Reflections on a Quarter-Century of Research in Sports Medicine Psychology

The three purposes of this paper are to provide reflections on (a) defining a new field of sports medicine psychology, (b) our research examining the genesis and testing of the integrated model of psychological response to the sport injury and rehabilitation process (Wiese-Bjornstal and Smith, 1993), and, (c) future directions for evaluating the model and advancing the field of sports medicine psychology. Illustrations visually summarize components of sports medicine psychology and show the integrated model, while a summary table highlights key findings from over 25 years of research about the integrated model components. Historical perspectives, philosophical dilemmas, conceptual frameworks, research findings, and professional issues interweave in addressing reflections in these three areas.Los tres objetivos de este artículo son el reflexionar sobre (a) la definición d un nuevo campo de la psicología de la medicina del deporte; (b) la investigaciones que han examinado la génesis y la comprobación del modelo psicológico integrado de respuesta a la lesión deportiva y del proceso de readaptación (Wiese-Bjornstal y Smith. 1993), y (c) las futuras direcciones para la evaluación del modelo y para el avance en el campo de psicología de la medicina del deporte. Se han usado ilustraciones para sintetizar visualmente los componentes de la psicología de la medicina del deporte, y para mostrar el modelo integrado, mientras que se resumen en una Tabla los hallazgos clave de los últimos 25 años de investigación acerca de los componentes del modelo integrado. Finalmente, se combinan de forma sinóptica las perspectiva históricas, los dilemas filosóficos, los marcos teóricos, los hallazgos de la investigación y los temas profesionales, con la finalidad de responder a esos tres objetivos.Os três objectivos deste artigo são reflectir sobre (a) a definição de um novo campo da psicologia da medicina desportiva; (b) as investigações que analisaram a génese e a comprovação do modelo integrado de resposta psicológica à lesão desportiva e do processo de reabilitação (Wiese-Bjornstal and Smith. 1993); e (c) as direcções futuras para a avaliação do modelo e para o progresso do campo da psicologia da medicina desportiva. Foram utilizadas ilustrações para sintetizar visualmente os componentes da psicologia da medicina desportiva, e para mostrar o modelo integrado, resumindo-se numa tabela as conclusões chave dos últimos 25 anos de investigação sobre os componentes do modelo integrado. Finalmente, combinam-se de forma sinóptica as perspectivas históricas, os dilemas filosóficos, os marcos teóricos, os resultados da investigação e as questões profissionais, visando responder a esses três objectivos

Religiosity and Ways of Coping With Sport Injuries Among Christian Athletes

Although research evidence supports religiosity’s predominantly positive mental and physical health benefits to patients coping with varied health problems, there are few studies exploring the influence of religiosity on coping with sport injuries among athletes identifying with specific religions. This study examined the relationships between religiosity and the use of religious and non-religious ways of coping with sport injuries by athletes affiliated with diverse Christian denominations. Within a concurrent mixed methods design, adult athletes (N = 88) responded to an online survey asking about several religiosity factors, their most serious or challenging sport injuries, and their ways of coping with those injuries. Quantitative results showed that religious commitment correlated with specific religious beliefs and behaviors, positive religious ways of coping predominated over negative, and religious commitment fully mediated the relationship between athletes’ Christian denominations and their use of positive, but not negative, religious ways of coping with sport injuries. Thematic template analysis of qualitative data similarly revealed that religious ways of coping with sport injuries were predominantly positive in valence and benefitted physical and mental rehabilitation and recovery processes. Christian athletes relied on both religious and non-religious coping sources during their sport injury recoveries, and their ways of coping centered on their personal and religious identities. These results support that holistic care models encompassing sport psychology, sports medicine, and sports ministry should adapt intervention and treatment plans to accommodate personal religiosity and build on positive and adaptive religious ways of coping with sport injuries when working with religiously committed Christian athletes

Can preinjury adversity affect postinjury responses? A 5-year prospective, multi-study analysis

Informed by and drawing on both the integrated model of response to sport injury (Wiese-Bjornstal et al., 1998) and the biopsychosocial model of challenge and threat states (Blascovich, 2008), this multi-study paper examined whether preinjury adversity affected postinjury responses over a 5-year time period. Study 1 employed a prospective, repeated measures methodological design. Non-injured participants (N = 846) from multiple sites and sports completed a measure of adversity (Petrie, 1992); 143 subsequently became injured and completed a measure of coping (Carver et al., 1989) and psychological responses (Evans et al., 2008) at injury onset, rehabilitation, and return to sport. MANOVAs identified significant differences between groups categorized as low, moderate, and high preinjury adversity at each time phase. Specifically, in contrast to low or high preinjury adversity groups, injured athletes with moderate preinjury adversity experienced less negative psychological responses and used more problem- and emotion-focused coping strategies. Study 2 aimed to provide an in-depth understanding of why groups differed in their responses over time, and how preinjury adversity affected these responses. A purposeful sample of injured athletes from each of the three groups were identified and interviewed (N = 18). Using thematic analysis, nine themes were identified that illustrated that injured athletes with moderate preinjury adversity responded more positively to injury over time in comparison to other groups. Those with high preinjury adversities were excessively overwhelmed to the point that they were unable to cope with injury, while those with low preinjury adversities had not developed the coping abilities and resources needed to cope postinjury. Practical implications and future research directions are discussed

A Meta-Analysis of Mental Imagery Effects on Post-Injury Functional Mobility, Perceived Pain, and Self-Efficacy

Objectives: We used meta-analysis to examine the effects of mental imagery (MI) on three bio-psycho-social factors, namely functional mobility, perceived pain, and self-efficacy. Method: Ten studies were included in the meta-analytical review. Cohen’s d effect sizes (ES) and Hedge's g weighted mean ES (WES) were computed for all dependent variables. Results: The analysis revealed that the effect of imagery interventions was (1) small and positive for functional mobility (g =.16), (2) large and negative for perceived pain (g = -.86), and (3) large and positive for self-efficacy (g = .99). These effects were all non-significant, probably because the interventions administered and populations sampled in the studies were mostly heterogeneous. Hence, the effects of MI on bio-psycho-social variables warrant continued empirical investigation. Conclusions: Given the observed statistical trends, MI interventions are likely to be beneficial for athletes recovering from injury, as they may serve to decrease negative affect and promote gains in mobility and positive affect

Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review.

The prime focus of research on sports injury has been on physical factors. This is despite our understanding that when an athlete sustains an injury it has psychosocial as well as physical impacts. Psychosocial factors have been suggested as prognostic influences on the outcomes of rehabilitation. The aim of this work was to address the question: are psychosocial factors associated with sports injury rehabilitation outcomes in competitive athletes?Mixed studies systematic review (PROSPERO reg.CRD42014008667).Electronic database and bibliographic searching was undertaken from the earliest entry until 1 June 2015. Studies that included injured competitive athletes, psychosocial factors and a sports injury rehabilitation outcome were reviewed by the authors. A quality appraisal of the studies was undertaken to establish the risk of reporting bias.25 studies were evaluated that included 942 injured competitive athletes were appraised and synthesised. Twenty studies had not been included in previous reviews. The mean methodological quality of the studies was 59% (moderate risk of reporting bias). Convergent thematic analysis uncovered three core themes across the studies: (1) emotion associated with rehabilitation outcomes; (2) cognitions associated with rehabilitation outcomes; and (3) behaviours associated with rehabilitation outcomes. Injury and performance-related fears, anxiety and confidence were associated with rehabilitation outcomes. There is gender-related, age-related and injury-related bias in the reviewed literature.Psychosocial factors were associated with a range of sports injury rehabilitation outcomes. Practitioners need to recognise that an injured athlete's thoughts, feelings and actions may influence the outcome of rehabilitation

Perfectionism and Coping with Injury in Marathon Runners: A Test of the 2×2 Model of Perfectionism

Perfectionism dimensions have previously demonstrated different relationships with coping strategies in sport. The purpose of the present study was to extend existing research by examining the interactive effects of perfectionism dimensions on strategies employed by marathon runners to cope with injury. This involved testing the hypotheses of the 2×2 model of perfectionism in marathon runners. Marathon runners (n = 224, female n = 81, M age = 39.77 years, SD = 9.50 years) completed measures capturing four sub-types of perfectionism (pure personal standards perfectionism, pure evaluative concerns perfectionism, mixed perfectionism, and non-perfectionism) and strategies for coping with injury (problem-focused coping, emotion-focused coping, and avoidance coping). Moderated regression analyses provided support for all four hypotheses of the 2×2 model for problem-focused coping, one hypothesis for emotion-focused coping, and one hypothesis for avoidance coping. The findings suggest that problem-focused coping is higher for pure personal standards perfectionism compared to the three other sub-types of perfectionism, emotion-focused coping is higher for pure personal standards perfectionism compared to non-perfectionism, and avoidance coping is similar across all sub-types of perfectionism. The results provide an initial indication of the potential of the 2×2 model of perfectionism to explain differences in the use of coping strategies in context of marathon running injury

Developmental experiences of elite female youth soccer players

To advance the literature on talent development within elite female athletes, this study investigated the developmental experiences of elite youth female soccer players. We adopted an interpretive approach where four players (M age = 16.75) were initially interviewed to gain a retrospective understanding of their development as soccer players. Subsequent fieldwork and further interviews were used to gain a current and prospective understanding of their development as players. Data were subjected to an inductive analysis, composite sequence analysis and a collaborative member checking process to co-construct a sequential, developmental understanding of the players' experiences within elite youth soccer. The findings suggested that the soccer experience of fathers and/or older brothers played a significant role in the players' development. Soccer fathers were able to provide advice and guidance specific to the needs of their daughter-player at different age ranges whilst at the same time reinforcing the importance of coach–player relationships. Soccer brothers acted as either positive or negative models for their sister-players and served as a source of information about key career choices. Friends inside (termed as soccer friends) and outside (termed as non-soccer friends) soccer played a significant role in helping players to lead the disciplined lifestyle required of an elite youth soccer player. Finally, findings suggest that self-regulation and adaptive volitional behaviours appear to be key intra-individual factors associated with talent development in female soccer. These findings are considered in the light of previous talent development literature alongside directions for future research

‘You always wanna be sore, because then you are seeing results’: Novel insights into lived experiences of ‘positive pain’ in competitive swimming

Pain has long been associated with sports participation, being analyzed variously as a physical phenomenon, as well as a socio-cultural construct in sport sociological literature. In this article, we employ a sociological-phenomenological approach to generate novel insights into the under-researched domain of ‘lived’ pain in competitive swimming. Analytic attention is paid to specific aspects of pain, including ‘discomfort’ and ‘good pain,’ and how these sensations can be positively experienced and understood by the swimmers, as well as forming an integral part of the everyday routines of competitive swimming. Here, training is seen as ‘work’ in the pursuit of athletic improvement. Discomfort and 'good pain' thus become perceived as by-products of training, providing swimmers with important embodied information on pace, energy levels, and other bodily indicators of performance

Stressors, social support, and tests of the buffering hypothesis: effects on psychological responses of injured athletes.

The purpose of this article was to examine the main and stress-buffering effect relationships between social support and psychological responses to injury