Overview
This lecture covers the emotional responses athletes may have to injury, explores theoretical models of these responses, and discusses factors influencing post-injury emotions and behaviors. It also addresses coping strategies, athletic identity, and the importance of recognizing when psychosocial intervention is needed.
Emotional Responses to Injury
- Emotional disturbances post-injury are common but vary widely among athletes.
- Typical emotional responses include fear, anxiety, identity crisis, confusion, isolation, and depression.
- Emotional responses often peak immediately after injury and before return to play.
Theoretical Models of Emotional Response
- Kubler-Ross Grief Model: Stages include denial, anger, bargaining, depression, and acceptance.
- Brown & Studemeyer Model: Shock, preoccupation with injury, and reorganization.
- Hardy & Grace Model: Denial, anger, sadness, acceptance/reorganization.
- Heil’s Affective Cycle: Distress, denial, and determined coping can cycle repeatedly.
- Brewer’s Cognitive Appraisal Model: Emotional response is influenced by personal and situational appraisal of injury.
- Udry Model: Injury-relevant processing, emotional upheaval, and positive coping.
- Integrated Model (Wiese-Bjornstal): Emphasizes dynamic interaction among cognitive, emotional, and behavioral responses.
- Biopsychosocial Model: Injury response is affected by biological, psychological, and social factors.
- Hedgepath & Gieck Model: Emotional reactions depend on injury severity and rehabilitation length.
Influences on Emotional and Behavioral Response
- Personal factors: Physical condition, personality, demographics.
- Situational factors: Context, sport culture, social support, type and timing of injury.
- Athletes may experience social loss and isolation due to injury.
Coping Strategies
- Emotion-focused coping: Managing emotional distress (e.g. relaxation or withdrawal).
- Instrumental (problem-focused) coping: Taking practical actions (e.g. seeking information, goal setting, compliance).
Athletic Identity
- Strong athletic identity means self-worth is closely tied to being an athlete.
- High athletic identity can hinder psychological recovery and adjustment post-injury.
- Maintaining or appropriately adjusting athletic identity during rehab is crucial.
Secondary Gain and Malingering
- Secondary gain: Subconscious benefits (attention/fear) may prolong recovery.
- Malingering: Conscious faking or exaggeration of injury for personal gain.
Special Cases: Concussion and Catastrophic Injuries
- Concussive injuries require academic and cognitive accommodations.
- Post-concussion syndrome can blur physical and psychological symptoms.
- Catastrophic/career-ending injuries may necessitate mental health referral due to loss of identity and isolation.
Facilitating Positive Outcomes and Growth
- Life Development Model: Emphasizes personal growth through change and adversity.
- Post-traumatic growth can occur in social, emotional, cognitive, personal, and spiritual domains.
- Goal setting during rehab can increase control and motivation.
Red Flags & Referral Criteria
- Warning signs include anger, denial, obsession with return, withdrawal, guilt, mood swings, and hopelessness.
- Athletic trainers should have protocols for psychosocial referral.
Key Terms & Definitions
- Emotional disturbance — Disruption in typical emotional state following injury.
- Athletic identity — Degree to which self-concept revolves around being an athlete.
- Secondary gain — Unconscious benefit from remaining injured.
- Malingering — Intentional fabrication or exaggeration of injury.
- Post-traumatic growth — Positive psychological change as a result of struggling with trauma.
Action Items / Next Steps
- Be able to recognize typical vs. atypical emotional responses to injury.
- Implement strategies for emotion-focused and instrumental coping with injured athletes.
- Use surveys (e.g., AIMS) to assess athletic identity in clients.
- Know the red flag signs and have a referral protocol for psychosocial support.