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Chapter 5
The Psychology of
Athletes and Sports
Injury
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
• Life Stress
• Depression
• Competitive Stress
• Eating Disorders
Psychosocial Variables
and 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.
Psychosocial Variables
and Injury
• Recent research has demonstrated
correlations between injury and exhaustion in
collegiate athletes. (Vetter and Symonds, 2010)
• Athletes reporting exhaustion occurring
sometimes.
• Females (66%); Males (59%)
• Athletes reporting exhaustion occurring
frequently.
• Females (30%); Males (23%)
Psychosocial Variables
and Injury
• Perceived stress, levels of social support, and fatigue
may all be connected to sports injury and need to be
addressed because they present problems for athletes
in their sport and life.
• There are very complex interactions between life
situations, personality, and current situations.
• Research typically seeks to define relationships
between variables in an effort to improve treatment
and recognition.
Personality Variables
• 5 general traits are
extraversion, agreeableness,
conscientiousness,
neuroticism, and openness
(Goldberg, 1990)
• Characteristics that may be
related to sports injuries
include:
• General personality; Trait
anxiety; Locus of control;
Self-concept; Stress
response
Self Concept and Injury
• Theory that athletes with a low self-concept are
less able to deal effectively with the stress of
competition.
• Though a true relationship has yet to be defined.
(Kleinert, 2002)
• Inability to cope may even result in behavior that
leads to injury.
• Injury gives the athlete a legitimate excuse to avoid
playing.
• Tennessee Self-Concept Scale (TSCS) may be
given for screening.
Life Stress in Injury
• Convincing findings have been produced from
research examining the relationship between
psychosocial factors (e.g., social environment, life
stress, and mood) and injury rates (Wiese-Bjornstal , 2010)
• Evidence suggests that when an athlete is
experiencing significant personal changes, especially
those seen as negative, the chances of injury
increase.
• Two psychosocial variables; history of stressors and
coping resources play a significant role in the cognitive
appraisal and physiological responses to stressful
situations and may influence the occurrence of
injuries.
Life Event Questionnaires
A 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.
• Social Readjustment Rating Scale (SRRS)
• Social and Athletic Readjustment Rating Scale
(SARRS)
• Life Event Scale for Adolescents (LESA)
• Life Event Questionnaire (LEQ)
• Life Event Survey for Collegiate Athletes (LESCA)
• Athletic Life Experience Survey (ALES)
Depression and Athletes
• Major depression, dysthymia, and bipolar disorder
are the most common.
• Identification in athletes may be tough.
• Seeking help is often seen as a sign of
weakness or failure rather than a sign of
strength (NCAA, 2012)
• 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.
Competitive Stress and
Adolescents
• As more adolescents participate in sports,
there are more concerns regarding the
psychological impact of competition:
• 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.
Competitive Stress 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.
Competitive Stress and
Adolescents
• 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.
Competitive Stress and
Adolescents
• 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.
Psychology of Injury
• Injury is a psychological stressor for athletes.
• According to Weiss & Troxel:
• Phase 1 –The athlete adapts to activity
restriction and situation.
• 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 longterm consequences.
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.
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.
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
Risk Factors
(Monsma, 2006)
• 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.
Research of Eating Disorders
(Rosen et al, 1986; Sanford-Martens, 2009; Greenleaf et al, 2009)
• More than 1/3 of athletes have
reported to use at least one extreme
dieting method.
• 25-32% of female 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
Sport Specificity and
Eating Disorders
• Female athletes (5%) are more likely to
practice pathogenic (unhealthy) dietary habits
than males (2%). (Sanford-Martens et al, 2005)
• 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?
Sport Specificity and
Eating Disorders
• Female athletes involved in sports that place a
premium on physical appearance (aesthetic
sports) demonstrate a significantly higher
prevalence of eating disorder symptoms than
do female nonathletes (Hausenblas & Carron, 1999)
• 33-40% of aesthetic and power sports had
symptomatic athletes
• 21-27% of cross country, swimming, track, and
ball sports had symptoms
Consequences of Eating Disorders
• Dehydration; gastric upset; esophageal
inflammation; erosion of tooth enamel;
hormone imbalances, amenorrhea; kidney
and heart problems; depression and anxiety
are often co-morbid syndrome in people with
eating disorders.
• female athlete triad links disordered eating
with osteoporosis and amenorrhea (Nattiv et. al,
2007)
• male athlete triad links energy deficits, bone
loss, and low sperm counts to hormonal
changes (Chatterton & Petrie, 2013).
Prevention
• Placing less emphasis on weight.
• Avoiding referral to weight in a negative
manner. Avoiding ostracizing an athlete for
being overweight.
• Avoiding mandatory weigh-ins.
• Coaches and parents need to be alert for early
warning signs of eating disorders.
• Screening or clinical interviews with athletes
during PPE.
• Athletes Targeting Healthy Exercise and Nutrition
Alternatives (ATHENA)
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.