Sports Psychology: Problems in Sports Stress and Injury Stress is

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Sports Psychology: Problems in Sports
1. Stress and Injury
a. Stress is leading cause of injury, misuse of PED’s and
burnout
b. Finch et al (1998): 20-30% of total injuries in a given
population are sports related
c. National Safe Kids Campaign (2004): est. 3.5 million US kids
under 14 are injured playing sports (# of adults ranges from
3 to 17 million depending on injury type)
d. In Australia: 1 in 17 players suffer injuries equaling almost
1 million with 40,000 requiring hospitalization costing over
$400 million annually
e. Research shows increased stress in life = increased injury in
sports
i. Smith et al (1990): 452 m/f high school athletes,
assessed stress, social support, coping skills and # of
days off related to injury
1. Results showed a correlation between stressors
and injury, other factors included low social
support and low coping skills
ii. Ford et al (2000): low self esteem and pessimism led
to high levels of injury
f. How can we explain this relationship between stress and
injury?
i. Williams et al (1991); stress disrupts attention,
reduces peripheral awareness
ii. Anderson & Williams (1999): negative life event
stressors were the only significant predictor of injury
in 196 college athletes
iii. Smith et al (2000): muscle tension caused by stress
interferes with normal coordination, thus increasing
rick of injury
iv. Stress can impact recovery
1. Cramer et al (2000): natural healing disrupted
by high glucocorticoids, impairing the immune
response and inhibiting production of growth
hormones
2. Perna et al (2003): stress caused impaired sleep
patterns and protein synthesis-essential for
recovery process
g. Athlete response to injury
i. Coping with 3 stressors (Physical, Psychological and
Social) essential to rehab process takes one of 2 forms
1. Grief Response Model (Hardy, Crace 1990)
a. See Kubler-Ross (1969) grieving process
i. Denial: injured players pushes it and
make it worse
ii. Anger: about injury’s impact on
ability/career
iii. Bargaining: deal making to mitigate
the injury
iv. Depression: reality of injury
v. Acceptance/reorganization: coping
can begin
b. Criticisms: not empirical, anecdotal, steps
not always followed in order (Brewer,
1994), no evidence of denial or bargaining
(Urdy et al, 1997)
c. Petitpas & Danish (1995): Identity Loss—
injury low self –
efficacydepressionlow self
confidencelow status and
motivationidentity loss
2. Cognitive Appraisal Model (Urdy et al, 1997)
a. Stages of “Information Processing” about
injury
i. Stage 1: Amount/type of pain,
how/why it happened, consequences
and rehab options
ii. Stage 2: emotional upheaval, reactive
behaviors—anger, frustration
1. Can be a relief from
performance pressures (Wiese,
Bjornstal et al, 1995) or cause
for depression (10 to 20%,
Brewer, 1995)
iii. Stage 3: Developing, outlook and
coping
b. “Cognitive Appraisal” (Wiese, Bjornstal,
1998)
i. Primary: what is at stake, challenge,
threat, benefit or loss
ii. Secondary: how can you cope,
options available
Diagram of the Wiese-Bjornstal Model
Dispositional Factors
Situational Factors
--Injury History
--Time in season
--Personality
--Status
--Motivational Orientation
--Social support
--Athletic Identity
--Coach’s influence
Cognitive Appraisal
--Goal adjustment
--Self perception
--Sense of loss/grief
--Cognitive coping
Behavioral Response
Emotion Response
--Risky behavior
--Anxiety/fear
--Malingering
--Frustration
--Commitment to rehab
--Depression
--Behavioral coping
--Positive outlook
2. Why has there been an increase in PED use during the last 20
years?
a. Physical considerations
i. Strength, endurance, alertness, aggression, fatigue,
anxiety, wt. gain/loss all can be impacted by PED’s
b. Psychological considerations
i. Coping w/stress, self esteem, confidence, respond to
external pressures
c. Social considerations
i. Social learning theory: see model (Bonds, Canseco,
Ben Johnson) do it without getting caught (Bandura;
Anshel, 1998)
ii. Conformity, coercion, peer pressure
iii. “Game Theory” (Axelrod, 1984): if you don’t use you
will be left behind by the using competition (e.g. EPO
doping in the Tour de France, roids in MLB), leads to
cognitive rationalization that the rewards outweigh
the risks of getting caught
3. Effects of drug use in sports
a. Physical: Steroids
i. synthetic derivatives of testosterone, anabolic effects
retention of protein to build muscle
ii. “stacking”: combo of different types can be
permanent
iii. Injections increase risk of Hepatitis B, HIV
iv. Damage may take years to see (Lyle Alzado)
v. Feminization Effect in men: decrease in male sex
function, low sperm count, impotence, development
of breasts, shrinking testicles, pain w/urination
vi. Women have “Masculinization Effect” (see East
German Olympians)
vii. Acne, wt. gain, liver damage, heart attack, stroke,
increased cholesterol, weak tendons (see Bo Carrol),
permanent growth halt in teens in both males and
females
b. Psychological: Steroids
i. Mood swings, extreme irritability/aggression (“roid
rage”), addiction and withdrawal issues
c. Other PED’s and their effects
i. Beta blockers: reduce anxiety, blood pressure, heart
rate, depresses CNS
ii. Diuretics: wt. loss, dehydration, cramping, kidney
stones, increased cholesterol
iii. EPO: increased oxygen and stamina, risks for blood
clots, heart attack, stroke
iv. Narcotics: mask pain, failure to feel injury, overdose
threat
4. Causes of Burnout
a. Def: the physical, emotional, psychological withdrawal
from formerly enjoyable activity due to stress or
dissatisfaction
b. Cognitive-Affective Stress Model (Smith 1986) how
thoughts and feelings influence athlete’s burnout
i. Stage 1: Situation Demands: demands exceed
resources = stress
ii. Stage 2: Cognitive Appraisal: threat vs. challenge
appraisal of situation = anxious or excited
iii. Stage 3: Physiological Responses: fight or flight due to
appraisal
iv. Stage 4: Behavioral Response: performance issues,
cohesion problems, withdrawal
c. Hardiness (Kobasa, 1986) is the key factor to overcoming
stressors and resisting burnout; based on 3 factors
i. Control: person’s ability to influence events
ii. Commitment: person’s refusal to give up
iii. Challenge: person’s willingness to change
d. Mental Toughness Model (Clough and Earle, 2001)
i. Mental toughness questionnaire resulted in a group
of mentally tough subjects and non mentally tough
who then did 3 30 minute cycling trials at 30, 50 and
70% max; oxygen uptake and reactions of subjects
was recorded
ii. Results showed MT subjects reported lower perceived
exertion, even at 70% suggesting MT helps withstand
stress/burnout
e. Self Determination Theory (Raedeke, 1997)
i. Burnout results from lack of intrinsic motivation or
control over participation; “have to” rather than “get
to” attitude
ii. Factors include: identity = sport, entrapment, social
support/demands
5. Measuring Burnout
a. Gould et al 1996-7: 2 strains of burnout
i. Dominant Strain: situational, environmental factors
ii. Physically Driven Strain: can’t meet demands of sport
b. Maslach Burnout Inventory: test based on 3 scales
i. Emotional Exhaustion
ii. Depersonalization
iii. Sense of Personal Accomplishment
6. Preventing Burnout
a. 2002 (Raedeke) semi structured interviews of swim coaches
identified 7 signs of burnout
i. Withdrawal from team
ii. Decreased sense of accomplishment
iii. Diminished sense of progress
iv. Devaluation of sport
v. Exhaustion: physical, mental, emotional
vi. Pressure: internal or external
vii. Loss of control/balance of sport/outside life
1. Prevention strategies revolved around the
following:
a. Identification by teammates/coaches early
b. Support/structure from team/coach/family
c. Coach’s empathy, recognition and support
i. Supportive, cooperative culture
ii. Flexibility, fun, exciting training
iii. Set realistic yet challenging goals,
task oriented
b. Cognitive Affective Stress Management (Smith, 1980)
i. Mental/physical coping strategies designed to
prevent burnout in 4 steps
1. Pre-treatment Assessment: interviews to assess
the athlete’s stress response and appraisal
2. Treatment Rationale: athlete analyzes and gains
understanding of personal stress reactions
3. Skill Acquisition: athlete learns relaxation,
cognitive restructuring and self talk
4. Skill Rehearsal: stress is induced to allow athlete
to practice new stress reducing skills
c. Stress Inoculation Theory (SIT) Meichenbaum, 1985
i. Athlete is exposed to increasing levels of stress in 3
stages, thereby enhancing his/her immunity “Learned
Resourcefulness”
1. Stage 1: Conceptualization: athlete becomes
aware of +/-- thoughts, self talk, imagery
2. Stage 2: Rehearsal: practice
3. Stage 3: Application: athlete encounters low
stress and then moves up to moderate then high
and applies what was rehearsed in stage 2
4. Prepare--control--cope--evaluate--overcome
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