2. 1 The Psychology of Injury

3. 2 Psychological Variables in Injuries –Stress Higher rate of fatigue Higher rate of fatigue Reduced peripheral vision Reduced peripheral vision Increased rate of injury Increased rate of injury –Personality Variables Trait Anxiety Trait Anxiety –General disposition or tendency to perceive certain situations as threatening and to react with anxiety response Locus of Control Locus of Control –An individual’s belief that they are in control of events that occur in their lives: INCONCLUSIVE RESULTS Self Concept Self Concept –Low self concept = higher incidence of REPORTED injury

4. 3 Seasonal Affective Disorder (SAD) Psychiatric disorder -- occurs mostly in the fall and winter seasons Psychiatric disorder -- occurs mostly in the fall and winter seasons Symptoms: loss of physical capacity, increased appetite, decreased libido, hypersomnia, impaired social activity Symptoms: loss of physical capacity, increased appetite, decreased libido, hypersomnia, impaired social activity Research on ice hockey -- 22/68 symptomatic Research on ice hockey -- 22/68 symptomatic Accurate tests available Accurate tests available “Light therapy” has shown promising results. “Light therapy” has shown promising results.

5. 4 Competitive Stress and the Adolescent More children, more concerns regarding impact More children, more concerns regarding impact –level of competition has increased –pressure to win comes from peers, parents, coaches, media and sponsors, etc. –competitive stress –parents & coaches need to be cautious

6. 5 Psychology of the Injured Athlete Injury causes immediate psychological stress Injury causes immediate psychological stress –The Stress Process #1: Injury Occurs –Possible restriction of normal activity #2: Appraisal of Injury –“How bad is it” –Begin to think short and long term #3: Emotional Response –Possible anxiety, depression, and anger #4: Consequences –Wide variety of problems including sleep disorders, loss of appetite, and decreased motivation

7. 6 Psychology of the Injured Athlete Recommendations Recommendations –treat the whole person –treat as an individual –communication skills –physical & psychological relationship –seek the help of a sports psychologist –reaction may be similar to grief response

8. 7 EATING DISORDERS OF THE ATHLETE –. What are eating disorders? Definition: Eating disorders are illnesses associated with disturbances in eating behavior, severe body image distortion and the obsession with weight. Definition: Eating disorders are illnesses associated with disturbances in eating behavior, severe body image distortion and the obsession with weight. Types: Anorexia nervosa, Bulimia nervosa, and Binge eating Types: Anorexia nervosa, Bulimia nervosa, and Binge eating All defined by APA DSM IV All defined by APA DSM IV

9. 8. Who is likely affected by eating disorders?. Who is likely affected by eating disorders? – Sports associated with eating disorders 1. Eating disorders and disordered eating are significant problems for many athletes 1. Eating disorders and disordered eating are significant problems for many athletes 2. Female athletes are especially at risk in sports which emphasize a thin body or appearance, such as gymnastics, ballet, figure skating, swimming, and distance running 2. Female athletes are especially at risk in sports which emphasize a thin body or appearance, such as gymnastics, ballet, figure skating, swimming, and distance running 3. Male athletes are especially at risk in body building and wrestling 3. Male athletes are especially at risk in body building and wrestling 4. A greater risk is associated with sports in which anaerobic activities predominate over aerobic activities 4. A greater risk is associated with sports in which anaerobic activities predominate over aerobic activities

10. 9 – Gender and eating disorders among athletes – 1. 90-95% of eating disorders occur among women – 2. There is evidence, however, that male athletes are at least equally at risk as female athletes for certain types of eating pathology – 3. A study of NCAA athletes found that binge eating occurred more often in male athletes than in female athletes – 4. More than three times as many male athletes as female athletes used saunas or steam baths to lose weight – 5. The same percentage of males and females used steroids to improve athletic performance – 6. Female athletes were four times more likely than males to use vomiting to lose weight

11. 10 Factors Contributing to the development of disordered eating Factors Contributing to the development of disordered eating – 1. Sociocultural Factors: Social norms in Western culture emphasizing thinness as preferred. – 2. Biologic Factors: Gender is the strongest biologic determinant with a 10 to 1 ratio of eating disorders in women compared with men.

12. 11 3. Psychological Factors: 3. Psychological Factors: – A. Family of origin: Women whose families have difficulty resolving conflict and expressing and tolerating negative emotions. Women whose families have difficulty resolving conflict and expressing and tolerating negative emotions. – B. Victimization: The development of disordered eating has been seen as a response to victimization by sexual or physical abuse. The development of disordered eating has been seen as a response to victimization by sexual or physical abuse. – C. Poor Coping Skills: Disordered eating is often an unhealthy attempt at coping with stress. Disordered eating is often an unhealthy attempt at coping with stress. – D. Low Self -Esteem: The female athlete who derives her sense of self from external feedback is at risk of a fluctuating sense of self- esteem. The female athlete who derives her sense of self from external feedback is at risk of a fluctuating sense of self- esteem. – E. Lack of Identity: The female athlete may experience a lack of sense of identity, outside of being an athlete, and may fail to develop other areas of her life. The female athlete may experience a lack of sense of identity, outside of being an athlete, and may fail to develop other areas of her life.

13. 12 Physiological changes seen in Restricted Caloric Intake. Physiological changes seen in Restricted Caloric Intake. Chronic fatigue Chronic fatigue Increases susceptibility to infection Increases susceptibility to infection Poor or delayed healing and recovery from injury Poor or delayed healing and recovery from injury Anemia Anemia Electrolyte imbalances Electrolyte imbalances Cardiovascular changes Cardiovascular changes Endocrine abnormalities Endocrine abnormalities Osteoporosis Osteoporosis

14. 13 The Female Athlete Triad The Female Athlete Triad 1. The triad of amenorrhea, disordered eating, and osteoporosis (brittle bones) is particularly likely to occur in female athletes. 1. The triad of amenorrhea, disordered eating, and osteoporosis (brittle bones) is particularly likely to occur in female athletes. 2. Amenorrhea or irregular menses in female athletes should be taken seriously because even brief episodes are associated with osteoporosis and infertility problems. 2. Amenorrhea or irregular menses in female athletes should be taken seriously because even brief episodes are associated with osteoporosis and infertility problems. 3. Multiple factors cause the amenorrhea seen in female athletes, including exercise, low weight, low fat content, stress, hormonal changes, and nutritional composition. 3. Multiple factors cause the amenorrhea seen in female athletes, including exercise, low weight, low fat content, stress, hormonal changes, and nutritional composition.

15. 14 Treatment of eating disorders Treatment of eating disorders – Treatments for eating disorders fall into several general types -- psychotherapy psychotherapy – Psychotherapy, or talking therapy, comes in many forms and can take place in individual, group, or family sessions. In general, therapy helps patients learn to recognize feelings that trigger the eating disorder and to learn new ways to deal with these feelings. – Medication is sometimes used to treat eating disorders. Specifically, antidepressants have been found to be helpful, particularly in the treatment of bulimia and binge eating disorder.

16. 15 medical treatment medical treatment – Other medical treatment may also be necessary to treat the physical health problems during or following disordered eating – such specialist include heart, bone, or digestive specialists, dentists, or other types of doctors to help restore physical health. nutritional counseling nutritional counseling – Nutritional counseling, usually by a nutritionist, is often useful to help establish a safe diet plan and restore proper eating and nutritional habits. self-help groups. self-help groups. – In addition, self-help groups can provide a supportive environment for individuals with eating disorders, their friends, and families.

17. 16 Prevention Prevention –Sample Test for Eating Disorder Screening: 1.Are you terrified about being overweight? 1.Are you terrified about being overweight? 2.Have you gone on eating binges where you feel you may not be able to stop? 2.Have you gone on eating binges where you feel you may not be able to stop? 3. Do you feel extremely guilty after eating? 3. Do you feel extremely guilty after eating? 4.Do you vomit or have the impulse to vomit after meals? 4.Do you vomit or have the impulse to vomit after meals? 5.Do you feel that food controls your life? 5.Do you feel that food controls your life?