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Barriers to Adherence, Coping, and Problem Solving Barriers to Adherence Glasgow, Hampson, Strycker, and Ruggiero (1997) have proposed two speci c categories of barriers that impede daily diabetes self-care: personal and social-environmental. The personal model includes patients cognitions about the disease including health beliefs (e.g., vulnerability to negative outcomes), emotions, knowledge, and experiences. Such perceptions affect the implementation of speci c health behaviors including disease management and patient-practitioner interactions. Social-environmental factors include barriers to self-care (e.g., weather), social support from family or peers, interactions with health care providers, and community resources and services (Glasgow, 1994). Gaining awareness of patients social contexts provides clinically relevant information on how patients live and cope with their diabetes on a daily basis. Research indicates that diabetes patients experience the greatest number of barriers to diet and exercise, a moderate amount of barriers to glucose testing, and the fewest barriers to insulin injections and medication-taking (Glasgow, Hampson, et al., 1997; Glasgow, McCaul, & Schafer, 1986). Each of the several components of the diabetes regimen can have its own set of personal and social-environmental barriers (Glasgow, 1994). For example, dietary planning has been shown to be in uenced by personal factors (e.g., motivation, emotions, food selection knowledge, understanding of meal plans; El-Kebbi et al., 1996; Travis, 1997), socialenvironmental factors (e.g., holidays; Travis, 1997), and lack of family support (e.g., pressure to deviate from dietary guidelines; El-Kebbi et al., 1996). To quantify particular barriers to diabetes self-care, researchers have developed psychometrically sound self-report

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Burnout Another outcome variable that is becoming popular in sport research is burnout (see Eklund & Cresswell, 28) Why is it that some athletes burn out, and what are the precursors of burning out Some recent research from a motivational perspective has given us some interesting findings Freudenberger (1980) has explained burnout as a syndrome that includes both physical and emotional exhaustion These symptoms occur concurrently with patterns of behavior that are strongly achievement oriented (Hall & Kerr, 1997) Individuals experiencing burnout tend to show a strong commitment to the pursuit of goals and set high standards for themselves Despite personal investment and great persistence, they often experience depression, depersonalization, disillusionment, and dissatisfaction as their goals are continually unmet Hall et al (1998) reported a strong relationship among elite athletes perfectionism, achievement goals, and aptitudes to perform.

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The author is greatly indebted to Lewis R. Goldberg, Gerard Saucier, and Jos M. F. Ten Berge for their incisive comments on a draft of this chapter.

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It is when athletes continually perceived their ability and their effort levels to be inadequate to meet their achievement goals that the maladaptive nature of their motivational orientation became apparent The athlete may drop out to maintain any real sense of self-worth Cohn (1990) has found that athletes at risk of burning out were likely to either participate in too much training and competition, lacked enjoyment while practicing their sport, or experienced too much self- or other-induced pressure Investigating young elite tennis players, Gould and colleagues (Gould, 1996; Gould, Tuffey, Udry, & Loehr, 1996; Gould, Udry, Tuffey, & Loehr, 1996) found that.