of the study suggested, that the presence of AIDS overshadows the evaluation and treatment decisions made by counseling psychologists when their patient has major depression and AIDS. Three factors-counseling psychologists' general experience with people who have AIDS, their clinical experience with AIDS patients and how the AIDS virus was contracted-were investigated for possible moderating effects of the overshadowing bias. How the AIDS virus was contracted was used as an indirect measure of clinician attitude toward people with AIDS. Neither general or clinical experience with AIDS patients appeared to have an effect on the diagnostic or treatment decisions made by counseling psychologists when evaluating depressed patients with AIDS. As with experience, method of contracting the AIDS virus did not have a moderating effect on the overshadowing bias. Implications of these results for the evaluation and treatment of depression in AIDS patients, as well as future research are discussed. / Department of Counseling Psychology and Guidance Services