BackgroundPsychosocial variables are known to play an important role in musculoskeletal pain. Recent efforts incorporating psychological theory into rehabilitative medicine, as part of patient‐centred care or psychologically informed physical therapy, have gained broader acceptance. The fear‐avoidance model is the dominant psychosocial model and has introduced a variety of phenomena which assess psychological distress (i.e., yellow flags). Yellow flags, such as fear, anxiety and catastrophizing, are useful concepts for musculoskeletal providers but reflect a narrow range of psychological responses to pain.ObjectiveClinicians lack a more comprehensive framework to understand psychological profiles of each patient and provide individualised care. This narrative review presents the case for applying personality psychology and the Big‐Five trait model (extraversion, agreeableness, conscientiousness, neuroticism and openness to experience) to musculoskeletal medicine. These traits have strong associations with various health outcomes and provide a robust framework to understand patient emotion, motivation, cognition and behaviour.Key ResultsHigh conscientiousness is associated with positive health outcomes and health promoting behaviours. High neuroticism with low conscientiousness increases the odds of negative health outcomes. Extraversion, agreeableness and openness have less direct effects but have positive correlations with important health behaviours, including active coping, positive affect, rehabilitation compliance, social connection and education level.Clinical ApplicationThe Big‐Five model offers an evidence‐based way for MSK providers to better understand the personality of their patients and how it relates to health. These traits offer the potential for additional prognostic factors, tailored treatments and psychological intervention.
INTRODUCTION: Pararescue personnel (PJs) deploy in high-risk environments and perform extraordinary missions under intense conditions, requiring an unusual combination of physical and psychological abilities. The rigorous nature of PJ training and the superior levels of fitness and cognitive functioning to perform challenging physical feats in high-pressure, high-intensity environments have prompted military commanders and embedded health care providers to compare successful performance in the PJ mission with the characteristics required of elite, Olympic-level athletes.METHODS: In the current study, we tested this assumption by comparing the social, emotional, and behavioral functioning of 160 U.S. PJ training candidate graduates and 73 elite, Olympic-level track and field athletes using scores on the NEO Personality Inventory-3.RESULTS: Results from this study suggest that although there are physical and psychological challenges inherent in both the PJ and elite athlete career fields, the emotional, social, and behavioral performance of PJs differs in functional ways from the elite athlete population, with PJs scoring significantly lower in Neuroticism and higher in Extraversion and Conscientiousness.DISCUSSION: The results of this study can be used to improve the delivery of embedded mental health services geared toward improving training and enhancing health, recovery, and performance within operational units.Shadle A, Waite L, Chappelle W. Personality trait comparison of pararescue personnel and elite athletes. Aerosp Med Hum Perform. 2022; 93(11):783–790.
In preparation for the 2020–2024 Olympic cycle, members of the USA Track and Field sport psychology (SP) subcommittee investigated the SP service provision needs and preferences of 88 elite Olympic-level athletes. A mixed-methods needs analysis was employed, which consisted of surveys, interviews, and a focus group, to help understand current SP usage and shape future SP services for USA Track and Field. Findings highlighted a lack of knowledge and exposure to SP services and a desire for increased contact with SP professionals among athletes, exposing gaps and room for improvement in service delivery. Athletes cited flexibility in terms of service delivery mode and shared common core preferences for mental training, including help managing stress, pressure, emotions, and other challenges of competition and training. The results are discussed in relation to strengthening the effectiveness of service provision through increasing visibility, accessibility, and education regarding the benefits of SP services.
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