Exploring the psychological aspects of sport injury
Exploring the psychological aspects of sport injury

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Exploring the psychological aspects of sport injury

2 Predicting how individuals will respond to sport injury

For those supporting Lois and Travis through their injuries – such as the coach Wilma, personal trainer Melissa and physiotherapists – it would be useful to have an understanding of how an individual might respond to injury and why. This may help them to plan and support Lois and Travis better.

A man looks upwards to a blackboard on which is drawn a large think bubble.
Figure 2 Responses to sport injury

This is where models of psychological response to injury are beneficial. They provide a framework to aid our understanding of how individuals respond to injury and the impact this might have. There are two groups of model that you will explore in this course:

  • grief response models, and
  • cognitive appraisal models.

You will look at one example of a grief response model (Kübler-Ross, 1969) and two examples of cognitive appraisal models (Brewer, 1994; Wiese-Bjornstal et al., 1998).

Activity 3 Models of psychological response to sport injury

Timing: Allow about 25 minutes

Watch the video below which introduces three models of psychological response to sport injury and then answer the following questions.

Note: The models shown in the video have been produced as images below – they will be useful for you to look at while you watch the video and you will also refer to these in the next activity:

Download this video clip.Video player: Video 3
Skip transcript: Video 3

Transcript: Video 3

CAROLINE HEANEY
In this video, we're going to explore some of the models that have been used to explain psychological responses to sport injury. The first group of models we're going to look at are grief response models, which are sometimes called stage models. Grief response models assume that an athlete will react to an injury in a similar way to which an individual might respond to a significant loss, such as the death of a loved one. This suggests the injury constitutes a form of loss to the individual.
Kubler-Ross's 1969 grief response model, which was originally developed to explain responses to terminal illness, has commonly been used in early psychology of sport injury research. The model is comprised of five stages, denial, anger, bargaining, depression and acceptance. It is suggested that following injury all athletes regress through each of the five stages in order.
Whilst these models are intuitively appealing, they do have limitations. The main limitation is their rigidity. They assume that every athlete is the same and that consequently all athletes respond to injury in the same stereotypical way. In practise, that is simply not the case. Different people respond to injury in different ways. For example, one person may be totally devastated by an injury whilst another person with the same injury who has been underperforming recently may see the injury as an escape from or an excuse for that poor performance. Such an athlete is unlikely to demonstrate, for example, a period of depression. Because they may actually be quite happy about being injured.
Due to these limitations, cognitive appraisal models have come to be more widely accepted as models of psychological response to sport injury. In contrast to grief response models, cognitive appraisal models take individual differences into account. In other words, they do not assume that all athletes respond in the same way to injury. Instead, they suggest how an individual appraises the injury will dictate their psychological responses. It is therefore the perception of an injury that affects psychological responses rather than the injury itself.
Brewer's 1994 cognitive appraisal model shown on screen now suggests how an individual appraises their injury, their cognitive appraisal, is influenced by two variables, personal factors and situational factors. Personal factors include things such as personality, age, and previous experiences of injury. Situational factors include things like the stage of the competitive year and social influences, such as the coach or teammates' reaction to an injury.
The model suggests how an individual appraises their injury, their cognitive appraisal, dictates their psychological or emotional response to the injury. The model further proposes that these emotional responses will affect the individual's behaviour in relation to the injury, for example whether or not they will adhere to their injury rehabilitation programme.
Brewer's model is a fairly simplistic cognitive appraisal model. In contrast, the integrated model of psychological response to sports injury is a more comprehensive model that has been widely adopted in sport injury psychology research. The model was developed specifically for sport injury. And unlike the other models it incorporates psychological factors that can increase the risk of injury as well as psychological responses to injury.
Like Brewer's model, the integrated model suggests that cognitive appraisal is dictated by personal and situational factors and provides a wealth of examples of these. This cognitive appraisal then impacts on the athlete's emotional and behavioural responses and recovery outcomes.
So how are these models relevant to people involved in supporting injured sport and exercise participants? They are useful in helping us to understand how and why individuals might respond in a particular way following injury, which might help us to identify appropriate interventions to prevent or minimise psychological difficulties. Additionally, we can look at the models and identify factors within our control that can have a positive influence on the injured person's recovery such as social support.
I hope you have found this video useful. Thanks for watching.
End transcript: Video 3
Video 3
Interactive feature not available in single page view (see it in standard view).

Now answer the following questions:

  1. What are grief response models?
  2. What are cognitive appraisal models and how do they differ from grief response models?
  3. What are the differences and similarities between the two cognitive appraisal models examined in the video?
Kübler-Ross’s (1969) Grief response model
Figure 3 Kübler-Ross’s (1969) Grief response model
Brewer’s (1994) Cognitive appraisal model
Figure 4 Brewer’s (1994) Cognitive appraisal model
Wiese-Bjornstal et al.’s (1998) Integrated model of psychological response to sport injury
Figure 5 Wiese-Bjornstal et al.’s (1998) Integrated model of psychological response to sport injury
Interactive feature not available in single page view (see it in standard view).

Discussion

  1. Grief response models assume that injury constitutes a form of loss to the individual and thus the onset of a grieving process. They suggest that an individual will respond to injury in the same way in which people respond to other significant losses, such as the death of a loved one (Brewer, 1994; Evans and Hardy, 1995). This involves progressing through a series of sequential stages. The number of stages varies from model to model, but in Kübler-Ross’s (1969) Grief response model – which has been most commonly applied in the sport injury psychology literature (Walker et al., 2007) – there are five stages.
  2. In contrast to grief response models, cognitive appraisal models take individual differences into account. They do not assume that everyone will react in the same way to injury. Instead they suggest that how an individual interprets or appraises the injury (cognitive appraisal) will determine their psychological reactions. This allows two people to exhibit entirely different psychological responses to the same injury. Therefore, it is the perception of an injury that affects psychological responses, rather than the injury itself.
  3. Both cognitive appraisal models suggest that how an individual interprets or appraises their injury is influenced by two key variables – personal and situational variables – and that cognitive appraisal influences emotional and behavioural responses to injury. The main difference between the models is that the Integrated model of psychological response to sport injury (Wiese-Bjornstal et al., 1998) is a more comprehensive model – this model also incorporates psychological factors that increase the risk of injury. The Integrated model has been widely applied within the sport injury psychology literature (Brewer and Redmond, 2017).

Next you’ll apply these models to the case studies.

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