Behavioral activation / inhibition systems and lifestyle as predictors of mental disorders in Adolescent Athletes during Covid19 pandemic

doi:10.21203/rs.3.rs-1607220/v1

Download PDF

Research Article

Behavioral activation / inhibition systems and lifestyle as predictors of mental disorders in Adolescent Athletes during Covid19 pandemic

https://doi.org/10.21203/rs.3.rs-1607220/v1

This work is licensed under a CC BY 4.0 License

You are reading this latest preprint version

Background: The following study investigates the correlational relationship between behavioral activation/inhibition systems, lifestyle and mental disorders in Adolescent Athletes during the Covid-19 pandemic.

Methods: Research methods are descriptive and correlational; 130 Adolescent Athletes subjects were selected to respond to Carver & White's Behavioral activation/inhibition systems Scale (BIS/BAS), Mille's Lifestyle Questionnaire and Goldberg & Williams's General Health Questionnaire (GHQ-12). Data was analyzed using linear regression analysis and Pearson’s correlation coefficient.

Results: Findings showed a positive correlation of statistical significance between behavioral inhibition systems (BIS) and mental disorders Adolescent Athletes at the 0.01 level and a negative correlation of statistical significance between scaling components of the behavioral activation systems (BAS), lifestyle and mental disorders Adolescent Athletes at the 0.05 level.

Conclusions: Analyzing the data, it can thus be concluded that whilst behavioral inhibition and activation systems seem to work together to significantly predict mental disorders in Adolescent Athletes, lifestyle cannot.

behavioral systems

lifestyle

mental disorders

Adolescent Athletes

Covid19 pandemic

Coronaviruses are a major group of viruses known to be responsible for a wide spectrum of diseases in multiple mammalian species, with subsequent effects of their viral infection leading to respiratory diseases such as the common cold, pneumonia, bronchitis, severe acute respiratory syndrome, and Middle East respiratory syndrome (Gaurav & Al-Nema 2019). At present, the newly identified SARS-CoV-2 has caused a significant number of deaths worldwide, posing a serious threat to global public health (Li a, Liu a, Yu b, Tang a, Tang, 2020). Current approaches to prevent transmission of the novel coronavirus have included social distancing and quarantining. These necessary methods of isolation have subsequently resulted in restrictions of mobility, social interactions, and daily activities of the general public (Hossain, Purohit, & Sultana, 2020). Restrictions of these kinds have been suggested to lead to challenges in psychological health, as well as of course general subsequent challenges in the navigation of social aspects (Suppawittaya, Yiemphat, Yasri, 2020). So, although social distancing is a crucial intervention to the slowing down of destructive effects of SARS-CoV-2 social distancing has also had significant negative consequences of its own, one of which can be concluded to be the possible increase of mental illness, particularly given that the two factors noted to be increasingly important to mental illness and health (behavioral systems and a person’s lifestyle) are also significantly affected by the consequences of the pandemic (Figueroa, Aguilera, 2020).

It has thus become increasingly clear in recent decades that lifestyle factors contribute significantly to the ever-growing burden of chronic illnesses and diseases. Understanding lifestyle factors that can come to affect our health only works to improve and reduce the prevalence of preventable diseases (Weinberg, 2013). Specifically, planned education on lifestyle modifications can coincide with the reduction of general anxiety levels in patients (Bayraktar, Berhuni, Zeki, Sener, & Sertbas, 2018). Questionnaire scores on lifestyle and mental disorders display inverse relationships of statistical significance (Siyami et al., 2017). The use of diet, exercise, and behavior modification may come to not only provide physical health benefits to the patients utilizing them, but also psychological health benefits overall, reducing severe patient depression and anxiety in general (Null, Pennesi, 2017).

The behavioral activation system (BAS) and the behavioral inhibition system (BIS) are two brain behavioural systems that also have a significant influence on these depressive symptoms (Toyoshima, Inoue, Kameyama, Masuya, Fujimura, Higashi & Ichiro, 2021). The behavioral activation system is an arousal system that works by initiating behaviour in response to conditioned stimuli for reward and punishment avoidance (Fowles, 1980). The neuroanatomical basis of the BAS has been indicated to be in the right dorsolateral prefrontal cortex, the right temporal polar region, the basal ganglia, the amygdala and the hippocampus (Fowles, 1980). This has then been supported by findings of greater left frontal brain activity showing higher BAS scores in investigated participants (Hewig, Hagemann, Seifert, Naumann, & Bartussek, 2006).

The behavioral inhibition system (BIS) is a behavioral system that instead inhibits behaviour in response to conditioned stimuli for reward and punishment avoidance (Fowles, 1980). Previous literature suggests the neuroanatomical basis of the BIS to be in the greater right frontal cortices due activation of that brain area coinciding with increased BIS scores in investigated participants (Sutton & Davidson, 1997). This however has now been refuted by subsequent research showing no significant relationship between the two (Hewig, Hagemann, Seifert, Naumann, & Bartussek, 2006). Other studies have instead revealed a positive association between behavioral inhibition systems and the right hippocampal volume. These findings suggest that structural variation or change affecting the hippocampal volume, the relative size of the left and right hippocampus in particular, reflects a predisposition to, or plays a part in, mediating BIS-related anxiety (Levita, Bois, Healey, Smyllie, Papakonstantinou, Hartley, & Lever, 2014).

Results investigating BIS related anxiety in recent years have been found to be especially interesting. One study found a moderating relationship between disgust propensity and anxiety sensitivity in regards to physical concerns surrounding the fear of contracting COVID-19, lending a unique support for individual variation in the activation of the BIS (Mckay, Yang, Elhai, & Asmundson, 2020). Taken separately in fact, both this anxiety sensitivity and disgust propensity predict the fear of contracting COVID-19 (Mckay et al, 2020). These findings are important in that they create a reminder of the necessity of developing alleviation methods for anxiety in individuals fearful about contracting COVID-19, with specific consideration on these disgust reactions that follow (Mckay et al., 2020), as because of anxiety and these disgust reactions, people come to adopt various unwanted lifestyle and dietary modifications under the influence of rumors (Roy, Tripathy, Kumar Kar, Sharma, Kumar Verma, & Kaushal, 2020) that might be of higher detriment. Thus general psychological conditions of the public are significantly affected during the COVID-19 outbreak (Huang & Zhao, 2020).

However, amidst the COVID-19 outbreak, little attention has been paid to the psychological and behavioral impacts this disease has had (Balkhi et al., 2020). Current evidence indicates a high prevalence of mental health problems among patients, caregivers and healthcare providers with a recent study specifically showing anxiety and depression symptoms being at an all-time high among healthcare professionals working in the operation room (Koksal, Dost, & Terzi, 2020). Although there has been substantial attention to creating measures that identify the mental health care issues induced by the pandemic, understanding of the needs of the victims of these mental impacts has nevertheless been neglected (Xiang, Yang, Zhang, Cheung, & Ng, 2020). Recognizing these challenges allows for strengthened mental health services during times of quarantine and isolation (Hossain et al., 2020). With public levels of anxiety-related symptoms increasing when a major infectious disease spreads (Huang, & Zhao, 2020) and heightened anxiety due to COVID-19 being found to linger in people for up to two weeks following any incidental contact with those believed to be possible hosts for the virus, (Mckay et al., 2020) the importance of promoting public awareness and scientific health education without the creation of anxiety and fear in the community is at an all-time high, especially since current methods might work to instead increase the worries and the demand on health services without any real indication (Al Turki, 2013).

Individual psychosocial factors should thus be thoroughly evaluated to identify risk and protective factors among individuals in order to guide the development and adoption of effective personalized mental health measures (Hossain et al., 2020). There are thus calls for increased awareness of the at-risk population as necessary targets for specialized psychiatric care and prompting continuous psychiatric intervention of this population during these outbreaks of life-threatening, epidemic-potential infectious diseases (Lee, Kong, Cho, Kim, & Park, 2018). Epidemiological and clinical studies clearly delineate extensive reduction in the quality of life of persons with anxiety and anxiety related disorders (Mendlowicz, 2000), and previous studies have shown that lifestyle interventions can be utilized to increase antidepressant efficacy (Ripoll et al, 2015) but nothing has come to suggest the possibility of a mediating role of behavioural systems between the two, especially in the context of lifestyles factors during the pandemic. The following research thus aims to investigate the relationship between behavioral systems, lifestyle and mental disorders during Covid19 pandemic, with the hypothesis that a negative correlation will be found between BAS and mental disorders. A positive correlation will be found between BIS and mental disorders, and finally a negative correlation will also be found between general lifestyle and mental disorders in Adolescent Athletes.

This is a descriptive correlational study. The sample of this study included randomly selected 130 Adolescent Athletes that responded to three questionnaires. Data was analyzed randomly selected using linear regression analysis and the Pearson correlation coefficient.

Instruments:

Behavioral Inhibition/Activation Systems Scale (BIS/BAS)

This questionnaire is a self-report questionnaire developed and validated by Carver and White (1994). It contains 20 items and two main scales: the scale of the behavioral inhibition system and the behavioral activation system. The BIS/BAS scales were associated with prefrontal cortical activity, affect, personality traits, and performance on reaction-time and learning tasks (Carver, & White, 1994; and Colder & O’connor, 2004)The BIS scale includes 7 items related to anticipation of punishment, whilst the BAS scale has 12 items and three subscales: Drive (D), indicative of persistence in obtaining desired goals, Fun-Seeking (FS), indicative of willingness to seek out and spontaneously approach potentially rewarding experiences, and Reward Responsiveness (RR), indicative of anticipation and positive response towards rewards.

Mille's Life Style Questionnaire

The following questionnaire contains 20 items in which participants answer each item using a five point Likert-type scale (1 = strongly disagree, 5 = strongly agree). Validity and reliability of the questionnaire was measured (Cronbach's alpha: 0.86).

General Health Questionnaire (GHQ-12)

The 12-Item General Health Questionnaire (GHQ-12) is the most extensively used screening instrument for common mental disorders, in addition a more general measure of psychiatric well-being overall. The 12-Item General Health Questionnaire (GHQ-12) (Goldberg & Williams, 1988) consists of 12 items, each one assessing the severity of a participant’s mental problems over previous weeks using a 4-point Likert-type scale (from 0 to 3). Individual scores were used to generate a total score ranging from 0 to 36 with high scores indicating worse health (Cronbach's alpha: 0.76).

The sociodemographic variables of the Adolescent Athletes (n = 130) are presented in Table 1. In summary, Adolescent Athletes had a significantly higher mean age of 15.7 years (Standard Deviation, SD = 0.8 years; range), mean height of 161.3 cm (SD = 7.6 cm), mean weight of 65.3 kg (SD = 1.9 kg), and mean Body Mass Index (BMI) of 21.2 (SD = 2.4, as calculated by the Centers for Disease Control and Prevention (CDC) BMI Percentile Calculator for Child and Teen (p = 0.001).

Table 1

Sociodemographic Variables of the Adolescent Athletes
Variable	Individual Athlete Group (n = 130)
Age	Mean	SD
Age	15.7	0.8
Height (cm)	161.3	7.6
Weight (kg)	65.3	1.9
BMI	21.2	2.4

SD = Standard Deviation; cm = centimeters; kg = kilograms; BMI = Body Mass Index, as calculated by the Center for Disease Control and Prevention (CDC) BMI Percentile Calculator for Child and Teen.

Table 2 shows that there is a positive correlation of statistical significance between behavioral inhibition systems and mental disorders, and a negative correlation of statistical significance between the scaling components of behavioral activation systems, lifestyle and mental disorders in Adolescent Athletes at the 0.01 and 0.05 level respectively (Table 1).

Table 2

Mean, Std. Deviation and Matrix of correlation between behavioral systems and lifestyle with mental disorders in Adolescent Athletes during Covid19 pandemic
	Mean	Std. Deviation	1	2	3	4	5	6	7
BIS	16.63	2.451	1	− .18^*	− .16^*	− .19^*	− .19^*	− .24^**	.37^**
Drive	6.96	.866	− .18^*	1	.79^**	.88^**	.94^**	.39^**	− .29^**
Fun-seeking	15.51	.961	− .16^*	.79^**	1	.78^**	.92^**	.39^**	− .25^**
Reward responsiveness	13.70	.890	− .19^*	.88^**	.78^**	1	.94^**	.44^**	− .33^**
BAS	36.16	2.548	− .19^*	.94^**	.92^**	.94^**	1	.44^**	− .31^**
Life Style	71.89	8.574	− .24^**	.39^**	.39^**	.44^**	.44^**	1	− .22^**
Mental Disorders	18.79	1.378	.37^**	− .29^**	− .25^**	− .33^**	− .31^**	− .22^**	1
. Correlation is significant at the 0.05 level. *. Correlation is significant at the 0.01 level.

Table 3 shows the predictability of behavioral systems and lifestyle on mental disorders. According to this table, behavioral inhibition systems and activation systems can significantly predict mental disorders, but lifestyle cannot.

Table 3

Regression analysis to predict behavioral systems and lifestyle on mental disorders in Adolescent Athletes during Covid19 pandemic
Model	Standardized Coefficients	t	Sig.	Collinearity Statistics
	Beta			Tolerance	VIF	F	Sig.	R Square	Durbin-Watson
BIS	.31	3.84	.000	.93	1.07
BAS	− .23	-2.6	.010	.79	1.25	10.61	.000	.202	1.86
Life Style	− .048	− .53	.590	.78	1.28

Amidst the COVID-19 outbreak, little attention has been paid to the psychological and behavioral impacts this novel virus has had on the public (Balkhi et al., 2020). Current evidence however indicates a high prevalence of mental health problems among patients, caregivers and healthcare providers, with a recent study showing anxiety and depression symptoms being at an all-time high among healthcare professionals working in the operation room (Koksal, Dost, & Terzi, 2020). Recognizing the challenges faced by those plagued with anxiety and depression allows for strengthened mental health services during these times of quarantine and isolation (Hossain et al., 2020). With public levels of anxiety-related symptoms increasing when a major infectious disease spread (Huang, & Zhao, 2020) and heightened anxiety due to COVID-19 being found to linger in people for up to two weeks following incidental contact with those believed to be possible hosts for the virus (Mckay et al., 2020), the importance of promoting public awareness and scientific health education without creating anxiety and fear in the community is at an all-time high. Unfortunately, however current methods suggest to instead work to increase worries of patients and demands on health services without any real indication of results (Al Turki, 2013).

The behavioral inhibition system (BIS) and the behavioral activation system (BAS)

(Serrano-Ibanez et al, 2019) are two neuropsychological systems that could potentially underlie the prevalence of certain mental health disorders. Dopamine not only has a major role in cognitive function and dysfunction (Smillie, & Wacker, 2014) but, it is also suggested to play a major role in the BAS by promoting stimulus-induced responses for conditioned or reward related stimuli (Jentsch, Roth, & Taylor, 2000). Conversely, serotonin has been to play a major role in the BIS, with decreased serotonergic activity being related to major anxiety and depression in patients (Albert,

Vahid-Ansari, Luckhart, 2014) and higher levels of anxiety or nervousness positively correlating with higher BIS scores, with both adult and child studies show statistical significance in the relationship between the anxiety or nervousness of an individual and his or her behavioral inhibitions (Exum, Hahn, Carney, Hettema, & Roberson-Nay, 2014). A research study that showed positive correlation between BIS and depression suggests that patients with depression had sensitivity and hyperactivity in the BIS that led to those negative emotions (Arfaie et al,2018). BAS arousal however seems to lead to an experience of hopeful excitement, by driving persistence to achieve desired goals and providing a sense of joy to the person when those goals are attained (Merchan-Clavellino et al, 2019).

During the pandemic it has been reported that there is an increasing amount of patient complaints on psychiatric symptoms such as depression, insomnia and suicidal (Lee, Chiew, & khong, 2020). Social isolation during this pandemic has become detrimental to patients in that they can no longer see their relatives or companions anymore, with even families living in the same residence having to remain cautious to the possibility of catching COVID-19 from one another (World Health Organization, 2020). Data has also shown a significant relationship between compromised quality of life and the increasing prevalence of mental and anxiety disorders (Mendlowicz, 2000). Healthy lifestyle, including proper nutrition, exercise and physical training as well as activities in life however have, as expected, found to have an inverse relationship with the prevalence of mental health itself (Siyami et al., 2017). Given the suggested role of behavioral systems with mental health, the relationship between behavioral systems, lifestyle and mental disorders during Covid19 pandemic was investigated to better understand possible future methods of intervention as well as current states of reality. Our findings were consistent with previous literature published by Albert, et al (2014), Alimoradi, et al (2011), Figueroa, et al (2020), Hossain, et al (2020), Kumar, et al (2020), McKay, et al (2020), Roy, et al (2020), Null, et al (2017). Our findings indicated a positive correlation of statistical significance between BIS and mental disorders and a negative correlation of statistical significance between BAS, lifestyle and mental disorders at the 0.01 and 0.05 levels respectively. Our analysis also indicated that whilst BIS and lifestyle factors can significantly predict mental disorders, BAS cannot.

Conflict of Interest: The authors state that the research was conducted in the absence of any commercial or financial relationships.

Ethics Approval and Consent to Participate:

Study protocol and procedures performed in accordance with the Declaration of Helsinki and were approved by the ethics committee of Faculty of Medicine, Tarbiat Modarres University (Ethical code: IR.MODARES.REC.1399.097); informed consent was obtained and signed by all subjects on the day of testing.

Consent for Publication:

Not applicable.

Availability of Data and Materials:

The datasets generated and analyzed during the current study are not publicly available, as individual privacy could be compromised, but are available from the corresponding author on reasonable request.

Competing Interests:

The authors declare that they have no competing interests.

Funding:

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors’ Contributions:

MHF contributed to the conceptualization, data curation, investigation, methodology, project administration, resources, supervision, validation, visualization, and writing (reviewing and editing) of the study. SS contributed to the data curation, investigation, project administration, resources, supervision, writing (original draft, reviewing, and editing) of the study. AH contributed to the data curation, formal analysis, investigation, project administration, resources, supervision, validation, and writing (reviewing and editing) of the study. SS and DJ contributed to the project administration, resources, and writing (reviewing and editing) of the study. All authors read and approved the final manuscript.

Acknowledgements:

The authors wish to thank Alireza Homayouni, Ph.D., for serving as the statistical expert for this research, Shahnaz Shahrbanian, for preparing the manuscript, the study participants for their contributions to this research, and the associated study research team

Albert, P. R., Vahid-Ansari, F., & Luckhart, C. (2014). Serotonin-prefrontal cortical circuitryin anxiety and depression phenotypes: pivotal role of pre-and post-synaptic 5-HT1A receptor expression. Frontiers in behavioral neuroscience, 8, 199, 1–13.
Alimoradi, L., Aubi, S., & Yousefi, S. (2011). Comparing the activity of brain/ behavioral systems and happiness in male and female students. Procedia-Social and Behavioral Sciences, 30, 1576–1580.
Al Turki, Y. A. (2014). Can we increase public awareness without creating anxiety about corona viruses? Patient education and counseling, 94(2), 286–287.
Arfaie, A., Safikhanlou, S., Roodsari, A. B., Farnam, A., & Shafiee-Kandjani,A. R. (2018). Assessment of Behavioral Approach and Behavioral Inhibition Systems in Mood Disorders. Basic and Clinical Neuroscience, 9(4), 261–268.
Aubi, S., & Alimoradi, L. (2011). Relationship between Brain/Behavioral systems andmental health among students. Procedia-Social and Behavioral Sciences, 30, 1683–1687.
Balkhi, F., Nasir, A., Zehra, A., & Riaz, R. (2020). Psychological and Behavioral Responseto the Coronavirus (COVID-19) Pandemic. Cureus, 12(5), 1–16.
-Balaratnasingam, S., & Janca, A. (2006). Mass hysteria revisited. Current Opinion in Psychiatry, 19(2), 171–174.
Bayraktar, N., Berhuni, O., Berhuni, M. S., Zeki, O., Sener, Z. T., & Sertbas,G. (2018).
Effectiveness of Lifestyle Modification Education on Knowledge, Anxiety, and Postoperative Problems of Patients with Benign Perianal Diseases. Journal of PeriAnesthesia Nursing, 33(5), 640–650.
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation,and affective responses to impending reward and punishment: the BIS/BAS scales. Journal of personality and social psychology, 67(2), 319–333.
Colder, C. R., & O'connor, R. M. (2004). Gray's reinforcement sensitivity model and child psychopathology: Laboratory and questionnaire assessment of the BAS and BIS. Journal of abnormal child psychology, 32(4), 435–451.
Del Pilar Sánchez-López, M., & Dresch, V. (2008). The 12-Item General Health Questionnaire(GHQ-12): reliability, external validity and factor structure in the Spanish population.Psicothema, 20(4), 839–843.
-Exum, A. C., Hahn, S. E., Carney, D., Hettema, J., Roberson-Nay, R. (2014, April).Behavioral inhibition and anxiety in juveniles. Virginia common wealth university.Poster session presented at the Symposium for Undergraduate Research and Creativity,Richmond, VA. - Figueroa, C. A., & Aguilera, A. (2020). The Need for a Mental Health Technology Revolution in the COVID-19 Pandemic. Frontiers in Psychiatry, 11, 1–5.
-Fowles, D. C. (1980). The three arousal model: Implications of gray's two-factor learning theory for heart rate, electro dermal activity, and psychopathy. Psychophysiology, 17(2), 87–104.
Gaurav, A., & Al-Nema, M. (2019). Polymerases of Coronaviruses: Structure, Function,and Inhibitors. In Viral Polymerases (pp. 271–300). Academic Press.
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological medicine, 9(1), 139–145.
Goldberg, D., & Williams, P. (1988). A user’s guide to the General Health Questionnaire.Windsor, UK: NFER-Nelson.
Hewig, J., Hagemann, D., Seifert, J., Naumann, E., & Bartussek, D. (2006). The relation of cortical activity and BIS/BAS on the trait level. Biological psychology, 71(1), 42–53.
- Hossain, M. M., Sultana, A., & Purohit, N. (2020). Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence. Available at SSRN 3561265.
-Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey.
Psychiatry research, 112954.
Jentsch, J. D., Roth, R. H., & Taylor, J. R. (2000). Role for dopamine in the behavioral functions of the prefrontal corticostriatal system: implications for mental disorders and psychotropic drug action. In Progress in brain research, 126, 433–453.
-Koksal, E., Dost, B., Terzi, Ö., Ustun, Y. B., Özdin, S., & Bilgin, S. (2020).Evaluation of depression and anxiety levels and related factors among operating theatre workers during the novel Coronavirus (COVID-19) pandemic. Journal of Peri Anesthesia Nursing, Pre-proof, doi: https:// doi.org/10.1016/j.jopan.2020.06.017
Kumar, A., & Somani, A. (2020). Dealing with Corona virus anxiety and OCD. AsianJournal of Psychiatry, 51: 102053.
-Lee, V. J., Chiew, C. J., & Khong, W. X. (2020). Interrupting transmission of COVID-19: lessons from containment efforts in Singapore. Journal of Travel Medicine,27(3), taaa039. - Levita, L., Bois, C., Healey, A., Smyllie, E., Papakonstantinou,E., Hartley, T., & Lever, C. (2014). The Behavioral Inhibition System, anxiety and hippocampal volume in a non-clinical population. Biology of mood & anxiety disorders, 7; 4(1): 4
Li, H., Liu, S-M., Yu, X-H., Tang, S-L., Tang, C-K. (2020). Coronavirus disease 2019 (COVID-19): current status and future perspectives. International Journal of Antimicrobial Agents, 55 (5): 105951.
McKay, D., Yang, H., Elhai, J., & Asmundson, G. (2020). Anxiety regarding contractingCOVID-19 related to interoceptive anxiety sensations: The moderating role of disgust propensity and sensitivity. Journal of Anxiety Disorders, 73, 102233.
Mendlowicz, M. V., & Stein, M. B. (2000). Quality of life in individuals with anxietydisorders. American Journal of Psychiatry, 157(5), 669–682.
Merchán-Clavellino, A., Alameda-Bailén, J. R., Zayas García, A., & Guil, R. (2019).
Mediating effect of trait emotional intelligence between the behavioral activation system
(BAS)/behavioral inhibition system (BIS) and positive and negative affect. Frontiers in psychology, 10, 424. - Null, G., & Pennesi, L. (2017). Diet and lifestyle intervention on chronic moderate to severe depression and anxiety and other chronic conditions.Complementary therapies in clinical practice, 29, 189–193.
-Ripoll, M. S., Oliván-Blázquez, B., Vicens-Pons, E., Roca, M., Gili, M., Leiva, A.,& GarcíaToro, M. (2015). Lifestyle change recommendations in major depression:Do they work? Journal of Affective Disorders, 183, 221–228.
-Toyoshima, K., Inoue, T., Kameyama, R., Masuya, J., Fujimura, Y., Higashi, S., & Kusumi, I. (2021). BIS/Bas as moderators in the relationship between stressful life events and depressive symptoms in adult community volunteers. Journal of Affective Disorders Reports, 3, 100050.
- Roy, D., Tripathy, S., Kar, S. K., Sharma, N., Verma, S. K., & Kaushal, V. (2020).Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian Journal of Psychiatry, 51.102083.
Serrano-Ibáñez, E. R., Ramírez-Maestre, C., Esteve, R., & López-Martínez, A. E.(2019). The behavioral inhibition system, behavioral activation system and experiential avoidance as explanatory variables of comorbid chronic pain and posttraumatic stress symptoms. European journal of psychotraumatology, 10(1), 1581013.
Siyami, M., Salari, A., & Samadieh, H. (2017). Comparison of lifestyle and mental health among physical training teachers and other teachers in Birjand city. Journal of Fundamentals of Mental Health, 19(6), 491–495.
Smillie, L. D., & Wacker, J. (2014). Dopaminergic foundations of personality and individual differences. Frontiers in human neuroscience, 8, 874, 1–3.
-Suppawittaya, P., Yiemphat, P., Yasri, P. (2020). Effects of Social Distancing, Self-Quarantine and Self-Isolation during the COVID-19 Pandemic on People’s Well-Being, and How to Cope with It. International Journal of Science and Healthcare Research, v5, i2, 12–20.
-Sutton, S.K., Davidson, R.J., 1997. Prefrontal brain asymmetry: a biological substrate of the behavioral approach and inhibition systems. Psycho-logical Science 8, 204–210
Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., & Ng, C. H.(2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry, 7(3), 228–229.
-Weinberg, J. L. (2013). Medicine’s Response to Lifestyle-Related Preventable Illness. AMA Journal of Ethics, 15(4), 283–285.
-World Health Organization (2020) Coronavirus disease (COVID-19) advice for the public. Updated 2020 Apr. 16; Available from: https://www.who.int/ docs/ default source/coronavirus/situation.

No competing interests reported.

Download PDF

Editorial decision: Major revision
06 Jun, 2022
Reviews received at journal
31 May, 2022
Reviewers agreed at journal
23 May, 2022
Reviewers invited by journal
23 May, 2022
Editor assigned by journal
23 May, 2022
Editor invited by journal
23 May, 2022
Submission checks completed at journal
23 May, 2022
First submitted to journal
29 Apr, 2022

You are reading this latest preprint version

Behavioral activation / inhibition systems and lifestyle as predictors of mental disorders in Adolescent Athletes during Covid19 pandemic

Status:

Version 1

Abstract

Introduction

Method

Instruments:

Results

Discussion

Declarations

References

Additional Declarations

Status:

Version 1