Anastasia Uspenskaia
The effects of injury on athletes’ mental health
Annotated Bibliography
1. A National Collegiate Athletic Association Division II university study found that athletes'
psychosocial responses during injury rehabilitation were often overlooked. Initially, athletes'
cognitive appraisals were negative, leading to negative emotions. However, these changed after
diagnosis and during the reaction-to-rehabilitation and reaction-to-sport phases. During the
reaction-to-rehabilitation phase, athletes reported mixed cognitive appraisals, with frustration
being the main emotional response. They sought social support from significant others and their
trainers. The study supports the integrated model of psychological response to sports injury and
rehabilitation, helping athletic trainers provide better care to injured athletes. A directed
content analysis revealed commonalities in athletes' psychosocial responses to injuries during
rehabilitation. Cognitive appraisals and emotional responses vary across phases and are
influenced by four events: initial reaction, post-diagnosis reactions, rehabilitation reactions, and
return to sport. Personal and situational factors also influence reactions.
Clement, D., Arvinen-Barrow, M., & Fetty, T. (2015, January 1). Psychosocial responses
during different phases of sport-injury rehabilitation: A qualitative study. Allen Press.
https://meridian.allenpress.com/jat/article/50/1/95/112394/Psychosocial-Responses-DuringDifferent-Phases-of
2. Injury is a significant stressor for athletes, as they must balance academic and athletic demands.
The psychological response to injury can trigger mental health issues such as depression, suicidal
ideation, anxiety, disordered eating, and substance use. Athletes often view seeking help as a
sign of weakness and may not have developed healthy coping behaviors, making the response
to injury especially challenging. The relationship between exercise and mental health disorders,
as well as chronic stress and mental health, is growing research. Mental health concerns such as
Anastasia Uspenskaia
The effects of injury on athletes’ mental health
eating disorders, depression, and suicide are among the most important in college-aged
students, both athletes and non-athletes. Performance anxiety, eating disorders, and binge
drinking may be more common in athletes than non-athletic peers. Symptoms of depression are
not uncommon in athletes, and elite athletes may be at a greater risk for depression than less
elite athletes. Resources to direct injured athletes to a mental health care provider are
necessary to address these issues.
Putukian, M. (2016, February 1). The psychological response to injury in student-athletes: A
narrative review with a focus on Mental Health. British Journal of Sports Medicine.
https://bjsm.bmj.com/content/50/3/145.info
3. The study investigated the causes of sports injuries and the psychological responses of athletes
based on the severity of the injury. It examined 68 athletes with surgically treated knee injuries,
with the more severely injured athletes experiencing a six-month rehabilitation period. The
study measured personality traits, athletic identity, coping with pain, rehabilitation beliefs,
motivation, and social support. Results showed that the more severely injured athletes
demonstrated less inhibited behavior, with higher levels of catastrophizing and higher individual
coping responses. Masculinity predicted self-efficacy and individual coping, while strength of
athletic identity predicted motivation and rehabilitation value. (“Psychological response of
athletes to injury. - APA PsycNet”) Athletes with lower athletic identity, lower masculinity, and
higher emotional lability were more exposed to adjustment difficulties after sustaining an injury.
The research suggests that successful rehabilitation strategies should focus on identifying
Anastasia Uspenskaia
The effects of injury on athletes’ mental health
athletes with personality traits that pose a higher risk of adjustment difficulties, promoting
adequate motivation, increasing coach support, and applying cognitive-behavioral strategies.
Masten, R., Strazar, K., Zilavec, I., Tusak, M., & Kandare, M. (2013, December
11). Psychological response of athletes to injury - srce. SRCE.
https://hrcak.srce.hr/file/182810
4. The study aimed to determine the psychological responses and coping behaviors athletes may
present to athletic trainers (ATs), the psychosocial strategies they currently use with their
athletes, the strategies they deem important to learn more about, and their current practices in
referring athletes to counseling or sports psychology services. A total of 215 ATs participated,
representing a response rate of 22.50%. The results showed that stress/anxiety, anger, and
treatment adherence problems where the primary psychological responses athletes may
present upon injury. Adherence and a positive attitude were identified as key determinants in
defining athletes' successful coping with their injuries. The top three psychosocial strategies ATs
deemed important to learn more about were understanding motivation, using effective
communication, and setting realistic goals. Only 27.44% of ATs reported referring an athlete for
counseling services, while 84.09% of those who had access to a sports psychologist reported
referring to sports psychology services. The results highlight ATs' current use of psychosocial
strategies and their desire to increase their knowledge and understanding while caring for
injured athletes.
Clement, D., Granquist, M. D., & Arvinen-Barrow, M. M. (2013, July 1). Psychosocial aspects
of athletic injuries as perceived by athletic trainers. Allen Press.
Anastasia Uspenskaia
The effects of injury on athletes’ mental health
https://meridian.allenpress.com/jat/article/48/4/512/191257/Psychosocial-Aspects-ofAthletic-Injuries-as
5. The study explores the views of injured professional athletes on the role of sports medicine
professionals (SMPs) in addressing the psychosocial aspects of injuries during rehabilitation. The
research involved ten professional football and rugby union players aged 22 +/- 3 years. The
results showed that athletes viewed injuries as part of their sports but reported frequent
feelings of frustration and self-doubt during the rehabilitation process. SMPs perceived their
role in injury rehabilitation as addressing physical concerns, and any intervention aimed at
psychosocial outcomes needed to be subtle and indirect. The study concludes that SMPs
working with injured athletes need to understand the psychosocial principles underpinning their
sport-injury processes and the effect of psychosocial reactions on athletes. Sports medicine
professionals (SMPs), such as athletic trainers and physiotherapists, are often the first to
address the psychosocial and physical processes of injury. They are often present immediately
after an injury, during the worst pain and confusion experienced by the athlete. Despite the
belief that psychosocial strategies are necessary for injury rehabilitation, many SMPs feel
inadequately trained to address these aspects.
Arvinen-Barro, M., V. Massey, W., & Hemmings, B. (2014, December 1). Role of Sports
Medicine Professionals in Addressing Psychosocial Aspects of Sport-Injury Rehabilitation:
Professional Athletes’ Views. Meridian.allenpress.com.
https://meridian.allenpress.com/jat/article/49/6/764/112293/Role-of-Sport-MedicineProfessionals-in-Addressing