Transcript Slide 1

Jingzhen Yang, PhD, MPH
Department of Community and Behavioral Health
College of Public Health
[email protected]
Sports Injury Research
Sports are an important and pervasive thread in the fabric of our
society
Motivations of this Study
Psychological aspect of sports injury is not
a new topic
Depression
Injury
Depression
Psychological factor as a consequence of
athletic injury
 Depression and anger were significantly increased, while
vigor was significantly reduced post-injury.
Smith AM, Scott SG, O'Fallon WM, and Young ML. Emotional responses of athletes to injury. Mayo Clin
Proc. 1990;65(1):38-50.
 Greater depression and lower self-esteem among injured
than in non-injured and recovered groups, immediately
following the injury and at the two-month follow-up.
Leddy M, Lambert M, and Ogles B. Psychological consequences of athletic injury among high-level
competitors. Res Q Exerc Sport. 1994;4:347-354.
 Athletes with severe injuries had higher depression scores
than those with minor injuries.
Smith AM, et al. Competitive athletes: preinjury and postinjury mood state and self-esteem. Mayo Clin
Proc. 1993;68(10):939-47.
Psychological factor as a risk factor of
athletic injury
 A personality profile typical of the “injury-prone” athlete
does not exist.
Lysens RJ, et al: The accident-prone and overuse-prone profiles of the young athlete. Am J Sports Med.
1989;17:612–619.
 Negative life events can cause stress and mood disturbance
among athletes .
Andersen MB, and Williams JM: A model of stress and athletic injury: Prediction and prevention. J Sport
Exerc Psychol. 1988;10:294–306.
 Athletes who experienced a negative family event or
personal loss were more likely to sustain an athletic injury.
Hardy CJ, and Riehl RE. An examination of the life stress-injury relationship among noncontact sport
participants. Behav Med. 198814: 113–118.
Limitations of previous studies
 Lack of comprehensive epidemiological data on postinjury depression among collegiate student-athletes.
 Little efforts have been devoted to research on how
post-injury depression affects injury recovery, both
psychologically and physically.
 A large number of studies are limited by retrospective
study design or relatively small sample size.
Psychological aspect of sports injury has a
new context
 Sport — more competitive, requires more physical ability
 Athlete — more individuals involved, start at younger ages
 Sports Medicine — more advanced medical interventions,
reduced time lost
 Media — more public attention and expectations
 Wages — earn more as a professional player
Pilot Study: 2005-06, Funded by IPRC
13 Participating Athletic Teams
 6 men’s sports (football, wrestling, baseball, men’s
gymnastics, men’s golf, and men’s tennis)
 6 women’s sports (women’s basketball, women’s
track & field, women’s cross country, women’s golf,
women’s rowing, and women’s field hockey)
 1 coed sport (spirit squad)
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Study Participants
-257 student-athletes
-75% participation rate at
student athlete level
-in the 2005-2006 academic
year, University of Iowa
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Research Aims
 Main Research Question:
Will social support help injured collegiate athletes
experience fewer symptoms of depression and
anxiety, and recover from an injury more quickly?
 The Central Hypothesis:
Collegiate athletes with a high level of social support
will experience less symptoms of depression and
anxiety, and will return to play sooner.
Conceptual Model
Personal
factors
(e.g.,
gender,
age, skill
level,
sports,
history
of
injury)
Perceived
Social
Support
Athletic
Injury
Depression
and
Anxiety
Symptoms
of
Depression
and Anxiety
Recovery
Outcomes
(return
to play)
Study Protocol
1. Recruiting and obtaining consent from a cohort
of athletes
2. A baseline survey among all athletes
3. Injury identified through weekly report from the
exiting Sports Injury Monitoring System (SIMS)
4. Once an athlete becomes injured, follow-ups will
start for injured athletes
5. Followed ups at intervals: 1 week, 1 month, 3
months, 6 months, and 1 week within return to
play
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Information Collected at Baseline
 Demographic characteristics
 Playing experience with collegiate sports
 History of injury
 Symptoms of depression and State- and TraitAnxiety
 Perceived social support from the coaches, athletic
trainers, friends, and family
 Self-reported pain
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Information Collected at Follow-ups
 Self-reported pain due to injury
 Symptoms of depression and state-anxiety due
to injury
 Perceived social support from the coaches,
athletic trainers, friends, and family during the
injury recovery
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The Measures Used
 Symptoms of Depression: the Center for
Epidemiological Studies Depression Scale (CESD), 20
items.
 Anxiety: the State-Trait Anxiety Inventory (STAI),
including separate measures of State-anxiety (20 items)
and Trait-anxiety (20 items).
 Perceived social support: the modified 6-item Social
Support Questionnaire, a shorter version of the 27-item
Social Support Questionnaire.
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Significance
 Integrate approaches that improve psychological
recovery with those that improve physical
recovery
 Findings feed into the development and
evaluation of effective social support
interventions
 Findings could be applicable to other athletes
(e.g. children) or other types of injuries
Main findings (n=257 athletes)
 21% of enrolled athletes experienced symptoms of
depression
 Over half of enrolled athletes (54%) sustained at least
one injury during one year follow-up
 Female athletes reported different social support
patterns compared to male athletes
Proportion of Student-athletes with Symptoms of
Depression, by Their Characteristics
(Number in Percentage)
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Proportion of Student-athletes with Symptoms of
Depression, by Their Characteristics
(Number in Percentage)
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Main Findings (n=257 athletes)
 Female athletes had 1.32 greater odds (95% CI = 1.01, 1.73) of
experiencing symptoms of depression than male studentathletes.
 Freshmen had 3.3 greater odds (95%CI= 1.63, 6.59) of
experiencing symptoms of depression than their more
senior counterparts.
 Student-athletes who reported symptoms of depression
were associated with higher scores of State-anxiety, and
Trait-anxiety, respectively (p < .0001).
Correlation of Depression, Anxiety
and Pain
Symptoms of
Depression Score
State-anxiety
Trait-anxiety
Pain
0.693
(p<.0001)
0.650
(p<.0001)
0.322
(p<.0001)
0.796
(p<.0001)
0.305
(p<.0001)
State-anxiety
Trait-anxiety
0.209
(p=.0010)
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Research Project
Title: Social Support and Depression and Anxiety
Following Injury in Collegiate Athletes
Funder: Centers for Disease Control and Prevention
Period: August 1, 2007 - July 31, 2012
Research Team – Co-PIs
John B. Lowe, DrPh
Professor, Community and Behavioral Health
Corinne Peek-Asa, PhD, MPH
Professor, Occupational and Environmental
Health
Ying Zhang, PhD
Associate Professor, Biostatistics
Research Team –
Advisory Committee
John Albright, MD, Professor, Orthopedic Surgery,
UI
Ned Amendola, MD, Professor, Orthopedic Surgery,
Sport Medicine
Director, UI
Dan Foster, PhD, Professor, Exercise Science, UI
Sam Maniar, PhD, Chair, Student-Athlete Depression Guidelines
Committee, NCAA
Jennifer E. Carter, PhD, Director, Sport Psychology,
University
Ohio State
Study Universities
 University of Iowa (Iowa City)
 Iowa State University (Ames)
 Michigan State University (East Lansing)
 Purdue University (West Lafayette)
Study Sports
 Men’s baseball
 Men's basketball
 Football
 Women's basketball
 Women’s soccer
 Women’s softball
 Women’s volleyball
Future Direction
High school athletes
Injury
depression
Re-injury
Questions/
Comments?
Thanks!!
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