Coping With Acute Stress in Sport: Linking Athletes' Coping Style, Coping Strategies, Affect, and Motor Performance

Coping strategies for handling stress and providing mental health in elite athletes: a systematic review

Background

The combination of stressors unique to the athletic context plus the sensitive developmental phase that elite athletes go through during their peak performance may increase the athletes' vulnerability to mental health decrements. To emphasize the necessity to raise elite athletes' awareness of health risks, it seems to be essential to teach them coping skills to handle stress and to make affected athletes aware of how to recognize, evaluate, and articulate potential risks to their health.

Objective

This systematic review analyzes coping strategies used by elite athletes to deal with stress and the effect of these strategies on mental health to identify gaps that future research could prioritize.

Methods

The current review analyzes studies containing quantitative, qualitative, and mixed data and results, all of them focusing on coping strategies to deal with stress and the effect of coping strategies on elite athletes' mental health. Literature search for this systematic review took place between August and October 2023 and included the use of 3 electronic databases: PubMed, PsychINFO, SPORTdiscus.

Results

There were initially 5,705 hits from 3 electronic databases, hand search and from a complementary search in Google Scholar. After the screening process and quality appraisal 30 studies were included. The analyzed study results point to a broad spectrum of coping categories, elite athletes make use of to deal with stressful situations. The results of this review underpin the necessity that especially young athletes being confronted with a wide range of stressors, need to be taught mental skills to cope with these stressors. In addition, teaching coaches and teammates about social support seemed to decrease elite athletes' stress reactions, such as anxiety or depressive symptoms.

Conclusion

Coping in elite sporting settings is very complex and dynamic. There is evidence of coping being effective to buffer stress, but the interrelationships between stressor, appraisal of the stressor, application of a corresponding coping strategy and its effect especially in terms of mental health outcomes is still unclear because of lacking intervention-based study designs.

Factors associated with high-level endurance performance: An expert consensus derived via the Delphi technique

There is little agreement on the factors influencing endurance performance. Endurance performance often is described by surrogate variables such as maximum oxygen consumption, lactate threshold, and running economy. However, other factors also determine success and progression of high-level endurance athletes. Therefore, the aim was to identify the relevant factors for endurance performance assessed by international experts by adhering to a structured communication method (i.e., Delphi technique). Three anonymous evaluation rounds were conducted initiated by a list of candidate factors (n = 120) serving as baseline input variables. The items that achieved ≥70% of agreement in round 1 were re-evaluated in a second round. Items with a level of agreement of ≥70% in round 2 reached consensus and items with a level of agreement of 40-69% in round 2 were re-rated in a third round followed by a consensus meeting. Round 1 comprised of 27 panellists (n = 24 male) and in round 2 and 3 18 (n = 15 male) of the 27 panellists remained. Thus, the final endurance expert panel comprised of 18 international experts (n = 15 male) with 20 years of experience on average. The consensus report identified the following 26 factors: endurance capacity, running economy, maximal oxygen consumption, recovery speed, carbohydrate metabolism, glycolysis capacity, lactate threshold, fat metabolism, number of erythrocytes, iron deficiency, muscle fibre type, mitochondrial biogenesis, hydrogen ion buffering, testosterone, erythropoietin, cortisol, hydration status, vitamin D deficiency, risk of non-functional overreaching and stress fracture, healing function of skeletal tissue, motivation, stress resistance, confidence, sleep quality, and fatigue. This study provides an expert-derived summary including 26 key factors for endurance performance, the "FENDLE" factors (FENDLE = Factors for ENDurance Level). This consensus report may assist to optimize sophisticated diagnostics, personalized training strategies and technology.

The Emergence of the Pandemic: High-Performance Coach and Athlete Experiences

The current study explored coach and athlete reactions and challenges leading up to the Tokyo 2020 Paralympic Games, with a specific focus on the impacts of the COVID-19 pandemic and the Games’ postponement. Nine Australian Paralympic coaches (n = 3) and athletes (n = 6) shared their experiences in semistructured interviews. The thematic analysis highlighted how participants experienced the emergence of the pandemic in different ways, but all were relieved when the late but eventual decision to postpone the Games was made. Regarding lockdown periods (i.e., social-distancing restrictions), some coaches and athletes thrived under the new reality (i.e., training from home, online coaching) while others had more difficulty adjusting. Furthermore, results highlight the many uncertainties still remaining, which continue to influence participants’ sport and personal lives. The experiences of coaches and athletes during the COVID-19 pandemic sheds light on strategies and resources that could support Paralympic coaches and athletes during current and future crises.

Types of Cognitive Appraisal and Undertaken Coping Strategies during Sport Competitions

The main aim of the research was to distinguish different types of sport competition appraisals and verify if athletes’ interpretation of a stressful situation changed their choice of coping methods. Athletes change their perception during competitions; thus, we assumed that configuration of different ways of interpreting stressful events is more important for coping than one particular appraisal. In total, 193 athletes filled out The Stress Appraisal Questionnaire and The Sport Stress-Coping Strategies Questionnaire to describe their stress appraisals and undertaken coping strategies during a remembered competition that took place within a month before the study. The athletes most often appraised stressful competitions as a challenge. They preferred the coping strategy of being determined to accomplish the established goal. The athletes hardly applied techniques that constituted the basis of mental training. The cluster analysis of the competitors determined three types of sport competition appraisals: positive, negative, and active. An ANOVA with post hoc comparisons showed that participants who revealed positive appraisals undertook the highest number of actions aimed at reaching goals and least frequently sought support. Athletes should be taught not only specific strategies for coping with stress, but also more frequent use of positive judgments of sports competitions.

Assessment of the Relationship between Selected Factors and Stress-Coping Strategies in Handcyclists-A Preliminary Study

Background and Objectives: Playing competitive sports is associated with stress, especially during the starting season. Disabled athletes are additionally burdened with physical and/or emotional factors, resulting from the trauma they have experienced. The aim of the work was to assess the relationship between strategies of coping with stress and the level of education, category of disability and its duration of handcyclists before the competition. Materials and Methods: 44 handcyclists with a mean age of 41.8 ± 11.6, from European countries, were divided according to the severity of mobility impairments, education and duration of the disability. The participants were asked to fill in the Mini-COPE Inventory for Measuring Coping with Stress, which provided answers in writing to some sociodemographic questions regarding age, sex, education, type of mobility impairment and duration of the disability. Results: The subjects who had suffered spinal injury at the cervical section obtained the lowest scores regarding their subjective assessment of their active stress management in difficult situations (p = 0.007). They scored the lowest, 1.5 points, when asked about acceptance in difficult circumstances compared to those with university education (p = 0.02). A statistically significant correlation was found to exist between education levels and positive revaluation, acceptance and seeking instrumental support. A negative correlation was observed between education and sustained use of psychoactive substances and denial. Conclusions: Highly educated cyclists with short-lasting disability, damage to the lower spine section or amputations tend to cope better with stress than other study participants.

Mindful Sensation Seeking: An Examination of the Protective Influence of Selected Personality Traits on Risk Sport-Specific Stress

Stress often has a negative influence on sports performance. Stress-induced decreases in performance can be especially disastrous for risk sports athletes, who often put their life at risk when practicing their sport. Therefore, it is of great importance to identify protective factors in stressful situations in risk sports. On average, risk sports athletes score extremely high on the personality trait sensation seeking. At the same time, theoretical considerations about dispositional mindfulness suggest that mindful athletes can handle stress more effectively. The main goal of this experiment is to examine the influence of sensation seeking and mindfulness on the stress response to a risk sport-specific stressor. To induce stress, 88 male students completed the Heidelberg Risk Sport-Specific Stress Test (HRSST) which utilizes fear of falling as the stressful event during a climbing exercise. Psychological (anxiety) and physiological (cortisol) responses were measured at multiple time points before and after the HRSST to determine the severity of the stress response. In reaction to the stressor, a significant increase in self-reported state anxiety, but no significant increase in cortisol were observed. The mindfulness subscale external observation correlated positively with anxiety in the climbing wall, sensation seeking and the anxiety scales after the jump correlated negatively and sensation seeking predicted anxiety subscales after the jump in hierarchical regression analyses. However, mindfulness did not predict anxiety measures. Neither sensation seeking nor mindfulness correlated significantly with cortisol levels. The results suggest that high sensation seekers perceive a risk sport-specific stressor as less stressful. The missing physiological response might be explained by the Cross-Stressor-Adaptation-Hypothesis and particularities of the sample. Good internal observers might be especially aware of their need of stimulation and new experiences, which in turn might explain the higher experience-seeking scores. Future studies should further examine the role of mindfulness in stressful situations and the interaction of its subscales with sensation seeking. The current experiment offers new possibilities for adjoining research fields at the interface between sports sciences, psychology and medicine: The findings can be transferred to high risk professions such as police officers, firefighters and military forces (e.g., for selection processes or for interventions).

The Power of Faith: The Influence of Athletes' Coping Self-Efficacy on the Cognitive Processing of Psychological Stress

Coping self-efficacy (CSE) has a positive mental health effect on athletes’ ability to cope with stress. To understand the mechanism underlying the potential impact of CSE, event-related potentials (ERPs) were used to explore the neural activity of the cerebral cortex under acute psychological stress in athletes with different CSE levels. Among 106 high-level athletes, 21 high-CSE athletes and 20 low-CSE athletes were selected to participate in the experiment. A mental arithmetic task was used to induce acute psychological stress. The results showed that high-CSE athletes responded more quickly than low-CSE athletes. In the stress response stage, the N1 peak latency of low-CSE athletes was longer than that of high-CSE athletes, and the N1 amplitude was significantly larger than that of high-CSE athletes. In the feedback stage, the FRN amplitude with error feedback of high-CSE athletes was larger than that of low-CSE athletes, and the P300 amplitude with correct feedback was larger than that with error feedback. The results indicate that high-CSE athletes can better cope with stressful events, adjust their behaviors in a timely manner according to the results of their coping, and focus more on processing positive information.

Randomized controlled trial of multidisciplinary team stress and performance in immersive simulation for management of infant in shock: study protocol

BACKGROUND

Human error and system failures continue to play a substantial role in adverse outcomes in healthcare. Simulation improves management of patients in critical condition, especially if it is undertaken by a multidisciplinary team. It covers technical skills (technical and therapeutic procedures) and non-technical skills, known as Crisis Resource Management. The relationship between stress and performance is theoretically described by the Yerkes-Dodson law as an inverted U-shaped curve. Performance is very low for a low level of stress and increases with an increased level of stress, up to a point, after which performance decreases and becomes severely impaired. The objectives of this randomized trial are to study the effect of stress on performance and the effect of repeated simulation sessions on performance and stress.

METHODS

This study is a single-center, investigator-initiated randomized controlled trial including 48 participants distributed in 12 multidisciplinary teams. Each team is made up of 4 persons: an emergency physician, a resident, a nurse, and an ambulance driver who usually constitute a French Emergency Medical Service team. Six multidisciplinary teams are planning to undergo 9 simulation sessions over 1 year (experimental group), and 6 multidisciplinary teams are planning to undergo 3 simulation sessions over 1 year (control group). Evidence of the existence of stress will be assessed according to 3 criteria: biological, electrophysiological, and psychological stress. The impact of stress on overall team performance, technical procedure and teamwork will be evaluated. Participant self-assessment of the perceived impact of simulations on clinical practice will be collected. Detection of post-traumatic stress disorder will be performed by self-assessment questionnaire on the 7(th) day and after 1 month.

DISCUSSION

We will concomitantly evaluate technical and non-technical performance, and the impact of stress on both. This is the first randomized trial studying repetition of simulation sessions and its impact on both clinical performance and stress, which is explored by objective and subjective assessments. We expect that stress decreases team performance and that repeated simulation will increase it. We expect no variation of stress parameters regardless of the level of performance.

TRIAL REGISTRATION

ClinicalTrials.gov registration number NCT02424890.

Resiliency against stress among athletes

<B>Background</B><br /> The aim of this paper is to describe the results of a study concerning the relationship between resiliency and appraisal of a stressful situation, anxiety reactions and undertaken methods of coping among sportsmen.<br /> <br /> <B>Participants and procedure</B><br /> The research concerned 192 competitors who actively train in one of the Olympic disciplines – individual or team. We used the following instruments: Resiliency Assessment Scale (SPP-25); Stress Appraisal Questionnaire A/B; Reactions to Competition Questionnaire; Coping Inventory for Stressful Situations (CISS); Sport Stress Coping Strategies Questionnaire (SR3S, self-constructed).<br /> <br /> <B>Results</B><br /> Athletes most frequently apply positive types of stress appraisal, and they cope with stress through a task-oriented style during competitions. There is a relationship between the level of resiliency and the analysed aspects of the process of stress. The higher the resiliency, the more positive is the appraisal of a stressful situation and the more task-oriented are the strategies applied. Similarly, in everyday situations resilient sportspeople positively appraise difficult situations and undertake mostly task-oriented strategies. Resiliency is connected with less frequently experiencing reactions in the form of anxiety.<br /> <br /> <B>Conclusions</B><br /> The obtained results, similarly to previous research, suggest that resiliency is connected with experiencing positive emotions. It causes more frequent appraisal of stressful situations as a challenge. More resilient people also choose more effective and situation-appropriate coping strategies. Therefore they are more resistant to stress.

Facilitating the coping self-efficacy and psychological well-being of student rugby players

Research into the ‘dual careers’ (simultaneous academic and sport endeavours) of student-athletes is growing. There is a need to optimise student-athletes’ transition from high school to tertiary institutions. The aim of this study was, first, to determine the personal, academic, and sporting needs of student rugby players, and, second, to evaluate the effectiveness of a purposefully developed experiential-learning programme on the coping self-efficacy and psychological well-being of first-year university rugby players. Players were evaluated prior to and 1 month after the intervention. The experiential-learning programme group showed significant improvements in all the measured variables, whereas the non-experiential-learning programme control group’s scores remained unchanged. When corrected for the pre-test differences, the experiential-learning programme group outperformed the non-experiential-learning programme group in terms of problem-focussed coping, dealing with negative emotions and thoughts, obtaining support from family and friends, as well as overall happiness. The experiential-learning programme contributed to facilitating coping self-efficacy and psychological well-being of student rugby players.

Effects of Implementation Intentions on Anxiety, Perceived Proximity, and Motor Performance

Anxiety leads to exaggerated perceptions of distance, which may impair performance on a physical task. In two studies, we tested one strategy to reduce anxiety and induce perceived proximity to increase performance. We predicted implementation intentions that reduce anxiety would increase perceived visual proximity to goal-relevant targets, which would indirectly improve performance. In two studies, we induced performance anxiety on a physical task. Participants who formed implementation intentions to reduce anxiety perceived goal-relevant targets (e.g., golf hole, dartboard) as physically closer and performed better than both participants without a strategy (Study 1) and participants with only a goal to regulate anxiety (Study 2). Furthermore, perceived proximity improved performance indirectly by increasing subjective task ease (Study 2). Results suggest that implementation intentions can reduce anxiety and lead to perceived proximity of goal-relevant targets, which helps perceivers make progress on goals.

Psychological factors affecting equine performance

For optimal individual performance within any equestrian discipline horses must be in peak physical condition and have the correct psychological state. This review discusses the psychological factors that affect the performance of the horse and, in turn, identifies areas within the competition horse industry where current behavioral research and established behavioral modification techniques could be applied to further enhance the performance of animals. In particular, the role of affective processes underpinning temperament, mood and emotional reaction in determining discipline-specific performance is discussed. A comparison is then made between the training and the competition environment and the review completes with a discussion on how behavioral modification techniques and general husbandry can be used advantageously from a performance perspective.

The approach-avoidance framework for identifying athletes' coping style as a function of gender and race

The purpose of this study was to identify the coping styles of competitive athletes as a function of gender and race in response to events experienced during the contest perceived as highly stressful using the approach and avoidance coping framework. Participants (N = 218) consisted of 111 males (48 African American and 63 Caucasian) and 107 females (41 African American and 66 Caucasian), and ranged in age from 18 to 54 yrs (M +/- SD; 22.29 +/- 3.9 yrs). They attended a university in the southeastern US, and were considered highly skilled athletes based on their current or former participation as competitive athletes. A 12-item inventory was completed consisting of six approach coping and six avoidance coping strategy items. Confirmatory factor analysis, composite reliability and Cronbach's alpha indicated acceptable model-data fit and internal scale consistency. The results suggested the athletes' preferred coping style was avoidance, rather than approach. A 2 x 2 ANOVA showed significant main effects for gender (p = 0.003) and race (p < 0.01); males used more approach coping than females, while Caucasians applied more approach coping than African Americans. No significant interaction was found. The results indicated the need for future study on examining gender and race as moderating variables in examining athletes' coping styles.

The effects of stress and coping on surgical performance during simulations

OBJECTIVE

This study investigates the effects of surgeons' stress levels and coping strategies on surgical performance during simulated operations.

METHODS

Thirty surgeons carried out each a non-crisis and a crisis scenario of a simulated operation. Surgeons' stress levels were assessed by several measures: self-assessments and observer ratings of stress, heart rate, heart rate variability, and salivary cortisol. Coping strategies were explored qualitatively and quantified to a coping score. Experience in surgery was included as an additional predictor. Outcome measures consisted of technical surgical skills using Objective Structured Assessment of Technical Skill (OSATS), nontechnical surgical skills using Observational Teamwork Assessment for Surgery (OTAS), and the quality of the operative end product using End Product Assessment (EPA). Uni- and multivariate linear regression were used to assess the independent effects of predictor variables on each performance measure.

RESULTS

During the non-crisis simulation, a high coping score and experience significantly enhanced EPA (beta1, 0.279; 0.009-0.460; P= 0.04; beta2, 0.571; 4.328-12.669, P< 0.001; respectively). During the crisis simulation, a significant beneficial effect of the interaction of high experience and low stress on all performance measures was found (EPA: beta, 0.537; 2.079-8.543; OSATS: beta, 0.707; 8.708-17.860; OTAS: beta, 0.654; 13.090-30.483; P< 0.01). Coping significantly enhanced nontechnical skills (beta, 0.302; 0.117-1.624, P= 0.03).

CONCLUSIONS

Clinicians' stress and coping influenced surgical performance during simulated operations. Hence, these are critical factors for the quality of health care.

Implementation Intentions and Shielding Goal Striving From Unwanted Thoughts and Feelings

Forming an implementation intention or “if-then plan” promotes the attainment of different types of goals (Gollwitzer, 1999; Gollwitzer & Sheeran, 2006). So far, research on implementation intentions has focused on the initiation of goal striving, whereas the issue of shielding of ongoing goal striving has been largely neglected. In two field experiments concerned with dieting (Study 1) and athletic goals (Study 2), goal shielding was supported by implementation intentions geared at controlling potentially interfering inner states (i.e., cravings for junk food in Study 1, and disruptive thoughts, feelings, and physiological states in Study 2). In both experiments, forming if-then plans enhanced the rate of goal attainment. Thus, implementation intention formation can be used to promote the realization of desired outcomes not only by facilitating getting started with goal striving but also by preventing goal striving from straying off course.

Tales of the unexpected: coping among female collegiate volleyball players

The purpose of this study was to examine patterns of appraisal, coping, and coping effectiveness in sport. Ten players from a collegiate female volleyball team were interviewed on two occasions, first in the week before a provincial final playoff tournament and in the week following the tournament. Data were transcribed verbatim and subjected to content and idiographic analyses. Athletes generally did not predict or anticipate the stressors they actually experienced during the tournament. Subjective appraisals of effective coping were associated with consistency between proactive and actual coping attempts. Reported effective coping was associated with the attainment of personal performance goals and use of cognitive, behavioral, and emotional coping strategies in the absence of behavioral avoidance. Reported ineffective and partially effective coping was associated with not attaining personal performance goals, and the use of cognitive coping strategies with behavioral avoidance. Finally, older, more experienced athletes reported they coped better than younger, less experienced athletes during the tournament.

Approach and avoidance coping during task performance in young men: the role of goal attainment expectancies

The present study investigated approach and avoidance coping strategies as a function of goal attainment expectancies in young men. Twenty-four male students participated in an experiment consisting of two rowing tests. After the initial test, participants were divided into two experimental groups and were assigned to conditions of attainable and unattainable goals for the final test, depending on performance in the initial test and experimental condition. Participants of the two groups reported similar goal attainment expectancies before the start of the final test; however, during the task expectancies for the attainable goal group increased, whereas those for the unattainable goal group decreased. After the conclusion of the task, participants were asked to respond with regard to coping strategies they used during the latest part of the final test, when goal attainment expectancies had been differentiated. The analysis revealed significant effects for effort increase, and mental and behavioural disengagement, whereas a non-significant but considerable effect was identified for planning. The higher goal attainment expectancies group scored higher on effort increase and planning, and lower on behavioural and mental disengagement, than the lower goal attainment expectancies group. The results of the present study are in accordance with the general theoretical assumptions of the control process theory, and more particularly highlight the importance of goal attainment expectancies as a factor influencing the employment of approach and avoidance coping strategies in achievement situations.