Perfectionism and training distress in junior athletes: a longitudinal investigation

Predictors of Running-Related Injury Among Recreational Runners: A Prospective Cohort Study of the Role of Perfectionism, Mental Toughness, and Passion in Running

BACKGROUND

The health benefits associated with recreational running are challenged by the occurrence of running-related injuries (RRIs). Effective preventive measures require knowledge of sport injury etiology. Psychological factors such as perfectionism, mental toughness, and passion are believed to predispose to sports injury by influencing training behaviors, motivation to run, and suppression of feelings of fatigue and pain. Yet their association with RRIs are understudied.

HYPOTHESIS

Perfectionism, mental toughness, and passion predict an increased risk of RRIs in recreational runners.

STUDY DESIGN

Prospective cohort study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 143 recreational runners (age 34.9 ± 13.9 years, 37% women) with a response rate of 76.5% answered an online questionnaire about their characteristics, running behaviors, and psychological variables (perfectionism, mental toughness, and running passion) as well as a sports injury survey. Then, as a primary outcome, RRIs were recorded biweekly for 6 months. The incidence of injuries was expressed as RRI per 1000 hours of running. The association between predictive factors and RRIs was estimated using logistic regression.

RESULTS

The incidence of RRIs during follow-up was 5.16 per 1000 hours of running. The knee was the location injured most often (26.4%), followed by the foot (18.9%) and lower leg (13.2%). Higher obsessive passion (OP) for running (odds ratio [OR], 1.11; 95% CI, 1.04-1.20) and perfectionistic concerns (OR, 1.22; CI,1.05-1.41) were associated with a greater risk of RRIs, as were previous injury (OR, 2.49; CI,1.10-5.70), weekly running distance (OR,1.10; CI, 1.03-1.16), and both supinated (OR, 4.51; CI, 1.11-18.30) and pronated (OR, 3.55; CI, 1.29-9.80) foot type. Following a running schedule (OR, 0.24; CI, 0.09-0.66) was associated with a lower risk of RRIs.

CONCLUSION

History of previous RRI, pronated and supinated foot type, weekly running distance, perfectionistic concerns, and OP increased RRI risk in recreational runners. Following a running schedule was a protective factor.

CLINICAL RELEVANCE

Multiple factors, including runners' psychological characteristics, predict RRIs. These findings can inform the development of injury risk management strategies.

Stressors in Indoor and Field Brazilian Soccer: Are They Perceived as a Distress or Eustress?

Soccer players inescapably live under stress during the sportive career, and many real-life aspects of soccer situations operate in the ongoing performance. This study’s main objective was to elaborate the List of Stressors in Professional Indoor and Field Soccer, a self-report instrument designed to measure the impact of 77 soccer situations upon the sport performance. Participants were 138 indoor and field soccer players from the Brazilian Premier League. Each situation was evaluated on a 7-point scale, ranging from the most negative (−3) to the most positive (+3). Data were analyzed according to the players’ perception of the items: distress or eustress and its intensity, and after that, situations perceived as plus −1 and +1 were compared by time in which they were experienced and distributed among five categories established by the literature: Expectations about the Performance, Personal Factors, Competition Aspects, Training Demands, and Relationship with Significant People. Narratives of athletes’ experiences were also used to discuss the results. An Exploratory Structural Equation Modeling using Bi-factorial (BI-ESEM) was employed to assess the factor structure. For the total participants, 49 situations were perceived as distress and 28 as eustress. Using the criteria established a priori, the distribution was among the five categories in the remaining 32 situations. Differences in perception between less and more experienced players were found in 11 situations. The results revealed that Brazilian professional soccer players experience various stressful situations. These events are important representations of environmental demands and could predict the performance as they are perceived as eustress or distress. Some of these stressful situations are inherent in sport and others adjacent to the sports system or environment. Coach pressure to win and conflicts with teammates are examples of stressors in-sport, family problems and disputes with press or fans are examples of stressors external to the team, also called peripheral opponents, and showed the relative social influence of significant others in soccer performance. We can conclude that the knowledge of the direction of a given stress situation has important practical implications in preparing athletes and helping them face the performance stressors that are part of soccer daily life.

The role of perfectionism in predicting athlete burnout, training distress, and sports performance: A short-term and long-term longitudinal perspective

This study examined the influence of perfectionistic strivings and perfectionistic concerns on athlete burnout and two key indicators of overtraining syndrome (training distress and subjectively perceived sports performance) using cross-sectional (N = 228), short-term (a 3-month interval, N = 93) and long-term (a 1-year interval, N = 83) longitudinal designs on a sample of adolescent athletes. In the cross-sectional analyses, sequential regressions revealed that perfectionism was a significant predictor of athlete burnout and both indicators of overtraining. In the three-month longitudinal perspective, both dimensions of perfectionism (strivings and concerns) contributed to the prediction of change in burnout and sports performance, but not training distress. When the one-year longitudinal relationships were regarded, only perfectionistic strivings significantly predicted decrease in burnout, and, for sports performance, the predictive power of both dimensions of perfectionism was even more pronounced when compared to the three-month longitudinal data.

Psychological risk profile for overuse injuries in sport: An exploratory study

Overuse injuries account for a substantial part of sport injury incidence among athletes of various sports and levels. Despite the gradual onset of symptoms, athletes often persevere in training and competing. The present exploratory study aimed to identify a psychological risk profile for overuse injury. One hundred and forty-nine athletes competing in various sports responded to a range of questionnaires measuring the following psychological variables: negative life stress, perfectionistic concerns, perfectionistic strivings, athletic identity, and the coach-athlete relationship. Participants subsequently answered the OSTRC Overuse Injury Questionnaire on a weekly basis during a 10-week period. Using a latent profile analysis, athletes were classified into three latent profiles regarding their psychological characteristics. Athletes in the second profile, characterized by a combination of high athletic identity, perfectionistic concerns and negative life stress and poor coach-athlete relationship, were found to be significantly more often affected by overuse injuries (74% of the time) than individuals in the two other profiles (52% and 48% of the time, respectively). In conclusion, psychological factors may contribute to the risk of overuse injuries through complex interactions (i.e. accounting for interdependencies within a specific configuration of variables) rather than through their independent influences.

"Oh, My God! My Season Is Over!" COVID-19 and Regulation of the Psychological Response in Spanish High-Performance Athletes

Background: In an unprecedented situation of interruption of the sporting dynamics, the world of sport is going through a series of adaptations necessary to continue functioning despite coronavirus disease 2019 (COVID-19). More than ever, athletes are facing a different challenge, a source of discomfort and uncertainty, and one that absolutely alters not only sports calendars, but also trajectories, progressions, and approaches to sports life. Therefore, it is necessary to identify the levels of psychological vulnerability that may have been generated in the athletes, because of the coexistence with dysfunctional responses during the COVID-19 experience, and which directly influence the decrease of their mental health. Methods: With a descriptive and transversal design, the study aims to identify the state of the dysfunctional psychological response of a sample of Spanish athletes (N = 284). The DASS-21 (Depression, Anxiety, and Stress Scale), Toronto-20 (alexithymia), and Distress Tolerance Scale questionnaires were administered to a sample of high-level Spanish athletes in Olympic programs. Results: The results suggest that the analyzed athletes indicate high levels of dysfunctional response (e.g., anxiety, stress, depression, and alexithymia) when their tolerance is low. In addition, the variables show less relational strength, when the capacity of tolerance to distress is worse and age is lower. At the same time, the greater the anxiety and uncertainty are, leading to more catastrophic and negative thoughts, the younger the athletes are. Conclusions: It is clear that both age and tolerance to distress are considered adequate protective factors for psychological vulnerability in general and for associated dysfunctional responses in particular. Moreover, the psychological resources offered by more experienced athletes are also a guarantee of protection against negativity and catastrophism.

A three-sample study of perfectionism and field test performance in athletes

Field tests are commonly used by sport scientists for performance monitoring and evaluation. While perfectionism predicts performance in a range of contexts, it is currently unclear whether perfectionism predicts performance in such tests. To address this lack of understanding, the present study examined the relationships between perfectionism and fitness-based field test performance across three athlete samples. After completing a measure of perfectionism (striving for perfection and negative reactions to imperfection), sample one (n = 129 student athletes) participated in a series of countermovement jumps and 20-metre sprint trials, sample two (n = 136 student athletes) participated in an agility task, and sample three (n = 116 junior athletes) participated in the Yo-Yo intermittent recovery test (level one). Striving for perfection predicted better sprint and Yo-Yo test performance. Negative reactions to imperfection predicted worse sprint performance. Mini meta-analyses of the combined data (N = 381) showed that striving for perfection was positively related to performance (r⁺  = .24), but negative reactions to imperfection was unrelated to performance (r⁺  = -.05). The present findings indicate that striving for perfection may predict better fitness-based field test performance, while negative reactions to imperfection appears to be ambiguous.

Perfectionism Profiles and Motivation to Exercise Based on Self-Determination Theory

This study complements extant variable-centered research that focus on the relationship between perfectionism and the autonomous and controlled motivation to exercise. A person-centered approach is used for identifying perfectionism profiles as well as analyzing inter-profile differences in terms of the six regulatory styles located on the autonomy-control continuum. A sample of 597 (M_age = 22.08, SD = 3.33) Ecuadorian undergraduates enrolled in a sport science degree program was employed. Latent Profile Analysis based on two higher-order perfectionism dimensions, Perfectionistic Strivings (PS) and Perfectionistic Concerns (PC), supported a four-class solution: Non-Perfectionists (low PS and PC), Adaptive Perfectionists (high PS and low PC), Maladaptive Perfectionists (high PS and PC), and Moderate Perfectionists (moderate PS and PC). Adaptive Perfectionists obtained the highest means on Intrinsic, Integrated, and Identified regulations. However, these differences where only significant when compared with Moderate Perfectionists, and only in the case of Integrated regulation, in comparison with Non-Perfectionists. In contrast, Maladaptive Perfectionists obtained significantly higher scores on Introjected and External regulations as well as on Amotivation than the other three classes. Results are discussed in light of Self-Determination Theory.

Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention: American Medical Society for Sports Medicine Position Statement

The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders, and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy (SORT) to grade level of evidence.

Perfectly Active Teenagers. When Does Physical Exercise Help Psychological Well-Being in Adolescents?

In the context of physical activity and sport, perfectionism and the regular practice of physical activity are related to psychological well-being and the regulation of psychological resources necessary for adaptation to effort and satisfaction. At the same time, the most active students are also those who show greater appetites for physical education classes. The goal of this work was to identify the influence of perfectionist beliefs and the regularity of the practice of physical exercise on psychological well-being. The participants were adolescents (n = 436) aged between 14 and 19 years (M = 16.80, SD = 0.77). They were administered the Multidimensional Perfection Scale, the Psychological Wellbeing Scale, the Global Physical Activity Questionnaire (GPAQv2), and a sociodemographic questionnaire. The results showed, under a non-random and transversal design, that the participants gave important value to physical exercise because they feel both active and vigorous. Regarding perfectionism, the functional aspects of perfectionism (expectations of achievement and organization) correlated positively, while the dysfunctional aspects (fear of committing errors and external expectations) did so negatively with the importance given to physical exercise performed by adolescents; this in turn positively predicted psychological well-being. In this way, the hypothesized model contemplated the relevance of the included variables and reflected the mediation of the degree of importance given to the practice of physical exercise on perfectionist beliefs and psychological well-being. Currently, most physical activity practice proposals for adolescents focus on federated and structured environments for competition, and those that deal with recreational and health-oriented sports are far less common. Hence, “the perfect way of doing sports” for a teenager should be accompanied by cognitive schemes aimed at strengthening psychological resources that allow the regulation of beliefs, attitudes, and behaviors.

General health complaints and sleep associated with new injury within an endurance sporting population: A prospective study

OBJECTIVES

To examine the association between subjective health complaints, sleep quantity and new injury within an endurance sport population.

DESIGN

Prospective cohort study.

METHODS

Ninety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Over 52-week period participants submitted weekly data regarding subjective health complaints (SHCs) (cardiorespiratory, gastrointestinal and psychological/lifestyle), sleep quantity, training load and new injury episodes. Applying a 7- and 14-day lag period, a shared frailty model was used to explore new injury risk associations with total SHCs and sleep quantity.

RESULTS

92.6% of 95 participants completed all 52 weeks of data submission and the remainder of the participants completed ≥30 weeks. Seven-day lag psychological/lifestyle SHCs were significantly associated with new injury risk (Hazard ratio (HR)=1.32; CI 95%=1.01-1.72, p<0.04). In contrast, cardiorespiratory (HR=1.15; CI 95%=0.99-1.36, p=0.07) and gastrointestinal (HR=0.77; CI 95%=0.56-1.05, p=0.09) SHCs were not significantly associated with new injury risk. New injury risk had a significant increased association with 14-day lag <7h/day sleep quantity (HR=1.51; CI 95%=2.02-1.13, p<0.01) and a significant decreased association with >7h/day sleep quantity (HR=0.63, CI 95%=0.45-0.87, p<0.01. A secondary regression analysis demonstrated no significant association with total SHCs and training load factors (Relative Risk (RR)=0.08, CI 95%=0.04-0.21, p=0.20).

CONCLUSIONS

To minimise an increased risk of new injuries within an endurance sporting population, this study demonstrates that psychological/lifestyle subjective health complaints and sleep quantity should be considered. The study also highlights a lag period between low sleep quantity and its subsequent impact on new injury risk. No association was demonstrated between subjective health complaints, sleep quantity and training load factors.

Profiles of Perfectionism Among Adolescents Attending Specialized Elite- and Ordinary Lower Secondary Schools: A Norwegian Cross-Sectional Comparative Study

The versatile construct of perfectionism has been heavily debated, e.g., its nature or measurement constituents, how it influences performances or, most importantly, our health. Conventional linear analyses seem inadequate to address such challenges. Hence, we used a latent variable and a person-centered approach to identify different patterns of perfectionism, and their relationships with psychological health as outcome among early adolescents (13-14 years) attending conventional or elite sports-/performance-oriented lower secondary schools (14 schools, 832 students, 53% girls). All students completed two perfectionism scales, i.e., the child-adolescent perfectionism scale (CAPS) and the frost multidimensional perfectionism scale (FMPS). The criterion-related variables of psychological health included anxiety, depression, eating disorder problems, self-worth and resilience, respectively. Exploratory and confirmatory factor analyses yielded a four-factor representation of perfectionism. Using latent class analysis extracted five profiles of perfectionism, which were related to the criterion variables. Three profiles were clear indicators of either low or high perfectionism score patterns. Two profiles showed a mixed picture of high and low scores, whereas one represented a psychological healthy subgroup. About four of ten adolescents in the ordinary schools matched the two most debilitating perfectionism profiles compared to two of ten in the elite schools. How these results align with international findings is discussed along with the relevance for early interventions aimed at preventing the potential downsides of perfectionism. Longitudinal studies are neeed to explore profile trajectories as well as possible health consequences.

Youth Distance Running: Strategies for Training and Injury Reduction

Running is a popular sport for children in the United States. However, review of available literature on health effects and safety recommendations for youth running has not been previously conducted. Unique factors for injury include periods of growth during puberty and potential for growth plate injury. Youth runners may benefit from activities that incorporate high-impact loading and multidirectional movement for optimal bone maturation, exercises to strengthen tendons and muscles, and strategies aimed at improving running biomechanics to reduce risk of injury. In addition, addressing lifestyle factors, including nutrition and sleep is essential for a runner's general health. Similar to other sports, sports specialization should not be encouraged in youth runners. Reducing running-related injury in growing children and assessing readiness for running should be based on a combination of physical, emotional, psychological, social, and cognitive factors. Youth runners require individualized training and competition to safely participate in the sport.

Are adolescent elite athletes less psychologically distressed than controls? A cross-sectional study of 966 Norwegian adolescents

Introduction

Psychological distress is increasing among adolescents and clusters with other mental health problems such as eating problems. The aim of this study was to investigate the prevalence of psychological distress among young elite athletes and age-matched controls and whether prevalence figures may be attributed to perfectionism and eating problems.

Methods

First-year athletes from all Norwegian elite sport high schools (n=711) and 500 students from randomly selected ordinary high schools were eligible for this cross-sectional study. In total, 611 athletes and 355 student controls provided self-report data about psychological distress, perfectionism, and eating problems (ie, body dissatisfaction and a drive for thinness), as well as their physical training/activity.

Results

A significantly higher proportion of controls scored above the cutoff point for marked psychological distress. Physical activity above the recommended levels for this age group predicted psychological distress among the controls, while the opposite was found in the student elite athlete sample. In both samples, perfectionistic concerns, ie, concern over mistakes, predicted overall psychological distress. However, among elite athletes, perfectionistic concerns were particularly associated with clinically significant psychological distress. Moreover, the impact of eating problems was negligible.

Conclusion

Results from this study highlight the need to target the maladaptive perfectionistic concerns to prevent psychological distress among young athletes as well as among their age-matched nonathlete counterparts.

Perfectionism and training distress in junior athletes: The mediating role of coping tendencies

Training distress occurs when athletes fail to cope with physiological and psychological stress and can be an early sign of overtraining syndrome. Recent research has found that perfectionism predicts increases in training distress in junior athletes over time. The current study provides the first empirical test of the possibility that coping tendencies mediate the perfectionism-training distress relationship. Adopting a cross-sectional design, 171 junior athletes (mean age = 18.1 years) completed self-report measures of perfectionistic strivings, perfectionistic concerns, problem-focused coping, avoidant coping, and training distress. Structural equation modelling revealed that avoidant coping mediated the positive relationship between perfectionistic concerns and training distress, and mediated the negative relationship between perfectionistic strivings and training distress. Problem-focused coping did not mediate any relationships between dimensions of perfectionism and training distress. The findings suggest that the tendency to use coping strategies aimed at avoiding stress may partly explain the relationship between perfectionism and training distress but the tendency to use, or not use, problem-focussed coping does not.

Taking a holistic approach to managing difficult stress fractures

Stress fractures and other bony stress injuries occur along a spectrum of severity which can impact treatment and prognosis. When treating these injuries, it should be borne in mind that no two stress fractures behave exactly alike. Given that they are not a consistent injury, standardized treatment protocols can be challenging to develop. Treatment should be individualized to the patient or athlete, the causative activity, the anatomical site, and the severity of the injury. A holistic approach to the treatment of the most difficult stress fractures should be taken by orthopedists and sports medicine specialists. This approach is necessary to obtain optimal outcomes, minimize loss of fitness and time away from sports participation, and decrease the risk of recurrence.