1. WEEK 4: 1/26/15 – 1/30/15 PSYCHOLOGY 310: SPORT & INJURY PSYCHOLOGY UNIVERSITY OF MARY INSTRUCTOR: DR. THERESA MAGELKY Psychological Responses to Injury/ Theoretical Models

2. Introduction Psychological responses to injury can impact an athlete’s rehabilitation behavior, the outcomes of rehabilitation, and return to training & competition Thus, understanding the process in which athletes respond psychologically to injuries is crucial Theoretical models have been developed to describe and explain psychological responses to sport injury Theoretical models provide framework to guide professionals in working with injured athletes

3. Primary Theoretical Models in Sport Psychology Grief-Response Models Cognitive Appraisal Models Integrated Model Biopsychosocial Model

4. Grief-Response Models Grief-response models assume that injury represents a form of loss to the athlete and the onset of a grieving process Athlete will respond to injury similarly to response to other significant losses, such as the death of loved one, progressing through series of sequential stages Kubler-Ross stages of grief (1969) – most commonly applied model to sport injury psychology:  1. Denial  2. Bargaining  3. Anger  4. Depression  5. Acceptance Recent research has moved away from grief-response models

5. Cognitive Appraisal Models Cognitive appraisal models are more widely accepted than grief-response models in explaining psychological reactions to injury Cognitive appraisal models are rooted in theories of stress and coping According to cognitive appraisal models, emotional & behavioral responses to injury are determined by an athlete’s cognitive appraisal or subjective interpretation of the injury  Importance is placed on how the injury is perceived (cognitively appraised) rather than on the injury itself

6. Cognitive Appraisal Models (cont.) Appraisal is process through which a potentially stressful situation (e.g., sport injury) is assessed and evaluated by the athlete According to Lazarus (1991), these appraisals occur in two forms:  Primary – involve assessment of what is at stake as a result of the injury including challenge, benefit, threat, harm/loss  Secondary – involve assessment of the coping options available to manage the demand of the injury Two athletes could respond very differently to a similar injury, according to cognitive appraisal model

7. Cognitive Appraisal Models (cont.) Cognitive appraisal models consist of four key components (Kolt, 2003): 1. Stressful situation (the injury) 2. Cognitive appraisal 3. Emotional responses 4. Consequences According to Brewer (1994), personal factors may mediate how an athlete appraised their injury  Injury-related characteristics, variable aspects of the social and physical environment Appraisals then affect emotional responses(e.g., anger, depression) and these further influence behavioral responses (e.g., adherence to treatment & rehabilitation)

8. Integrated Model The integrated model is a broader integrated stress- process model  After an athletic injury, cognitive appraisal occurs first which leads to emotions commonly associated with grief (e.g., depression, anger This model also incorporates pre-injury factors adapted from model of stress & athletic injury Includes relationship between cognitive appraisal, behavioral response, and emotional response, referred to as the dynamic core

9. Biopsychosocial Model Developed by Brewer et al. (2002) Biopsychosocial model of sport injury rehabilitation suggests that health, illness, and injury involve the interaction between biological, psychological, and social factors Involves numerous variables associated with the sport injury rehabilitation process  Characteristics of injury and sociodemographic factors influence the biological, psychological, and social/contextual factors  These factors then influence the intermediate biopsychological outcomes such as pain, rate of recovery, and range of motion  This is bidirectional, indicating that biopsychological outcomes can influence psychological factors  Intermediate biopsychological outcomes affect sport injury rehabilitation, in addition to psychological factors  AND the rehabilitation that occurs can affect psychological factors and biopsychological factors

10. References Arvinen-Barrow, M., & Walker, N. (2013). The Psychology of Sport Injury and Rehabilitation (1 st ed.). Routledege. Kremer, J., Moran, A., Walker, G., & Craig. C. (2012). Key Concepts in Sport Psychology. Sage Publishing.