Models of Injury Current Research Injured people experience

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Models of Injury
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Current Research

• Injured people experience more tension, anger,
  depression, confusion, anxiety, fatigue, self
  esteem than non-injured
• Profile of Mood States (POMS) as the instrument
• Not developed for injured people only

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Pxs with Current Research

• Frequency of testing a px
• Group similarities/differences
• Time of 1st data collection

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Predictive Model

• Williams Andersen 1998
• Believe they are able to predict injury using
  psychological variables such as cognitive
  thinking, physiological variables, behavioral,
  intrapersonal, social, and stress hx.
• Most important is

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Stress and Injury Model
History of Stressors
Personality
Coping Resources
Stress Response Cognitive
Physiological/ Appraisals Attentional
Changes
Potentially stressful situation
Injury
Interventions
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• Individuals who are able to manage stressful
  situations or interpret certain environment
  stimuli as being non-stressful may avoid exercise
  related injury.

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Conceptual Basis of Grief

• Studies asso with bereavement, job loss, marital
  separation, loss of a pet, loss of a limb
• Definition an intense emotional suffering set
  off by a loss.
• Significance of the loss is determined by
  individuals value system
• active process that changes over time

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Concepts of Grief cont

• Most research focuses on the stages
• b/t 3-6 stages depending on the researcher
• Each person grieves in their own manner
• Not at the same pace

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Denial as coping strategy

• Shock, numb, disbelief
• Normally 1st
• This cannot be happening to me
• This stage depends on how well the patient is
  prepared for outcome

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When denial no longer works Anger

• Fear, rage, envy, resentment, hostility,
  aggression
• Friends loved ones common targets
• Why me? Why not someone else?
• Unpredictable mood swings
• Maybe even self abuse

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• Length of denial anger stages vary from person
  to person
• Problematic individuals may stay in these phases
  longer

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Grief bargaining

• Series of feelings related to the loss or
  separation
• Dynamic state
• Long for what they use to be
• Live in the past, talk about memories

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Grief cont

• This phase is influenced by
• Nature of loss
• Social system of support
• Personality
• Coping behaviors
• Intelligence
• Social, cultural ethnic and religious backgrounds

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• Initial stage of recovery
• Bargaining begins
• Begins talking to a supreme being
• Attempts to make a deal
• Desperate effort final attempt
• Once they realize there are no miracles coming
  then they enter the acceptance stage

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Depression

• This stage is present in some
• A sense of great loss
• Withdraw from activities social support
• Verbalized helplessness
• Lacks sense of purpose

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Re-integration

• Difficult to define
• A return to normal

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Grief Models versus Cognitive Appraisal Models

• Cognitive models account for individual
  differences in response to injury
• Emphasis is placed on cognition

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Stress Based Cognitive Appraisal

• Ones interpretation of an injury will determine
  the psychological response
• Relationship has been developed b/t emotional
  response to injury and injury severity, duration
  of injury, injury history, social support for
  rehabilitation, physician rated current injury
  status, impairment of performance

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Cognitive Appraisal Concepts

• Trying to understand the process athletes may
  experience in response to injury
• Deals with coping (persons ever changing efforts
  to manage circumstances varies person to person,
  situation to situation)
• Primary Appraisal (assessment of what is at
  stake)
• Secondary Appraisal (assessment of coping options)

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• Deal more with stress (relationship b/t person
  environment)
• Deals with emotional response trying to
  determine why people may experience certain
  emotions

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General Adaptation Syndrome (GAS)

• Selye (1974) a reactive model to stress
• When 1st exposed to a stressor, initial response
  is alarm

Then one of two things happens

• Adaptation phase
• Individual is able to handle the stressor
• Individual becomes stronger

Resistance to other stressors is compromised. If
stressor continues, exhaustion may occur causing
one to give in to stressor
OR
Similar to Erikson we learn through resolving
developmental crises
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• Injury usually results in
• Loss of fine or gross motor movement
• Stress anxiety
• Causes inability to obtain goals

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• See Integrated Model of Psychological responses
  to injury rehabilitation.