Literature Review 3

Citation:

“Sport-Related Concussion Reporting and Coach-Athlete Attachment Among Collegiate

Student-Athletes.” Journal of Clinical Sport Psychology, vol. 12, no. 2, 2018.

Summary:        

            This article displays the findings from a study regarding coach-athlete attachment and help-seeking behavior relative to concussion reporting. The study shows that as increased coach-athlete anxiousness leads to an increase in not reporting injuries; while coach-athlete secureness increases, not reporting is less likely.

            According to the article, a “concussion is a subset of mild traumatic brain injury (TBI) caused either by a direct blow to the head, face, neck, or elsewhere on the body with a force diffused to the head.” This trauma can result in neurocognitive impairment, sensory-motor difficulties, somatic symptoms, as well as a myriad of psychosocial impairments; which can impact both academic and social performance. Concussion symptoms last longer when injury reporting is delayed. It is estimated that 12%-60% of athletes delay seeking care following concussion. For some athletes, delayed reporting is due to lack of knowledge of the injury; for others, late reporting is influenced by an inter-related mix of expectancies, incentives, and environmental pressures.

            Most concussion reporting- related research has been based off normative and competitive pressures to continue play, rather than take interpersonal context into account. One can explain the coach-athlete relationship using attachment theory. The attachment theory is a developmental paradigm that organizes human behavior, cognition, and emotion from infancy to adulthood to explain the influence of interpersonal dynamics in relationships on how individuals respond to periods of distress. This theory is especially relevant for college athletes, as many are away from home for the first time and coaches act as surrogate parents. When a coach-athlete relationship is healthy, a coach acts as a beacon of safety and comfort for athletes in distress. This type of relationship can explain why an athlete may or may not be willing to report concussions accurately or honestly.

            High anxiety and avoidance are considered insecure forms of attachment, while low anxiety and avoidance are considered secure attachment. Athletes who have high attachment anxiety typically exaggerate experiences, seeking attention and security. Those who have a higher attachment anxiety may also be more likely to be conflicted when reporting an injury due to the consequences they may receive from communication their distress. Individuals who are highly avoidant tend to downplay emotions when responding to attachment figures who angrily or disapprovingly respond to concerns. Avoidant athletes most likely avoid coaches and do not gain a sense of connection, making it more difficult for them to discuss to issues. Secure attachments lead to athletes knowing they can rely on their coaches in times of need.

            The researchers distributed surveys to 1,333 student-athletes online at the University of North Carolina Greensboro. Athletes were asked to indicate sex, age, and sport. A high collision vs. low collision variable was computed using athletes’ reported sport and the NCAA impact expectation by sport list. Participants were asked if they ever experienced concussion symptoms throughout their lifetime; if answered yes, athletes were then asked is they reported it to a coach or trainer. They then asked athletes to respond to statements regarding their coach-athlete relationship on a 7-point Likert scale, ranging from strongly agree to strongly disagree. Lower scores on the avoidance and anxiety scales indicate a higher degree of attachment security and higher scores indicate a greater degree of distress experienced within the relationship. High scores on the secure scale signal high security, while low scores signal low security.

            Results show that coach-athlete anxiousness increases, so do not reports concussions and as secureness increases, not reporting symptoms decrease. It was found that as coach-athlete attachment increases, the likelihood of not reporting symptoms went down, regardless of the anxiety factor. The findings were consistent with the researchers’ hypothesis. Essentially, athletes who have closer relationships with coaches feel more confident approaching coaches about injuries and other general issues.

            It is extremely important for coaches to work on relationships with athletes to ensure a safe, comfortable environment, open to communication. Coaches can use the CAAS scale to indicate the types of relationships athletes believe they are building together. The results reported prove that the use of sport psychology professionals can be useful in creating encouraging concussion reporting environments. Learning more about coach-athlete attachments and athlete communication is critical to the health of current and future athletes.

Authors:

           

The authors of this report are: Jeffery J. Milroy, Stephen Hebard, Emily Kroshus, and David L. Wyrick. Jeffrey J. Milroy is the Associate Director of the Institute to Promote Athlete Health and Wellness, as well as a professor in the Department of Public Health Education at UNC-Greensboro. Stephen Hebard earned his Ph.D. in Clinical Mental Counseling at UNC-Greensboro, while working as a research associate at Prevention Strategies. He is also a member of the Institute to Promote Athlete Health and Wellness. Emily Kroshus is a Research Assistant Professor at the University of Washington. Before working at Washington, Kroshus was a Post-Doctoral Research Fellow at the NCAA, where she conducted research and contributed to program development relevant to concussion and mental health in college sports. David L. Wyrick is the Director of the Institute to Promote Athlete Health and Wellness, as well as an Associate Professor of Public Health Education and Faculty Athletics Representative at the UNC-Greensboro. He works as a prevention scientist and has worked with organizations such as the NFL and NCAA.

Key Term:

Athlete wellness

Coach-athlete attachment

Concussion reporting

Quotes:

“Findings suggest that as coach-athlete anxiousness increases, not reporting increases. And as coach-athlete secureness increases, not reporting decreases. Logic regression analyses indicate that secure coach attachment significantly predicts greater likelihood of SRC reporting. These findings underscore the important role coach-athlete relationships may have on care-seeking behaviors of student-athletes and can inform individual and group interventions promoting SRC reporting,”(268-269).

“The authors suspect that the athletes who securely attached to their coaches are more willing to report their symptoms because they have anticipated an effective interaction with coach when in need of support,” (271).

“Given our knowledge that coach-athlete relationships characterized by negativity are predictive of athlete distress and attrition and positive relationships induce self-efficacy and healthy coping (e.g. Cote, 2002; Smith & Smoll, 2002) coaches could be provided comprehensive training that prioritizes a coach’s reflection on their coaching style and educates them about how their behaviors affect their relationship with their athletes,” (277).

“Learning more about this important relationship can help inform individual and group interventions to better support help seeking for SRC, and potentially other health challenges, among college athletes,” (278).

Value:

            This report is extremely valuable to my report. It relays statistics that show a correlation between coach-athlete attachment/relationships and concussion reporting. The coaches set the tone for team culture. How the coaches interact with athletes greatly influence athlete willingness to self-report sport-related concussions (SRC). It supports my argument that team culture influences how athletes take care of their bodies.