Knowledge and awareness of sport concussion has been forwarded by research modeled on the neuropsychological testing paradigm associated with Barth’s “sport as laboratory” assessment model. The purpose of this paper is to elucidate lessons learned from that research. Key considerations for planning and implementing large-scale studies of concussion in sport while making adequate provision for the clinical needs of concussed athletes are reviewed. Toward that end, logistical, methodological, and ethical considerations are discussed within the context of research conducted in a university setting. Topics addressed include culture of sport and risk; research planning and design; communication with strategic partners; defining injury; choosing a test battery; data management, outcomes, and analyses; dissemination of results; and finally, clinical and ethical implications that may arise during the research enterprise. The paper concludes with a summary of the main lessons learned and directions for future research.
Lynda Mainwaring, Paul Comper, Michael Hutchison and Doug Richards
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.
Michael McCrea and Matthew R. Powell
This article reviews the essential components of a practical, evidenced-based approach to the management of sport-related concussion in an ambulatory care setting. The model presented is based on the core philosophy that concussion assessment and management be approached from the biopsychosocial perspective, which recognizes the medical/physiological, psychological, and sociological factors that influence recovery and outcome following concussion. Based on the biopsychosocial paradigm, we outline a care delivery model that emphasizes an interdisciplinary approach in which the clinical neuropsychologist is a key participant. We discuss the importance of nonmedical, psychoeducational interventions introduced during the acute phase to facilitate recovery after sport-related concussion. Finally, using the local experience of our “Concussion Clinic” as a backdrop, we offer two separate case studies that demonstrate the value of this model in evaluating and managing athletes after sport-related concussion. The overall objective of this paper is to provide an adaptable template that neuropsychologists and other healthcare providers can use to improve the overall care of athletes with sport-related concussion and civilians with mild traumatic brain injury.
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.
.g., activation; see Johnson, Edmonds, Kamata, & Tenenbaum, 2009 ; Kamata, Tenenbaum, & Hanin, 2002 ). Essentially, this probabilistic approach reflects a postpositivist research paradigm, in which the linkage between a predictor variable and an outcome variable do not represent a deterministic function (one
Jenny H. Conviser, Amanda Schlitzer Tierney and Riley Nickols
. ( 2015 ). Severe and enduring anorexia nervosa (SE-AN): In search of a new paradigm . Journal of Eating Disorders, 3 , 26 . 26236477 doi:10.1186/s40337-015-0065-z 10.1186/s40337-015-0065-z
Jeffrey J. Milroy, Stephen Hebard, Emily Kroshus and David L. Wyrick
, 1970 ) attachment theory, a developmental paradigm constructed to organize human behavior, cognition, and emotion from infancy to adulthood, explains the influence of interpersonal dynamics in close relationships on how individuals respond during periods of marked distress. These early experiences have
Michelle L. Bartlett, Mitch Abrams, Megan Byrd, Arial S. Treankler and Richard Houston-Norton
). Anger & aggression in sports: Toward a practical understanding . In B. Jurica (Chair), Anger & aggression in combat sports: A novel approach to an existing paradigm . Symposium conducted at the meeting of Association for Applied Sport Psychology , Atlanta, GA . Buss , A.H. & Durkee , A
Jens Van Lier and Filip Raes
poor problem solving ( Watkins & Moulds, 2005 ). Studies using conditioning and memory paradigms in students have previously shown that abstract processing of negative events leads to increased negative generalization ( Van Lier, Vervliet, Boddez, & Raes, 2015 ; Van Lier, Vervliet, Vanbrabant, Lenaert
Taylor K. Wise
also identified recurring themes noted in policies and attempted to gain an understanding of what components should be incorporated into future policies. Method Research Design and Participants The post-positivist research paradigm was used to find and analyze existing ED policies specific to athletes