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Aditi Mankad and Sandy Gordon

Context:

Grief can be a common psychological characteristic of long-term injury, but few athletes are taught how to effectively deal with these intense emotions.

Objective:

To examine the effectiveness of Pennebaker's standard writing paradigm in improving athletes' psychological response to injury after engaging in written disclosure.

Design:

Repeated-measures design with 6 data-collection time points.

Setting:

Sport-injury clinics.

Participants:

9 elite long-term-injured athletes.

Measures and Intervention:

Participants were administered the Psychological Responses to Sport Injury Inventory and the Rehabilitation Beliefs Survey at 3 times preintervention and postintervention. Intervention comprised three 20-min writing sessions. Linguistic analyses were carried out using the Linguistic Inquiry Word Count to determine whether changes in word categories would be associated with postintervention changes in grief characteristics and rehabilitation-belief subscales.

Results:

There were significant differences in athletes' grief characteristics postintervention, with athletes feeling less devastated, dispirited, cheated, and restless by their injury and increasing the reorganization of their thoughts. Corresponding evidence from text analyses further supported these changes, with athletes linguistically demonstrating that they were actively working through their grief-related response using improved cognitive processing (F 2,16 = 5.15, P = .019, η2 = .39) and the disinhibition of positive and negative affect (F 2,16 = 4.05, P = .038, η2 = .34). There were no significant changes in athletes' rehabilitation beliefs, which remained high throughout the testing period.

Conclusions:

Overall, the findings demonstrated that written emotional disclosure was effective in enhancing psychological rehabilitation by contributing to a greater personal understanding of the injury event and attenuating athletes' grief-related response.

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Aditi Mankad, Sandy Gordon and Karen Wallman

Psychological trauma associated with long-term injury can cause athletes to experience intense stress-like symptoms and considerable negative affect (e.g., Tracey, 2003; Udry, 1997). Due to the nature of competitive sport, however, it is thought that injured athletes inhibit these emotions to the detriment of their physical health. The present study examined Pennebaker’s (1989) emotional disclosure paradigm within a sporting context. It was hypothesized that writing about a traumatic injury would reduce athletes’ mood disturbance and stress during rehabilitation. Further, it was believed that these changes would correspond with an increase in immune expression from pre- to postintervention. Elite injured athletes (N = 9) rehabilitating from anterior cruciate ligament surgery participated in the 3-day writing intervention, consisting of 3 X 20 min writing sessions, during which athletes disclosed negative emotions associated with their injury and rehabilitation experiences. Measures were taken at six time-points (T1-T6), with pre- and postintervention phases lasting for 4 weeks each. Measures consisted of psychological stress (intrusion and avoidance), total mood disturbance, and relative cell-counts/µL for circulating T-cells (CD4/8) and NK cells (CD16/56). Repeated-measures ANOVAs showed a signifcant main effect of time for intrusion, F(5, 70) = 5.83, p =.001, η2 = .29 and avoidance, F(5, 70) = 5.73, p =.002, η2 = 0.29 subscales; mood disturbance, F(5, 70) = 3.71, p= 0.005, η2 = 0.21; and CD4+, F(5, 65) = 2.39, p= 0.048, η2 = .16. Subsequent linear contrasts provided further evidence of significant prepost differences among the stress, mood state, and immune variables. These results suggest that the written disclosure intervention has potential psycho-immunological benefits for athletes rehabilitating from long-term injury.

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Aditi Mankad, Sandy Gordon and Karen Wallman

The present study adopted a qualitative, exploratory approach to describe the underlying emotional climate among injured athletes within team sport environments. Nine elite athletes undergoing long-term injury rehabilitation (LTIR) participated in semi-structured interviews to describe their LTIR experience. A general inductive analysis extracted three higher-order themes: (a) emotional trauma, (b) emotional climate, and (c) emotional acting. Athletes reported experiencing emotional trauma throughout LTIR. To maintain in-group norms, they described engaging in avoidance behaviors and reported suppressing negative affect for fear of negative evaluation. They also reported frequently controlling emotions in public using acting strategies. Athletes perceived these emotionally inhibitive behaviors as encouraged within their team environment. These results have important implications for the identification and treatment of emotionally destructive behaviors that could potentially delay an athlete’s psychological rehabilitation from athletic injury.

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Aditi Mankad, Sandy Gordon and Karen Wallman

The present study features a psycholinguistic analysis, using Pennebaker’s (1989) emotional disclosure paradigm, of an athlete’s experience in recovering from injury. “GL,” a male athlete rehabilitating from anterior cruciate ligament reconstruction, participated in a 9-week testing protocol. A 3-day intervention was used, consisting of three 20-minute writing sessions, which promoted disclosure of negative emotions associated with injury and rehabilitation. In addition, measures of stress, mood disturbance, and self-esteem were administered from pre- to postintervention and at follow-up. Results revealed decreases in stress and mood disturbance, as well as an increase in self-esteem. Analysis of writing samples revealed increased use of linguistic markers indicating affective awareness. Findings also highlighted the importance of emotional disclosure and cognitive integration in reducing stress and enhancing understanding of injury.