Heather N. Schuyler, Brieanne R. Seguin, Nicole Anne Wilkins, and J. Jordan Hamson-Utley
The practice of athletic training involves both physical and psychological strategies when leading patients through the injury recovery process. Research on the psychology of injury offers theoretical foundations that guide the application of strategies to assist the patient with stressors that emerge during rehabilitation. This article applies theory to athletic training practice during injury recovery by examining the stressors that patients experience across the phases of rehabilitation. Addressing both physical and psychological aspects of injury recovery is expected by patients and provides a holistic care model for healthcare practitioners.
Zella Moore, Jamie Leboff, and Kehana Bonagura
Major depressive disorder, dysthymia, and bipolar disorder are very common diagnoses seen among athletes, and they are serious conditions that can be debilitating if not properly addressed. These disorders warrant careful attention because they can adversely affect multiple domains of an athlete’s life, including athletic motivation, performance outcomes, interpersonal well-being, health, and overall daily functioning. Key foci include the prevalence of, clinical characteristics of, causes of, and risk factors for major depressive disorder, persistent depressive disorder/dysthymia, bipolar I disorder, and bipolar II disorder. Sport psychologists should integrate such important information into their overall case conceptualization and decision-making processes to ensure that athletes and performers at risk for, or struggling with, such mental health concerns receive the most effective, efficient, and timely care possible.
Aidan Moran, Nick Sevdalis, and Lauren Wallace
At first glance, there are certain similarities between performance in surgery and that in competitive sports. Clearly, both require exceptional gross and fine motor ability and effective concentration skills, and both are routinely performed in dynamic environments, often under time constraints. On closer inspection, however, crucial differences emerge between these skilled domains. For example, surgery does not involve directly antagonistic opponents competing for victory. Nevertheless, analogies between surgery and sport have contributed to an upsurge of research interest in the psychological processes that underlie expertise in surgical performance. Of these processes, perhaps the most frequently investigated in recent years is that of motor imagery (MI) or the cognitive simulation skill that enables us to rehearse actions in our imagination without engaging in the physical movements involved. Research on motor imagery training (MIT; also called motor imagery practice, MIP) has important theoretical and practical implications. Specifically, at a theoretical level, hundreds of experimental studies in psychology have demonstrated the efficacy of MIT/MIP in improving skill learning and skilled performance in a variety of fields such as sport and music. The most widely accepted explanation of these effects comes from “simulation theory,” which postulates that executed and imagined actions share some common neural circuits and cognitive mechanisms. Put simply, imagining a skill activates some of the brain areas and neural circuits that are involved in its actual execution. Accordingly, systematic engagement in MI appears to “prime” the brain for optimal skilled performance. At the practical level, as surgical instruction has moved largely from an apprenticeship model (the so-called see one, do one, teach one approach) to one based on simulation technology and practice (e.g., the use of virtual reality equipment), there has been a corresponding growth of interest in the potential of cognitive training techniques (e.g., MIT/MIP) to improve and augment surgical skills and performance. Although these cognitive training techniques suffer both from certain conceptual confusion (e.g., with regard to the clarity of key terms) and inadequate empirical validation, they offer considerable promise in the quest for a cost-effective supplementary training tool in surgical education. Against this background, it is important for researchers and practitioners alike to explore the cognitive psychological factors (such as motor imagery) that underlie surgical skill learning and performance.
Steven J. Petruzzello
A historically popular research topic in exercise psychology has been the examination of the exercise-anxiety relationship, with an ever-growing literature exploring the link between exercise and anxiety. In addition to its potential for preventing anxiety and anxiety disorders, an increasing number of studies have examined the utility of physical activity and exercise interventions for the treatment of elevated anxiety and clinical anxiety disorders. A National Institute of Mental Health “state-of-the-art workshop” in 1984 was the first significant call put forth that understanding the anxiety-reducing potential of exercise was important and required further investigation. Since the publication of the evidence that came out of that NIMH workshop in Morgan and Goldston’s 1987 book, “Exercise and Mental Health,” a great deal more has been learned yet key aspects of the relationship between exercise and anxiety remain unknown. There is a great deal of work that remains to make good on the “potential efficacy of exercise.”
Gershon Tenenbaum and Edson Filho
Trustworthy measurement is essential to make inferences about people and events, as well as to make scientific inquiries and comprehend human behaviors. Measurement is used for validating and building theories, substantiating research endeavors, contributing to science, and supporting a variety of applications. Sport and exercise psychology is a theoretical and practical domain derived from two domains: psychology and kinesiology. As such, the measurement methods used by scientists and practitioners relate to the acquisition of motor skills (i.e., genetics and environment-deliberate practice), physiological measures (e.g., heart rate pulse, heart rate variability, breathing amplitude and frequency, galvanic skin response, and electrocardiogram), and psychological measures including introspective instruments in the form of questionnaires, interviews, and observations.
Sport and exercise psychology entails the measurement of motor performance (e.g., time-trials, one repetition maximum tests), cognitive development (e.g., knowledge base and structure, deliberate practice, perception-cognition, attention, memory), social aspects (e.g., team dynamics, cohesion, leadership, shared mental models, coach-performer interaction), the self (e.g., self-esteem, self-concept, physical self), affective and emotional states (e.g., mood, burnout), and psychological skills (e.g. imagery, goal-setting, relaxation, emotion regulation, stress management, self-talk, relaxation, and pre-performance routine). Sport and exercise psychologists are also interested in measuring the affective domain (e.g., quality of life, affect/emotions, perceived effort), psychopathological states (e.g., anxiety, depression), cognitive domain (e.g., executive functioning, information processing, decision making, attention, academic achievements, cognition and aging), social-cognitive concepts (e.g., self-efficacy, self-control, motivation), and biochemical markers of human functioning (e.g., genetic factors, hormonal changes). The emergence of neuroscientific methods have ushered in new methodological tools (e.g., electroencephalogram; fMRI) to assess central markers (brain systems) linked to performance, learning, and well-being in sport and exercise settings. Altogether, the measures in the sport and exercise domain are used to establish linkages among the emotional, cognitive, and motor systems.
This article aims to provide a narrative overview on injury prevention in sport and performance psychology. Research and applied interest in psychological injury prevention in sport and performance psychology has risen in popularity over the past few decades. To date, existing theoretical models, pure and applied research, and practice-based evidence has focused on conceptualizing and examining psychological injury occurrence and prevention through stress-injury mechanisms, and predominantly in sport injury settings. However, given the inherited similarities across the different performance domains however, it is the authors’ belief that existing injury prevention knowledge can be transferable beyond sport but should be done with caution. A range of cognitive-affective-behavioral strategies such as goal setting, imagery, relaxation strategies, self-talk, and social support have been found beneficial in reducing injuries, particularly when used systematically (a) prior to injury occurrence as part of performance enhancement program and/or as a specific injury prevention measure, (b) during injury rehabilitation, and (c) as part of a return-to-activity process to minimize the risk of secondary injuries and reinjuries. Existing theoretical and empirical evidence also indicates that using cognitive-affective-behavioral strategies for injury prevention are effective when used as part of a wider, multi-modal intervention. Equally, such interventions may also need to address possible behavioral modifications required in sleep, rest, and recovery. Considering the existing empirical and anecdotal evidence to date, this paper argues that injury prevention efforts in sport and performance psychology should be cyclical, biopsychosocial, and person-centered in nature. In short, injury prevention should be underpinned by recognition of the interplay between personal (both physical and psychological), environmental, and contextual characteristics, and how they affect the persons’ cognitive-affective-behavioral processes before, during, and after injury occurrence, at different phases of rehabilitation, and during the return to activity or retirement from activity process. Moreover, these holistic injury prevention efforts should be underpinned by a philosophy that injury prevention is inherently intertwined with performance enhancement, with the focus being on the individual and their overall well-being.
Martin Turner and Marc Jones
Sport and stress are intertwined. Muhammad Ali once said, “I always felt pressure before a big fight, because what was happening was real.” As this quote attests, sport is real, unscripted, with the potential for psychological, and often physical, harm. The response to stress, commonly described as “flight or fight,” is an evolutionary adaptation to dangerous situations. It guides behavior and readies a person to respond, to fight, or flee. However, the stress response is not evoked solely in situations of mortal danger; it occurs in response to any situation with the potential for physical or psychological harm, such as sport. For example, the possibility of missing out on a life-changing gold-medal win in an Olympic Games, or losing an important competition that you were expected to win.
Stress in sport is often illustrated by the archetypal image of an athlete choking; snatching defeat from the jaws of victory. But stress can also help athletes perform well. Stress also plays a role in behavior away from the competition arena, influencing interactions with significant others, motivation and performance in training, and how athletes experience and manage injury and retirement from sport. In sport stress, the psychophysiological responses to stress are not just abstract theoretical concepts removed from the real world; they reflect the thoughts, feelings, and experiences of athletes.
It is important to understand the arousal response to stress in sport. Both theory and research suggest a connection between arousal and athletic performance. Recent approaches propose ideas about how the nature of arousal may differ depending on whether the athlete feels positively (as a challenge) or negatively (as a threat) about the stressor. The approach to seeing stress as a challenge supports a series of strategies that can be used to help control arousal in sport.
Joan N. Vickers and A. Mark Williams
Considerable debate has arisen about whether brain activity in elite athletes is characterized by an overall quieting, or neural efficiency in brain processes, or whether elite performance is characterized by activation of two simultaneous networks. One network exercises cognitive control using increased theta activation of premotor and cingulate gyrus, whereas the second reduces alpha activation in an inhibitory network that prevents the intrusion of debilitating thoughts emanating from the temporal lobe and other areas. Also, there is controversy about how a long-duration “quiet eye” (QE) can fit within a single efficient neural system, or whether a dual system where both increased cognitive control and reduced inhibitory processes has advantages. The literature on neural efficiency, the QE, and theta cognitive control, suggest that a long-duration QE promotes both an increase in theta band activation of the medial prefrontal cortex and anterior cingulate and reduced activation and inhibition of the temporal regions during high-pressure situations when a high level of focused, cognitive control is essential.
Katherine A. Tamminen and Courtney Braun
Adolescent athletes face increasing opportunities for competition at higher levels, as well as increasing demands on their time, pressure from parents and coaches, and conflicts with teammates and opponents, all during a time when adolescents are exploring different aspects of their identity and sense of self. Sport is a context for adolescent development, and despite the wide array of positive benefits that have been associated with sport participation during adolescence and into adulthood, it is also acknowledged that sport participation does not automatically confer benefits to adolescent athletes, and it may lead to potentially negative experiences and poor psychosocial outcomes.
Key concerns for researchers and practitioners working with adolescent athletes include managing various stressors and the development of adaptive coping strategies, the risk of experiencing sport burnout, bullying, and the potential for withdrawing or dropping out of sport. Despite these concerns, a large body of research among adolescent athletes provides evidence that athletes’ performance and positive psychosocial development may be enhanced among adolescent athletes by intentionally structuring the sport environment to promote positive outcomes; in particular, coaches, parents, and peers play an important role in shaping the sport experiences of adolescent athletes. Furthermore, the psychosocial characteristics and competencies associated with sport participation may not automatically transfer to other areas of adolescents’ lives unless they are intentionally and systematically structured to do so. It is important for coaches, parents, and sport administrators who are involved in developing and delivering programs for adolescent athletes to be aware of some of the psychosocial concerns that are relevant for this population, and to consider intentionally structuring sport programs to promote high levels of achievement as well as healthy psychological and social development among young athletes.
Barbi Law, Phillip Post, and Penny McCullagh
Modeling and imagery are distinct but related psychological skills. However, despite sharing similar cognitive processes, they have traditionally been investigated separately. While modeling has shown similar psychological and physical performance benefits as imagery, it remains an understudied technique within applied sport psychology. Social cognitive and direct perception approaches remain often-used explanations for the effectiveness of modeling on skill acquisition; however, emergent neuropsychological explanations provide evidence to support these earlier theories and a link to the imagery literature.
With advances in technology and the development of applied frameworks, there is renewed interest in exploring modeling effects and how they parallel imagery use in applied settings. Specifically, modeling research has expanded beyond controlled laboratory settings to explore the effect of various theoretical models on motor performance and related cognitions within practice and competitive settings. The emergence of affordable video editing technology makes it easy for coaches and athletes to incorporate modeling into practice. The accessibility of video technology has sparked applied research on how various forms of modeling influence motor performance and cognitions, such as confidence and motivation. These applied investigations demonstrate the complementary nature of modeling and imagery in enhancing sport performance and skill acquisition, while highlighting the challenges in separating modeling and imagery effects. Both literatures offer possibilities for new methodological approaches and directions for studying these psychological skills in tandem as well as independently. Thus, there is much that imagery and modeling researchers can learn from each other in sport and other performance settings.