Psychological responses to injury in competitive sport: a critical review.

Research has attempted to examine the psychological impact of athletic injury to assist rehabilitation personnel when treating injured athletes. Sports trainers, sports therapists, physiotherapists, medical staff and sports psychologists should be aware of psychological factors impacting on the injury experience when involved in an athlete's rehabilitation. A number of models have been proposed as useful frameworks for investigating and describing the psychological response to athletic injury. Many researchers have relied upon applying or adapting grief and cognitive appraisal models originally derived from the clinical and stress related psychology literature in an attempt to describe the psychological response to athletic injury. This article provides an overview of these models and offers a critical appraisal of this research, specifically focusing on the grief response models and the integrated model of response to sport injury and rehabilitation. Criticisms focus on the lack of research supporting a uniformed sequence of stages as a feature of response to athletic injury. Further grief criticisms centre on the absence of denial in much of the research to date. The article then focuses on the dynamic core of the integrated response to sport injury and rehabilitation model. It is argued that the interrelationships between emotional responses, behavioural responses, cognitive appraisals and recovery outcomes are not as simple as suggested in the model.