Stronger Athlete Identity Is a Risk Factor for More Severe Depressive Symptoms After Musculoskeletal Injury in Pediatric Athletes: a Systematic Review

Abstract

Purpose of Review Treatment for musculoskeletal sports injuries often neglects the psychological components of health and recovery. Pediatric patients require particular consideration of their psychosocial and cognitive development. This systematic review investigates the effects of musculoskeletal injury on mental health in pediatric athletes. Recent Findings Athlete identity may increase in adolescence and is associated with worse mental health post-injury. Psychological models suggest loss of identity, uncertainty, and fear mediate the association between injury and symptoms of anxiety, depression, post-traumatic stress disorder, and obsessive–compulsive disorder. Fear, identity, and uncertainty also influence return to sport. Summary In the reviewed literature, there were 19 psychological screening tools and 8 different physical health measures with various adaptations to athlete developmental level. In pediatric patients, no interventions were studied to reduce the psychosocial impacts of injury. Musculoskeletal injury is associated with worse mental health in pediatric athletes, and stronger athlete identity is a risk factor for the development of depressive symptoms. Psychological interventions that reduce uncertainty and address fear may help mitigate these risks. More research is needed on screening and interventions to improve mental health post-injury.

Global knee function rating more strongly influences adolescent athletes that sustain a sports‐related surgical ACL re‐injury or contralateral ACL injury

“…In a scoping review of 22 studies and 1852 athletes, Renton et al [35] reported that athletic identity was most frequently associated with psychosocial, behavioural and injury-specific outcomes. In a systematic literature review, Park et al [32] found that in paediatric athletes, musculoskeletal injury was associated with worse mental health, and stronger athlete identity was a depression risk factor. In a study of 269 adolescent tennis players, Johansson et al [16] suggested that higher athletic identity was associated with a greater likelihood for an athlete to attempt to 'play through pain'.…”

Same game, different worlds? General conditions, perceived stress, and associations between stress and past season injuries in elite female and male ice hockey players

“…The strength with which an athlete identifies as an athlete is called athlete identity [ 29 ]. Strong athletic identity is considered a risk factor for mental health problems following injury [ 30 ]. The threat of losing that identity due to injury and psychological distress related to injury is associated with retirement from sport and may explain why the correlation between perceived stress and injury was stronger among male than among female players.…”

Proximal Hamstring Repair With All-Suture Anchors and an Accelerated Rehabilitation and Bracing Protocol Demonstrates Good Outcomes at 1-Year Follow-Up

“…This may be due to high athletic identity, the concept that athletes define themselves based on their sport or activity, which then serves as a basis of their sense of self-worth. 29 A study by Furie et al. 30 found that injured athletes showed greater rates of anxiety and depression compared with the general population and those who had to involuntarily retire from their sport had increased psychological distress.…”