Emotional Responses of Athletes to Injury

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Increased participation in sports is associated with increased related injuries. This study was conducted to identify the emotional responses of athletes to injury and to determine which responses might interfere with rehabilitation and necessitate psychologic or psychiatric intervention. In 72 patients, follow-up surveillance was continued from the time of injury until resumption of sports activity. Patients completed the Emotional Responses of Athletes to Injury Questionnaire and the Profile of Mood States (POMS) test, and significant differences were found when the POMS scales of depression and anger were compared with college norms. Mean POMS scores were compared (by multivariate analysis of variance) by sex, age, and severity of injury. No gender differences were found, and only for anger were age groups significantly different (younger athletes were most angered). Three severity-of-injury groups (based on the duration of time the athlete was unable to participate in sports) were also compared. The most seriously injured group experienced significantly more tension, depression, and anger and less vigor than college norms, a mood disturbance that lasted 1 month. Emotional disturbance can occur after a sports-related injury, and its prompt recognition may facilitate the athlete's optimal rehabilitation and a safe return to participation in sports.

Section snippets

Definition of Terms.

For the purposes of this study, an injured athlete is one who, as a consequence of participating in exercise, sports, or a game, sustained an injury. A sport-related injury is one that, as a result of sports, exercise, or a game, restricted activity beyond 1 day after the injury (nomenclature as defined by the American Medical Association) and that motivated the patient to seek treatment in the Section of Sports Medicine at the Mayo Clinic.

Preliminary Studies.

Before this study, 57 injured athletes of various ages,

Characteristics of Study Subjects.

The age distribution of the 72 patients (12 to 54 years) was unimodal and negatively skewed, inasmuch as 33 of them were 16 years old. The majority of the patients (82%) received treatment within 8 days after sustaining an injury, although four patients were examined a few days beyond 2 weeks. More (10) patients were seen on the first day after injury than on any other day. For 69% of patients, it was the first experience with this particular injury, whereas 31% had experienced a similar injury

DISCUSSION

The 72 injured athletes in this study initially rated frustration, depression, and anger highest on the Likert scale of the ERAIQ (Table 1). Of the six POMS scales, depression and anger had the highest scores. Similar mood disturbances were recorded regardless of the method used (volunteering, choosing, rating, or POMS) to assess the emotional response (Table 3). Although the mood scales of depression and anger were significantly elevated in the overall group in comparison with college norms,

ACKNOWLEDGMENT

We thank Christine M. Wiltgen (Section of Biostatistics), Joanne Mair (Cardiovascular Research), and Dr. Donald MacEachern (University of Minnesota).

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