Chapter 5

1. Chapter 5 The Psychology of Injury

2. Psychology of Injury • The relationship between psychological variables and sports injuries is increasingly being investigated. The following have been identified as areas that might affect both the mental and physical health of an athlete. • Personality traits and Life Stress • Depression • Competitive Stress • Eating Disorders

3. Psychosocial Variablesand Injury • Psychosocial variables develop through interaction between individual and a changing social environment. • Life events can be stressful either positively or negatively. • A strong relationship exists between negative events and increased injury risk. • Athletes with higher degrees of coping skills are less likely to get injured.

4. Psychosocial Variablesand Injury • Recent research has demonstrated correlations between injury and exhaustion in collegiate athletes. (Vetter and Symonds, 2010) • 38-56% of surveyed athletes experienced acute or chronic injury. • Athletes reporting exhaustion occurring sometimes. • Females (66%); Males (59%) • Athletes reporting exhaustion occurring frequently. • Females (30%); Males (23%)

5. Personality Variables • Personality is defined as “stable, enduring qualities of the individual.” (Kerr and Fowler, 1988) • Characteristics that may be related to sports injuries include: • General personality. • Trait anxiety. • Locus of control. • Self-concept. • Life Stress. Marko Risovic/Webphotographer/Alamy Images

6. Self Concept and Injury • Strongest evidence of a link between injury and personality variables is with self-concept. • Theory that athletes with a low self-concept are less able to deal effectively with the stress of competition. • Low self-concept may result in behavior that leads to injury. • Injured athletes often get more attention from coaches and peers.

7. Life Stress in Injury • Evidence suggests that when an athlete is experiencing significant personal changes, especially those seen as negative, the chances of injury increase. • Variety of scales can be used to assess life stress. • Athletes with high life-stress scores might benefit from referral to a counselor in an effort to improve coping skills.

8. Depression and Athletes • May be clinical or seasonal affective disorder (SAD). • Identification in athletes may be tough. • Athletes are taught to “play through the pain, handle problems on their own, and never let your enemies see you cry”. (NCAA Handbook, 2009) • Common signs and symptoms • Indecisiveness, Feeling sad, Difficulty concentrating, Loss of interest, Frequent feelings of worthlessness • Athletic departments should foster relationships with mental health resources.

9. CompetitiveStress and Adolescents • As more adolescents participate in sports, there are more concerns regarding the psychological impact of competition because • Intensity of competition has increased. • Pressure to win has risen. • Coaches and parents must take care to avoid forcing children beyond their ability to cope. • Young athletes may be more prone to injury, psychosomatic illness, burnout, and other stress-related problems.

10. CompetitiveStress and Adolescents • According to the Association of Applied Sport Psychology concern should be raised if • Conversations at home are dominated by sport discussions. • Child is allowed little time to spend with his friends • Child’s education becomes a distant second priority to competition and talent development • Child is overly nervous about competing especially when parents are watching

11. CompetitiveStress and Adolescents The DOs • Do allow children to be interested and want to play whatever sport he or she chooses. • Do teach children to respect his/her coach. • Do be willing to let children make his/her own mistakes and learn from them. • Do be interested and supportive, light and playful, understanding. • Do model flexibility of your own opinions.

12. CompetitiveStress and Adolescents The DON’Ts • Don’t try to relive your youth through children. • Don’t blame the equipment, coach, other players, referees or even the weather if the team does not do well or win. • Don’t push, push, push….Children who are pushed beyond their capabilities may lose their self-confidence. • Don’t expect perfection or tie your ego or image to the children’s performance.

13. Psychology of Injury • Injury is a psychological stressor for athletes. • According to Weiss & Troxel: • Phase 1 –The athlete adapts to activity restriction. • Phase 2 – The athlete appraises short- and long-term significance of the injury. • Phase 3 – The athlete experiences emotional responses. • Final stage – The athlete copes with long-term consequences.

14. Psychology of the Injured Athlete • Recommendations involve: • Treating the person, not just the injury. • Treating the athlete as an individual. • Keeping in mind the importance of communication skills. • Remembering the relationship between physical & psychological skills. • Seeking the help of a sports psychologist.

15. Eating Disorders Why are eating disorders prevalent in athletics? • Majority of sports have narrow parameters for appropriate body type for athletic success. • Specific sports require specific body types. • Media exposure focuses on physical appearance, especially for females. • Emphasis on the ideal body has negative effects on the athletes and can lead to serious diseases.

16. Types of Eating Disorders • Anorexia nervosa – self-starvation motivated by obsession with thinness and overwhelming fear of fat • Bulimia nervosa – repeated bouts of binge eating followed by some form of purging • Subclinical Disordered Eating • Dieting obsessively when not overweight • Preoccupation with food, calories, nutrition, and cooking • Excessive exercising • Frequent weighing

17. Risk Factors • Sport task- revealing uniforms or being physically evaluated • Sport environment- comments from teammates, coaches, parents or judges • Biological characteristics- metabolism and physical size • Psychological characteristics- self-esteem, body image and anxiety. Monsma, 2006

18. Eating Disorders • Research (Rosen et al, 1986; Sanford-Martens, 2009; Greenleaf et al, 2009) • 18-32% of athletes were classified as having symptoms and patterns of clinical disordered eating. • 2-3.4% were classified as having a clinical diagnosis of an eating disorder

19. Eating Disorders • Female athletes (5%) are more likely to practice pathogenic (unhealthy) dietary habits than males (2%). • More research is needed into the pathogenic eating disorders in male athletes. For example, making weight in wrestling. • Are males susceptible to the same pressures as female counterparts? • Is there underreporting in the male population?

20. Sport Specificity and Eating Disorders • Females in aesthetic sports demonstrated a significantly higher prevalence of eating disorder symptoms than female non-athletes. • Greenleaf et al., 2009 • Gymnastics, diving, cheerleading, crew, and downhill skiing had the most symptomatic athletes (33-40%). • Cross country, swimming, track, and ball sports (21-27%).

21. Consequences of Eating Disorders • Dehydration and gastric upset. • Esophageal inflammation, erosion of tooth enamel • Hormone imbalances • Kidney and heart problems • Amenorrhea. • Depression and anxiety are often co-morbid syndrome in people with eating disorders.

22. Prevention Prevention efforts include: • Placing less emphasis on weight. • Avoiding referral to weight in a negative manner. • Avoiding mandatory weigh-ins. • Avoiding ostracizing an athlete for being overweight. • Coaches and parents need to be alert for early warning signs.

23. Treatment • Ranges from counseling and education to hospitalization. • May include psychological counseling as eating disorders can be symptoms of severe psychological problems such as depression. • One-third of all cases do not respond to therapy.