A Psychological Study of Health, Injury, and Performance in Athletes on the US Alpine Ski Team

Association study of SLC6A2 gene Thr99Ile variant (rs1805065) with athletic status in the Brazilian population

Genetic variants in monoamine neurotransmitter genes have been recurrently associated with panic disorder, addiction and mood disorders. Recent evidence also indicates that norepinephrine neurotransmission can influence a series of psychophysical and psychobiological parameters related to athletic performance, and the presence of variants in the SLC6A2 (solute carrier family 6 member 2) gene, which encodes the norepinephrine transporter, can be detrimental to an adequate noradrenergic signaling. Accordingly, the objective of the present study was to explore the SLC6A2 Thr99Ile variant (rs1805065) in a cohort composed of highly-trained individuals and non-trained individuals. A total of 1556 Brazilians: 926 non-athletes and 630 athletes (322 endurance athletes and 308 power athletes) were compared in this case-control association study. The Thr99Ile variant showed only two genotypes (C/C or C/T), and a low minor allele frequency of ≈1%. However, none of the power athletes had the mutant T-allele (i.e., the C/T genotype), which may be related to decreased norepinephrine transporter activity. The genotype distribution and allele frequency observed in power athletes were significantly different when compared to non-athletes or endurance athletes. Therefore, the presence of the T-allele may decrease the chance of belonging to the group of athletes involved in explosive physical tasks. These results still need to be replicated in independent cohorts. However, it appears reasonable to assume that there is an association between the SLC6A2 gene variant and power athletic status.

Stress, Coping, and Injuries in Male and Female High School Basketball Players

Past research has identified a positive relationship between life-event stress and football injuries, but research in other sports has yielded more ambiguous results. It seems, then, that the relation of life stress and injury may be sport-specific and that different sports must be studied separately before such a relationship is assumed. The present investigation examined the relationships among life-event stress, coping skills, social support, and injuries of male and female high school basketball players. Contrary to the hypothesis, the number of days missed due to injury was not significantly related to life-event stress. As expected, the injury measure was negatively correlated with both the coping-skills and social-support variables, but these correlations did not reach statistical significance. Recommendations for research are discussed.

Behavioural Intervention Following a Sporting Injury: A Case Study

Sport psychology interventions generally derive from strategies developed in clinical contexts. This paper describes the use of a graded hierarchy, with fading of response induction aids at each step, in treating avoidance behaviour arising in a sporting context. A twelve-year-old gymnast was treated for a simple phobia following a fall.

Psychiatric conditions in sports: diagnosis, treatment, and quality of life

The social stigma surrounding psychiatric illness may prevent athletes from seeking counseling, psychotherapy, medication, or other treatment when needed. Few controlled studies on athletes exist to guide the team physician, clinician, or psychiatrist who must deal with diagnostic issues. Management involves setting realistic goals, educating as well as inducing the patient into treatment, soliciting support from family or significant others, and delivering appropriate treatment (the most difficult task). The objective is to improve performance and quality of life. Confidentiality issues are paramount during diagnosis and treatment. Physicians who understand sports and team dynamics may have more success in helping patients follow through with treatment.

Diagnosis and psychiatric treatment of athletes

Although enormous amounts of time and money have been invested in enhancing performance for college and professional athletes, their psychiatric needs have been minimally addressed. Given the virtual absence of controlled scientific literature, in this article the authors detail the diagnostic issues and delineate treatment principles, including: (1) making an accurate diagnosis; (2) setting realistic goals; (3) delivering psycho-education; (4) inducing the patient to undergo treatment, including involving the family and significant others; and (5) delivering appropriate treatment (the most difficult task). The objective is to improve performance and quality of life by treating the problem or psychiatric illness. A special concern is minimizing countertransference feelings and avoiding undertreatment, because by definition the athlete needs to perform.

Psychological factors in sport performance: the Mental Health Model revisited

The Mental Health Model (MHM) of sport performance purports that an inverse relationship exists between psychopathology and sport performance. The model postulates that as an athlete's mental health either worsens or improves performance should fall or rise accordingly, and there is now considerable support for this view. Studies have shown that between 70 and 85% of successful and unsuccessful athletes can be identified using general psychological measures of personality structure and mood state, a level superior to chance but insufficient for the purpose of selecting athletes. Longitudinal MHM research indicates that the mood state responses of athletes exhibit a dose-response relationship with their training load, a finding that has shown potential for reducing the incidence of the staleness syndrome in athletes who undergo intensive physical training. The MHM also has implications for the general care of athletes as support services have traditionally been limited to preventing or treating physical problems. Despite its simple premise and empirical support, the MHM has often been mischaracterised in the sport psychology literature and recently some authors have questioned its validity. This overview will summarise MHM research, including the more recent work involving the model's dynamic features in an effort to resolve disputes surrounding the model.

The influence of psychological factors on sports injuries. Review of the literature

The influence of psychological factors on sports injuries has been demonstrated in numerous empirical studies. Almost all investigations have been based on stress theory or a personality-profile approach. Although the majority of studies have employed different methods, the results are in general agreement that "life events" can influence the risk of injury in athletes. In this context, social support appears to have a buffering effect. According to existing results, the influence of stress-coping strategies is somewhat questionable. From the numerous psychological attributes that have been investigated in relation to sports injuries, only competitive anxiety has been shown to be associated with injury occurrence. A personality profile typical of the "injury-prone" athlete does not exist. However, several studies have shown a certain readiness to take risks (lack of caution, adventurous spirit) on the part of injured athletes. In this review, the current knowledge regarding the relationship between psychological factors and sports injuries is presented and a stress theory model is developed.

Athletic injury, psychosocial factors and perceptual changes during stress

In this study, we measured changes in state anxiety, visual perception and reaction time during stress among 196 collegiate athletes participating in 10 sports. The athletes also completed measures of life events and social support at the beginning of their seasons. Measures of life events stress, social support, perceptual changes and changes in reaction time during stress were used as predictors of the number of injuries. For the entire sample, the only significant predictor of injury was negative life events stress (R = 0.45, P < 0.001). Following the suggestions of Smith et al., simple correlations were performed for those with least social support (bottom 33%, n = 65). Among this group, those individuals with more negative life events and greater peripheral narrowing during stress incurred more injuries than those with the opposite profile. Our findings are in line with the model of Andersen and Williams, in that those individuals who were low in a variable that buffers stress responsivity (i.e. social support), their negative life events and peripheral narrowing under stress (large and medium effect sizes, respectively) were substantially related to their number of injuries.

A measure of stress for athletic performance

The Athlete Stress Inventory of 49 items was developed. Using factor analysis on the intercorrelations of responses of 148 women student-athletes, four orthogonal factors of stress in athletes were identified-Negative Mood, Team Compatibility, Physical Well-being, and Academic Efficacy. Scales for these factors were reliable and valid. The predictive validity of these scores was investigated by correlations with the athletic performance of 32 women athletes on three intercollegiate teams-tennis, gymnastics, and basketball. Stress scores (except Emotional Mood) reported four days prior to competition tended to be significantly correlated with performance for the individual sports (tennis and gymnastics) but not for the group sport (basket-ball). The correlation involving Physical Well-being was not significant for gymnasts.

Subject-related risk factors for sports injuries: a 1-yr prospective study in young adults

The purpose of this study was to investigate the importance of subject-related risk factors for sports injuries, taking exposure time into account. At baseline in 182 healthy males and females (27 yr) the following subject-related risk factors were assessed: body mass index (BMI), maximal oxygen uptake (direct treadmill measurement), seven aspects of neuromotor fitness (MOPER fitness test), strength of the hamstring and quadriceps muscles (CYBEX), having sustained a sports injury in the 12 months preceding the baseline measurement ("previous injury"), and 16 psychological and psychosocial factors (measured with 8 standard, valid, and reliable questionnaires). For 1 yr, subjects were asked to make daily entries on a monthly log concerning all sports activities exceeding an intensity of 4 MET and all sustained sport injuries. Completed logs were returned by 139 subjects (75 males and 64 females). Fifty-one injuries were registered in 41 subjects. The overall incidence rate (IR) was 3.7 sports injuries per 1000 h of sports participation (95% confidence interval 2.8-4.9). For various subcategories, the following IR per 1000 h of sports participation were calculated: contact sports IR = 11.0 (95% CI 7.4-16.3); noncontact sports IR = 2.3% (95% CI 1.6-3.3); competition IR = 13.4 (95% CI 8.7-20.6); and training IR = 2.8 (95% CI 1.6-5.1). Data were analyzed by stepwise multiple logistic regression. The following five variables were independent and significant (P < 0.05) predictors of risk in sustaining a sport injury: dominance (odds ratio (OR) = 1.71; 95% CI = 1.44-2.03), vital exhaustion (OR = 1.85; CI = 1.22-2.86), stressful life events (OR = 1.84; 95% CI = 1.10-311); these ORs were calculated for an increase of 10% of the range of obtained scores, starting at minimum value. For total sporting time, the OR was calculated by taking the group with a total sporting time below the median (4050 h) as a reference (OR = 6.87; 95% CI = 2.09-22.55). For previous injury, subjects that had not sustained a sports injury in the 12 months preceding the baseline measurements served as a reference for the calculation of the OR (OR = 9.41; 95% CI = 2.80-31.58). These findings confirm that both exposure time and previous injury are more important predictors of sports injuries than psychological, psychosocial, physiological, and anthropometrical factors.

Effects of life-event stress on anxiety and peripheral narrowing

This study examined one of the mechanisms proposed to be behind the relationship between life stress and injury. Past researchers have identified a correlation between high life stress and athletic injury for contact and noncontact sports and for male and female athletes, but they did not investigate why athletes who experienced stress from life events were more prone to injury than those whose lives were low in stressful events. The authors tested the hypothesis that recreational athletes with high life-event stress would, when placed in a stressful, dual-task laboratory situation, experience greater narrowing of peripheral vision and state anxiety than recreational athletes with low life-event stress. ANOVA and regression results offered support for peripheral vision deficits as a potential mechanism in the life stress-injury relationship and very minimal support the effect of elevated state anxiety. The great variability in peripheral vision changes for the groups with high life stress suggests that, for certain subjects, some unmeasured variable may be buffering the adverse impact of high life-event stress. The authors recommend that future researchers examine potential moderating variables, such as coping resources, and assess the relative contributions of psychosocial variables, stress history variables, and mediating mechanisms in predicting actual injuries.

Personality, stress, and injuries in professional ballet dancers

Twenty-nine soloist and principal dancers (mean age, 29.08 years) from America's two most celebrated ballet companies were administered questionnaires measuring personality (API), occupational stress (OES), strain (PSQ), and coping mechanisms (PRQ), and injury patterns. The results revealed that male dancers demonstrated significantly more negative personality traits and psychological distress than female dancers or men in the general population. In addition, physical stress and personality traits, characteristic of the "overachiever," distinguished injured dancers. It is suggested that classical ballet's emphasis on the ballerina may be at odds with a masculine identity in male dancers. Furthermore, the qualities that lead to success in this profession may contribute to injuries if carried to an extreme.

An examination of the life stress-injury relationship among noncontact sport participants

This study was designed to determine if life stress is predictive of athletic injury among male and female participants in intercollegiate noncontact sports. The Athletic Life Experiences Survey (ALES) was administered to 86 athletes from the sports of baseball, softball, tennis, and track before the start of the season. After the administration of the ALES, injury frequency and severity were recorded for all practices and contests. The results indicated that total life change (TLC) and negative life change (NLC) were significant (p less than .05) predictors of athletic injury frequency. When partitioned by sex and sport, females and track athletes showed significant (p less than .05) predictive relationships, with TLC the significant predictor for females and object loss (OL) for track athletes. No significant predictive models were found for severity of injury. These results suggest that life stress is predictive of the frequency of injury among noncontact sport participants, particularly for track and female athletes.