Changes in Athletes' Anxiety, Anger, and Impulsiveness following : Changes in Athletes' Anxiety, Anger, and Impulsiveness following
Concussion
Megan Byrd
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Changes in Athletes’ Anxiety, Anger, and Impulsiveness following Concussion
Megan Byrd, M.S.
Dissertation submitted to the College of Physical Activity
and Sport Sciences at West Virginia University
in partial fulfillment of the requirements for the degree of
Doctor of Philosophy
In
Kinesiology
With an emphasis in Sport and Exercise Psychology
Sam Zizzi, Ed.D, Chair.
Anthony Kontos, Ph.D.
Edward Etzel, Ed.D
Damien Clement, Ph.D., ATC
College of Physical Activity and Sport Sciences
Morgantown, West Virginia
2017
Keywords: Concussion, Sport, Anger, Anxiety, Impulsivity, Mental Health, Athletes
Copyright 2017 Megan Byrd
ABSTRACT
Changes in Athletes’ Anxiety, Anger, and Impulsiveness Following Concussion
Megan Byrd
The impacts and effects of sport-related concussion have been considered a major health concern
as early as 1999 (Kelly, 1999) and have continued to be a prominent topic of controversy among
all levels of sport. Amidst this concern and controversy, the emotional impacts of sport-related
concussion, particularly anxiety, anger, and impulsivity are still relatively unknown. The
primary purpose of this study was to examine the relationship between sport concussions and
anger, anxiety, and impulsivity in collegiate athletes. The secondary purpose of this study was to
determine if there is a subset of athletes who are more likely to exhibit certain emotions based on
pre-existing risk factors, or the manner in which the concussion was sustained. The study utilized
a multi-method, longitudinal design and was sequential in nature. Participants were male and
female collegiate athletes and completed the study during three time points: (a) 1 to 10 days post
diagnosis (n = 30) (b) 11 to 21 days post-concussion (n = 12), and (c) 30 days post-concussion (n
= 10). Slightly more than half (n =16) of athletes reported self or others noticing a difference in
their behavior or mood since sustaining a concussion and the mean on all measures were above
norms for college aged men and women during time point a. Most notably, 11 out of 30 athletes
scored above a 10 on the clinical anxiety measure, indicating a diagnosable level of anxiety for
Generalized Anxiety Disorder. Overall, the results indicated that the athletes were experiencing
anxiety, anger, and impulsivity following concussion and anxiety seemed to be the mediating
factor. The more anxious athletes felt regarding their symptoms and symptomology, the more it
seemed to influence their frustration and behavior. Results indicated that the athletes believed
they would benefit from education regarding the affective symptoms of concussions and that
rehabilitation of concussions should be tailored to each athletes’ symptomology.
iii
Acknowledgments
To say completing a dissertation takes a village would be a vast understatement. Luckily, I have
found myself among incredible people who didn’t give up on me, even when I was ready to give
up on myself. This dissertation journey began five years ago during my PhD interview with Dr.
Sam Zizzi when he asked me what it meant to lose the forest among the trees. So, it’s only fitting
that it ends (or starts a new beginning) in a similar fashion. The magnitude of guidance and
support provided by Dr. Zizzi is unmeasurable and difficult to convey in words. Thank you for
trekking through the literature forest with me and serving as a beacon of light when I found
myself traveling too far. You lead by an example I can only hope to follow and are the type of
advisor I strive to be. You remind me not to take myself too seriously and to always engage in
karmic cleansing. Thank you.
I would like to thank Dr. Anthony Kontos for agreeing to meet me in a coffee shop two years
ago, and even more so for listening to what I assumed were grandiose ideas for a dissertation.
Without your willingness to share your breadth of knowledge and resources, this dissertation
does not happen. Thank you for your honest and genuine feedback and suggestions during this
process. Your work in concussions is inspiring and I’m grateful to play a small part in
improving recovery and rehabilitation for athletes. Thank you.
Dr. Etzel is the source of big picture thinking. Thank you for reminding my why the work we do
is important and how small gestures can make a huge difference. From sending articles about
concussions or baseball to allowing me to sit in your office in the comfy blue chairs when I
needed a minute to myself, thank you for showing me what reaching out looks like. Thank you.
I’m grateful to Dr. Damien Clement for agreeing to be involved in this project even after the self
proclamation, “I don’t mess with concussions.” Thank you for being a stable voice among the
instability that has been this project. You provided information in an area I knew very little about
and did so with patience. Thank you.
To all the help along the way: thank you Trevor Jones, Danielle Funk, Adam Hansell, Brandon
Lucke-Wold, Cindy Holland, Valerie Reeves, Jake Manumalo, Alison Pope-Rhodius, and rest
the staff, faculty, and students at John F. Kennedy University.
When you join a PhD program, you join a family. At WVU, we have a great one. Thank you to
all the SPAFers who came before me, who experienced it with me, and who will come after me.
Ashley, Chelsea, Pete, and Jesse; thank you for always answering my texts and showing me the
way. MegHan, Stefanee, and Tammy; thank you for being my tribe and a source of unwavering
love and support. Sharing in the highs and lows along the way makes everything worth it.
Thank you to all of my friends near and far, and Drew for keeping me sane during an
inconceivably insane situation.
Thank you to my exceptional family. Dad, Mom, Adam, Stephen, and everyone else I’m lucky to
call part of me. You have provided me the opportunity to grow through and never doubted my
abilities. Love you.
v
Table of Contents
Introduction . . . . . . . . . . 01
Concussion Symptoms. . . . . . . . 04
Emotional and Behavioral Responses Following Concussion. . . 04
A New Approach: Concussion Profiles. . . . . . 08
Methods . . . . . . . . . . 09
Research Design . . . . . . . . 09
Participants . . . . . . . . . 10
Instrumentation. . . . . . . . . 12
Procedure . . . . . . . . . 15
Data Analysis: Quantitative Phase. . . . . . . 16
Data Analysis: Qualitative Phase. . . . . . . 17
Results . . . . . . . . . . 18
Quantitative Phase . . . . . . . . 18
Qualitative Phase . . . . . . . . 23
Discussion . . . . . . . . . . 33
Conclusion . . . . . . . . . 53
References . . . . . . . . . . 54
Appendix A – Extended Literature Review . . . . . . 72
Appendix B – Tables and Figures . . . . . . . 148
Appendix C – Consent Form . . . . . . . 150
Appendix D – Assessments . . . . . . . 153
Appendix E – Interview Guide . . . . . . 160
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List of Tables and Figures
Figure 1 – Using Concussions Clinical Trajectories ..
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Table 1 – Athlete Pseudonyms and Demographics Phase 3 Participants.
Table 2- Mean Differences on Paried Samples T-Test
Table 3- Descriptive Data Time Point 1 and 2.
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Table 4 – Bivariate Correlations of Significant Symptoms . .
Table 5- Demographics for Phase 1 and 2 Participants
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1
Introduction
In the 10-year period from 2000 to 2010, emergency room visits for sports- and
recreation-related head injuries among adults and adolescents have increased by 60% (Centers
for Disease Control, 2010). In sport, incidence rates per athletic exposure (number of practices
and competitions in which an individual actively participates) of all high school sports is 4.9 per
10,000 athletic exposures and collegiate sports is 3.4 per 10,000 athletic exposures (Gessel et al.,
2007; Hootman, Dick, & Agel, 2007; Lincoln et al., 2011). A concussion, as defined in the
Zurich consensus statement, is a pathophysiological process resulting in functional neurological
impairments, as a consequence of forceful biomechanical impacts directly on or transmitted to
the head, neck, or face (McCroy et al., 2013). In a retrospective study of 328 collegiate football
and soccer players using self-reported symptoms of concussion, Delaney and colleagues (2002)
found that 62.7% of soccer players and 70.4% of football players experienced symptoms of a
concussion during their previous athletic season. Headache was the most commonly experienced
symptom (71%) followed by confusion and disorientation (56%). A history of concussions have
been shown to be a significant risk factor for repeat concussions (McCrory et al., 2013) and other
neurological conditions, including early-onset Alzheimer’s disease (Graves et al., 1990;
Rasmusson, Brandt, Martin, & Folstein, 1995), chronic depression (Holsinger et al., 2002),
epilepsy (Langlois, Rultand-Brown, & Wald, 2006) and chronic traumatic encephalopathy (CTE;
McCrory, Zazryn, & Cameron, 2007; Omalu et al., 2005).
Unfortunately, stories of athletes who have taken their lives are becoming increasingly
more common. Many of these athletes who have taken their lives have shown signs of brain
injury sustained from concussions in post-mortem brain scans in the form of CTE, a degenerative
2
disease typically caused by multiple hits to the head. CTE can only be diagnosed after death, but
patients with CTE often display symptoms such as impulsivity, forgetfulness, depression, and
sometimes suicidal ideation (Omalu et al., 2005). While the link between CTE and sport
concussion is still being investigated and there are conflicting views on the relationship, it is
clear that athletes are experiencing emotional symptoms following concussion. For example,
qualitative studies with former professional hockey players detailed suicidal ideations in those
who sustained repeated concussions during their career (Caron, Bloom, Johnston, & Sabiston,
2013; Gulli, 2011). In 2014, 22-year-old Kosta Karageorge, an Ohio State football player, and
former collegiate wrestler, was found dead from a self-inflicted gunshot wound. He sustained
numerous concussions throughout his playing career and in a text to his mother prior to his death
Kosta referenced his concussions saying they had his head “all messed up” (Thamel, 2014).
While the link between CTE and sport concussion is still being investigated, and there are
conflicting views on the relationship, tragedies such as this can be prevented with proper medical
attention following concussion.
Concussions are a type of traumatic brain injury (TBI) and while the phrases
“concussion” and “mild TBI” are often used interchangeably this paper will use the term
concussion as a subset of TBI. Concussions may occur from a direct hit to the head, face, neck or
elsewhere that results in a force to the head. Rapid functional neurological impairments are often
a consequence of concussion that may be short-lived or protracted. Concussion severity ranges
from “mild” (i.e., a brief change in mental status or consciousness) to “severe” (i.e., an extended
period of unconsciousness or memory loss after the injury), however all brain injuries are serious
and may occur without loss of consciousness.
3
Due to the nature and the mechanism of concussion, combined with the physical and
psychological symptoms, athletes may be more vulnerable to negative mood states such as
depression, isolation, and anxiety, as compared to athletes suffering from musculoskeletal
injuries (Chen, Johnston, Petfies, & Pitio, 2008; Hutchison et al., 2009). Therefore, the emotional
sequelae following concussion is an area for continued research as a preventative measure
against suicide and other mental health issues. By better understanding the manifestation of
symptoms following concussion, more specific individualized treatment plans can be developed
to aid athletes in their recovery and future health.
Collegiate and professional leagues have reformed rules regarding legality of plays,
equipment, and return to play protocols to enhance athlete safety. However, even with better
detection and stricter rules it has been estimated that as high as 50% of concussions go
undiagnosed (McCrea et al., 2004) due to athletes’ unwillingness to report symptoms, and
delayed symptom onset (Beckwith et al., 2013; Delaney et al., 2002; Duhaime, et al., 2012).
These incident rates do not account for subconcussive impacts, which are characterized as hits to
the head that do not cause a concussion to occur, but repeated exposure has been found to be as
detrimental as concussions (McKee et al., 2009).
Following concussion, and during symptom recovery, an athlete is more susceptible to
future head injury, so return to play decisions should be made carefully and with proper testing
and screening (Baugh, 2014; McCrory et al., 2013). The American Academy of Neurology has
recommended the use of neurological assessment to measure severity and assess treatment,
specifically return to play guidelines (Giza et al., 2013). Neuropsychological assessments, such
as the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT 2.0; Lovell,
4
Collins, Podell, Powell, & Maroon, 2000), test memory function, reaction time, and speed of
cognitive processing.
Concussion Symptoms
Signs and symptoms following concussion are often characterized into four discrete
system clusters: somatic, cognitive, emotional, and sleep-related (Pardini et al., 2004). In 80% of
athletes, these symptoms typically resolve in less than three weeks (Iverson, Brooks, Collins, &
Lovell, 2006) with 20% of athletes experiencing lingering symptoms. Little is known about how
a concussion changes the brain on either a structural or a neurochemical level (Henry, Tremblay,
Boulanger, Ellemberg, & Lassonde, 2010) and so it is difficult to determine if athletes’
psychological symptoms are purely emotional, or if they are caused by change within the brain.
This unknown factor can lead to difficulties in studying athletes with concussions, specifically
the cluster of emotional responses. There is research to suggest that neurobiological and
pathophysiological changes associated with brain injury, regardless of severity level, may be
directly related to the onset of psychological symptoms (Chen et al., 2008; Hudak et al., 2011;
Reger et al., 2012). Concussions and head injuries often damage the prefrontal cortex, ventral
frontal lobe and the anterior temporal lobe, which are implicated in recognizing, regulating, and
reacting to emotionally relevant stimuli (Etkin, 2010; Etkin, 2012; Kennedy et al., 2007).
Emotional and Behavioral Responses Following Concussion
There is substantial research documenting the emotional and behavioral responses
following injury that include depression, tension, anger, anxiety, frustration, and boredom (e.g.,
Brewer, Van Raalte, & Linder, 1991; Leddy, Lambert, & Ogles, 1994). With the combination of
physical and psychological symptoms of concussions, athletes who sustain concussions may
5
experience different emotional responses to injury compared to athletes who have sustained
musculoskeletal injuries (Hutchison et al., 2009). Furthermore, concussions have no outward
visibility, so concussed athletes may present different responses during rehabilitation and
recovery than an athlete who has a visible injury with specific physical limitations.
The most frequently cited and studied emotional symptom following concussion is
depression (Guskiewicz et al., 2007; Rutherford, 1977). Given the high degree of comorbidity
between depression and anxiety (Stavrakaki & Vargo, 1986) and non-concussed injured athletes’
endorsement of anxiety during the rehabilitation process (e.g., Mainwaring et al., 2010; Tracey,
2003) athletes with concussion may be prone to both anxiety and depression after injury. General
anxiety disorder (GAD) in persons following a TBI has been reported at rates that are double
those found in the general population (Hiott & Labbate, 2002). A retired professional hockey
player once described his experience with anxiety following a concussion as, “Anxiety.
Absolutely. That year was the worst I’ve ever felt…use the comparison of having your foot on a
gas pedal and everything is going too fast. Everything was going too fast for me” (Caron, Bloom,
Johnston, & Sabiston, 2013, p. 172).
In a prospective cohort study by Yang, Peek-Asa, Covassin, & Tomer (2015), the authors
found that among 67 male and female Division I collegiate athletes who sustained a concussion
within the 2007-2008 to 2011-2012 seasons, one-fifth of concussed athletes (n = 14, 19.8%)
reported experiencing symptoms of depression, and one-third of concussed athletes (n = 24;
33.8%) reported symptoms of anxiety. Post-concussion symptoms of depression significantly co
occurred with post-concussion state anxiety (OR = 8.35; 95% CI = 2.09, 33.34). Similarly,
Bailey et al. (2010) found that in 47 concussed college football players, 13% of the athletes had
6
elevated anxiety levels as compared to their baseline scores. Additionally, 4% of the athletes had
clinically significant levels of anxiety compared to their baseline scores and met the diagnostic
criteria for an anxiety disorder. These studies demonstrate that athletes do experience feelings of
anxiety following concussion and the findings should be replicated to further understand when in
the recovery process athletes feel anxious and how long the feelings linger.
Athletes with head injury history who have taken their lives may have done so due to
depressive feelings they cannot seem to overcome, although another reason may be due to
increased impulsive behavior while feeling anxious or depressed. Impulsivity is a construct that
encompasses a multitude of behaviors or responses that frequently result in unwanted or
damaging outcomes (Daruna & Barnes, 1993). Impulsivity is a common consequence following
head injury (Rochat, Ammann, Mayer, Annoni, & van der Liden, 2009; Starkstein & Robinson,
1997), and is also related to difficulties with emotional regulation, such as irritability and poor
temper control (Cattran, Oddy, & Wood, 2011). The prefrontal cortex, a commonly injured
region, plays an important role in emotional and behavioral regulation, as well as social
awareness. Grafman and colleagues (1996) suggested that the inability to control one’s behavior
may result from a loss of frontal lobe inhibition due to damage to the subcortical limbic
structures in the brain that are involved in the facilitation of aggression and impulses to act. In
athletes, these impulses may lead to risk-taking behaviors after concussion. Research shows that
male athletes are more likely to engage in risk-taking behaviors, such as substance abuse, alcohol
use, and injurious behavior, than males who are non-athletes (Kokoatlio, Henry, Koscik,
Fleming, & Landry, 1996). Thus, impulse control problems and poor emotion regulation after
concussion could put athletes at greater risk for additional problems such as re-injury (i.e.,
7
returning to sport too soon), self-injury (i.e., suicidal ideation), or dysfunctional behaviors
outside of sport. This risk may be greater given the prevalence of irritability following
concussion.
Eames and Wood (2003) have described a cluster of symptoms characterized by
intermittent states of altered affect or behavior called temporolimbic disorders in patients with
TBI. They have noted that the change in often sudden, unpredictable, and typically “out of
character” for that individual. This type of behavior has been termed an intermittent form of
anger following head trauma, and that is closely related to impulse control disorders. Anger has
been recognized as a prevalent emotion in sport (Brunelle, Janelle, & Tennant, 1999) and has
been endorsed by athletes following sports injury (e.g., Brewer et al., 1991; Leddy et al., 1994).
There are theories as to why anger is experienced after sport injury, many centered on frustration
that accompanies sport injury.
Compared to athletes with musculoskeletal injuries, athletes with concussions have
higher reported levels of anger one and two weeks post injury (Hutchison et al., 2009), but this
research is limited because it did not follow athletes through return to play. Research has yet to
determine if the change in anger was due to removal from play or the concussion itself. Using the
State-Trait Anger Expression Inventory-2 (STAXI-2; Spielberger, 1999), Bailie and colleagues
(2015) examined the impact of TBI on the experience and expression of anger in a military
population. Compared to participants without history of TBI, participants with TBI were four
times more likely to have three or more atypical STAXI-2 scale scores than the control group,
with the largest difference on the state anger scale (η2 = 0.10). This effect indicates that TBI does
8
have a moderate influence on a person’s anger levels, but these findings have not been replicated
in an athlete population.
As a way to illustrate the differences in emotions between athletes with concussion and
other injuries, Mainwaring (2008) presented the concussion crevice profile using data the short
form Profile of Mood States Assessment (Morgan, 1980). It was found that athletes with
concussion had elevated levels of fatigue, low vigor, elevated depression, and confusion scores.
Likewise, as compared to athletes with other types of injury (Hutchison et al., 2009) and non
injured athletes (Mainwaring et al., 2004) concussed athletes had greater mood disturbance,
decreased energy, and increased levels of fatigue and confusion. Based on their research of the
emotional sequelae of concussion, Mainwaring and colleagues (2012) have advocated for more
comprehensive concussion management approaches that include the assessment and
management for emotional symptoms.
A New Approach: Concussion Profiles
As a way for research to unite practice and inform rehabilitation programs, Collins,
Kontos, Reynolds, Murawski, and Fu (2014) have developed a conceptual approach to
developing clinical profiles to inform the treatment of sport-related concussion (Figure 1). The
model suggests using assessment information including a clinical interview and
neuropsychological data from athletes to gauge the trajectory of the concussion and to inform the
treatment plan. Based on empirical data and clinical experience, the model postulates that
symptoms are indicative of the treatment and rehabilitation pathway that would be most
beneficial to an athlete’s recovery. For instance, if an athlete presents with cognitive symptoms
such as confusion and emotional symptoms, such as sadness, the athlete would likely be on the
9
mood and anxiety profile. To determine the concussion profile, athletes would be assessed within
the first seven days of injury when they experience the highest manifestation of symptoms, then
reassessed one to two weeks later. If clinicians can better gauge the trajectory the concussion
may take, the rehabilitation and treatment can be geared toward those specific symptoms.
Based on the existing literature on the emotional sequelae of concussions, particularly the
gaps in understanding of athletes’ experiences over time, the purpose of this study was to explore
the relationship between sport concussions and impulsivity, anger, and anxiety in collegiate
athletes. The study also seeks to determine if there is a subset of athletes who are more likely to
exhibit certain emotions based on pre-existing risk factors, or the manner in which the
concussion was sustained. The study’s repeated measures, multi-method design with multiple
dependent variables will allow the researcher to track emotional responses over time in an athlete
population.
Research Design
Methods
A multi-method, longitudinal design was used to explore the emotional sequelae post
concussion in collegiate athletes. The study was sequential in nature as first the participants were
given the quantitative assessments, which informed the follow-up interviews. The study was
conducted over three time points: (a) 1 to 10 days post-diagnosis, (b) 11 to 21 days post
concussion, and (c) 30 days post-concussion. Time points “a” and “b” reflected the quantitative
portion of the study and the qualitative interviews took place 30 days post-concussion. In
additional to demographic and injury-related items, the participants filled out measures of
concussion symptoms, anxiety, anger, and impulsiveness.
10
The benefit of conducting a multi-method study is the opportunity to follow up on
quantitative scores, or capture differences that are not represented by the measures (Greene &
McClintock, 1985). Furthermore, researchers (e.g., Brewer, 1993; Johnston & Carroll, 1998;
Udry et al., 1997) have recommended the need for using qualitative methods early in the injury
process and collecting several data points in injury recovery. The data from both sources was
used in combination to create a more holistic and detailed description of the experiences of the
participants. The data was not combined for analysis, but to aid in making sense of both sets of
data. As Denzin and Lincoln (2000) stated, triangulation in this perspective, “is best understood
as a strategy that adds rigor, breadth, complexity, richness, and depth to any inquiry’ (p. 5). By
simultaneously tracking multiple emotions in one study over time, this study improves upon
previous research designs regarding the emotional sequelae of concussions.
Participants
Participants were recruited through multiple NCAA institutions, a sports medicine center
and snowball sampling. Thirty-seven athletes were recruited during the course of two years to
participate. Of those 37, a total of 30 collegiate athletes completed the quantitative surveys (81%
response rate) 1 to 10 days post-concussion and 12 of 30 athletes completed surveys (40%
response rate) 11-21 days post-concussion. Ten of 12 volunteered to complete the qualitative
portion of the study 30 days post-concussion (83% response rate). There are two potential
reasons as to why the response rate of athletes declined between 1 to days post-concussion and
11 to 21 days post-concussion. First, athletes may have been cleared to play and no longer
experiencing concussion symptoms, thus no longer interested in completing a survey on their
concussion symptoms. Secondly, participation in all three phases of this study were time
11
consuming and athletes were not compensated for their time. Demographics for athletes who
completed Phase 1 or Phase 2, including scores on the Post-Concussion Symptom Scale, can be
found in Table 5.
Athletes met the inclusion criteria if they were at least 18 years of age and diagnosed with
a sport-related concussion by a medical professional. According to the National Collegiate
Athletic Association (NCAA) concussion policy (NCAA, 2013) the concussion must be
diagnosed by a “physician or physician’s designee.” Concussion diagnosis was based on the
following criteria:
(1) observed or reported acceleration/deceleration of the head (2) any observable
alteration in mental status; and/or (3) observable signs such as confusion, vacant stare,
poor coordination, difficulty concentrating, poor balance; and/or (4) any self-reported
symptoms such as headache, loss of consciousness, nausea, balance problems, or
difficulty reading or concentrating.
Participants were male (n = 23) and female (n = 7) collegiate athletes from soccer (n = 3),
volleyball (n = 2), football (n = 22), lacrosse (n = 1), diving (n=1), and basketball (n = 1) who
sustained a sport-related concussion during the fall 2015 through fall 2016 athletic seasons.
Athletes ranged in year in school from freshman to graduate student, with the highest number of
participants in their senior year (n = 19). The mean age of participants was 20.47 (SD = 2.01).
One fifth (n = 6) of athletes had been diagnosed with more than one concussion during the year.
The range of number of concussions sustained during their collegiate careers thus far was 1 to 4,
with a mean of 1.6 (SD = .95). Slightly more than half (n =16) of athletes reported self or others
noticing a difference in their behavior or mood since sustaining a concussion. Four athletes
disclosed being previously diagnosed with a mental illness. Two athletes indicated they had been
previously diagnosed with anxiety, one athlete reported having a learning disability, and the
12
fourth athlete did not disclose their mental illness. Only 1 athlete who completed all three phases
of the study disclosed previously having a mental illness (anxiety). De
Demographic data for the 10 athletes who participated in all three data collections periods
differed slightly from the athletes who participated in solely the quantitative portion. Participants
mean years of age was similar (M = 20.10, SD = 2.92) to the larger sample. Athletes were male
(n = 4) and female (n = 6) collegiate athletes from football (n = 4), soccer (n = 2), volleyball (n =
2), lacrosse (n = 1), and basketball (n =1). The biggest difference in the samples were the number
of concussions in their college careers (M = 2.3, SD = 1.16) and 80% of the athletes reported self
or others noticing a difference in mood or behavior since their concussion, and one athlete
reported having previously been diagnosed with a mental illness (anxiety disorder). The athletes’
pseudonyms and demographics, including scores on the Post-Concussion Symptom Checklist
can be found in Table 1.
Instrumentation
During time periods 1 (1–10 days post-concussion) and 2 (11-21 days post-concussion),
athletes were given the following quantitative assessments to assess reported levels of anxiety,
anger, and impulse during their recovery period.
(1) Demographic questionnaire (time point 1 only) assessing athletic sport history, age,
sport type, concussion history, how the concussion occurred, and mental health history.
(2) Post-concussion Symptom Scale. Concussion symptoms were measured using the
Post-Concussion Symptom Scale (PCSS; Lovell & Collins, 1998) of the Immediate Post
Concussion Assessment and Cognitive Test (ImPACT Version 2.0; Lovell, Collins, Podell,
Powell, & Maroon, 2000). It is a 21-symptom checklist to document and track concussion
13
symptoms on a 7-point Likert scale (0 = no experience of a symptom to 6 = severe symptom).
The items on the scale were developed to represent player report symptoms as opposed to
medical verbiage (i.e., feeling “slow”). Iverson, Lovell, and Collins (2003) found evidence of
moderate test-retest reliability (r = .65) and pre-to post-season intraclass correlation (r = .55).
Internal consistency reliability on the PCSS in samples of non-concussed high school and college
students has ranged from .88 to .94 (Lovell et al., 2006). In high school and college athletes with
concussions, Cronbach alphas for men and women were .93 and .92, respectively (Lovell et al.,
2006). Symptoms are classified into five categories based on normative data for healthy men and
women and categorized by severity (low-normal, broadly normal, borderline, very high, and
extremely high).
(3) Barratt Impulsiveness Scale-version II. Impulsivity was measured using the Barratt
Impulsiveness Scale–II (BIS-II; Patton, Stanford, & Barratt, 1995). The original scale was
developed to relate impulsiveness, along with anxiety, to psychomotor efficiency (Barratt, 1959).
Through several factor analytic studies (e.g., Barratt, 1965; Barratt, 1985) it was concluded that
impulsiveness was not unidimensional and three sub-trait factors were identified, motor
impulsiveness, non-planning, and attentional impulsiveness. However, the majority of studies
using this scale have reported only the total score, ignoring both the first-and second-factor
subscales (Stanford et al., 2009).
The scale has 30 questions that are ranked on a 4-point Likert scale (1 = rarely/never to 4
= almost always/always), with 4 indicating the most impulsive response. The higher the summed
score for all items, the higher level of impulsiveness. Example items from the questionnaire are
“I plan tasks carefully; I say things without thinking; I am restless at lectures or talks.” This
14
questionnaire has shown good internal consistency in college undergraduates (α = .84, Hatfield
& Dula, 2014) and test-retest reliability (Stanford, et al., 2009). Total score means for men and
women in an adult sample (N = 1577; n = 1178 college students) are 62.8 (SD = 9.2) for men,
and 62.1 (SD = 10.6) for women. Previous studies (e.g., Patton et al., 1995) have used a BIS-11
score of one standard deviation above the mean to designate high impulsiveness.
(4) State-Trait Anger Inventory-2. Perceptions of anger were assessed using the State
Trait Anger Inventory (STAXI-2; Spielberger, 1999). The inventory consists of six major scales
and five subscales measuring the experience, expression, and control of anger. The STAXI-2 is
comprised of 57-items measured on a 4-point Likert type scale (1 = not at all/almost never, 4 =
very much so/almost always). For the purpose of this study, only the State-Anger subscale will
be used. State-Anger (S-Anger; 15 items) refers to an emotional state consisting of subjective
feelings that vary in intensity from mild annoyance to intense fury, accompanied by muscular
tension and arousal of the automatic nervous system. This subscale was chosen for two reasons.
First trait anger, as a personality measure, would not likely be effected in a short period of time.
Second, research by Bailie et al. (2015) found the largest statistically significant effect on the
State Anger subscale when comparing military personnel who had a history of at least one TBI
as compared to a control group of persons with no TBI history (η2 = 0.10). Internal consistency
reliability has a Cronbach alpha value ranging from .73 to .95 for the total scale and .91 for the
S-Anger subscale (Spielberger, 1999).
(5) Generalized Anxiety Disorder 7-item. Anxiety was assessed on the generalized
anxiety disorder 7-item screening measure (GAD-7; Spitzer, Kroenke, Williams, & Lowe, 2006).
It has 7 items answered on a 4-point Likert Scale (0 = not at all sure; 3 = nearly every day). The
15
GAD-7 is a clinical anxiety assessment, with a score above 10 indicating a probable diagnosis of
anxiety, and a score above 15 indicating severe anxiety. This measure was developed based on
the anxiety disorder diagnosing criteria in the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition (DSM-IV). In the construction of the assessment, patients who were
diagnosed with GAD had a mean score of 14.8 (M = 14.8; SD = 4.7), compared to a mean score
of 4.9 (M = 4.9; SD = 4.8) of people without GAD. Participants are prompted with “Over the last
2 weeks, how often have you been bothered by the following problems?” Example problems are
“feeling nervous, anxious, or on edge” and “trouble relaxing.” Internal consistency was reported
as Cronbach alpha α = .92, and test-retest reliability has shown good intraclass correlation of .83.
This measure was chosen because it is brief and can be used as a screening tool for athletes. All
participants were provided with information to counseling services, in addition athletes who
scored above 10 on this measure were followed up with by the PI and encouraged to seek
counseling services.
Procedure
Institutional Review Board approval was obtained at two institutions, a large Mid
Atlantic Division I university and a Regional Medical Center. Participants were recruited for
voluntary participation via team doctors, head athletic trainers, or through snowball sampling
from other participants. Once recruited, athletes gave informed consent via signature or online
acceptance prior to taking part in the study (Appendix C). All athletes were assigned a code
number and identifier kept separately from the data to protect confidentiality. Athletes completed
the surveys in-person or using Qualtrics online software. All data was stored in a password
16
protected computer inside a locked office and on a secure online database (Qualtrics Research
Suite, 2014).
After athletes completed the questionnaires at time point 2, an interview time was
scheduled. At time point 3, the athletes participated in a semi-structured interview with the head
researcher via synchronous computer-mediated interviewing on Skype (n = 1), face-to-face (n =
1), or telephone (n = 8). The purpose of the interviews were to capture the athletes’ experiences
with their emotional changes that could not be assessed via the quantitative measures. Semi
structured interviews were used to provide participants “flexibility to express their opinions,
ideas, feelings, and attitudes” (Smith & Sparkes, 2016, p. 103). The majority of interviews lasted
approximately 35-40 minutes, were audio recorded and then transcribed verbatim. The interview
modality was chosen by the participant depending on travel and their convenience. Non-verbal
communication from the two athletes who participated in the Skype and face-to-face interviews
were noted. Although phone interviews can lose the physical information provided by face-to
face interviews, Hanna (2012) argues that telephone interviews provide safety for participants
that may lead to the disclosure of sensitive information they might be hesitant to share in face-to
face interviews. The interview guide asked athletes to explain their experiences with the
emotional impacts of concussion, by prompting them with their survey scores (e.g., “You scored
X on the anxiety measure. Can you tell me more about the anxiety you were feeling regarding
your sport concussion?; Where do you think these emotional changes come from?”).
Data Analysis: Quantitative Phase
Descriptive statistics. Descriptive statistics were used to determine the characteristics of
the sample based on (a) gender; (b) age; (c) sport (e) concussion (g) range of scores on
17
instruments, including means, medians, modes, and standard deviation per item and overall
scores at 1 to 10 days post-concussion and 11 to 21 days post-concussion. Descriptive data for
each time point can be found in Table 3.
Inferential Statistics. Three, one way repeated measures ANOVAs were calculated
used to answer the first research question: “Do athletes’ measured levels of impulsivity, anger,
and anxiety change after sustaining a concussion during their sport season?” It was hypothesized
that the athletes will score highest out of the three time points on impulsivity, anger, and anxiety
after an athlete has been cleared to play.
To determine if there is a subset of athletes who are more likely to exhibit certain
emotions based on pre-existing risk factors, Pearson correlation coefficients were calculated to
show the bivariate relationship between each of the symptoms assessed (i.e., headache, dizziness,
fatigue, balance problems, sadness, nervousness) and emotional responses (i.e., anger, anxiety,
and impulsiveness).
Data Analysis: Qualitative Phase
Qualitative data was analyzed using thematic analysis (Grbich, 1999; Braun & Clarke,
2006). Thematic analysis allows for patterns to emerge and be described across an entire data set
(Braun, Clarke, & Weate, 2016). First, the researcher familiarized self with the qualitative data
by transcribing or reviewing the transcriptions of the interview and then generated initial codes
throughout the data set. Initial codes were generated using abductive coding to establish three
higher themes based on pre-determined dependent variables of (1) anxiety, (2) anger, and (3)
impulsivity. Next, themes were searched for and organized in lower order themes that were
coded using InVivo Coding (Strauss, 1987). This type of coding is used to ensure that themes
18
and concepts are as representative of the participants’ words as possible. Themes were then
reviewed in relation to the dataset and checked for examples that did not fit within the themes.
The code of impulsivity required extensive example checking as the athletes talked about a range
of items within this topic. Lastly, themes were refined and links between the themes were
created.
Reliability of the interviews was established by audio-recording all interviews and
transcribing the interviews verbatim. Additionally, quotes have been presented in length with the
question that prompted the response included where applicable. Data trustworthiness was
established through using specific questions to capture significant experiences related to
concussion (Denzin & Lincoln, 2015). Another way to ensure the trustworthiness of findings is
through methodological integrity (Levitt, Motulsky, Wertz, Morrow, & Ponterotto, 2017). Levitt
and colleagues (2017) describe methodological integrity as a context-driven approach where the
research design and procedures support the research goals. As the purpose of this study was to
understand how athletes experience emotional effects after concussion, using a sequential design
of quantitative assessments to influence qualitative interviews fits this approach.
Results
Quantitative Phase
Descriptive Data. Assessment means were higher during 1 to 10 days post-concussion
than 11 to 21 days post-concussion, with the exception of the BIS-II. The athletes mean score on
the STAXI-2 was 22.9 (SD = 10). The mean on the STAXI-2 decreased to 19.33 (SD = 6.7) 11 to
21 days post-concussion. The mean score on the BIS-II 1 to 10 days post-concussion was 66.53
(SD = 10.8) and 67.5 (SD = 10) 11 to 21 days post-concussion. On the GAD-7, the mean score
19
was 7.4 (SD = 5.6) 1 to 10 days post-concussion and decreased to 6.25 (SD = 6.6). Eleven
athletes scored above a 10 on the GAD-7 1 to 10 days post-concussion, indicating a probable
diagnosis of anxiety. Athletes scored a mean of 47.7 (SD = 30.2) on the PCSS 1 to 10 days post
concussion and substantially lower 11 to 21 days post-concussion with a mean of 16.0 (SD =
16.3). By gender, women average symptoms were 45.14 (SD = 35) and men scored an average of
16.3 (SD = 19.6) at 1 to 10 days post-concussion. At 11 to 21 days post-concussion, women had
an average of 16.3 (SD = 19.6) and men had an average of 15.2 (SD = 15.9). Mean scores and
standard deviations for all variables can be found in Table 3.
Effect of Time on Outcome Measures. Mean differences in scores on the assessments
were only significant on the Post-Concussion Symptom Checklist (PCSS). On the PCSS, athletes
selected significantly more concussion symptoms (M = 53.7, SE = 8.26) t(11) = 5.55 p < .05, r=
.83 1 to 10 days post-concussion that 11 to 21 days post-concussion. The range of scores 1 to 10
days post-concussion was 1 to 92 (M = 47, SD = 30.1), and the range of scores 11 to 21 days
post-concussion was 0 to 42 (M = 16, SD = 16.3). At 1 to 10 days post-concussion, headache was
the symptom selected the most often (n = 28) and with the highest intensity (M = 3.2, SD = 1.8).
The next most frequently endorsed symptoms were fatigue (n = 23), feeling fogging (n = 23),
and difficulty remembering (n = 23) and irritability (n = 21). At 11 to 21 days post-concussion,
fatigue (M = 1.3, SD = 2.2, n = 4), excessive sleep (M = 1.8, SD = 2.3, n = 5), irritability (M =
1.8, SD = 2, n = 6), feeling foggy (M = 1.3, SD = 1.8, n = 5), and difficultly concentrating (M =
1.5, SD = 2.1, n = 6), and difficulty remembering (M = 1.2, SD = 1.9, n = 4) were the only
symptoms with means above 1.0.
20
When only including the 10 participants who completed all three phases, significant
differences were found on the GAD-7. All participants indicated some feelings of anxiety (M =
10, SD = 3.68) 1 to 10 days post-concussion with five of the ten participants scored above a 10
on the GAD-7, a screening tool for anxiety. A score above 10 on this tool is indicates a probable
diagnosis of anxiety and of those, one scored 17, indicating severe anxiety. All athletes who
scored above a 10 were referred to counseling services. AT 11 to 21 days post-concussion
athletes scored an average of 5.5 (SD = 5.7). Athletes endorsed significantly higher feelings of
anxiety (M = .2, SD = 3.12) t(9) = 2.32, p < .05, , r = .57 during 1 to 10 days than 11 to 21 days
post-concussion. Nine of 10 athletes scored lower at the second point (M = 5.5, SD = 5.68), with
the exception being the athlete who indicated previously being diagnosed with an anxiety
disorder.
Mean differences between 1 to 10 days and 11-21 days post-concussion on the anger and
impulsivity measures were not significant with all participants who completed both quantitative
phases (n = 12) or with the athletes who completed all three phases (n = 10). All mean
differences can be found in Table 3.
Correlational Analyses. To determine if there was a relationship between reported
symptoms, concussion history, and scores on the three assessments, several point-biserial and
bivariate correlations were conducted. Point-biserial correlations were conducted on the
dichotomous variables where a response of no was equal to zero, and yes was equal to 1. There
was a significant relationship between the variable “Have you or others noticed a difference in
your behavior or mood since sustaining a concussion?” and the variable “How many concussions
have you been diagnosed with in your college career?”, rpb (28) = .52, (all p
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Examining the Impact of a Short-Term Psychological Skills Training Program
on Dancers’ Coping Skills, Pain Appraisals, and Injuries
Leigh A. Bryant, MS, MA
Dissertation submitted to
the College of Physical Activity and Sport Sciences
at West Virginia University
in partial fulfillment of the requirements for the degree of
Doctorate of Philosophy in
Sport and Exercise Psychology
Damien Clement, PhD, ATC, Chair
Edward F. Etzel, EdD
Kelly Knox, MFA
Monica Leppma, PhD
Sam Zizzi, EdD
College of Physical Activity and Sport Sciences
Morgantown, West Virginia
2017
Keywords: intervention, injury, psychological skills training, dance, pain appraisal, coping
Copyright 2017 Leigh A. Bryant
ABSTRACT
Examining the Impact of a Short-Term Psychological Skills Training Program
on Dancers’ Coping Skills, Pain Appraisals, and Injuries
Leigh A. Bryant
Psychological skills interventions are often conducted with individual athletes and sports teams
in an effort to build mental toughness, prevent injury, or enhance performance. Dancers remain
an underserved population in the delivery of sport/performance psychology services, with
extremely limited literature addressing college dance students. The dance community has several
inherent physical and psychosocial demands, which can promote resilience. However, dancers
may also strive to meet these demands by employing unhealthy coping strategies that could be
linked to maladaptive appraisals and increased injury risk. The present study examined the
impact of a psychological skills intervention program on college dance students’ (N = 30) coping
skills, pain appraisals, and injuries over a six-week period. A two-group pre-test/post-test quasi
experimental methodology was used to capture the potential influence of the intervention
program. At the end of the six-week period, there were no significant differences observed
between the treatment and control groups on the three major constructs. In particular, the results
demonstrated the need for a single, operational definition of injury within the dance context. A
focus group discussion led to several recommendations for future research and improvements for
mental skills and life skills intervention programs. Best practices for scholars, applied
practitioners, and dance educators are also discussed.
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
iii
ACKNOWLEDGEMENTS
I would like to thank my Committee Chair, Dr. Damien Clement, for your thorough feedback
and encouragement throughout the dissertation process.
I would also like to thank the other members of my committee—Dr. Ed Etzel, Dr. Monica
Leppma, Professor Kelly Knox, and Dr. Sam Zizzi—for the time and energy that you put into
helping me complete this project.
A big “thanks” to all of the faculty, staff, and students in the Sport & Exercise Psychology and
Counseling programs at West Virginia University.
Another big “thanks” to the dancers who took part in this study, and the instructors and
administrators who supported their participation.
Special thanks to Alison Coates, Jana Fogaça, Stefanee Maurice, and Anna Onderik for your
interest in and contributions to this project.
Finally, thank you to my parents—Neil and Jennifer Bryant—and to my husband—Kurt
Skvarla—for your love and support.
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
iv
TABLE OF CONTENTS
Page
Introduction …………………………………………………………...……………….……….. 1
Methodology ………………………………………………………………...……………......... 8
Research Design ………………………………………………………...……….……... 8
Participants ………………………………………………………...……………..…...... 8
Dance Program Characteristics and Setting ……………………………………...…….. 9
Instrumentation …………………………………………………….……………...…... 12
Basic Demographics Survey …...………………………….…………………….…...... 12
Athletic Coping Skills Inventory-28 ……………………….…………...…….….…..... 12
Pain Appraisal Inventory .……...………………………….………………....……....... 15
Injury Tracking Survey ……………………………………………………...……..….. 17
Dance Experiences Survey ……………………………………………..….………….. 18
Intervention Program …………………………………………………..…….………... 19
Adherence Journal ……………………………………………………..….………...… 21
Procedure …………………………………………………….……………..…………. 21
Data Analyses ……………………………….…………………………..…………...... 25
Results …………………………………………………….……………………..…………..... 27
Descriptive Statistics ………………………………….……………………..……...… 27
Quantitative Results ..……………………………………………………..………..…. 28
Qualitative Results ……...…………………………………………….…..…...……… 29
Exploratory Findings ….…………………………………………………..………..… 33
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
v
Discussion ……………………………………………………………………….……..……... 36
Limitations ……………………………………………………………….…….…..…. 53
Future Recommendations …………………………………………….….…...….…… 57
Implications for Practice ……………………………………………………….…..… 62
Concluding Thoughts ……………………..……………………………….……….… 66
References ……………………………………………………………………….………..….. 67
Tables ………………………………………………………………………………....……… 77
Appendices ……….………………………………………………………………….....…...... 88
Appendix A: Extended Review of Literature ….……………………………….…….. 88
Appendix B: Basic Demographics Survey ………………………………………...…138
Appendix C: Athletic Coping Skills Inventory-28 ………………………………….. 141
Appendix D: Pain Appraisal Inventory …………………………………...…..…….. 144
Appendix E: Injury Tracking Survey………………………………………….…….. 146
Appendix F: Dance Experiences Survey …………………………………....………. 149
Appendix G: Intervention Protocol Outline ……………………………...…………. 155
Appendix H: Intervention Program Exercises and Activities …………..……...…… 157
Appendix I: Adherence Journal …………………………………………………….. 167
Appendix J: Participant Contact Information Form………...………………..…...… 168
Appendix K: Semi-Structured Interview Guide for Focus Group Discussion ….….. 169
Appendix L: Stakeholder Interview Findings …………………………………..….. 170
Appendix M: Sample Self-Talk Statements and Associated Bible Verses ……..….. 173
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 1
Introduction
Dancers are considered to be both artists and athletes, given the rigor of their physical
training, the necessity of self-expression, and the emphasis on the mind-body connection (Dick
et al., 2013). A dancer’s body is trained to move in complex, highly-technical ways and to stand
in atypical positions (e.g., on the tips of one’s toes). For this reason, dancers often have time
limited careers, with very few individuals performing beyond their thirties (Kelman, 2000;
Turner & Wainwright, 2003; Watson, 2013). Additionally, the path to artistic perfection is a
never-ending process, because one’s performance cannot be objectively measured by a judge or
audience member (Dick et al., 2013; Estanol, Shepherd, & MacDonald, 2013). Many dancers
spend the entirety of their careers making technical and aesthetic improvements. They strive to
maintain a slim and athletic physique, endure long rehearsal hours, and execute advanced
technical requirements (Grove, Main, & Sharp, 2013; Hamilton & Robson, 2006; Shah, 2008).
With no final score to use as a measure of success, dancers often need to engage in self-reflection
to assess their strengths and areas for growth.
As Kelman (2000) has stated, “dancers must be physically strong and have a high
tolerance for pain. The performing artist’s instrument is their body” (p. 431). The mentality of
“no pain, no gain” that is often used to characterize an intense sport climate may also be an
appropriate description of a passionate dancer’s assessment of pain or injury (Anderson &
Hanrahan, 2008). When adopted and reinforced, this “push through it” mindset can be one that is
self-motivating and temporarily adaptive. Nevertheless, it is also possible that this mindset can
contribute to injury risk if the pain is not properly identified and addressed (Anderson &
Hanrahan, 2008; Rip, Fortin, & Vallerand, 2006). In other words, dancers who conceal or ignore
physical pain in order to keep training and performing (Krasnow, 2005; Noh & Morris, 2004)
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 2
may be doing more damage to their body, and negatively influencing the environment in which
they want to thrive (Anderson & Hanrahan, 2008).
The physical demands and the socio-cultural climate of many schools and studios (Dick
et al., 2013; Grove, Main, & Sharp, 2013) may lead dancers to a metaphorical tipping point. In
some cases, dancers demonstrate resilience in the face of such pressures and engage in strategies
that can enhance performance and well-being (e.g., Rivers, 2014). However, a lack of coping
skills can lead to disruptions in dancers’ ambitions, or the adoption of destructive behaviors
(Kelman, 2000; van Staden, Myburgh, & Poggenpoel, 2009). For instance, obsessive passion can
lead to inattentiveness to pain and injury (Rip, Fortin, & Vallerand, 2006). Similarly, low levels
of self-awareness about how to properly manage pain or recognize injuries that require medical
attention might put dancers’ short- and long-term health at risk (Nordin-Bates et al., 2011).
Therefore, it is critical to understand dancers’ appraisals of pain, how these appraisals
relate to the desire to keep improving, and what factors influence dancers who engage in positive
or adaptive coping strategies, such as those that might be introduced in a prevention or
intervention program. As stated by Noh, Morris, and Andersen (2007), “the focus on enhancing
coping skills…[may] help dancers cope more effectively with the demands of the dance
environment and reduce injury incidence” (p. 28). To date, very little research has examined the
delivery of psychological skills training programs to dancers (Noh, Morris, & Andersen, 2007).
Historically, these programs have focused on repairing—rather than preventing—dysfunctional
coping strategies, unhelpful cognitive habits, and injuries (Hays, 2002).
The literature shows that in an eight-month period, up to 97% of university dance majors
may experience an injury (Kerr, Krasnow, & Mainwaring, 1992). Other researchers have also
reported high rates of injury, with one sample of pre-professional dancers sustaining an average
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 3
of 1.42 injuries per dancer over the course of a year (Ekegren et al., 2013). Dancers deal with
both acute and chronic injuries such as ankle sprains, anterior cruciate ligament tears, tendonitis,
and stress fractures (Bauman, Gallagher, & Hamilton, 1996; Dick et al., 2013). As such, they are
likely to cope with injury related pain in addition to generalized pain that may stem from training
and performing.
Sustaining an injury may have several consequences for a dancer (Mainwaring, Krasnow,
& Kerr, 2001). More specifically, being injured may necessitate taking time off from dancing,
which may equate to missed opportunities to advance one’s development. Dancers who have a
strong athletic identity (Brewer, Van Raalte, & Linder, 1993) and/or contingent self-worth (Hall
& Hill, 2012) may experience decreases in self-esteem should they become injured or have to
manage chronic pain. Moreover, for dancers who are employed or seeking employment, the
inability to work can result in financial strain (Kelman, 2000; Wainwright, Williams, & Turner,
2005). Financial pressures could lead to additional stress, and possibly the need to pursue a
different career.
These potential consequences may serve as motivation for dancers to keep injuries
hidden. Dancers may self-medicate in an effort to treat or cover-up injuries and/or pain without
interfering with regular training and performances (e.g., Wozny, 2016). While researchers have
noted that some dancers do inform a teacher or director that something is bothering them, they
will nevertheless continue to dance (Nordin-Bates et al., 2011). Nordin-Bates and colleagues
(2011) have further suggested that dancers may view rest as a form of “non-constructive
passivity” that could have consequences for their fitness, technical training, and/or status, as
previously described (p. 82). Therefore, although missteps or improper technique can lead to
physical injury in dance, sometimes injuries may occur due to one or more psychological and/or
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 4
psychosocial factors (e.g., Noh & Morris, 2004; Noh, Morris, & Andersen, 2005; Nordin-Bates,
Quested, Walker, & Redding, 2012; Smith, Ptacek, & Patterson, 2000).
Coping skills, pain appraisals, and injury status may be important to a dancer’s mental
well-being and performance-related outcomes. To characterize dancers’ perceived stressors,
Noh, Morris, and Andersen (2002) conducted a qualitative investigation with a sample of
professional ballet dancers. The researchers found that fear of injury, dance directors’ criticism,
and competition for roles were prevalent. Additionally, over 60% of the dancers in their sample
reported engaging in dysfunctional coping behaviors (e.g., drinking alcohol) as a means of
dealing with perceived stress. Consistent with literature focused on stress and coping, researchers
have identified several factors that may make individuals more susceptible to injury in a stressful
situation. These factors include low levels of coping skills, high state-trait anxiety, and a history
of several negative life events (e.g., Yatabe et al., 2014).
Consequently, it is important for dancers, and those who work with them, to be equipped
with accurate, evidence-based knowledge about healthy coping skills, adaptive pain appraisals,
and injury risk. Andersen and Williams (1988) have developed and revised a model that explores
the relationship between stress and injury in sport (Williams & Andersen, 1998). The model
emphasizes personality, coping skills, and history of stressors as antecedents to injury risk
(Andersen & Williams, 1988; Noh, Morris, & Andersen, 2005). Researchers have previously
used this model with dancers to target coping skills as a protective factor for injury (e.g., Noh,
Morris, & Andersen, 2007).
In the present study, Williams and Andersen’s model (1998) was used as a lens through
which to view the role of interventions focused on coping skills, cognitive appraisals of pain, and
injury risk in a collegiate environment. In particular, the impact that intervention content may
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 5
have on cognitive appraisal was of interest to the primary researcher. While the model is often
said to be linked to acute injury prediction, it was used in the present study to understand the
relationship between intervention programming and cognitive appraisal of situations that could
lead to or include dance-related pain and/or injury.
The model also highlights the potentially meaningful role of coping skills when
managing perceived stress. Thus, learning skills to identify and manage stress has implications
not only for dancers’ performance-related outcomes, but also for their other life pursuits. A life
skills approach to the intervention content may help dancers to better recognize the applicability
of psychological skills training to their academics, social situations, and/or personal development
(e.g., Danish, Petitpas, & Hale, 1993). Accordingly, the primary researcher developed and
selected instruments and program content tailored to a dance population, and, more specifically,
for university-level dance students. The psychological skills training program was ultimately
aimed at dancers’ coping skills, appraisals of physical pain, and self-reported injuries over a six
week time frame.
The present study sought to contribute to the current applied research literature in the
field of sport/performance psychology. Noh and Morris (2004) previously used Williams and
Andersen’s (1998) model to design injury prevention programs with a sample of Korean dancers
(N = 105). The authors examined the predictive power of coping skills, stress, social support, and
anxiety on injury frequency and duration, further testing the veracity of the stress-injury model to
the dance population. Building on this work, Noh, Morris, and Andersen (2007) published the
findings of two intervention programs used with a sample of dancers (N = 35) for the purpose of
injury prevention across a 24-week period. The first 12 weeks of the intervention program
consisted of the delivery of coping skills content, and the subsequent 12 weeks were used to
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 6
collect follow-up data as dancers practiced these skills. Their results suggested that teaching
broad-based coping skills could in fact influence the duration of dancers’ injuries. Noh and
colleagues (2007) reported that dancers who were assigned to a treatment group spent less time
injured than dancers who were assigned to a control group.
While some research focused on coping skills and injury has been conducted within the
dance population, the current literature contains few intervention programs delivered to dancers
in a group context. Consequently, the present study’s methodology is rooted in literature from
psychology, counseling, and family systems, which all, to some extent, utilize group sessions,
cognitive-behavioral approaches, and brief interventions. Researchers have suggested that, in just
a few sessions, individuals have the capacity to learn new material and make long-term
behavioral changes (e.g., Bell, Skinner, & Fisher, 2009; Meichenbaum, 1993). In this way, the
present study allowed dancers to learn and then apply psychological skills into their training and
performances.
It was hoped that these skills and strategies might positively influence dancers’ stress
management and injury susceptibility, and also translate to other life pursuits such as social
situations or academics. Hamilton and Robson (2006) have stated that consultants who work
with performing artists have the opportunity to teach “constructive strategies that enhance
performance” while helping dancers to recognize and change self-destructive behaviors or
coping methods (p. 257). The constructive strategies that they discussed included diaphragmatic
breathing, relaxation exercises, positive self-talk, and imagery (Hamilton & Robson, 2006).
These strategies have previously been taught to non-elite and collegiate athletes across a
variety of sports, including gymnastics and rowing. For instance, over the course of a
competition season, Kerr and Goss (1996) conducted individualized sessions with young adult
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gymnasts (N = 24) that focused on thought control, imagery, and self-talk. While no statistically
significant findings were reported, the researchers found that the gymnasts who had participated
in the intervention program had lower levels of negative athletic stress at the end of the season.
Furthermore, Perna, Antoni, Baum, Gordon, and Schneiderman (2003) conducted a three
week intervention program that focused on stress management for college rowers (N = 34). Two
practitioners taught athletes assigned to a treatment group a variety of skills for performance
enhancement and personal development. These skills included deep breathing, progressive
muscle relaxation, and imagery. At the conclusion of the intervention program, the researchers
found that athletes who had been assigned to the treatment group had fewer reported injuries and
illnesses compared to the athletes who were assigned to a control group. The results of these
studies, in combination with their limitations and future recommendations, suggest that
interventions focused on psychological skills and life skills development can have an important
impact on young adult athletes with respect to performance and overall well-being.
Therefore, the purpose of the present study was to examine the impact of a short-term
psychological skills training program on college dancers’ self-reported coping skills, pain
appraisal, and injuries. This psychological skills training program was rooted in the stress
management and performance enhancement literature, and adopted a cognitive-behavioral
approach. In accordance with the study’s purpose, the four main research questions were: (1) Is
there a difference in self-reported coping skills between dancers who participate in the
intervention program and those who do not? (2) Is there a difference in self-reported pain
appraisals between dancers who participate in the intervention program and those who do not?
(3) Is the rate and severity of injuries affected by the intervention program? (4) What are the
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dancers’ reactions to this intervention program, and, more specifically, what aspects of the
program were useful and not useful, and why?
Methodology
Research Design
The present study utilized a two-group pre-test/post-test quasi-experimental design (Gay
& Airasian, 2003). Participants were assigned to a condition, as a group, based on the dance
course in which they were enrolled for the spring 2016 semester. One class was assigned to be
the treatment group; this group completed study-related instruments and received a short-term
psychological skills intervention program on a weekly basis. The other class was assigned to be
the control group; this group also completed study-related instruments without participating in
the intervention program. This type of research design is commonly utilized in educational
settings, where purely random assignment of participants to groups is not feasible or practical
(Gay & Airasian, 2003). The treatment group participants were currently enrolled in a modern
dance course, and the control group participants were currently taking a dance conditioning
course. These classes were part of the dance program curriculum and led by full-time faculty
members at the institution.
Participants
Participants were male (n = 4) and female (n = 26) dance students (N = 30) studying at
the same institution in the Mid-Atlantic region of the United States. Students were encouraged to
participate by their instructors, but ultimately the decision to participate was their own. One
student was deemed ineligible to participate due to age (less than 18 years), and one student in
the control group asked to be removed from the study.
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Participants’ ages ranged from 18 to 22 years (M = 19.77, SD = 1.45). On average,
dancers reported a range of 3 to 19 years of dance training (M = 13.30, SD = 4.50). Participants
represented all four class years, namely freshman or first year (n = 13), sophomore (n = 2), junior
(n = 12), and senior (n = 3). Prior to their participation in this study, few dance students had
experience working with a sport psychology consultant (n = 3). The remaining students (n = 27)
indicated no prior experience with a sport psychology consultant in an individual or group
setting. At the start of the study (i.e., during the first week), almost half of the participants (n =
13) indicated that they were currently suffering from one or more injuries; four injured dancers
were in the control group, and the other nine were in the treatment group.
On average, dancers in the treatment group were 2.4 years older than dancers in the
control group. Dancers in the control group were slightly younger (Mage = 18.60, SD = 0.91) than
dancers in the treatment group (Mage = 20.93, SD = 0.80). Members of the control group reported
a range of 14 to 25 hours of dance training per week. Members of the treatment group reported a
range of 11 to 28 hours of dance training (see Table 1 for basic demographic information).
The sampling procedure used in this study was both convenient and purposive (Patton,
2002). An appropriate sample size was determined prior to the start of the study. A sample of 28
participants was deemed suitable by the primary researcher in consultation with a statistician and
G*power software (Faul, Erdfelder, Lang, & Buchner, 2007) by adopting a moderate effect size
of 0.56 (Cohen, 1988) with a desired power of 0.80.
Dance Program Characteristics and Setting
Based on self-reported data from the participants, their dance program was somewhat
rigorous, requiring a number of hours of class, rehearsal, and/or performance that is comparable
to the 20 countable hours put forth by the National Collegiate Athletic Association (NCAA) for
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college student-athletes. Of the 30 participants, 29 reported that they had to audition in order to
be admitted into the program. When asked to describe the technical focus of their program, 77%
of dancers (n = 23) described their program as ballet-based, and the other 23% of dancers (n = 7)
described the program as either mixed-repertoire or consisting of more than one technical
discipline (e.g., ballet, modern). Dance majors at this liberal arts institution could receive either a
Bachelor of Arts degree in Dance or a Bachelor of Fine Arts degree in Dance, with the latter
degree traditionally requiring additional studio work to prepare students for a professional career
in the dance industry.
The program is housed in an on-campus building, which consists of several dance studio
spaces, dressing rooms, and faculty/staff offices. There were pianos in the studios for times when
live accompaniment was offered for class. The studios were well-lit, clean, and had flooring that
was appropriate for dance conditioning and performance. Outside of the studios, there was a
lounge where dancers could stretch, eat, socialize, use their phones or iPods, and complete
written homework between classes. Based on the primary researcher’s observations, this lounge
area encouraged a sense of “community,” such that multiple conversations could be held at once,
and people would make the space their own by spreading out textbooks, lunch boxes, or their
own bodies when they needed to recover from or prepare for a technique class. The lounge area
also housed resources for students, such as exercise DVDs, stretching equipment, and dance
program photo albums.
When the primary researcher arrived to the site each week to meet with the dancers in the
treatment group, the lounge area served as the “home base” for the project. It was here that
dancers could seek out the primary researcher for questions and concerns. One dancer used this
space for a few brief individual consultations with the primary researcher about managing stress
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and expectations. Another dancer approached the researcher in the studio space to inquire about
an approach to stress management that a family member had utilized. A third dancer asked the
researcher for more information on health/wellness careers such as performance psychology, and
the researcher shared resources in a brief in-person meeting and via email correspondence. It
should be noted that many dancers in the treatment and control groups acknowledged the
primary researcher’s (and research assistant’s) presence in the lounge, but very few asked for
advice or consultation over the six-week period, particularly when in the presence of other dance
students.
The primary researcher and research assistant observed that classes seemed to
consistently begin a few minutes late, either due to students still transitioning from a previous
class, or the faculty member needing to take a few minutes to switch focus from a meeting and/or
to finalize content. The most commonly observed dance class was the one that the treatment
group participants were taking (i.e., modern dance). This class was fairly structured, and it was
clear from observing that the students were accustomed to this structure. Sometimes the students
faced the front of the studio so that they could pay attention to the instructor and/or see
themselves reflected in the wall-length mirror. Other times they faced different directions for
individual or small group exercises, or stood in a circle to do community-focused dance work.
Despite the program having an emphasis on classical ballet technique, dancers did not
look uniform in appearance and dress code. The dance students represented many body types and
wore a range of dancewear, including leotards, tights, sauna pants, t-shirts, sweat pants, and
leggings. Women’s hair was typically pulled back in a loose or tight bun or ponytail. Both the
primary researcher and research assistant noted the presence of coffee, tea, and water bottles
placed around the borders of the dance studio, which dancers would visit during short breaks.
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Although a somewhat casual tone was established, there were clear classroom norms as well. For
instance, dancers would never re-enter a studio space during an exercise or dance number. They
would wait until the music stopped and a combination or section of dancing was complete.
Additionally, dancers clapped for the pianist at the end of each class. They also thanked any
person of authority, including the primary researcher and research assistant, before leaving.
Instrumentation
Basic demographics survey. The primary researcher developed a basic demographics
survey specifically for this study in an effort to contextualize the sample (see Appendix B).
Survey items included participants’ age, gender, year in school, total number of years dancing,
total number of hours dancing per week, and current injury status. The demographics survey also
asked participants to rate their level of familiarity with the skills to be introduced during the
intervention program (i.e., diaphragmatic breathing, progressive muscle relaxation, imagery,
self-talk, and mindfulness). Information gathered via this instrument was intended to help
describe the sample’s characteristics, rather than to answer a particular research question.
Athletic Coping Skills Inventory-28. The Athletic Coping Skills Inventory-28 (ACSI
28; Smith, Schutz, Smoll, & Ptacek, 1995) is a multi-dimensional measure of self-reported
psychological skills utilized in sport (see Appendix C). Seven sport-specific subscales make up
the full measure, each subscale having four items answered on a 4-point Likert scale from 0
(almost never) to 3 (almost always). A total score, combining all 28 items, is used to assess
overall coping skills, with a possible range of 0 to 84. The primary researcher chose to use this
survey due to its multi-dimensional measure and the fact that it had previously been used with a
dance population.
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Researchers Estanol, Shepherd, and MacDonald (2013) have previously reported a mean
total score of 49.34 and a standard deviation of 10.14 on the ACSI-28 for their sample of dancers
(N = 205). Their sample consisted of collegiate-level ballet and modern dancers, professional
dancers, and contemporary dancers. The researchers’ descriptives are comparable to the present
study’s sample for both week one (M = 48.83, SD = 9.79) and week six (M = 48.72, SD = 10.66).
The reliability and validity of the ACSI-28 has been tested with multiple samples and has
been used to study coping skills and behaviors in the sport context (e.g., Mummery, Schofield, &
Perry, 2004; Omar-Fauzee, Daud, Abdullah, & Rashid, 2009; Smith et al., 1995). Researchers
have indicated questionable to acceptable reliability for the concentration subscale, with a
Cronbach’s alpha of 0.62, and good reliability for the peaking under pressure subscale, with a
Cronbach’s alpha of 0.78. These statistics represent the lowest and highest measures of internal
consistency across all subscales of the instrument (Noh, Morris, & Andersen, 2007; Smith et al.,
1995). Additionally, researchers reported that one-week test-retest coefficients from a sample of
90 college students and athletes had a median of 0.82 (Noh, Morris, & Andersen, 2007; Smith et
al., 1995).
In the present study, the primary researcher examined five-week test-retest reliability of
the ACSI-28. The correlation between ACSI-28 total scores collected during the first and sixth
weeks of the study was strong, r = 0.756, p = 0.000. Additionally, the primary researcher
observed the relationship between pre- and post-intervention total scores on this instrument by
group condition. There was a strong relationship between pre- and post-intervention ACSI-28
total scores for the treatment group, r = 0.870, p = 0.000. There was also a statistically
significant correlation between these scores for the control group, r = 0.555, p = 0.039. These
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correlations are relatively consistent with the reliability statistics reported by the instrument’s
developers (Smith, Schutz, Smoll, & Ptacek, 1995).
As for convergent and discriminant validity, the developers reported moderate
correlations between the ACSI-28 and other similar instruments. These instruments included the
Self-Control Schedule (Rosenbaum, 1980) (r = 0.44), Sport Anxiety Scale (Smith, Smoll, &
Schutz, 1990) (r = -.43), and Self-Efficacy Scale (Coppel, 1980) (r = 0.58). In contrast to other
coping questionnaires that are non-specific to sport (e.g., COPE; Carver, Scheier, & Weintraub,
1989), the ACSI-28 was developed specifically for use with athletes. However, it should be
noted that the instrument is not grounded in one or more theories of stress and coping (Croker,
Kowalski, & Graham, 1998), but may be considered as having originated from a cognitive
behavioral approach (Estanol, Shepherd, & MacDonald, 2013).
For the purpose of this study, some of the items were modified to reflect a dance-specific
context. The words “coach” or “manager” were replaced with “instructor” or “choreographer.”
Similar changes have been made to the ACSI-28 by others in their research with dancers (e.g.,
Estanol, Shepherd, & MacDonald, 2013; Noh, Morris, & Andersen, 2007). Estanol and
colleagues (2013) reported a Cronbach’s alpha of 0.84 for the ACSI-28 when modified and used
with their sample. Noh and colleagues (2007) reported slightly lower reliability with these
modifications. However, the ACSI-28 had been translated into Korean, and so the translation
could also have influenced their reliability estimates.
In the present study, a Cronbach’s alpha of 0.727 was observed for week one across 30
participants, and a Cronbach’s alpha of 0.741 was observed for week six across 29 participants.
As for the subscales, internal consistency coefficients ranged from a low of 0.508 for the
confidence and achievement motivation subscale, to a high of 0.861 for the peaking under
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pressure subscale (see Table 2 for internal consistency at week one compared to the developers’
alphas). These numbers are fairly consistent with the findings of Estanol, Shepherd, and
MacDonald (2013). They reported low internal consistency for one subscale (i.e., coachability),
with all other subscales having a Cronbach’s alpha greater than 0.65. This was also the case in
the present study, although the subscale below this 0.65 cut-off point was confidence and
achievement motivation, instead of coachability.
Pain Appraisal Inventory. The Pain Appraisal Inventory (PAI; Unruh & Ritchie, 1998)
is a self-report instrument comprised of 16 items that quantifies and classifies individuals’ beliefs
about physical pain. The PAI also helps to evaluate what respondents think about their pain, and
how these thoughts make them feel (see Appendix D). Based on literature in stress and coping
research, the developers of the PAI included two scales within this instrument: threat appraisal
and challenge appraisal. Threat was defined as “anticipated or actual physical or psychological
harm, loss, injury or damage associated with a pain event,” while challenge was defined as “a
test of strength, endurance or abilities, with the potential for growth, mastery or gain associated
with a pain event” (Unruh & Ritchie, 1998, p. 106). One might expect these two subscales to be
negatively related. However, researcher Anderson and Hanrahan (2008) reported the relationship
between threat and challenge to be weak to moderate (r = 0.41) in a sample of dancers (N = 51)
who represented a variety of styles and training levels.
Each subscale contains eight items that are scored on a six-point Likert scale from 1
(strongly disagree) to 6 (strongly agree). A total composite score for pain appraisal can be
calculated by summing the 16 items, with a possible range of 16 to 96. The sum of each subscale
can also be calculated, with a possible range of 8 to 48. However, it should be noted that the
developers stated that they initially considered a rating of “3” or higher to indicate an appraisal
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of pain (Unruh & Ritchie, 1998), and so the total scores and possible ranges for this instrument
and its subscales may be highly dependent on the severity and duration of pain that participants
are experiencing when this survey is administered.
Previously, Anderson and Hanrahan (2008) have reported a range of 8 to 43 for the threat
subscale, and a range of 8 to 41 for the challenge subscale. No total scale psychometrics were
reported in their study. Compared to Anderson and Hanrahan’s (2008) sample, the present
study’s participants reported a similar range of scores on the PAI subscales. The threat subscale
had a range of 8 to 37 for week one (M = 18.31, SD = 9.35) and a range of 8 to 32 for week six
(M = 18.68, SD = 7.94). Similarly, the challenge subscale had a range of 8 to 42 for week one (M
= 20.62, SD = 10.27) and a range of 8 to 43 for week six (M = 21.03, SD = 9.52).
The instruments’ developers reported evidence of good validity and reliability.
Concurrent criterion validity was determined by comparing the PAI’s properties to other pain
instruments, including the McGill Pain Questionnaire (MPQ; Melzachk, 1987) and the Pain
Disability Index (PDI; Tait, Chibnall, & Krause, 1990). Using data collected from a sample (N =
46) of college students, health professionals, and community members, the developers reported
that the threat subscale yielded a Cronbach’s alpha of 0.86 and the challenge subscale yielded a
Cronbach’s alpha of 0.81. In the present study, internal consistency was also strong. Cronbach’s
alpha for the PAI at week one was 0.881. At week six, Cronbach’s alpha was 0.886. When
observing the two subscales separately, the threat subscale had a Cronbach’s alpha of 0.914, and
the challenge subscale had a Cronbach’s alpha of 0.904.
The developers of the PAI have discussed some of the instruments’ limitations. Among
these limitations is the unexplored relationship between appraisals, and chronic versus acute
pain; the developers have suggested that differences in type of pain and their direct or indirect
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effects on appraisal is unknown. The instrument’s developers have also reported a lack of test
retest reliability. Given this fact, the primary researcher in the present study decided to run
correlations on the PAI total scores as well as both subscales across all participants. The
correlation coefficient for the PAI total scores was moderate, r = 0.399, p = 0.035. When
observing PAI threat subscale scores, no meaningful relationship was observed between the first
and second set of scores, r = 0.111, p = 0.575. In contrast, the PAI challenge subscale scores
were strongly correlated, r = 0.527, p = 0.004 (see Table 3).
When examining test-retest reliability by group condition, there were slightly different
findings. The relationship between pre- and post-intervention PAI total scores in the control
group was weak, r = 0.229, p = 0.430. The threat subscale showed no relationship, r = -0.196, p
= 0.502, and the challenge subscale showed a moderate relationship, r = 0.497, p = 0.071 (see
Table 4). In contrast, the pre- and post-intervention PAI total scores for the treatment group
showed a strong relationship, r = 0.702, p = 0.005. The threat subscale data showed a weak
relationship, r = 0.336, p = 0.240, and the challenge subscale data showed a moderate
relationship, r = 0.664, p = 0.010 (see Table 5).
Injury tracking survey. The primary researcher developed an injury tracking survey
specifically for this study (see Appendix E). The content of this survey was inspired by several
sources, including an injury tracking form developed by members of the Dance/USA Task Force
on Dancer Health, and researchers Noh, Morris, and Andersen (2007). Previous research
suggests that “dancers may under report injuries on surveys,” and, therefore, multiple questions
about injury were presented (Thomas & Tarr, 2009, p. 51). Dancers were asked to report their
current injury status; where their injury or injuries occurred on the body; if the injury or injuries
caused them to miss or modify any training, rehearsals, or performances; whether they sought
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medical attention; and the presence and severity of pain they may have experienced. Participants
in the present study were incentivized to submit their injury reports every week throughout the
study in order to be eligible to receive a $100 Visa gift card via a raffle system.
The National Collegiate Athletic Association (NCAA) has defined a physical injury by
focusing on three specific criteria. First, the injury must occur within the training or competition
setting, and not in a different environment. Second, the injury must require the attention of an
athletic trainer or physician affiliated with the particular group/team. Third and finally, the injury
must restrict or prevent the athlete’s participation in sport for at least one day subsequent to the
day in which the injury occurred (Dick, Agel, & Marshall, 2007). Due to the fact that dancers
may be inclined to keep their injuries hidden, the primary researcher adopted a modified version
of the NCAA’s third criterion. Specifically, any self-reported time lost was considered an
instance of injury, rather than having dancers wait until the following day to “start the clock” on
minutes or hours of dancing missed.
Dance Experiences Survey. The Dance Experiences Survey (Krasnow & Mainwaring,
1990) was used in the present study to capture stressors that individuals may experience as a
result of their role as dancers (see Appendix F). The instrument consists of 48 items, and asks
participants to use “Yes” or “No” to indicate if each item applies to them at the present time. For
those items that do apply, participants indicate the impact that these stressors have on them from -3 (extremely negative) to +3 (extremely positive). The instrument begins with an example so that
participants are clear on the instructions and the format of the survey. At the end of the 48 items,
participants are provided space to write-in any other stressors that they are experiencing, and to
report the perceived impact of these stressors. The developers did not provide psychometric data
via personal correspondence with the primary researcher, and there is a lack of psychometric
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data available in the literature that uses this survey. As such, the information gathered via this
instrument was intended only to describe the sample.
Intervention program. The short-term psychological skills intervention program
consisted of six sessions, with one session being conducted each week for the treatment group.
This six-week time frame was determined through a search of the literature focused on short
term behavior change and psychological skills interventions in sport (e.g., Bell, Skinner, &
Fisher, 2009; Johnson, 2000; Meichenbaum, 1993). The primary researcher developed the
intervention program content in collaboration with other sport psychology and counseling
professionals, and from the content presented in the existing research literature. Face and content
validity was confirmed by meeting with a licensed counselor and counselor educator to review
all materials (see Appendix G for an overview of the intervention program protocol).
Additionally, pilot testing was completed on all activities and handouts with two
volunteer undergraduate students who reported a background in dance. During pilot testing, these
two students provided verbal and written feedback about the aspects of the program’s content
that they liked and did not like, and what they thought could be improved upon before its
delivery to treatment group participants. The primary researcher compiled this feedback in
written format and used it as a guideline for finalizing all intervention program materials. The
primary researcher also asked these two students to complete all self-report surveys so that an
estimated time period could be established for the data collection packets to be administered
during the first and sixth weeks of the study.
All sessions followed a similar outline, with exception of the first and last, which focused
on data collection procedures. For the second through fifth weeks, the primary researcher’s
routine for each session consisted of: (1) having the participants review what they had learned or
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practiced in the previous week, (2) introducing the new skill to be learned or practiced, and then
(3) providing an experiential learning activity focused on the week’s topic. After each skill was
introduced and practiced, participants reflected on their experiences. For instance, participants
were encouraged to pose questions or concerns about the topic or activity and to share their
thoughts on how to use the skills(s) in dance class or other life pursuits.
The first skills introduced were diaphragmatic breathing and progressive muscle
relaxation. Participants were led through a deep breathing script and then through a progressive
muscle relaxation exercise (in either an active or passive manner). The next skill introduced was
imagery. Participants were led through a relaxation and coping imagery script based on Jon
Kabat Zinn’s Mountain Meditation, and also led through a performance imagery script intended
to help them prepare for dance class. The fourth week’s focus was on cognitive reframing and
self-talk. Participants were given a handout that contained many negative, maladaptive, or
irrational statements related to dancing. In small groups, they came up with more positive,
adaptive, and truthful statements to use when they are dancing. The final skill introduced was
mindfulness. Participants were led through a mindfulness-based stress management script that
asked them to focus on their breath, a small item in their hand (a rock, provided by the primary
researcher), and the present moment (see Appendix H for all of the exercises and activities used
in the intervention program).
Throughout the intervention program, the dancers’ class instructor remained present in
the dance studio for all discussion, exercises, and activities. The instructor did not observe the
sessions, but rather participated in the same way as the treatment group participants. However,
the instructor did not participate in any data collection procedures during weeks one and six, and
did not take part in the post-intervention focus group discussion.
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For each week of the intervention program, the primary researcher sent the course
instructor the written scripts used for each session, as well as audio-recordings of the respective
exercises or activities. The instructor offered to post these files in an online portal, to which the
treatment group participants had access throughout the semester. Audio-files were created via
QuickTime software and could be downloaded and listened to with an iTunes account.
Adherence journal. A weekly adherence journal was developed by the primary
researcher and loosely based on the journal that Noh, Morris, and Andersen (2007) used in their
study with Korean dancers (see Appendix I). Participants received a link to a secure, online
survey so that they could complete the items on their own time following weeks two through five
of the program (i.e., dance students were asked to submit an adherence report four times
throughout the study). The survey asked participants to indicate which skill(s) they were
practicing, and for what amount of time they were practicing them. Participants were also
prompted to rate their efforts to practice the skill(s) on a 4-point Likert scale from 1 (no effort) to
4 (excellent effort). This particular item was intended to capture their perceived level of
investment in the program. Findings from this instrument are reported as exploratory analyses
following the results of the main research questions.
Procedure
The primary researcher contacted several dance program chairpersons in the Mid-Atlantic
region of the United States by email. The email to these chairpersons contained a brief proposal
of the research study and its anticipated timeline. Once a dance professor expressed interest in
the study, a phone call was scheduled to talk to this professor one-on-one to further explore
his/her interest. Then, the primary researcher and the interested professor assessed the feasibility
of recruiting another professor from the same department who might also be interested in the
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study. Once this second person was identified, the two professors and the primary researcher
developed a schedule that worked for all parties involved.
The primary researcher obtained Institutional Review Board (IRB) approval from the
primary institution and completed supplemental documents for the approval of the institution at
which data collection procedures occurred. These latter documents included an IRB
Authorization Agreement and letters of permission from each classroom instructor. The research
team—which consisted of the primary researcher, an advisor, and two research assistants—then
finalized all instrumentation and the intervention program content.
For six consecutive weeks, the primary researcher traveled from her primary institution to
the data collection site. During weeks one and six, data collection was the main focus. At the
start of the first week, the primary researcher briefly explained the research design to all
participants so that they understood how group assignments were made. Participants completed
the Athletic Coping Skills Inventory (ACSI-28; Smith, Schutz, Smoll, & Ptacek, 1995), the Pain
Appraisal Inventory (PAI; Unruh & Ritchie, 1998), and an injury tracking measure developed
specifically for this study for the first and sixth weeks. In addition, two instruments were used to
contextualize the sample, and were collected during week one. These included a basic
demographics survey and the Dance Experiences Survey (Krasnow & Mainwaring, 1990), the
latter of which was intended to capture perceived levels of stress in dance-specific situations. A
research assistant accompanied the primary researcher for weeks one and six so that the data
collection procedures could be viewed by participants as a somewhat separate process from the
delivery of the intervention program itself.
To ensure confidentiality throughout the study, participants who volunteered to take part
in data collection procedures used code names. These code names were developed during week
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one of the study with both groups, and consisted of two letters and four numbers. The creation of
code names was necessary given the repeated measures nature of some of the surveys. The
participants’ contact information (i.e., phone numbers and email addresses) was also voluntarily
provided during the first week of the study, and these details were stored as a separate file on a
password-protected computer throughout the course of the study. Participants’ contact
information was necessary in order to collect data for weeks two through five (see Appendix J).
Emails were sent through Gmail and text messages were sent using EZ Text, a messaging service
that allows recipients to opt-in or opt-out of correspondence at any time.
For weeks two through five, the control group did not meet with the primary researcher.
Participants in this group were sent the injury tracking survey via email or text message. The
treatment group also received the injury tracking survey via email or text message during this
same time frame. In contrast to the control group, the treatment group met weekly with the
primary researcher to learn and practice the psychological skills previously described.
While at the site, the primary researcher took field notes to capture the overall context of
the dance program and the setting in which the participants were learning and training. The
primary researcher also arrived early to each session to observe other classes and to be available
to answer participants’ questions. After each session with the treatment group, the primary
researcher remained on-site to address questions and/or comments. In addition to receiving the
injury tracking survey on a weekly basis, participants in the treatment group received an email or
text message that contained a secure link to the weekly adherence journal. The purpose of the
adherence journal was to capture participants’ efforts to practice the skills introduced throughout
the intervention program.
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 24
At the end of the intervention program—and once data collection procedures for week six
were complete—the research assistant conducted a focus group discussion with participants in
the treatment group (see Appendix K for semi-structured interview guide). This discussion was
audio-recorded so that all responses could be fully transcribed. Focus group participants were
incentivized with the offer of a chance to receive a $50 Visa gift card via a raffle system.
Participants were asked to describe: (1) what went well, (2) what didn’t go well, (3) what was
surprising or new, (4) how participants could use information provided in the intervention in
their lives, and (5) what about the delivery (and/or the deliverer) would they change.
Following the focus group discussion, the primary researcher conducted two exploratory
interviews (i.e., stakeholder interviews) with each of the course instructors who allowed the
researcher access to their classrooms. The instructors were interviewed via phone, and the
interviews were audio-recorded so that they could be subsequently transcribed. Both instructors
were informed that their names and titles would not be affiliated with the results and that any
identifying information would be removed from the transcriptions. These interviews focused on
gathering the instructors’ thoughts on their institution, program and teaching philosophies, and
investment in the research topics and/or process. Interviews ranged from approximately 30 to 50
minutes and followed a semi-structured interview guide (see Appendix L for a summary of
findings from these interviews).
Following the conclusion of the study, the primary researcher remained available to
participants and their instructors for follow-up questions or concerns. A basic summary of results
was also provided. Finally, the primary researcher worked with the instructors to make the
intervention program content available to those dancers who were initially assigned to the
control group.
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 25
Data Analyses
Before any analyses were conducted, the researcher cleaned the data set by looking for
impossible values, missing data, and cases of attrition. A few issues were found. The weekly
injury reports had the highest response rate at the start of and end of the study, and the lowest
response rate for the weeks in between. Two inconsistent or not plausible cases were identified
within the injury data. Three participants reported their injury status either twice in the same day
or twice in the same week. Given the timing of these submissions, the primary researcher made
the decision to interpret the first of the two submissions as the report for the previous week, and
the second of the two submissions as the report for the current or upcoming week. No impossible
values were discovered within the data, and no other major issues were discovered.
Multiple statistical analyses were used to answer the proposed research questions. Basic
descriptive and frequency statistics were run to contextualize the sample used in the present
study. Then, to answer the first research question, an ANCOVA was run on the post-test data
from the ACSI-28, using pre-test ACSI-28 scores as the covariate. This analysis was run on the
total scores for the ACSI-28 as well as for the seven subscales of the instrument. The
significance level was set to p = 0.05, with the goal of observing a small to moderate effect size.
The second research question was answered by running a second ANCOVA on the post
test data from the PAI, using pre-test PAI scores as the covariate. This analysis was run on the
PAI total scores, as well as for the two subscales of the instrument. The significance level was
again set to p = 0.05. The primary researcher chose these statistical analyses based on the fact
that ANCOVA may be used to increase statistical power and may potentially help with adjusting
pre-test differences between the non-random groups used in the present study (Harlow, 2014). It
should be noted that the use of ANCOVA to statistically control for a covariate is a somewhat
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 26
controversial approach, and therefore statisticians recommend that results be interpreted with
caution (Harlow, 2014; Miller & Chapman, 2001)
The primary researcher planned to run repeated measures analysis of variance (ANOVA)
to answer the third research question. This specific test could allow for the examination of the
average frequency and duration of self-reported injuries throughout the intervention program.
However, this analysis could not be run for two primary reasons. First, the number of dancers
who reported their injury status (and injury details) varied by week. Most or all participants
reported their injuries for weeks one and six. However, during the weeks in between, the number
of reports decreased. Given that repeated measures ANOVA requires information to be observed
or collected on the same participants at each time-point, the missing data greatly affected the
ability to conduct this analysis. Additionally, there were very few dancers (n = 3) who reported
any time lost due to injury. Time lost could have served as the continuous dependent variable in
this analysis had more injury reports, and the details within them, been submitted each week. In
the absence of this analysis, basic descriptive statistics were run in an effort to report other
informative findings.
As for the fourth and final research question, the primary researcher utilized qualitative
analyses. The primary researcher and two graduate students followed open coding procedures
(Creswell, 2007; Patton, 2002), and utilized a typological approach to identify themes and
categories from the focus group discussion. This same protocol was used to analyze the two
exploratory stakeholder interviews. The coding team also engaged in data triangulation (Patton,
2002) so as to determine similar and different perspectives.
IMPACT OF A PSYCHOLOGICAL SKILLS TRAINING PROGRAM
BRYANT 27
Results
Descriptive Statistics
At the start of the research study, participants in the control group had a slightly lower
average score (M = 38.47, SD = 15.84) on the Pain Appraisal Inventory (PAI) than did
participants in the treatment group (M = 39.42, SD = 14.77). In contrast, control group
participants reported slightly higher coping skills (M = 52.00, SD = 8.26) as measured by the
Athletic Coping Skills Inventory-28 (ACSI-28) when compared to treatment group participants
(M = 45.67, SD = 10.42) at the start of the study.
At the conclusion of the study, participants in the control group reported lower scores on
the PAI (M = 36.14, SD = 16.27) when compared to treatment group participants (M = 43.07, SD
= 11.49). For the ACSI-28, control group participants
Players' Responses to and Primary Caregivers' Perceptions of Authoritarian and Authoritative Coaching in the Inner-City : Players' Responses to and Primary Caregivers' Perceptions of Authoritarian and Authoritative Coaching in the Inner-City
Renee Brown
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Players’ Responses to and Primary Caregivers’ Perceptions of Authoritarian and
Authoritative Coaching in the Inner-City
Reneé Brown
Dissertation submitted to the College of Physical Activity and Sport Sciences at West
Virginia University
in Partial fulfillment of the requirements for the degree of Doctor of Philosophy in
Coaching and Teaching Studies/ Positive Youth Dynamics
Ryan Flett, Ph.D., Chair
Sean Bulger, Ph.D.
Andrea Taliaferro, Ph.D.
Suzanne Hartman, Ph.D.
Department of Coaching and Teaching Studies
Morgantown, West Virginia
2017
Keywords: Positive youth development, inner-city, coaching styles, coaching
Copyright 2017 Reneé Brown
Abstract
Players’ Responses to and Primary Caregivers’ Perceptions of Authoritarian and
Authoritative Coaching in the Inner-City
Reneé Brown
An abundance of research in sport-based positive youth development (PYD)
indicates that coaches should be positive, promote autonomy-supportive and authoritative
coaching styles, and caution the use of authoritarian leadership, while too often ignoring
elements of authoritarian leadership such as discipline and structure. However, most of
the studies conducted targeted middle-upper socioeconomic status (SES) suburban, White
populations, with little emphasis on the inner-city underserved context. Parenting and
teaching literature provides strong support for authoritarian styles in the underserved
setting (Hartman & Manfa, 2015; Smetana, 2011). Similarly, the few studies conducted
in the underserved sport settings show support of authoritarian styles (Brown et al., in
preparation; Cowan et al., 2012; Flett et al., 2012; Flett et al., 2013; Richardson, 2012).
The purpose of this study is to extend the previous year’s season-long qualitative study of
a single girl’s basketball team (Brown et al., in preparation) to include perspectives from
parents of that team and quantitative surveys from players across the league.
Participants included five head coaches with 14.2 years of experience and 80
players from the five teams in the league. The study incorporated interviews with six
parental/primary caregivers from Team C; and quantitative surveys for players in the
league. An abductive approach was used to develop thematic categories from the
interview data (Miles, Huberman, & Saldana, 2014).
Quantitative results revealed that players are improving life skill development
over time. Additionally, in order for coaches to have the biggest impact, they must use
authoritative coaching styles and foster a caring and mastery climate. More importantly,
results indicated that authoritarian coaching was a unique predictor of life skills
development, however, it did not affect life skill development in a negative or positive
manner. Qualitative results revealed that parents/primary caregivers relied on the coach
as a unique source of support and guidance to supplement, complement or compensate
their adolescent’s home life. Additionally, parents/primary caregivers strongly preferred
authoritarian coaching combined with authoritative components to instill values and
positively influence life skill development.
iii
Acknowledgements
First and foremost, I would like to give the praise, honor and glory to God for
allowing me this opportunity to grow as a person, mentally, physically, spiritually,
emotionally, and giving me the strength to endure through all odds. I am forever grateful
and thankful for my advisor, Dr. Ryan Flett, because without your commitment, intuitive
feedback, and immeasurable help, I would not have been able to complete this process
without you. Throughout the years, you have been in my corner supporting me with
everything whether it was academics, personal life, and exposed me to different
opportunities to help develop me into the person that I am today. Dr. Flett, I want you to
know that I sincerely appreciate and respect all that you do, because you go above and
beyond the traditional role of a chair and I think more professors should strive to be more
student-centered like you. To Dr. Hartman, I am so grateful that you were a part of the
entire process. Your positive reinforcement, encouragement, and open-door policy helped
motivate me through my dark times. I will forever remember the words you said to me,
“If it was easy, then everyone would do it.” To Dr. Taliaferro, I am so happy that you
were willing to be a part of the committee because the thing I valued most was that you
were straight-forward and did not sugar coat anything and it was from a place of love,
which reminded me of my mother. To Dr. Bulger, thank you for having a listening ear
and reminding me that everyone has breakdowns at one point in time, but the most
important thing is that you get back up and little did you know; it was those very words
that kept picking me up. I would also like to acknowledge Stephanie McWilliams for her
assistance in the qualitative analysis and all participants in the study. I am grateful that
you all allowed me your time to help me complete the study, given all the other
iv
tasks and responsibilities you had going on. Without you all, none of this would be
possible.
There is an old African proverb which states “it takes a village to raise a child”
little did you know, you were all that village and an extension of my family. If I could do
everything over again, without changing one thing, I would; because I value each of you
and because of your ideas and feedback made this a stronger dissertation.
To my parents, Cardell Nino Brown Sr., and Reneé Bernice Drummond-Brown,
WVU has made me understand without a shadow of a doubt that none of my
accomplishments would have been possible without parents like you. Your patience,
trainings and beliefs helped shaped me into the person I am today. I know it has been
rough over the years, and we did not always see eye to eye, but you never gave up on me
because you both seen something greater in my future. Thank you for making sacrifices
that you did and I hope that I have made you proud.
To my grandfather, Peter Charles Drummond, thank you pap-pap for loving me
unconditionally, and being present at all of my presentations.
To my siblings, Cardell Nino Brown Jr. and Raven Chardell Brown, although,
you could not be there at times physically, because of jobs and travel; you were always
there with me in spirit.
To Anthony Antonelli and Family, thank you for the love, support and kindness
you have shown me throughout the years. The Antonelli family will forever hold a
special place in my heart.
v
To my late grandmother, Barbara Ann Drummond, this degree is for you. I cannot
thank you enough because it was you and mom who both challenged and inspired me to
pursue a PhD. While at WVU as you both requested, I held on to this scripture, 2Timothy
2:15 “Study to shew thyself approved unto God, a workman that needeth not to be
ashamed rightly dividing the word of truth,” I hope I made you proud! I love you!
To all my extended family and supportive friends (too numerous to mention)
please know, that I am grateful for your love, support and prayers throughout the
education process, you also hold a special place in my heart. To God be the glory for the
things He has done in my life.
vi
Table of Contents
Acknowledgements ...............................................................................................................................iii
CHAPTER I ................................................................................................................................................. 1
Introduction .............................................................................................................................................. 1
Inner-City Context and Issues ........................................................................................................................ 2
PYD, Sport, and Underserved Inner-City Youth ...................................................................................... 4
The Coach’s Role in Inner-City Underserved Settings ......................................................................... 5
Statement of Purpose...................................................................................................................................... 10
Statement of Significance .............................................................................................................................. 11
Research Questions ......................................................................................................................................... 11
Key Terminology .............................................................................................................................................. 13
CHAPTER II............................................................................................................................................. 16
Extended Literature Review ............................................................................................................ 16
Positive Youth Development ....................................................................................................................... 17
Framing Key Literature in Theory............................................................................................................. 23
Effective Coaching, Mentorship, and Sport Issues .............................................................................. 30
Coaches’ Roles and Responsibilities ......................................................................................................... 39
Underserved Context and Sport ................................................................................................................. 45
Purpose ................................................................................................................................................................. 51
Hypothesis ........................................................................................................................................................... 53
CHAPTER III ........................................................................................................................................... 57
Method ..................................................................................................................................................... 57
vii
Design .................................................................................................................................................................... 57
Setting ................................................................................................................................................................... 58
Participants ......................................................................................................................................................... 59
Measures .............................................................................................................................................................. 61
Pilot Testing ........................................................................................................................................................ 66
Procedure ............................................................................................................................................................ 68
Data Analysis ...................................................................................................................................................... 72
CHAPTER IV ........................................................................................................................................... 79
Results ...................................................................................................................................................... 79
Participant Numbers, Measurement Reliabilities, and Assumptions ......................................... 79
Descriptive Data and Correlations ............................................................................................................ 82
Research Question 1: Developmental Outcomes and Related Factors ..................................... 85
Research Questions 2: Common and Comparison of Coaching Style in Context .................. 92
Research Question 3: How Parents View Sport and/or Coaches ................................................ 93
Summary of qualitative findings ............................................................................................................. 106
CHAPTER V ........................................................................................................................................... 108
Discussion ............................................................................................................................................. 108
Summary of Findings ................................................................................................................................... 108
Limitations ....................................................................................................................................................... 113
Recommendations for Future Research .............................................................................................. 115
References ............................................................................................................................................ 117
Appendix A ........................................................................................................................................... 135
viii
APPENDIX B ......................................................................................................................................... 139
Appendix C ............................................................................................................................................ 142
Appendix D ........................................................................................................................................... 147
Appendix E............................................................................................................................................ 156
AUTHORITARIAN AND AUTHORITATIVE COACHING
1
CHAPTER I
Introduction
The current dissertation is grounded in the ecological systems theory (EST) and
expands Brown, Hayes, Goodson, Hartman, and Flett’s (in preparation) season-long
ethnography and interview study to include parental/primary caregiver perspectives and
the other high school girls’ basketball teams within the same city league. The purpose of
this study is four-fold. First, it will inform the reader of the coaching styles used in the
underserved setting. Second, it will explore the impact of the coaching style and
objectively track developmental outcomes throughout the season. Third, it will explore
the use of authoritarian strategies in the underserved setting, which is under-represented
in the sport literature. Lastly, it will investigate parental/primary caregivers’ perceptions
of the coaching style used in the underserved setting, the intentionality of the coach,
whether life skills (LS) are transferred from the sport setting to other domains of life, and
how the coach supplements or augments parental/primary caregivers’ efforts in this
context. In summary, the purpose of this study is to expand the previous year’s season
long qualitative study of a single girls’ basketball team to include perspectives from
parents of that team and quantitative surveys from players across the league.
Positive youth development (PYD) is especially important in underserved
communities because youth are less likely to have positive emotional, social, and
cognitive developmental experiences (Flett, Gould, & Lauer, 2013; Smetana, 2011).
Sport is an avenue for youth to engage in PYD; however, PYD occurs from positive
experiences and coaching, not from sport alone (Thomas-Fraser, Côté, & Deakin, 2005).
AUTHORITARIAN AND AUTHORITATIVE COACHING
2
The sport-based PYD literature encourages coaches to create autonomy-supportive
climates, be “positive” with their players, and cautions the use of authoritarian,
controlling coaching styles (Cowan, Taylor, McEwan, & Baker, 2012). PYD research
typically focuses primarily on white, middle- to high-class populations with limited
research on coaches in underserved urban settings. Based on strong support from
parenting literature—and to a lesser extent, the teaching literature—authoritarian styles
may be the most developmentally effective approach in underserved settings. This
chapter will provide a basic overview of the literature and issues in inner-city contexts,
PYD in sport, and the coach’s role in the underserved setting, and will conclude with
definitions of key terminology.
Inner-City Context and Issues
The underserved setting can be defined as those individuals that are provided with
low levels of access, inadequate services (i.e. health services, low rates of insurance, etc.)
and face a multitude of barriers in everyday life (Walsh, 2008). This context can be
characterized by high-risk factors such as poverty, high crime rates, and lack of support.
Youth who grow up in this setting are more likely to be at a developmental disadvantage
socially, emotionally, and cognitively because they are not afforded the same
opportunities as higher socioeconomic (SES) communities (Smetana, 2011). Underserved
youth are more likely to face challenges such as broken homes, racism, poverty, lower
quality health care, poor education, gang violence, crime, and limited extracurricular
activities (Martinek & Hellison, 1997; Martinek & Schilling, 2003; Walsh, 2008).
Experts have argued that youth living in the underserved settings are in the greatest need
AUTHORITARIAN AND AUTHORITATIVE COACHING
3
of PYD-support because they are more likely to lack developmental experiences and
support systems (Flett et al. 2013; Walsh, 2008).
Parents and primary caregivers are responsible for socializing and teaching their
children the socially desirable behaviors of the culture. However, parenting styles differ
from home to home. Furthermore, Coakley (2002) indicated that upper-middle income,
predominately White families place emphasis on upward mobility, as compared to an
underserved minority family which emphasizes control and discipline. Research in
parenting literature shows strong support for Coakley’s claim and revealed that parents in
the underserved setting are more likely to use authoritarian parenting styles because they
are developmentally effective and serve as a protective factor to underserved youth
(Eamon, 2002, Smetana, 2011). For example, Eamon’s two-year longitudinal study with
participants living in poverty found that the use of physical punishment prevented anti
social behavior. In a similar study, Dearing (2004) found that authoritarian parenting
served as a protective factor for youth living in a neighborhood characterized by rape,
robbery, burglary, larceny, and aggravated assault. The authors also found that the
authoritarian parenting style had a positive effect on academic performance.
Research in teaching literature describes that the utilization of an authoritarian
approach by staff and teachers toward youth living in poverty is associated with fewer
child-behavior concerns (Hartman & Manfra, 2015; Higgins & Moule, 2009). For
example, Hartman and Manfra conducted a year-long study to explore the relation
between the quality of childcare and behavioral development with low-income
underserved Latino children. The findings revealed that a controlling and strict (i.e.
authoritarian) approach improved child behavior and decreased behavior concerns. In
AUTHORITARIAN AND AUTHORITATIVE COACHING
4
sum, some research indicates that authoritarian styles are developmentally effective for
youth living in the underserved settings.
PYD, Sport, and Underserved Inner-City Youth
PYD is a holistic strength-based approach that focuses on enhancing pro-social
norms and optimizing personal development, and engaging youth within their family,
school, and community contexts. This leads to involvement in extracurricular activities
and develops and refine youth skills (Coakley, 2011). Experts emphasize that organized
sport participation could be beneficial and aid in PYD (Deakin, 2005).
Sport is considered the most popular and time-consuming activity in high schools
(Hansen & Larson, 2007), and is typically available to underserved populations. Many
believe that sport is an appropriate activity for enabling PYD because it can serve as a
protective factor, enhance personal and interpersonal development, and provide
opportunities for youth to build rapport with adults, such as coaches (Cowan et al., 2012;
Flett, Gould, Griffes, & Lauer, 2012; Flett et al., 2013; Gould, Flett, & Lauer, 2012;
Richardson, 2012). Research shows that sport can have positive outcomes such as
physical health (Côté & Fraser-Thomas, 2007), teamwork/cooperation opportunities
(Gould et al.), positive relationships with adults (Fry & Gano-Overway, 2010) and
positive self-esteem (Smith, Smoll, & Curtis, 1979). However, other researchers found
sport to have negative outcomes on youth such as increased stress (Merkel, 2013),
emotional abuse (Stirling & Kerr, 2013), poor cooperation, and negative peer influence
(Dworking & Larson, 2006). In other words, PYD does not occur from sport participation
alone; other social contextual factors (i.e. coaches) contribute to the fostering of PYD
(Petipas, Cornelius, Van Raalte & Jones, 2005; Holt, 2008).
AUTHORITARIAN AND AUTHORITATIVE COACHING
5
The Coach’s Role in Inner-City Underserved Settings
As stated earlier, PYD does not occur from sport alone; coaches play a pivotal
role in player development through their coach-athlete relationship (Jowett & Ntoumanis,
2004; Petipas et al., 2005; Smith & Smoll, 2011) motivational climate, coaching style,
and coaching behavior, especially in the underserved settings.
Coach-Athlete Relationship. In underserved settings, interpersonal relationships
within non-familial adults (such as coaches) are important (Levine & Munsch, 2016). The
coach-athlete relationship is essential because coaches have the ability to become role
models and mentors to their athletes due to the consistency and time spent in games,
practices, and off-court activities (Jaime et al., 2015). Furthermore, research shows that
athletes’ perceptions of strong coach-athlete relationships are linked to positive
developmental experiences (Jowett, 2008). Richardson’s (2010) study in the underserved
context of New York City showed that caring and trust was built between players and
coaches through consistent interactions during practices and off-court activities. As a
result, the coach was able to reduce risk, promote resiliency, and provide safety to players
through mentorship. In addition, the coach kept players occupied with various activities
and talked to players about their actions and choices. Experts emphasized the importance
of the caring element when it comes to working with underserved youth.
Motivational Climate and Caring Climate. Another important factor that has a
direct impact on player experience is the motivational climate. Coaches are responsible
for creating and structuring an environment that is beneficial to PYD. Research strongly
supports the idea of using a mastery climate because success is based on personal
improvement, effort, helping others, learning through cooperation, and hard work (Cox,
AUTHORITARIAN AND AUTHORITATIVE COACHING
6
2002). Furthermore, studies have shown that mastery climates increased positive attitudes
towards sport and coach (Fry & Newton, 2003), decreased burnout (Vitali et al., 2015),
decreased athlete anxiety (Fry & Newton, 2003), and increased personal and social
development. Gould et al. (2012) found that a mastery-oriented climate has the most
positive impact on underserved youth.
However, Gould et al. (2012) also found that “kids don’t care what you know,
unless they know you care,” (p.86) and hypothesized that the caring climate defined by
Newton et al. (2007, p.70) as "the extent to which individuals perceive a particular setting
to be interpersonally inviting, safe, supportive, and capable of providing the experience
of being valued and respected” is more important than a motivational climate and is more
likely to influence PYD. The caring climate is an important factor in PYD because if
players perceive the feelings of being cared for (feelings of support, safety, value, and
respect) then they are more likely to value the perspective of their coach (Gano-Overway
et al., 2009). In other words, coaches who create a caring climate can impact their
players’ beliefs and foster prosocial behaviors. Similar to Richardson’s (2010) study,
Gould et al. found that building rapport, caring, and supporting the athletes allowed the
coach to be more effective in their personal and social development (e.g. teamwork,
physical skills, initiative, cooperation). Additionally, Fry and Gano-Overway (2010)
found that players who perceived a caring climate reported having higher enjoyment and
more positive attitudes towards the coach and teammates.
Coaching style. Coaches in urban, underserved settings are believed to be more
authoritarian, controlling and militaristic towards their athletes because they want to
protect and prepare their players for the ways of the world as opposed to creating an
AUTHORITARIAN AND AUTHORITATIVE COACHING
7
autonomy-supportive climate (Flett et al., 2013). For example, Flett et al. (2012)
conducted a qualitative comparison study in inner-city Detroit with 12 youth coaches
from six different sports. The authors used ethnographic methods and interviews to
observe the coaches 14 times in practice and game settings before conducting in-depth
interviews with each coach. Findings indicated that coaches who utilized an authoritarian,
militaristic coaching style were invested in their athletes lives and knew the personal
struggles the athletes faced (e.g. gang violence, crime, abuse, uninvolved parents,
dangerous neighborhoods, etc.). Furthermore, coaches wanted to prepare players for the
ways of the world with “tough-love.” The coaches who utilized this approach disciplined
the players out of love and went to the extremes to protect their athletes from negative
outcomes. In addition, the authors found that discipline may be effective in the urban
underserved settings, which is consistent with the parental literature.
However, the same sample of coaches tended to use authoritarian styles in overly
harsh, ineffective ways. Discipline and toughness used by these coaches were
understandable and justified, but extreme anger, harsh verbal attacks and emotional
manipulations were unjustifiable. The study did not investigate the coaches’ behavior
over a long period of time, did not interview parents, and this particular study did not
incorporate quantitative measures or a more generalizable sample size.
Cowan et al. (2012) conducted a case study in the underserved setting of Scotland
to explore coaching behaviors and the common assumption that autonomy-supportive
coaching is adaptive, versus controlling coaching which is considered to be maladaptive.
The sample included two male head coaches and 18 athletes from two teams between the
ages of 16 to 19 years. The authors found that the coaches were considered to be
AUTHORITARIAN AND AUTHORITATIVE COACHING
8
controlling and militaristic. However, the coach used humor to help buffer the negative
outcomes associated with his authoritarian, controlling coaching style. In addition, the
authors found that the provision of choice to the players was maladaptive in this setting
because players lacked confidence and self-esteem. The study was limited because the
authors were not immersed into the culture of the team but instead relied on non
participant observations. This underserved setting may also differ from North American
high school sport. Although the context may differ, the fact remains that an authoritarian
coaching style was effectively used in an underserved setting. Based on the few studies
published about underserved sport-based PYD, results suggest that authoritarian coaching
styles play a significant role in underserved PYD (Cowan et al., 2012; Flett et al., 2012;
Flett et al., 2013; Gould et al., 2012; Richardson, 2012).
Brown et al. (in preparation) conducted a season-long in-depth ethnographic study
to observe a coach’s style and impact on players in the underserved setting. In addition,
the study included interviews to assess the coach and players’ perceptions of the
developmental environment, the coach’s perceived role/responsibilities, and the rationale
for coaching style/strategies. In an effort to address multiple gaps in the literature, this
study focused on a high school girls’ basketball team, was conducted over an entire year,
and the primary investigator was embedded within the team as a volunteer coach (and
had already coached with that team for a full season before this research study). As such,
the data collected in this dissertation represents the author’s third year with the team and
second year researching them and the city-league.
The results of Brown et al. (in preparation) indicated that the coach was
characterized as highly authoritarian and controlling, but also highly caring and sensitive
AUTHORITARIAN AND AUTHORITATIVE COACHING
9
to the needs of the players. Together, these attributes are indicative of what the authors
term a “tough-love” approach: caring, understanding, and supportive, yet disciplined,
demanding, and lacking autonomy support. The coach consumed and controlled much of
the player’s time in order to develop academics, life skills, and character while keeping
them from threats in the community. Player and coach-interviews revealed that the coach
had high expectations for the players and disciplined them out of love. The coach used
physical tactics such as Charlie Horsing (light jabs in the arm), “popping” (i.e. slapping
players in the head), and “socking” (i.e. punching) to get players back on task, to
motivate, and to keep their attention. All players believed the coach used physical contact
in a positive and humorous manner, never in a negative manner, because the coach cared
for the players. Critical to the literature, results indicated that players generally supported
the coach’s use of an authoritarian approach, and expressed a desire for even more
disciplinary, controlling, and strict leadership (in order to manage newer and more unruly
girls). However, the study was limited in its design because the authors focused on one
team in the league and did not make comparisons to other teams. In addition, they did not
obtain quantitative assessments of developmental outcomes or perceived coaching style.
Parents of the players also expressed an interest in being interviewed so that they could
share their perspectives on the coach, context, and their daughter’s development.
What works for one context may be maladaptive in another context. Authoritarian
styles used in underserved, high-crime/-violence, and disadvantaged settings are more
likely to facilitate resilience and positive outcomes in youth (Cowan et al., 2012; Flett et
al., 2012; Flett et al., 2013; Gould et al., 2012; Hartman & Manfra, 2015; Richardson,
2012). Additionally, authoritative styles in these settings may be considered harmful and
AUTHORITARIAN AND AUTHORITATIVE COACHING
10
maladaptive. Coaching styles should be context-specific and focus on players’ needs
(Flett et al., 2016).
After reviewing the foundational articles related to coaching in the underserved
settings, future research needs to explore parental/caregiver views on the coaching style
and how it impacts child development, the transfer of life skills, and the use of
authoritarian strategies. The current sport-PYD literature is not representative of the
underserved context and the unique challenges they face in everyday life. As stated
earlier, parenting literature and to an extent, some teaching literature shows strong
support for authoritarian (controlling, monitoring, and strict) styles in the underserved
setting. However, coaching literature typically cautions the use of authoritarian styles and
supports the use of positive, choice-based, autonomy-supportive (i.e. authoritative) styles
for PYD—but may be overgeneralizing their findings.
Furthermore, the current sport-PYD literature needs to expand and become more
culturally and socioeconomically diverse. Additionally, the literature must progress and
change from streamlining and stating that the use of authoritarian coaching and parenting
is wrong. More importantly, the most valuable question that needs to be answered is:
How can authoritarian styles of coaching be used most effectively, especially in the
underserved settings?
Statement of Purpose
In summary, the purpose of this dissertation will address the lack of underserved
PYD research; address the need for more longitudinal mixed-method studies; objectively
measure and track developmental outcomes throughout a season; and better understand
coaching styles used and how they impact PYD in the underserved setting (Cowan et al.
AUTHORITARIAN AND AUTHORITATIVE COACHING
11
2012; Flett et al. 2012 and 2013). In addition, the dissertation will answer the question
“what combination of coaching style factors has the strongest influence for PYD in the
underserved setting?” Lastly, it will look at parental/caregiver perceptions and
preferences of coaching styles, the intentionality of the coach, and transferable life skills.
Statement of Significance
The following dissertation contributes to the existing sport-based PYD literature
by exploring a multitude of coaching styles used in the underserved settings of the inner
city. To the knowledge of the primary investigator (PI), this study is the first to
objectively measure authoritarian and authoritative coaching in sport (in the underserved
or any other setting). Additionally, the current study will assess life skill outcomes at two
time periods, which differs from the current sport-based literature utilizing one time of
data collection. This study is informed by not only the sport literature but also parental
and teaching literature.
Research Questions
This study will use quantitative measures to survey teams across the city league
located in an urban underserved setting in the North East United States, and in-depth
interviews with parents/primary caregivers from one team (Team C) within this league.
The research questions and sub-questions guiding the study are as follows:
1. Do life skills (LS) improve from participation, and what coaching style factors
influence those LS outcomes?
1.1 Do quantitative measures of life skills show improvement for players across
the season (Do scores change over time)?
AUTHORITARIAN AND AUTHORITATIVE COACHING
12
1.2 Do quantitative measures of coaching style change over the basketball season
(between Time 1 and Time 2)?
1.3 Are certain coaching styles greater for LS development (i.e. authoritarian,
authoritative, caring, mastery, ego)?
1.4 If you were to combine all coaching style factors, which have the strongest
influence on LS?
1.5 What influence does authoritarian coaching have on LS when combined with
each of the other three coaching style factors (i.e. caring, mastery, ego), one at
a time (i.e. authoritarian + caring; authoritarian + mastery; and authoritarian +
ego).
1.6 What influence does authoritative coaching have on LS when combined with
each of the other three coaching style factors (i.e. caring, mastery, ego), one at
a time (i.e. authoritative + caring; authoritative + mastery; and authoritative +
ego).
2. What is the common style of coaching in the city league?
2.1 What is the common coaching style in the city league?
2.2 How does Coach DD’s (Team C) style compare to other coaches’ styles in the
city league?
3. Is this coach (Coach DD, Team C) developing LS through basketball, and if so, what
skills and how does she develop them?
3.1 What developmental outcomes do parents think occur from participation with
this coach and team (i.e. life skills development, intentionality, and
transferability)?
AUTHORITARIAN AND AUTHORITATIVE COACHING
13
3.2 Does the coach foster youth development intentionally? If so, how does she
intentionally develop LS?
3.3 Do parents feel they can provide concrete examples of transferrable LS? If so,
how are they being transferred?
3.4 Do parents think the sport or coach supplement psychosocial development in
the players’ home lives? If so, how does the coach or sport supplement
psychosocial development in the players’ home lives?
Key Terminology
Adolescents. Youth who are in the transitional stage concerning childhood and
adulthood between the ages of 13 to 19 years.
Authoritarian. A person who is characterized as highly demanding, less
responsive, controlling, and rarely provide rationales (Baumrind, 2013). Authoritarians
tend to create a disciplined environment with clear rules, and monitor behaviors, and
activities of youth (Holt, Tamminen, Black, Mandigo & Fox, 2009).
Authoritative. A person who is characterized as highly demanding, responsive,
consistent, and provides rationales (Baumrind, 2013). In addition, authoritative people are
assertive, and use supportive rather than disciplinary actions (Holt et al. 2009).
Autonomy-supportive. “A style that actively supports self-initiated strivings and
creates conditions for athletes to experience a sense of volition, choice, and self
endorsement (Bartholomew, Ntoumanis, Thøgersen-Ntoumani 2010).” In addition, an
autonomy-supportive style allows youth to feel that they initiate their actions rather than
feeling coerced to act in a certain manner (Grolnick, 2003).
AUTHORITARIAN AND AUTHORITATIVE COACHING
14
Caring climate. “The extent to which individuals perceive a particular setting to
be interpersonally inviting, safe, supportive and capable of providing the experience of
being valued and respected” (Newton et al., p.70).
Positive youth development. A holistic intentional approach that engages youth
in all contexts (i.e. school, home, work, etc.) while enhancing pro-social norms and
helping youth reach their full potential (Holt, 2008; U.S. Department of Health and
Human Services, 2007).
Sport. Structured physical activity governed by a set of rules and facilitated by a
coach or instructor that is implemented in an individual or group setting.
Tough-love. A formal, established definition for this term is not available from
the literature, but because the term is frequently used in this dissertation, it is important to
provide clarity it. The term has emerged from research by Flett et al. (2013) and Brown et
al. (in preparation). Tough-love is meant to describe a highly caring and respectful
approach to authoritarian, or more controlling, coaching. Such an approach would not be
“entirely” authoritarian in that there could be elements of autonomy-supportive and
authoritative behaviors. Finally, based on Flett et al.’s work, it is important to clarify that
a tough-love approach is not angry, unregulated, out of control coaching. A tough-love
coach is able to model life skills and positive psychosocial attributes.
Underserved. According to the American Journal of Managed Care (2013),
underserved populations are defined as vulnerable populations that include the
economically disadvantaged, racial and ethnic minorities, the uninsured, low-income
children, the elderly, the homeless, those with human immunodeficiency virus (HIV), and
those with other chronic health conditions, including severe mental illness. It may also
AUTHORITARIAN AND AUTHORITATIVE COACHING
15
include individuals who often encounter barriers to accessing healthcare services. The
vulnerability of these individuals is enhanced by race, ethnicity, age, sex, and factors
such as income, insurance coverage (or lack thereof), and absence of a usual source of
care. Their health and healthcare problems intersect with social factors, including
housing, poverty, and inadequate education. For the purpose of the dissertation,
underserved will be characterized as those who are socially disadvantaged, living in
poverty, and face many unique challenges such as racial discrimination, gang violence,
substance abuse, and cultural barriers (see, Flett, Gould, & Lauer, 2013; Richardson,
2012; Walsh, 2008).
AUTHORITARIAN AND AUTHORITATIVE COACHING
16
CHAPTER II
Extended Literature Review
This dissertation addresses the need for research on sport coaches and positive
youth development (PYD) in the underserved setting. The study will explore inner-city
coaching styles throughout the season and their impact on developmental outcomes. In
addition, the study will examine parents’/primary caregivers’ perceptions of the coaching
style in the city league, and intentionality and transferability of life skills.
While an authoritative style and positive coaching strategies (e.g., autonomy
support) are staples of a PYD approach to coaching, authoritarian parenting and teaching
styles are more developmentally effective in underserved settings. Bartholomew,
Ntoumanis, and Thøgersen-Ntoumani (2010) argued that coaches can use a mixture of
both autonomy-supportive and controlling strategies simultaneously and still be
considered adaptive. Youth from underserved settings are in the greatest need of PYD
because of the unique challenges they face in their everyday life (Walsh, 2008).
Researchers believe that underserved youth may also be less likely to have positive
developmental experiences in sport (Flett, Gould & Lauer, 2012; Flett, Gould, Griffes, &
Lauer 2013; Richardson, 2012). Sport is a popular activity in high school and many
perceive it to be an effective activity to enhance personal development and serve as a
protective factor for underserved youth (Coakley, 2011). Sport provides underserved
youth the opportunity to develop interpersonal relationships and build rapport with peers
and non-familial adults, such as coaches.
AUTHORITARIAN AND AUTHORITATIVE COACHING
17
The purpose of this chapter is to explain the importance of PYD and how it relates
to this study. Additionally, this chapter will discuss the context needed for PYD to occur
in sport and explain the importance of girls’ participation in sport. The chapter will then
focus on the ecological systems theory (EST), which will help explain the importance of
interpersonal relationships throughout different contexts, and how they play an enormous
role in player psychosocial development. Furthermore, it will then focus in depth on
effective coaches, with specific emphasis on the coaches’ role, style, and the created
motivational and caring climate. Lastly, the chapter will review the scant literature in
sport and the underserved setting, address gaps, and discuss future directions.
Positive Youth Development
In the past, traditional youth development was reactive and focused on
minimizing and reducing problems such as teen pregnancy, sexual involvement,
substance abuse, problem behaviors and delinquency during adolescence in targeted
populations (Holt, 2008). This traditional approach provided intervention programming
and treated youth as beneficiaries as opposed critical resources and solutions. Pittman et
al. (2011) noted that problem-free youth are not fully prepared to be productive members
of society. Larson (2000) argued that healthy development involves more than reducing
and minimizing problem behaviors. In addition, Holt (2008) and others argued that a
comprehensive, holistic approach is more beneficial and would achieve long lasting
results for youth. As a result, a shift has been made from a traditional deficit reduction
approach to a humanistic positive youth development approach.
PYD is a holistic, strength-based approach that engages all youth within their
families, school, and community context. PYD has no singular definition. It concentrates
AUTHORITARIAN AND AUTHORITATIVE COACHING
18
on enhancing pro-social norms, helping youth reach their full potential (U.S Department
of Health and Human Services, 2007), fostering positive relationships (Strachan, Côté, &
Deakin, 2009), and viewing youth as contributing members of society and critical
resources to be developed as opposed to problems to be solved (Holt, 2008; Roth &
Brooks-Gunn, 2003).
Within the PYD field, several researchers have outlined key components needed
for optimal development. Larson (2000) believed that there needs to be a match between
experiences of adolescents and requirements of the adult word. He argued that youth need
three important characteristics to function as healthy adults: initiative, empowerment and
leadership opportunities. Damon (2009) believed youth need to have a “purpose” in life,
which, in turn, helps adolescents cope and allow them to be optimistic no matter the
situation. The Five C’s Model of PYD created by Lerner and colleagues (2005) address
psychological, behavioral, and social characteristics in youth including: competence,
confidence, connection, character and caring. Youth who acquire the Five C’s are
considered to be thriving and will develop a sixth C, described as contribution to self,
family, and community (Zarrett & Lerner, 2008).
Similarly, the Search Institute identified 40 developmental assets, also known as
“building blocks” for human development. These assets help youth to become more
healthy, caring, and responsible adults. The developmental assets are organized into two
components, internal assets and external assets, with eight domains. Internal Assets are
sets of skills, links to the personal development, competencies, and values within a
person and are grouped into four categories: 1) positive identity, 2) positive values, 3)
social competencies, and 4) commitment to learning (Benson et al., 2011). External
AUTHORITARIAN AND AUTHORITATIVE COACHING
19
assets describe the environmental, contextual and relational assets (formation of strong
bonds and relationships with the developing person), and are likewise grouped into four
categories: 1) empowerment, 2) support, 3) constructive use of time, and 4) boundaries
and expectations (Benson et al., 2011; Brofenbrenner, 2009). In order to develop these
assets, youth must positively and effectively interact within various contexts (family,
school, and community) to build important relationships and foster opportunities to
enhance their skills (Strachan et al., 2009). Research shows that adolescents who acquire
multiple assets have a greater chance of developing in a healthy manner (Benson et al.,
2006; Strachan, Fraser-Thomas, & Nelson-Ferguson, 2016). Fraser-Thomas, Côté and
Deakin (2005) implied that organized sport participation could benefit youth and help
them grow into caring and responsible adults.
Sport and PYD. PYD engages youth through multiple contexts (family, school,
and community) and provides youth the opportunity to get involved in various
extracurricular activities, like sport, to develop and refine their skills. In almost every
school, sport is the most popular and time-consuming activity (Hansen & Larson, 2007).
In the United States, approximately 21.5 million youth between the ages of 6 to 17
participate in organized team sports annually (Kelley & Carchia, 2013). The late Nelson
Mandela stated:
Sport has the power to change the world. It has the power to inspire, it has the
power to unit people in a way that little else does. It speaks to youth in a language
they understand. Sport can create hope, where once there was only despair
(Laureus World Sports Awards, Monaco 2000).
AUTHORITARIAN AND AUTHORITATIVE COACHING
20
Organized sport enhances personal development more so than informal activities
such as hanging out with friends (Mahoney & Stattin, 2000), or hanging out at the mall
(Osgood & Anderson, 2004). According to Perkins et al. (2007), “Time spent in youth
programs is the most consistent predictor of youth thriving,” and research supports that
youth participating in organized sport are more likely to experience positive
developmental outcomes in comparison to those who do not participate in organized sport
(Larson, 2000). Empirical findings have shown that organized sport can lead to healthy
social, psychological, and physical developmental outcomes such as an increase in
physical health (Bailey, 2006; Côté & Fraser-Thomas, 2007), self-esteem (Bailey, 2006;
Smith, Smoll & Curtis, 1979), decreased stress (Smith, Smoll, & Cumming, 2007),
leadership opportunities (Gould & Carson, 2008), teamwork/cooperation opportunities
(Gould et al., 2012), increased academic achievement (Bailey), character development
(Donnelly & Coakley, 2007; Gould, Collins, Lauer, & Chung, 2007), responsibility
(Hellison & Cutforth, 1997) and the establishment of positive relationships with adults
(Fry & Gano-Overway, 2010; Strachan et. al, 2009).
The cultural and structural context of sport influences personal and social
development (Theokas, Danish, Forneris, Hodge, & Heke, 2008). Factors such as
personal characteristics of the athletes and coach (Peterson, 2004), actions of the coaches
(Smith& Smoll, 2002), and the environmental context (Fry & Gano-Overway, 2010;
Holt, Sehn, Spence, Newton & Ball, 2012; Martinek & Hellison, 1997) play a role in
developmental outcomes in sport. Larson, Hansen, and Montea (2006) contend that
positive outcomes of sport will likely occur when it is intentional, structured, and
systematic because sport is more likely to enhance external and internal assets in
AUTHORITARIAN AND AUTHORITATIVE COACHING
21
adolescents (Hodge, 1989; Petipas, Cornelius, Van Raalte, & Jones, 2005). However,
sport participation alone is not the “magic ingredient” to enhance PYD.
Negative outcomes and best-practices. Although many studies show that sport
can be beneficial to PYD, negative outcomes can occur if PYD is not intentional. If sport
is not conducted in the right manner, it has the potential to deter youth from personal and
social development and result in eating disorders (Reel, SooHoo, Petrie, Greenleaf, &
Carter, 2010), elevated use of alcohol (Lisha, Crano, & Delucchi, 2014; Veliz, Boyd, &
McCable, 2015), sport injuries (Vitali, Bortoli, Bertinato, Robazza, & Schena, 2015),
decrease in self-esteem and confidence (Stirling & Kerr, 2013), athlete burnout (Vitali et
al.), increased stress (Gould & Carson, 2010), poor sportsmanship (LaVoi, & Stellino,
2008), emotional abuse (Stirling & Kerr), and/or poor cooperation and negative peer
influence (Dworkin & Larson, 2006). These negative outcomes are believed to occur
because of parents, youth, and coaches placing too much emphasis on sport outcomes
(i.e. winning, losing, and playing time), lack of formal education for coaches, and sport
susceptibility to adult domination (Gould & Carson, 2008).
The research presented shows empirical support for both positive and negative
outcomes that may result from sport participation. As stated earlier, sport participation
alone is not the “magic ingredient” to enhance PYD. Coakley (2011) argued that, “By
itself, the act of sport participation among young people leads to no regularly identifiable
developmental outcomes” (p. 309).
In an effort to reduce negative experiences, Petipas et al. (2005) created a PYD
sport framework grounded in research findings and best practices in the field of youth
development (Larson, 2000; Smith & Smoll, 2002). Petipas et al. indicated that PYD will
AUTHORITARIAN AND AUTHORITATIVE COACHING
22
occur when youth a) are engaged in a desired activity within the appropriate context, b)
are surrounded by positive, caring external assets, and c) have the opportunity to learn
and acquire internal assets. In addition, Lerner and Lerner (2006) indicated that structure
and physical/psychological safety of athletes are critical factors to instilling PYD. In the
teaching personal and social responsibility (TPSR) framework, Martinek and Hellison
(1997) suggested that youth development programs should develop a sense of values,
purpose, and empowerment; respect diversity; promote safety; and develop resiliency. In
other words, youth programs need to create and maintain a physically, psychologically,
emotionally, and socially safe setting where coaches provide opportunities to teach youth
the necessary skills and instill positive values needed for sport and other domains (i.e.
school life, home life, and work life). The current study looks at how coaching styles,
sport participation, and intentionality of the coach may promote PYD.
Girls in sport. This study will look at PYD in the context of high school girls’
basketball teams. A generation ago, sport literature focused primarily on male
involvement because girls participating in sport were not culturally accepted nor
acknowledged. Within the past 40 years, there has been an increase in girls participating
in sports in America due to Title IX of the Educational Act of 1972, which prohibits
gender discrimination in any federally funded education program or activity (Paule-Koba,
Harris, & Freysinger, 2013). Title IX states, “No person in the United States shall, on the
basis of sex, be excluded from participation in, be denied the benefits of, or be subjected
to discrimination under any education program or activity receiving financial assistance”
(Title IX and Sex Discrimination, 2015). As a result, Title IX increased athletic
opportunities for girls and women. Women participating in sports has become more
AUTHORITARIAN AND AUTHORITATIVE COACHING
23
culturally accepted and celebrated (Cooky, 2010). Research shows that sport and physical
activity positively impact the physical and psychosocial well-being of girls and women
(Staurowksy et al. 2009). Sport can potentially increase girls’ self-confidence, prevent
eating disorders, and enhance their physical health (Kane et al., 2007). In addition, sport
participation is associated with a positive body image (Hausenblas & Fallon, 2006;
Huang et al. 2007), an increase in educational achievement (Coakley, 2011), and a
decrease in teen pregnancy and substance abuse (Staurowsky et al.). Allen (2003) implies
that a sense of belongingness and enjoyment is the motivator for girls in sport.
Furthermore, Allen (2003) also provided support that girls prefer social, “fun” activities,
and opportunities to learn concepts and skills as motivators for their participation
(Passmore & French, 2001; Perkins et al., 2007).
Despite Title IX and increased athletic opportunities, sport participation gaps for
underserved African American girls still exist in urban and rural communities (Sabo &
Veliz, 2008). Sabo (2009) suggested that the lack of participation in urban and rural
communities can be explained by multiple contextual factors that include family income,
race and ethnicity, and the type of community. Sport may be helpful to achieve PYD for
underserved girls, but as stated earlier it is not the only ingredient (Coakley, 2011;
Hartmann & Kwauk 2011). Coakley (2011) argued that other factors within and outside
the sport program help to foster developmental benefits.
Framing Key Literature in Theory
Multiple theories have been used in sport PYD literature to explain the positive
and negative outcomes of sport. Due to the pragmatic approach for this dissertation, the
theory used for the current study is grounded in the ecological systems theory (EST). The
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24
current study uses the EST (Brofenbrenner, 2009) to organize the review of literature and
as the rationale for including parents and other teams from this league as participants in
this study. EST allows the researcher to look at a broader picture of how an inner-city
girls’ basketball team functions in relation to the entire league and the parents’/primary
caregivers’ point of view.
Ecological System Theory. Brofenbrenner’s (1977; 2009) EST suggests that
human development and human behavior occur from person to context interactions. EST
provides a framework to understand the significance of social interactions within and
between various contexts, such as the home, school, and work environments. EST has
been used across several research domains (e.g. sport, public health, psychology, child
development, sport, etc.) to understand the bidirectional influence between youth and
their context (Lerner et al., 2011).
Within the EST framework, the ecological systems model is organized into four
nested systems that include: microsystem, mesosystem, exosystem and macrosystem. The
microsystem represents one’s immediate context that directly impacts development (e.g.
home, school, church, team). The mesosystem represents regular social interactions and
interconnectedness between the microsystems (i.e. the relationship between a coach and
player). The exosystem represents the relation between a social setting and one’s
immediate context, which the individual does not have an active role in (i.e. the coach’s
relationship with the player’s parents). Lastly, the macrosystem represents the cultural
context, such where one lives (e.g., neighborhood), SES, poverty and ethnicity. EST is
relevant to the sport domain because it takes into account the bidirectional influence of
individual, environmental, and program characteristics, rather than studying the
AUTHORITARIAN AND AUTHORITATIVE COACHING
25
individual in isolation. Integrating EST into the design of this study reinforces the PYD
perspective, because PYD is grounded in an ecological systems approach to youth
development (Holt, 2008). The family, school, and community contexts of PYD are
considered below.
Family context. Within the family context (microsystem), parenting strategies
and techniques are used to socialize and teach their children appropriate behaviors of the
culture. Parenting styles differ throughout cultures and vary from home to home. Coakley
(2002) emphasized that upper- middle income, predominantly White families have
different ideas about PYD and believe that outcomes should emphasize achievement and
upward mobility, in comparison to underserved minority families who emphasize control
and discipline.
Baumrind (2013) created a typology that described four different parenting styles
grounded in research findings: authoritarian, authoritative, permissive and disengaged.
For the purpose of this paper, authoritarian and authoritative parenting styles will be
defined and emphasized as they relate to coaching in the inner-city. Authoritarian
parenting styles are described as highly structured with clear stated rules, high control,
and militaristic with the use of physical discipline such as spanking (Deater-Deckard,
Lansford, Dodge, Pettit & Bates, 2003; McLoyd, Kaplan, Hardaway & Wood, 2007).
Parents who utilize this style are considered to be high in demand and low in acceptance
and responsiveness to their child. These types of parents often have a large number of
rules that they expect their children to obey and rarely provide rationales for their rules
and expectations. On the other hand, authoritative parenting styles are described as
parents being highly demanding and highly accepting/responsive to their children. Unlike
AUTHORITARIAN AND AUTHORITATIVE COACHING
26
authoritarian parenting styles, authoritative parents tend to provide rationales for their
rules/expectations and listen to their child more (Baumrind, 2013). Experts suggest that
authoritative parenting styles are linked to positive PYD outcomes; however, these
findings may not be generalizable to other contexts because the majority of these studies
examined white, middle-class populations.
Coll and Pachter (2002) advised researchers studying African American or other
minority populations to use a historical and cultural lens to try to account for their
experiences (i.e. slavery, racism, and poverty). Similar to EST, sociocultural theorist
Vygotsky believed “development occurs over time within the context of the culture”
(Gardiner & Kosmitzki, 2008, p. 302). In other words, learning and development occurs
through context and social events, and cannot be separated from cultural, historical, and
social contexts in which they are situated (Wang, Bruce, & Hughes, 2011). This
paradigm looks at how social interaction and participation in organized activity play a
role in psychological development (Scott & Palinscar, 2009). According to Thompson
(2004), “African Americans in urban communities are socialized very differently from
Whites from middle-class communities” (p. 72). Research has shown that authoritarian
parenting practices used in low-income families correlate with lower levels of child
behavior problems. For example, Eamon (2002) conducted a two-year longitudinal study
with a sample of 963 participants between the ages 10 to 12 years old. Results showed
that poverty was strongly related to neighborhood problems more than parental and peer
influences. In addition, Eamon found that authoritarian parenting styles and the use of
physical punishment for kids living in poverty buffered anti-social behavior. Similarly,
Dearing (2004) conducted a longitudinal study in Massachusetts with three ethnic groups
AUTHORITARIAN AND AUTHORITATIVE COACHING
27
(i.e. African American, Latino American, and European American) living in an
underserved setting plagued by rape, robbery, burglary, larceny, and aggravated assault.
The purpose of the study was to examine how neighborhood characteristics moderated
associations between parenting and child outcomes. Results showed that
restrictive/controlling (authoritarian) parenting styles were a protective factor and had a
positive effect on academic performance for African American and Latino American
children, but had a negative effect on European American children. Furthermore, research
shows that minority parents living in dangerous and imp
Psychosocial Development of Junior Hockey Players : Psychosocial Development of Junior Hockey Players
Alexander John Sturges
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Psychosocial Development of Junior Hockey Players
Alexander John Sturges
Dissertation submitted
to the College of Physical Activity and Sport Sciences
at West Virginia University
in partial fulfillment of the requirements for the degree of
Doctor of Philosophy in
Sport & Exercise Psychology
Edward Etzel, Ed.D., Chair
Kristen Dieffenbach, Ph.D.
Larry Lauer, Ph.D.
Scott Barnicle, Ph.D.
Department of Sport & Exercise Psychology
Morgantown, West Virginia
2018
Keywords:
Psychosocial development; adolescence; elite sport development; athletic identity
Copyright 2018 Alexander John Sturges
ABSTRACT
Psychosocial Development of Junior Hockey Players
Alexander John Sturges
Junior hockey is an elite sport development model that impacts over twenty thousand adolescent
male athletes each year. Participation in junior hockey commonly requires adolescents, 16 to 21
years of age, to move away from home, disrupt academic plans, and participate in an intense elite
sport development model during critical developmental years. The influence of junior hockey on
long-term psychosocial development is widely unknown. The present research measured
developmental outcomes of college-enrolled former junior hockey player utilizing the Student
Development Task and Lifestyle Assessment (SDTLA) and the Athlete Identity Measurement
Scale (AIMS). Statistical analyses examined the impact of various measures of the junior hockey
experience on measures of athletic identity and psychosocial development, with comparisons
also being made to a representative population of male college students. Findings indicate junior
hockey’s potential contribution to increased measures of athletic identity as well as delays in
specific aspects of adolescent psychosocial development when compared to a normative
population of male college students. Recommendations are provided for junior hockey
shareholders towards improving the developmental outcomes associated with a junior hockey
experience.
iii
Table of Contents
Abstract ............................................................................................................................... ii
Introduction ..........................................................................................................................1
Statement of Purpose .................................................................................................6
Primary Research Questions ......................................................................................7
Hypotheses .................................................................................................................7
Methods................................................................................................................................8
Introduction ................................................................................................................8
Theoretical Orientation ..............................................................................................8
Previous Research ......................................................................................................9
Research Design.......................................................................................................10
Sample inclusion criteria.....................................................................................10
Sampling procedure ............................................................................................10
Electronic surveys ...............................................................................................12
Data collection procedures ..................................................................................12
Sample size .........................................................................................................13
Statistical Analyses ..................................................................................................13
Research question 1 variables .............................................................................14
Research question 1: Junior hockey and athletic identity ...................................14
Research question 2 variables .............................................................................15
Research question 2: Psychosocial development compared to normative population
................................................................................................................................15
Research question 3 variables .............................................................................15
Research question 3: Athletic identity and psychosocial development ..............15
Summary ..................................................................................................................16
Results ................................................................................................................................17
Data Preparation.......................................................................................................17
Overview of Data Analysis ......................................................................................18
Demographic Characteristics of the Participants .....................................................19
iv
Table 1: Number of participants by ethnicity .....................................................19
Table 2: Number of participants by age ..............................................................20
Table 3: Number of participants by class rank ...................................................20
Table 4: Number of participants by international student status ........................20
Table 5: Number of participants by current hockey status .................................21
Table 6: Number of participants by junior hockey years ....................................21
Table 7: Number of participants by number of JH teams played for ..................21
Table 8: Number of participants by school changes due to JH ...........................22
Table 9: Number of participants by residence changes due to JH ......................22
Table 10: Participant rating of “enjoyment” of junior hockey experience .........22
Table 11: Participant rating of “benefit” of junior hockey experience ...............23
Table 12: Descriptive statistics for participant AIMS scores .............................23
Table 13: Frequency distribution of participant AIMS scores............................23
Analysis of Research Question 1 .............................................................................23
Table 14: Bivariate correlation of AIMS and JH experience .............................24
Analysis of Research Question 2 .............................................................................24
Table 15: SDTLA subtask standard T scores by class ........................................25
Table 16: SDTLA task standard T scores by class .............................................26
Analysis: Research Question 3 ................................................................................26
Table 17: Multivariate analysis of the variance (AIMS and SDTLA)................26
Table 18: Test of between-subject effects ..........................................................26
Discussion .....................................................................................................................27
Introduction .........................................................................................................27
Research Question 1 Discussion .........................................................................28
Research Question 2 Discussion .........................................................................31
Academic autonomy subtask ........................................................................32
Instrumental autonomy subtask .....................................................................34
Salubrious lifestyle scale ................................................................................36
v
Research Question 3 Discussion .........................................................................39
Summary of findings...........................................................................................40
Recommendations ...............................................................................................41
Limitations ..........................................................................................................43
Future Directions ................................................................................................45
Conclusion ..........................................................................................................47
Appendix A: Extended Review of the Literature ..............................................................48
Junior Hockey ..........................................................................................................49
Introduction to Junior Hockey ............................................................................49
Junior hockey history .....................................................................................49
Fundamental Experiences ........................................................................................53
Athlete relocation ................................................................................................53
Academic disruptions..........................................................................................54
New primary support system ..............................................................................58
Junior hockey structure .......................................................................................58
Junior hockey player rights ............................................................................60
Junior Hockey Culture .............................................................................................62
Deviance .............................................................................................................63
Alcohol and Substance use .................................................................................64
Positive junior hockey outcomes ........................................................................65
Enjoyment ......................................................................................................65
Junior Hockey Development System .......................................................................66
Long-term athlete development ..........................................................................66
Youth sport.....................................................................................................68
Elite sport development .................................................................................69
Sport mastery .................................................................................................70
Relative age effect..........................................................................................71
Perceptions of junior hockey ..............................................................................73
vi
Summary of the Junior Hockey Experience ............................................................74
Adolescence .............................................................................................................76
Introduction to adolescence ................................................................................76
Problem behavior theory .....................................................................................78
Adolescent risk behaviors ...................................................................................79
Adolescent development .....................................................................................81
Athletic identity ..................................................................................................83
Adolescent transition ..........................................................................................84
Adolescent mobility ............................................................................................86
Educational mobility ......................................................................................88
Residential mobility .......................................................................................89
Homesickness ...........................................................................................90
Adolescent adjustment ...................................................................................91
Late adolescence .................................................................................................91
Developmental tasks ...........................................................................................93
Adolescent psychosocial development ...............................................................94
Psychosocial development in college .................................................................95
Non-traditional college students .........................................................................96
Student Development Task & Lifestyle Assessment ...............................................99
Uses of the SDTLA ...........................................................................................103
Athletic Identity Measurement Scale .....................................................................104
Uses of the AIMS..............................................................................................105
Research with the SDTLA and AIMS ...................................................................106
Summary ................................................................................................................107
Appendix B: Definition of Key Terms ............................................................................109
Appendix C: Basic Demographic Questions ...................................................................112
Appendix D: Athletic Identity Measurement Scale (AIMS) ...........................................114
Appendix E: Student Development Task and Lifestyle Assessment (SDTLA) ..............116
vii
Appendix F: Participant Cover Letter ..............................................................................142
Appendix G: Participant Recruitment Email Templates .................................................144
Appendix H: Participant Follow-up Email Templates.....................................................146
Appendix I: Academic Autonomy Subtask Questions ....................................................149
Appendix J: Instrumental Autonomy Subtask Questions ................................................151
Appendix K: Salubrious Lifestyle Scale Questions ........................................................153
References ........................................................................................................................156
Introduction
1
Junior hockey is an elite sport development system providing athletic opportunities for
over 20,000 participants annually. Selection to join a junior hockey team represents a watershed
moment in a player’s career, as they are following in the footsteps of the many thousands of
great professional players who taken the same path. The junior hockey system is widely
celebrated across Canada and the United States as it is viewed as a shaper of men, a molder of
professionals, and as a symbol of community prosperity and opportunity. However, despite its
prominent role in advancing the careers of talented hockey players, little is known about the
influence of this experience on adolescent psychosocial development. Junior hockey is unique
compared with other mainstream North American sports in that it systematically challenges
traditional academic, family, and social institutions. Furthermore, success in junior hockey is
measured primarily through athletic outcomes (e.g. achieving a college scholarship or being
drafted into the National Hockey League) and professionalized competitive forces hold
substantial influence over the structuring of the system and therefore the experience for
participants. Because of this, little attention is paid to the intricate process of adolescent
development taking place throughout and after the junior hockey experience. To date, research
on junior hockey has focused primarily on team and individual performance variables, and little
work has been done to consider the potential impact of junior hockey on athletes moving through
the system or transitioning to advanced developmental stages.
The modern junior hockey system is rooted in the growth and professionalization of
Canadian ice hockey throughout the 20th century (Kidd & MacFarlane, 1972). Junior hockey’s
earliest form involved regional sponsors hosting local senior league teams that would compete
for distinction across Canada and some Northern sections of the United States. Through the
initial years of organized ice hockey, teams were stocked with local talent and embraced the
2
ideology of amateur competition (viewing sport as leisure instead of a legitimate vocational
option). However, as the popularity of ice hockey grew, so did opportunities for money to be
made by sponsors, promoters, and organizers. The introduction of new revenue streams and
financial sponsorship led to private and community investments in larger, more spectator
friendly arenas, as well as the recruitment and payment of hockey talent brought in to help teams
win (Whitson & Gruneau, 2006). As the sport of ice hockey grew and elite professional leagues
began to organize, top franchises needed a system of identifying and developing young talent to
eventually play for their elite teams, and therefore began sponsoring junior organizations.
Conceived as a stepping stone to the pro ranks, junior hockey embodies characteristics of
professionalized sport, emphasizing performance and athletic advancement to serve the interests
of professional sport organizers. From small-town beginnings, junior hockey expanded
exponentially, evolving to ideally suit the needs of higher level programs making selections from
the junior hockey talent pool. Through this growth, junior hockey has become a major financial
and social institution, as well as a source of pride for many communities across the United States
and Canada.
The junior hockey landscape is diverse, involving over 600 registered teams in 60
different leagues. Although most leagues and teams are affiliated with national governing bodies
of sport for either Canada or the United States, very little oversight or standardized regulation
exists. Most of the operational and cultural norms of junior hockey are guided by traditions that
have been passed down through generations of the sport, making junior hockey a unique but
unifying experience for those who participate in the system. Despite diversity in locations,
competitive levels, and offered resources of junior hockey teams and leagues, four fundamental
components can be identified that encapsulate the lived experience for participants within the
3
junior hockey system. For the purposes of this study, these common factors have been
established to conceptualize junior hockey and its key developmental influences. The four
identified fundamental factors of junior hockey included: 1) athlete relocation, 2) new primary
support systems, 3) academic disruption, and 4) the professionalized nature of the junior hockey
environment.
First, the full-time relocation of junior hockey participants is a long-accepted practice of
junior hockey. Junior hockey relocation involves moving adolescents away from their immediate
families, established peer groups, and familiar community support systems, and placing them in
unfamiliar environments subject to forces of highly competitive sport. Advocates for junior
hockey have historically embraced the process of athlete relocation and see it as a benefit to the
cultural integration of the athlete to the sport (Mason, Duquette, & Sherer, 2005). However, the
impact of youth athlete relocation and the environments participants are being asked to integrate
into have not been critically examined. Junior hockey often represents an individual’s first
experience living away from home. While relocation has long been viewed as a necessary step
towards maturity, junior hockey’s lack of oversight, and inconsistent policy regarding relocation
and housing make this fundamental process worthy of further examination.
Second, physically relocating for junior hockey introduces personal challenges for
participants as they are introduced to new towns and teammates to which they have limited if any
social or emotional connection. This period of transition can have a range of behavioral and
developmental consequences, including the formation of a strong emotional attachment with
teammates, team personnel, and overall junior hockey culture (Finn & McKenna, 2010).
Traditionally, the process for relocating junior hockey players involves the assignment of billet,
4
or host families (local families willing to house junior hockey players, often compensated by the
team). Players live in their billet’s home, share meals and experiences, and even take
responsibility for chores and helping around the house. Familiarizing with a billet’s rules and
values can be a very impactful experience for junior hockey participants, especially because this
may be their first experience living away from their own families (Dubé & Schinke, 2008).
Junior hockey and its relocation practices have the potential to significantly impact an
individual’s development by means of exposure to unique social and interpersonal challenges.
The third feature of a junior hockey experience is the regular feature of academic
disruption. Junior hockey participation typically occurs during the transition between high school
and college. While many junior hockey players are required to maintain high school academic
progress, players who have completed high school may not be enrolled in any schooling at all.
While most current junior hockey teams and leagues encourage the continuation of academic
progress, no enforceable guidelines exist, and no public data is available regarding individual or
team academic progress. Furthermore, junior hockey requires a commitment to strenuous
training and competition schedules, often conflicting with classes and/ or participation in the
school environment (Koshan, 2004). Overall, the fundamental structure of junior hockey lacks
congruency with the academic goals and interests of participants, and long-term consequences of
this process remain widely unknown.
The fourth fundamental experience of junior hockey is the professionalized approach in
structuring this elite sport development system. Franchises and leagues are privately funded, and
their primary purpose is to serve the financial interests of management and ownership groups,
who yield substantial power and influence (Whitson & Gruneau, 2006). Teams are not required
to make long-term commitments to players, despite holding considerable control over their
hockey careers. Players can be cut or traded at any time based on subjective performance
5
standards, and franchises that fail to produce financial viability can fold or relocate, even after a
single season. This instability contributes to a competitive, high-pressure environment that is
found consistently throughout junior hockey’s varying levels. Overall, junior hockey’s
competitive structure, together with required relocation, and social and academic disruptions
represent four foundational factors that are found at all levels of junior hockey and have strong
developmental implications.
Junior hockey occurs during the developmentally dynamic stage of adolescence.
Adolescence is a period of intense change and identity exploration in which numerous
meaningful developmental challenges must be overcome (Steinberg & Morris, 2001). Along
with the challenge of establishing a stable and authentic sense of self-identity, adolescents also
must navigate social interactions of ever-increasing complexity and significance. Normative
adolescent development also calls for the healthy formation of career ambitions, ability to form
proper interpersonal relationships, and to solidify oneself as an autonomous feature of the
environment (Demos & Demos, 1969; Eccles et al., 1993). Taking into consideration the timing
and potential intrusiveness of the junior hockey experience, an established understanding of the
influence of junior hockey on adolescent development is crucial.
The transition from high school to college is a well-documented developmental process
that has a significant impact on the lifespan trajectory of individuals. Development within the
college environment is seen as constant, cumulative, and occurs on a continuum that can provide
insight as to potential developmental outcomes (Winston, Miller, & Cooper, 1999). Research in
this domain has identified specific developmental tasks associated with proper psychosocial
development. Chickering and Reisser’s (1993) seven developmental vectors (which include
developing competence, interdependence, mature interpersonal relationships, emotional
6
management, sense of purpose, and integrity) have played a major role in shaping the accepted
notion of appropriate college student development. The unique demands placed by junior hockey
on academic progress produces many non-traditional college students, a population known to
adapt differently to the college environment, and therefore may require specialized programming
and accommodations (Macari, 2003). Given the long-term developmental significance of the
college and university, factors that influence this experience are worthy of inquiry. Overall, the
presence of junior hockey in key transitional periods of adolescence, as well as its potential
influence on the transition to the college setting, emphasizes the importance of research on the
development of individuals participating in this system.
Statement of Purpose
The present study explored the psychosocial development of college-enrolled former
junior hockey players. The study also examined long-term developmental implications of junior
hockey and offers recommendations to improve programming and participant experiences.
Junior hockey is unique from other major sport development structures in North America in its
scale (over 20,000 annual participants) and its cultural norms, (e.g., expected participant
relocation) which actively disrupt sources of adolescent stability and support. Junior hockey’s
intense and professionalized system influences participants lives during a developmentally
sensitive period in which the formation of a stable and secure identity is a primary feature.
Furthermore, the role of junior hockey in normalizing the delay of college enrollment as well as
its potential influence on college selection may play a role in altering the college experience and
potentially in subsequent development. Overall, the present study examined the influence of
junior hockey on identity formation and subsequent psychosocial development in the college
7
setting.
Primary research questions
The following three research questions were developed to address the primary purpose of
the study and to guide the methodology:
1. What is the relationship between measures of junior hockey participation and measures of
athletic identity in college-enrolled former junior hockey players?
2. In what ways does junior hockey participation influence measures of psychosocial
development when compared to the normative sample population of male college
students?
3. Are measures of athletic identity predictive of measures of psychosocial development in a
population of college-enrolled former junior hockey players?
Hypotheses
The following represent the three primary research hypotheses, although methodology tested
null hypotheses.
1. Measurements of junior hockey participation are related to measurements of athletic
identity in college-enrolled former junior hockey players.
2. Junior hockey participation influences measurements of psychosocial development when
compared to a normative sample population of college students.
3. Measurements of athletic identity are predictive of measurements of psychosocial
development in college-enrolled former junior hockey players.
Methods
8
Introduction
The selected methodology examined the relationship between the junior hockey
experience and developmental processes in a sample of college-aged, former junior hockey
participants utilizing the collection and analysis of data from validated measurements of athletic
identity and psychosocial development. Two primary measurement instruments were featured:
The Athletic Identity Measurement Scale (Brewer, Van Raalte & Linder, 1993) to measure
participant athletic identity, and the Student Development Task and Lifestyle Assessment
(Winston, Miller, & Cooper, 1999) to measure aspects of psychosocial development within the
college setting. The following chapter outlines the selected research parameters and methods of
statistical analysis applied to address the primary research questions pertaining to the
developmental impact of junior hockey. Theoretical underpinnings, data collection procedures,
and aspects of research integrity are also discussed.
Theoretical Orientation
The present research adopted a positivist theoretical stance. A positivist perspective aims
to test a theory or describe a unique experience through observation and measurement to
establish the ability to predict and/ or control a phenomenon (Campbell & Stanley, 1963;
Mackenzie & Knipe, 2006). A positivist perspective also assumes that observable phenomena are
knowable through empirical and reductionist scientific inquiry, and that methodology should be
constructed with precision and detail so that experimental conditions can be replicated by other
researchers (O’Leary, 2004). Concepts of psychosocial development and athletic identity have
generally agreed upon definitions previously established through the literature. However,
concrete understanding of these topics is an ongoing and fluid process, as evidenced by the
9
varied theoretical positions and continued empirical work expanding to new and emerging
contexts (Shutte & McNeil, 2015; Gucciardi, 2017; Hardy et al., 2017). The present research
contributes to the literature by focusing on a specific realm of elite sport development system
(junior hockey) and its potential impact on aspects of adolescent psychosocial development.
Previous Research
A pilot study utilizing an electronic version of the SDTLA on a sample of college
enrolled former junior hockey players was conducted by the principal investigator, testing the
appropriateness of this methodology. SDTLA and demographic data was collected from a
convenience sample of 45 male college students with varying levels of junior hockey experience.
Participant scores were compared to the normative population of male college students on each
developmental task. Results showed that standard scores produced by former junior hockey
players were significantly lower on tasks of developing mature interpersonal relationships and
establishing autonomy. Results were consistent with developmental principles proposed by
Chickering and Reisser (1993) that college students display psychosocial development through
time spent in college (scores for freshman were typically lower than seniors). Furthermore, the
pilot study results suggested that junior hockey has a potential impact on former participants’
ability to successfully transition and display appropriate psychosocial development in the college
setting. Results of the pilot study generally supported the need for more research on the topic of
psychosocial development on this population.
Research Design
The present study utilized a descriptive, correlational research design to address the
10
research questions. Descriptive correlational design refers to research in which the size and
direction of a relationship between variables is observed, however no direct attempt is made to
control for or randomize participant experience (Shadish, Cook & Campbell, 2002). Descriptive
correlational research evaluates connections between various behavioral outcomes and
illuminates potential paths of inquiry that may provide a deeper understanding of the observed
phenomenon (Lappe, 2000). Correlational designs are well-suited for studies that apply validated
measures to novel contexts, especially when the observed behaviors are social and exploratory in
nature. Furthermore, descriptive data collection can help formulate new research questions or
guide future research (Anderson, 1998).
Sample inclusion criteria. College-enrolled males with experience playing junior hockey,
whether they are still competing in the sport or not, were eligible to participate. The construct of
junior hockey experience was defined (for this study) as time spent within any level of junior
hockey for any duration of time. Participants were required to be currently enrolled in a college
or university continuously for at least four weeks to ensure adequate acclimation to the
environment (Winston, Cooper, Miller, 1999). Participants also had to be at least 18 years of age.
No additional participant exclusion criteria regarding race, ethnicity, or nationality were featured.
Sampling procedure. The present study utilized non-probability purposive sampling. Purposive
sampling, the deliberate choice of participants based on inherent characteristics, best meets the
goals of the study in understanding a specific population through a theoretical framework
(Tongco, 2007). Presently, no collective database of former junior hockey players exists, and
therefore purposive sampling allows for data to be collected from the desired population in a
timely manner (Battaglia, 2008).
Participant contact information was accessed by networking with hockey shareholders
11
willing to provide contact information of potential participants. Current and former junior and
collegiate hockey coaches/ organizers were contacted through email and phone to discuss
possible inclusion of former junior hockey player contacts. Snowball sampling was also used in
limited cases in which participants were willing to connect other individuals within their network
to the research study (Goodman, 1961). Electronic correspondence in the form of email was
established directly with potential participants, or indirectly through a coach/ organizer. This
initial contact was followed by delivery of an anonymous and unique access code for the testing
instrument (See Appendix F, G, & H for email correspondence templates). One initial email, and
two follow-up emails were distributed individually to all participants to maximize survey
completion (McPeake, Batterson & O’Neill, 2014).
Limitations to this method of participant recruitment included: a) potential selection bias
(Ahern, 2005) towards successful junior hockey players (indicated by actualized opportunities to
continue competing after junior hockey), b) surveying of a potentially non-representative sample
(Jones, Murphy & Edwards, 2008) through exclusion of junior hockey participants who do not
continue on to college, c) non-randomized participant sampling (Reeves, Deeks, Higgins &
Wells, 2008) and d) potential for lower response rates (Robson, 2011) due to the format of the
survey instrument. To counteract bias and establish trustworthiness, connections were
established with as large and diverse a population of former junior hockey participants as
possible, and specific inclusion/ exclusion criteria were followed to increase the generalizability
of findings (McPeake, Batterson & O’Neill, 2014; Higgins et al., 2013; Hopkins, Marshall,
Batterham & Hannin, 2008).
12
Electronic surveys. Electronic surveys were utilized for data collection. Online surveys can be
an effective data collection tool that yield meaningful responses regarding a phenomenon within
a specific target population with near universal internet access (Crawford, Couper & Lamias,
2001; Aldridge & Levine, 2001; Creswell, 2003). Electronic surveying has been found to be a
reliable and efficient way to reach a large proportion of the sample population and is considered
a valid form of data collection (Schleyer & Forest, 2000). For the present study, use of electronic
surveying allowed for the most convenient data collection procedure, reaching the maximum
possible sample population.
Both the SDTLA and the AIMS are approved and validated for use in electronic form by
their authors (Winston, Milller & Cooper, 1999; Brewer, Van Raalte & Linder, 1993).
Furthermore, both the SDTLA and AIMS have been successfully utilized in online versions in
research settings with similarly aged populations (Coe-Meade, 2015; Turton, Goodwin, &
Mayer, 2017; Wisdom, 2006). Benefits of employing these measures in an online format include
ordered presentation of questions, reduction of non-responses, increased convenience for
participants, lower cost, and faster data analysis (Aldridge & Levine, 2001; Granello & Wheaton,
2004).
Data collection procedures. Prior to data collection, approval was obtained from the West
Virginia University Institutional Review Board for the Protection of Human Subjects to ensure
ethical protection of all participants. Study procedures, outline of participant rights, and informed
consent were presented to participants for approval prior to accessing the survey instrument. The
full survey instrument (see Appendices B, C, & D) was administered to participants utilizing the
Qualtrics software platform (Qualtrics, Provo, UT). Each participant received a unique and
anonymous link to the instrument that was accessed at their convenience. All possible efforts
13
were made to ensure confidentiality and minimize collection of identifying information through
the survey instrument, and no identifying information as included in data analysis proceedings.
Data was secured and accessible through one password protected account, only accessible to the
researcher. Downloaded data sets were stored on a password protected computer.
Sample size. Data collection remained open until desired sample size was reached. Estimates
utilizing the GPower software suite (Faul, Erdfelder, Lang & Buchner, 2007) indicated that for a
low-to-medium effect size, with power set at .95, and a .05 Pearson’s coefficient, that
approximately 210 participant responses would be required to obtain significant results. Desired
sample size has further been determined through recommendations from similar studies as well
as parameters in the literature regarding appropriate sampling procedures (Bartlett, Kotrlik &
Higgins, 2001).
Statistical Analyses
Statistical analysis of the data was conducted in three separate steps and addressed each
research question individually. All data analyses were conducted through the SPSS statistical
software suite (SPSS Inc.) and Microsoft Excel. First, participant scores on the AIMS and
SDTLA were calculated as defined by official assessment manuals and published data
calculation procedures. Prior to conducting any statistical analyses, the data set was examined for
missing/ incomplete responses, and multicollinearity (Schroeder, Lander & Levine-Silverman,
1990). Cook’s distance measure was conducted to test for and remove unduly influential outliers
in the data set. In addition, SDTLA task and subtask data missing more than 12% of responses
were not included in the data analysis, as recommended by the authors (Winston, Miller, &
Cooper 1999). AIMS measures missing any of the seven question responses were also excluded
(Brewer, Van Raalte & Linder, 1993). Participant total scores on the AIMS were reflected by a
14
cumulative score of the seven answered questions, ranging from a minimum of 7 to a maximum
of 49. Scores on each of the SDTLA’s five tasks/scales were converted to standard scores,
allowing individual scores to be compared to the normative population.
Research question 1 variables. Research question one examined the relationship between junior
hockey experience and athletic identity. To address this question, two demographic variables and
two questions related to perceived enjoyment and benefit of the junior hockey experience were
collected through the survey instrument and served as independent variables. The four
independent variables included: a) number of years of junior hockey participation, b) number of
junior hockey teams played for, c) “I enjoyed my junior hockey experience”, and d) “junior
hockey was beneficial to my college experience”. The two questions regarding perceived
enjoyment and benefit of the junior hockey experience were scored on five-point Likert scales.
The dependent variable was represented by cumulative athletic identity scores assessed by the
AIMS, ranging from 7 to 49 (Brewer, Van Raalte & Linder, 1993).
Research question 1: Junior hockey experience and athletic identity. Research question one
addressed the relationship between measures of junior hockey participation and the athletic
identity measurement scale (Brewer, Van Raalte & Linder, 1993). Junior hockey experience was
measured by four variables; number of years played, number of teams played for, and rating of
perceived enjoyment and benefit. Pearson product correlation coefficient, r, was calculated to
determine the relationship between two key demographic variables (i.e., years in junior hockey
and number of teams played for) and athletic identity. Bivariate correlations are used to assess
the degree of relationship between two continuous variables (Tabachnick & Fidell, 2001).
Results of this test are intended to assess the relationship between athletic identity and factors
associated with junior hockey experience, including years played, and number of teams played
15
for, and ratings of perceived enjoyment and benefit.
Research question 2 variables. Research question two examined the relationship between
college-aged former junior hockey players and non-junior hockey playing college students on
measures of psychosocial development through the SDTLA (Winston, Cooper, & Miller, 1999).
Comparisons were drawn between former junior hockey players and a normative population of
male college students categorized by academic class standing. Between each academic class
standing (freshman, sophomore, junior, and senior), four developmental measures of
psychosocial development were assessed. The four SDTLA tasks/ scales included; a) academic
autonomy, b) mature interpersonal relationships, c) clarifying sense of purpose, d) salubrious
lifestyle scale.
Research question 2: Psychosocial development compared to normative population.
Research question two examined the relationship between psychosocial development in former
junior hockey players in comparison to normative scores for male college students. Participant
SDTLA data was stratified based on academic class standing to allow for comparison to
normative data. Comparisons of converted T-scores were conducted between participant SDTLA
task and subtask scores with normative sample population scores provided by the authors. This
comparison determined if mean score on specific tasks for the research sample were significantly
different than established norms for male college students (Tambachnick & Fidell, 2001).
Research question 3 variables. Research question three examined the relationship between
psychosocial development and levels of athletic identity in former junior hockey players. To
address this question, participants were stratified according to their AIMS scores into low,
medium, and high athletic identity groups. The middle group was formed based on +/- 0.5
16
standard deviation from the sample mean. High athletic identity was represented by scores more
than 0.5 standard deviations above the sample mean, and low athletic identity was represented by
scores more than .05 standard deviations below the sample mean. The research question was
addressed by comparing the stratified groups of athletic identity (measured through the AIMS),
with participant aggregate scores on the Student Development Task & Lifestyle Assessment
(SDTLA) for the established primary developmental tasks.
Research question 3: Athletic identity and psychosocial development. Participants were
stratified according to their AIMS scores into low, medium, and high athletic identity groups.
The middle group was formed based on +/- 0.5 standard deviation from the sample mean. High
athletic identity was characterized by scores more than 0.5 standard deviations above the sample
mean, and low athletic identity was characterized by less than scores more than .05 standard
deviations below the sample mean. The stratified groups of AIMS scores were used as
independent variables and run in a one-way Multivariate Analysis of Variance (MANOVA),
testing mean differences between athletic identity and the four scales/ task measures of the
SDTLA (Tabachnick & Fidell, 2001). This test explored the predictive value of athletic identity
scores and specific aspects of psychosocial development in college-enrolled former junior
hockey players.
Summary
The present methodology was determined to be the best means to address the primary research
questions based on a thorough empirical review of the literature. The methodology addressed the
examined relationships between junior hockey experience, athletic identity, and psychosocial
development in a college-aged population. The sample population was defined as college
enrolled former junior hockey players, having been in college for at least four weeks. The
electronic survey instrument for this study included demographic questions, the AIMS, and the
17
SDTLA. Data analyses was conducted to make comparisons between the data sets and to address
the three primary research questions outlined previously. Responsible and ethical research
practices were observed as defined by the Institutional Review Board, and participant rights to
confidentiality were enforced throughout the data collection and analysis process.
Results
Data Preparation
Data collection conducted through the Qualtrics online platform was closed when pre
determined sampling thresholds were reached. From a potential audience size of 563
participants, 344 participants accessed the survey and 258 surveys were submitted (75%
completion rate for surveys opened by participants). Collected data was converted and
downloaded through Qualtrics to SPSS v.25 for analysis. All remaining identifying information
was removed from the data set in preparation for analysis. In addition, score adjustments for
individual items were entered according to the published SDTLA scoring key before scale,
subtask, and task scores were calculated.
Following a preliminary review of participant data, specific factors were determined to be
grounds for removing cases from the data set. Total sample size progressed through three
adjustments based on the requirements of each of the three research questions. For research
question one, participants were removed if they did not indicate having any junior hockey
experience (based on years played or teams played for). Graduate students (N=10) were also
removed from the sample prior to analysis. A final exclusion criterion implemented prior to
analysis for research question one involved the SDTLA response bias scale. The SDTLA
includes a six-item response bias scale within the instrument, through which the authors
recommend removal of participant scores on this scale equal to or exceeding 3 of a possible 6
18
(Winston, Miller, & Cooper, 1999). Although research question one did not involve the SDTLA
instrument, the indication of a high participant social desirability rating was determined to be a
threat to AIMS and demographic measurements, both administered at the same time as the
SDTLA. Analysis for research question one included N=215 participants.
The data set from research question one was established then adjusted in preparation for
analysis with research question two. Exclusion criteria for this question included participant
responses that fell below 75% completion due to their inability to provide complete SDTLA task
or subtask scores. Although the authors of the SDTLA provide instructions for customized
scoring of assessments with missing data, it was determined that all participants would be scored
the same. If a participant’s subtask or subsequent task score was incomplete, that measure was
excluded in the final analysis. Surveys with 75%-100% completion were retained for analysis
only on task/ subtasks where all required items were completed, and scores were able to be
calculated. Analysis for research question two included N=203 participants.
One final exclusion criterium was utilized for research question three. Incomplete
participant responses (below 100%) were not included in the MANOVA analysis, which reduced
the sample to N=199 participants.
Overview of Data Analysis
The purpose of the study was to investigate the impact of junior hockey participation on
identity formation and psychosocial development in a population of college-enrolled former
junior hockey players. Research question one was examined by running bivariate correlations
between junior hockey experience (as measured by years of junior hockey played, number of
junior hockey teams played for, and personal ratings of enjoyment and benefit) and athletic
19
identity (as measured by the seven item AIMS). Research question two was addressed by
comparing differences on standardized scores between former junior hockey players and the
norm sample population on task and subtask measures of the SDTLA. Research question three
was addressed through mean score comparisons of task measures of psychosocial development
through the SDTLA and athletic identity scores as measured by the AIMS.
The following results are presented in this chapter: (a) description of participants, (b)
description of AIMS scores, (c) description of SDTLA task and subtask scores, and (d) the
results of a one-way multivariate analysis of variance (MANOVA).
Demographic Characteristics of the Participants
The utilized sample population was comprised of 215 college-enrolled former junior
hockey players. All participants were male and over the age of 18. The average participant was
22 years old. Demographic summaries of ethnicity, age, class rank, and international status are
provided in tables 1-4.
Table 1
Number of Participants by Ethnicity
Ethnicity Label
White
Black
American Indian or Alaskan Native
Asian
Native Hawaiian or Pacific Islander
Hispanic
RQ1
207
1
0
5
1
1
RQ2
196
0
0
5
1
1
RQ3
192
0
0
5
1
1
Totals (N)
215
203
199
20
Table 2
Number of Participants by Age
Age RQ1 RQ2 RQ3
19 5 4 4
20 29 27 27
21 43 41 39
22 57 55 54
23 41 39 38
24 24 23 23
25 9 8 8
26 1 1 1
27 1 1 1
Totals (N) 215 203 199
Mean age = 22
*Five participants did not register age information
Table 3
Number of Participants by Class Rank
Class Rank RQ1 RQ2 RQ3
Freshman 42 40 38
Sophomore 57 51 51
Junior 61 59 58
Senior 55 53 52
Totals (N) 215 203 199
Table 4
Number of Participants by International Student Status
Classification RQ1 RQ2 RQ3
International Student 36 35 35
Not International Student 179 168 164
Totals (N) 215 203 199
Hockey Experience. Demographic information pertaining to experience within the sport
of hockey was measured through self-reported current hockey status (level of participation),
number of years spent playing junior hockey, number of junior hockey teams played for, number
of school changes due to junior hockey, and number of residence changes due to junior hockey.
21
Two additional questions were included regarding participant perception of enjoyment and
benefits of their junior hockey experience (“I enjoyed my junior hockey experience”, and “junior
hockey was beneficial to my college experience”). These questions were scored on five-point
Likert scales ranging from “strongly disagree” to “strongly agree”. Frequency and mean scores
for these questions are provided in Tables 5-11.
Table 5
Number of Participants by “Current Hockey Status”
Status RQ1 RQ2 RQ3
Competing in college (NCAA/ CCAA level) 114 113 112
Competing in college (Club level) 94 84 82
Participating in college (rec./ intramural) 3 2 1
Not participating in hockey 4 4 4
Totals (N) 215 203 199
Table 6
Number of Participants by “Junior Hockey Years”
Years RQ1 RQ2 RQ3
0-1 22 19 19
1-2 74 71 69
2-3 54 49 49
3-4 42 41 39
4-5 23 23 23
Totals (N) 215 203 199
Mean years = 2.9
Table 7
Number of Participants by “Number of JH Teams Played For”
Teams RQ1 RQ2 RQ3
1 76 71 70
2 64 60 60
3 38 36 34
4 20 20 20
5 17 16 15
Totals (N) 215 203 199
Mean number of teams = 2
22
Table 8
Number of Participants by “School Changes Due to JH”
Changes RQ1 RQ2 RQ3
0 7 6 6
1 97 92 91
2 64 61 60
3 24 23 23
4 18 16 14
5 5 5 5
Totals (N) 215 203 199
Mean school changes = 1.8
Table 9
Number of Participants by “Residence Changes Due to JH”
School Changes RQ1 RQ2 RQ3
0 1 1 1
1 51 47 46
2 38 36 36
3 44 42 42
4 37 34 33
5 44 43 41
Totals (N) 215 203 199
Mean residence changes =2.9
Table 10
Participant Rating of “Enjoyment” of Junior Hockey Experience
RQ1 RQ2 RQ3
Strongly disagree 2 2 1
Somewhat disagree 5 5 5
Neither agree nor disagree 10 9 9
Somewhat agree 55 49 48
Strongly agree 143 138 136
Totals (N) 215 203 199
Table 11
Participant Rating of “Benefit” of Junior Hockey Experience
RQ1 RQ2 RQ3
23
Strongly disagree 2 2 1
Somewhat disagree 5 4 4
Neither agree nor disagree 17 15 15
Somewhat agree 44 43 42
Strongly agree 147 139 137
Totals (N) 215 203 199
Participant frequency scores and descriptive statistics for the AIMS are provided in
Tables 12-13.
Table 12
Descriptive Statistics for Participant AIMS Scores
N Min Max Mean SD
RQ1 215 18 49 40 5.4
RQ2 203 18 49 40 5.4
RQ3 199 21 49 40 5.2
Table 13
Frequency Distribution of Participant AIMS Scores
AIMS Score RQ1 RQ2 RQ3
18-21 2 2 1
22-25 1 1 1
26-29 8 6 6
30-33 18 13 13
34-37 32 28 27
38-41 76 61 60
42-45 65 60 59
46-49 37 32 32
Totals (N) 215 203 199
Analysis: Research Question One
Research question one addressed the relationship between the athletic identify (measured
by the AIMS) and junior hockey experience (measured by years spent in junior hockey, number
of teams played for, and personal perception of benefit and enjoyment of the experience).
Because junior hockey experience was a requirement for participation in this study, the lowest
value for participation was one year (i.e., participant years included time spent up to or equaling
that number). Significant positive correlations were observed between AIMS score and the
24
variables representing time, perceived enjoyment, and perceived benefit. Bi-variate correlation
results are presented in Table 14.
Table 14
Bivariate Correlation: AIMS and Junior Hockey Experience
Time (years)
AIMS
.2*
Pearson
Correlation
Sig. (2-tailed)
Sum of Squares
and Cross
products
.004*
260.2
# of teams
“Enjoyable”
.083
.228
117.7
.2*
.003*
176.1
“Beneficial”
.18*
.009*
166
N = 215
Significance marked at the .05 level.
Analysis: Research Question Two
Data collected for the SDTLA was sorted by current academic standing and then
converted into standard scores according to the published scoring instrument provided by the
SDTLA authors. Means and standard deviations derived from the normative sample population
were used to compute individual standard T scores for each participant for each sub-scale and
scale of the SDTLA. The purpose of converting participant raw scores to T scores was for
comparison to the normative sample population, represented as 50 for each category. Participant
scores .5 standard deviations above or below the published norm (+/- 5) are considered
significant findings according to the SDTLA technical manual (Winston, Brewer, & Cooper,
1999). Average scores for each academic class standing are presented below (See Table 15).
Analyses revealed significant differences between the sample population and the norm in
two subtask categories and on the Salubrious Lifestyle Scale. On the Academic Autonomy
subtask, sophomores, juniors, and seniors scored below the published norms. For the
25
Instrumental Autonomy subtask, scores for sophomores also fell below the expected range, while
scores for the other three class ranks neared falling significantly below. Both subtasks containing
significantly lower participant scores fell within the Developing Autonomy Task.
Table 15
SDTLA Subtask Standard T Scores by Class
Class Career
Purpose
Tolerance
Peer
Relationships
Lifestyle
Planning
Cultural
Participation
Educational
Involvement
Academic
Autonomy
Interdepende
nce
Instrumental
Autonomy
Emotional
Autonomy
FR 48.1 51.4 46.5 49.1 54.8 45.2 46.4 48.8 45.3 50.9
SO 46.3 47.1 46.7 46.4 53.9 46.3 43.9* 48.9 44.3* 48.3
JU 46.5 49.7 46.3 50.0 52.1 45.7 43.4* 49.1 45.1 52.0
SR 46.1 50.6 46.0 47.2 53.4 48.2 44.5* 47.7 45.7 51.7
* Indicates score >.5 +/- standard deviations from the normative sample
Significant differences were also found in the Salubrious Lifestyle Scale, one of the
instruments primary measurements (See Table 16). Cumulative scores from Freshman and
Seniors on this measure fell below the expected range.
Table 16
SDTLA Task Standard T Scores by Class
Class
FR
SO
JU
SR
Salubrious Lifestyle
Scale
43.1*
48.2
48.3
44.7*
Establishing and
Clarifying Purpose Task
47.9
47.7
46.9
48.1
Mature Interpersonal
Relationships Task
50.1
45.8
49.6
48.2
Developing Autonomy
Task
47.3
45.9
47.3
47.1
* Indicates score >.5 +/- standard deviations from the normative sample
26
Analysis: Research Question Three
AIMS scores were categorized to “high”, “medium” and “low” according to +/- 0.5
standard deviation from the mean to test variance of the SDTLA model in relation to athletic
identity. Table 17 shows the results of the one-way MANOVA conducted. Wilks’ Lambda and F
values were not found to be significant. A subsequent between-subjects test of the AIMS
categories and the SDTLA tasks did not yield significant values. F scores for the Clarifying
Purpose and Salubrious Lifestyle Scale neared significance (See Table 18). However, these
findings were not maintained when controlling for differences attributed to class rank within the
model.
Table 17
Multivariate Analysis of the Variance (AIMS and SDTLA)
Value F df Error Sig. Power
AIMS
Rank
Wilks'
Lambda
.96 1.2 8 386 .39 .5
N=199
Table 18
Test of Between-Subject Effects
DV SS df F Sig. Power
AIMS AUT 23.9 2 .514 .599 .13
SAL 153.1 2 1.617 .201 .34
PUR 392.9 2 3.25* .041* .62
MIR 10.7 2 .420 .658 .12
N=199
Discussion
27
Introduction
Junior hockey is an influential sport development system that impacts thousands of
adolescent hockey players prior to their developmental transition to college and early adulthood.
Despite the size of this system (approximately 20,000 annual participants in 250 teams in 40
leagues across North America), very little work has been done to understand the effect of a
junior hockey experience on participants. Unique from other sport development models, junior
hockey embraces a series of non-traditional organizational norms, including the requirement of
participants to move away from home, change schools, and alter educational trajectory. Thus, the
purpose of the present research was to better understand developmental outcomes of a junior
hockey experience through measurements of athletic identity and psychosocial development in a
population of college-enrolled former junior hockey players.
Research Question One Discussion
Research question one hypothesized that the junior hockey experience would influence
the amount of athletic identity reported by former junior hockey participants. Junior hockey
experience was represented by time spent (in years) within the system, number of teams played
for, as well as personal reflection on enjoyment and benefits of the junior hockey experience.
The hypothesis was partially supported, as significant positive correlations were found in self
reported “time spent” (r = .2), ratings of personal enjoyment (r = .2), and ratings of perceived
benefit of junior hockey (r = .18) yielded a significant correlation of at the .01 level. Number of
teams played for was not significantly correlated with scoring on the AIMS. These findings
indicated that more time spent in junior hockey is associated with the greate
Coaching life skills through sport: An application of the teaching personal and social responsibility model to youth sport in eSwatini : Coaching life skills through sport: An application of the teaching personal and social responsibility model to youth sport in eSwatini
Zenzi Huysmans
zehuysmans@mix.wvu.edu
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Coaching life skills through sport: An application of the teaching personal and social
responsibility model to youth sport in eSwatini
Zenzi Huysmans, M.S.
Dissertation submitted
to the College of Physical Activity and Sport Sciences
at West Virginia University
in partial fulfillment of the requirements for the degree of
Doctorate of Philosophy in Kinesiology with a Major in Sport, Exercise, and Performance
Psychology
Sport and Exercise Psychology
Damien Clement, Ph.D., Chair
Sam Zizzi, Ed.D.
Christiaan Abildso, Ph.D., MPH
Meredith Whitley Ph.D., Adelphi University
Department of Sport Sciences
Morgantown, West Virginia
2018
Keywords: youth development, life skills, coaching, teaching personal and social responsibility
model, eSwatini
Copyright 2018 Zenzi Huysmans
Abstract
Coaching life skills through sport: An application of the teaching personal and social
responsibility model to youth sport in eSwatini
Zenzi Huysmans
Adolescence is a formative developmental period where youth learn the life skills and values
needed to become compassionate and civically-engaged young people and navigate increasingly
challenging global environments. Youth in eSwatini face major context-specific challenges that
impede their healthy development as well as limited engagement with government initiatives
intended to support their development. This feasibility study aimed to employ youth sport as a
creative and engaging context to facilitate life skills development in underprivileged youth in
eSwatini. Specifically, this study explored the youth participation experiences, positive youth
outcomes, and implementation successes and challenges of a sport program for underprivileged
youth in a community in eSwatini. The sport program was designed using the teaching personal
and social responsibility (TPSR) model, which is a well-established instructional model for life
skills education through sport. Although this model had been widely applied in Western
contexts, the current study explored how the model might operate differently in a non-Western
context where youth face different developmental challenges. An intervention design was
employed to implement a three-week sport program for youth in a small community in the
Lobamba region of eSwatini. Local coaches were the primary implementers of the program and
participants were youth (N=33), aged 11-15 years old, who attended the grade six and seven
literacy development afternoon club at a community-based children’s organization. Findings
from the current feasibility study provided further support for the value of using the TPSR
framework in the design and implementation of sport-based life skills education programming in
a novel youth context in eSwatini. The focus of the model on building caring coach-youth
relationships, creating an enjoyable sport experience, fostering small successes, and providing
intentional opportunities for youth to actively practice and engage in their own learning were the
most meaningful elements of the model in the current youth context. The developmental
outcomes and changes in life skills associated with participation in the current program may also
be highly pertinent to helping youth navigate the most salient health and resource challenges in
the community. Notably, the current study also identified culture and context-specific
considerations that should be made when implementing TPSR-based youth programming in
eSwatini. These included, but are not limited to, adaptations to the awareness talk and self
reflection time, the use of active learning strategies and behavioral management techniques, and
the provision of fruit and food to meet basic survival needs. Continued future explorations of the
program design elements and coaching strategies that most meaningfully contribute to a holistic
youth development and a positive sport participation experience in eSwatini is warranted.
Acknowledgements
iii
Traveler, the path is your tracks
And nothing more
Traveler, there is no path
The path is made by walking - Antonio Machado –
It takes a village to raise a child and I have had so many supporting hands help me get to this
point. To the family, friends, and community in eSwatini who believed in me from the very
beginning, “I am because we are”. What a beautiful thing to have been shaped by so many kind
hearts over the years. Siyabonga kakhulu!
To the children of the Moya Center, the staff, and the coaches who helped me bring this
dissertation to life. It was an immense privilege to develop this program alongside you all. You
are the reason why I do what I do. To the community members, key informants, coaches, and
students who participated in the needs assessment that grounded this dissertation, thank you!
Your voices are present in every chapter of this dissertation story!
To my wonderful SEP colleagues. As the African proverb says, “If you want to go fast, go alone,
if you want to go far, go together.” We have journeyed far together…and what an adventure it
has been! Over the years we have shared so many moments of laughter and joy, and also
experiences of sadness and challenge. In those difficult times, your support and kindness have
meant everything to me. I will cherish both; the deep belly laughter and also the compassion you
have shown me! Thank you! Matt and Tammy…not all heroes wear capes! Thank you for
investing yourselves so fully in the coding process of my dissertation. Your enthusiasm and
dedication to my work was a beautiful thing to witness.
To the SEP and Counseling faculty members and my dissertation committee. I have been lucky
to grow both personally and professionally under the wings of such compassionate, dedicated,
and pioneering people. Dr. Clement: over the years you have pushed me to become the best
possible version of me. You have supported my independence while also reaching out a helping
hand when I needed it. Dr. Zizzi: You have helped me trust my way of being and enjoy the
journey as it unfolds. Your kindness has been so appreciated. Dr. Etzel: it has meant more than
you know to journey around the world with you through our chats about music, books, recipes,
and life experiences. Thank you for trusting and nurturing my vision for consulting when I was
still searching for my professional identity. Dr. Whitley: You have dedicated your life’s work to
using sport as a platform for the positive and holistic development of youth all over the world.
Your passion and work ethic is truly an inspiration. I hope to emulate that in my own
professional journey. Dr. Abildso: Thank you for taking a leap with me. I look forward to
continuing to explore the intersection of sport and community-based public health programming
under your mentorship.
To my dearest friends, you are my heart and soul connections for life! The greatest gifts of life
are friendships, and I have been blessed with some truly beautiful ones. See you in eSwatini one
day! Killeen, it’s hard to describe how you have impacted my life. In some of my most difficult
iv
moments of challenge, you were an unwavering presence. You give to everyone around you so
selflessly. I feel privileged to have shared this chapter with you, to have watched your continued
growth into a strong, compassionate, and balanced woman. Aaron. Morgantown will always be
synonymous with you. Your way with people is something that will stick with me. You have an
incredible ability to connect with others and make everyone you meet feel valued. Thank you for
giving me a space to share the contents of my heart. Sofia, in you I have found a kindred spirit. A
playful, optimistic, and deeply values-oriented soul. Thank you for the light you have brought to
my life! Jay. Your determination and resilience have been pillars for me. Challenge upon
challenge has been thrown your way and you have stepped up to the plate every time. Please
know that even when you feel alone in those experiences, you are shaping the lives of those who
are watching your fighting spirit. Thank you for all the laughter and roasts. I have met my
match…but never underestimate the slow roast! Bobby. We have truly adventured far and
wide together…through the depths of some personal sorrows, through the dark but also beautiful
caves of consulting and counseling internship, all the way to the humor and authentic connection
that characterizes our friendship. Thank you! August…our journey did not go the direction we
imagined it. But you were my pillar and biggest supporter for a very long time. Thank you for
growing with me and loving me. I will forever cherish the depth of the love we shared.
Most of all, thank you to my family, klavertje vier – AZRA – for showing me how to put love,
kindness, and compassion at the center of all things. To my sister, Aissa…my moon spirit…my
life companion – for journeying through life with me and showing me what the purest form of
love feels like. “Both sun and moon blissfully call the tune. The one at midnight, the other at
noon.” Rolf Huysmans. “You are imperfect, you are wired for struggle, but you are worthy of
love and belonging.” Brené Brown. To my mammsy, Ann…my pillar of strength – for
grounding me so firmly in optimism, kindness, and determination. “The way we talk to our
children becomes their inner voice.” Peggy O’Mara. To my wonderful dad, Rolfinho – your
presence is eternally missed. Not a day goes by that I don’t reflect on how incredibly fortunate I
was to have your light of integrity, beauty, and vision guiding me. You were truly an exceptional
human. You and mammsy showed me what love really means…when it is unconditional, when it
is reflected in our everyday choices of how we treat others. Merci beaucoup!
Quand on n’a que l’amour
Pour unique raison
Pour unique chanson
Et unique secours…
Quand on n’a que l’amour
Pour tracer un chemin
Et forcer le destin
A chaque carrefour…
Alors sans avoir rien
Que la force d’aimer
Nous aurons dans nos mains
Amis le monde entire. - Jacques Brel –
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI v
Table of Contents
Chapter 1: Introduction ................................................................................................................... 1
Chapter 2: Methods ....................................................................................................................... 11
Paradigm .................................................................................................................................... 11
Positionality ............................................................................................................................... 12
Setting........................................................................................................................................ 13
Needs assessment/pilot phase .................................................................................................... 13
Participants ................................................................................................................................ 15
Sport Program Design ............................................................................................................... 17
Sport Program Implementation ................................................................................................. 22
Instrumentation/Measures ......................................................................................................... 26
Procedures ................................................................................................................................. 32
Pre-program data collection procedures .................................................................................... 35
During-program data collection procedures .............................................................................. 36
Post-program data collection procedures .................................................................................. 37
Data Analyses ............................................................................................................................ 39
Chapter 3: Results ......................................................................................................................... 43
Preliminary results ..................................................................................................................... 44
Program implementation ........................................................................................................... 44
RQ1: What is the youth participation experience in a TPSR-based youth sport program in
eSwatini? ............................................................................................................................... 44
RQ2: What are the coaching strategies and program design elements (strengths and
weaknesses of coach training and sport program) that contribute most strongly to life skills
learning in a TPSR-based youth sport program in eSwatini? ................................................ 54
RQ3: To what extent was fidelity to the TPSR model achieved in terms of daily structure,
youth responsibility behaviors, and coaching strategies? ...................................................... 82
Program impact ......................................................................................................................... 92
RQ4: What positive developmental outcomes and changes in life skills are associated with
youth participation in a TPSR-based youth sport program in eSwatini? .............................. 92
Researcher reflexivity ............................................................................................................... 99
Youth experiences ................................................................................................................. 99
Program design .................................................................................................................... 102
Chapter 4: Discussion ................................................................................................................. 105
Program implementation ......................................................................................................... 106
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI vi
Research question one: youth participation experiences ..................................................... 106
Research question two: coaching strategies and program design elements ........................ 112
Research question three: fidelity to the TPSR model .......................................................... 131
Program impact ....................................................................................................................... 140
Research question four: youth positive developmental outcomes and life skills ................ 140
Limitations .............................................................................................................................. 146
Practical Implications and Future Directions .......................................................................... 148
Conclusions ............................................................................................................................. 152
References ................................................................................................................................... 154
Tables and Figures ...................................................................................................................... 177
Appendix: Extended Introduction ............................................................................................... 194
Scope of the Study................................................................................................................... 194
Basic Assumptions .................................................................................................................. 195
Limitations of the Study .......................................................................................................... 196
Definition of Terms ................................................................................................................. 197
Significance of the Study ........................................................................................................ 198
Appendix: Extended Literature Review ...................................................................................... 200
Youth, development, and sport: eSwatini context ................................................................... 201
Sport for development and peace ............................................................................................ 211
Sport for development in South Africa and eSwatini ............................................................. 223
Youth coaching in Southern Africa and eSwatini ................................................................... 232
Role of coaches in positive youth development and sport for development ........................... 240
Teaching personal and social responsibility through sport ..................................................... 248
Application of the TPSR model .............................................................................................. 253
Theoretical framework ............................................................................................................ 280
Precede-Proceed model ....................................................................................................... 281
Needs assessment/pilot phase (PRECEDE) to inform dissertation feasibility study .......... 283
Youth sport program: Theoretical framework ..................................................................... 290
Summary of Literature Review ............................................................................................... 296
Appendix A: Sport Program Outline .......................................................................................... 299
Appendix B: Coach Training Manual ......................................................................................... 329
Appendix C: Demographics Survey ........................................................................................... 351
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI vii
Appendix D: Demographics and Personal and Social Responsibility Questionnaire (PSRQ) ... 352
Appendix E: Multidimensional Scales of Perceived Self-Efficacy (MSPSE) ............................ 353
Appendix F: Student Learning Quiz ........................................................................................... 357
Appendix G: Coach Focus Group Guide .................................................................................... 358
Appendix H: Youth Focus Group Guide .................................................................................... 359
Appendix I: Teacher Interview Guide ........................................................................................ 360
Appendix J: Tool for Assessing Responsibility-Based Education (TARE) – Post-Teaching
Reflection .................................................................................................................................... 361
Appendix K: TPSR Implementation Checklist ........................................................................... 365
Appendix L: Coach Consent Form ............................................................................................. 366
Appendix M: Youth Assent Form .............................................................................................. 368
Appendix N: Parental Consent Form .......................................................................................... 370
Appendix O: Teacher Consent Form .......................................................................................... 372
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
1
Chapter 1: Introduction
Adolescence is a formative period in the healthy development of youth and lays the
foundation for future well-being and fulfillment (Holt, 2008; Fatusi & Hindin, 2010). In
developing countries, this age demographic makes up the largest proportion of the population
(UNFPA, 2015). However, young people in these areas are facing significant health-related
challenges as well as limited resources to support their development (Fatusi & Hindin, 2010). In
the Kingdom of eSwatini (formerly known as Swaziland), a small country in Southern Africa,
36% of the population is between the ages of 10-24 years (WHO 2013; Mavundla, Dlamini,
Nyoni, & Mac-Ikemenjima, 2015). While youth in eSwatini struggle with the more universal
challenges associated with adolescence such as social identity development and peer pressure,
emaSwati youth are also faced with major context-specific challenges. These include but are not
limited to economic and resources concerns such as unemployment, low school attendance, and
high poverty rates as well as health challenges such as risk for HIV/AIDS (Huysmans, Clement,
Hilliard, & Hansell, 2017). Specifically, the population-level poverty rate in eSwatini is 63%,
unemployment for youth aged 15-24 is 42.6%, and only about half of youth attend school
(Mavundla et al., 2015; Ministry of Sports, Culture and Youth Affairs, 2015).
Of even more concern is the fact that eSwatini has the highest global prevalence of
HIV/AIDS; almost 30% of adults (15-49 years old) are infected (UNAIDS, 2016). The high
prevalence of HIV/AIDS in eSwatini has not only put youth at significantly higher risk for
infection (AVERT, 2014), but it has also had psychological, social, and economic effects on the
lives of young emaSwati (Foster & Williamson, 2000). These include, but are not limited to,
becoming the caretaker of a sick parent, experiencing increased financial pressure in already
poor living situations, having to drop out of school to earn a living, and experiencing the death of
one or both parents (AVERT, 2014; Foster & Williamson, 2000). This is consequential given the
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
2
significant body of research that indicates that exposure to adverse childhood experiences
(ACEs) such as neglect or chronic illness and the death of a parent put children at greater risk for
future cognitive, emotional, social and health impairments (Anda, Butchart, Felitti, & Brown,
2010; Felitti et al., 1998). Furthermore, the high adult mortality rates due to the HIV epidemic in
eSwatini has resulted in a youth population (under 18 years of age) composed of almost 50%
orphans and vulnerable children (AVERT, 2014). This is concerning because emaSwati (Swazi)
youth are therefore not only exposed to adverse childhood experiences alongside health and
resources challenges, but they are also lacking guidance and mentorship from adult role models
to support their healthy development. Investing in youth development and mentorship initiatives
in eSwatini should therefore be prioritized.
Although there are government-led policies, and initiatives, for youth development operating
at the national and community level in eSwatini, youth buy-in to these systems is limited
(Mavundla et al., 2015; Ministry of Sports, Culture and Youth Affairs, 2015). Moreover, the gap
between provision, and adoption, of youth services may suggest that there is a need to find ways
to engage young people in their own development through creative, fun, and intentional
programming. Sport-based youth development programming may be one avenue through which
to achieve this goal (Beutler, 2008). Sport is seen as an appropriate vehicle through which to
deliver youth development initiatives because it is an engaging and well-liked avenue for health
promotion and behavior change in adolescents (Kaufman, Spencer, & Ross, 2013). It is also
valued as an innovative, practical, and cost-effective tool for development (Beutler, 2008). On a
global scale, a multitude of research supports the role of sport as a vehicle for youth development
(Schulenkorf, Sherry, & Rowe, 2016; Svensson & Woods, 2017).
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
3
The role of sport in youth development is conceptualized as a fertilizer (Coakley, 2011) that
can create the right environment to help cultivate socially desirable skills that all young people
have the innate potential to develop (Coakley, 2011). Positive youth sport experiences have been
found to not only meaningfully contribute to performance outcomes and future sport
participation, but also personal development (Côté & Hancock, 2016). It also exposes youth to
positive role models, social connections, and constructive environments that may buffer the
negative impacts of ACEs and developmental trauma (Hughes, Ford, Davies, Homolova, &
Bellis, 2018; Whitley, Massey, & Wilkison, 2018), build resilience (Bellis et al., 2018), and help
them grow into civically engaged and conscientious adults (Beutler, 2008; Coakley, 2011). For
socially vulnerable populations, sport participation can also help youth develop the life skills
needed to overcome the challenges of everyday life and “succeed in the different environments
in which they live, such as school, home and in their neighborhoods” (Danish, Forneris, Hodge,
& Heke, 2004, p.40). Life skills may be important for socially vulnerable youth to develop due to
the increased likelihood that they face stressors, mental health issues, and social isolation
(Hermens, Super, Verkooijen, & Koelen, 2017). Sport-based life skills development
programming may therefore be a potential vehicle through which to support the healthy
development of emaSwati youth.
Several studies in eSwatini indicate a large percentage of youth hold positive attitudes toward
sport and its benefits on health and well-being (Huysmans et al., 2017; Ndlangamandla, Burnett,
& Roux, 2012; Toriola, 2010). Both male and female youth have indicated that sport helps them
develop life skills including but not limited to discipline, respect, team work, and managing
emotions (Huysmans et al., 2017). Youth also reported that sport has the potential to help them
overcome some of their developmental and community challenges by serving as a positive
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
4
distraction and teaching them helpful skills. In addition, youth expressed that sport may help
them interact with peers who share similar struggles, and support them in building the
confidence and self-esteem to progress through adversity (Huysmans et al., 2017).
However, only a small percentage of youth actually participate in sport or physical education
at school (Huysmans et al., 2017; Ndlangamandla et al., 2012; Toriola, 2010). Further, female
perceptions of competence and participation in sport is generally much lower than for males and
decreases significantly from primary school to secondary school (Toriola, 2010). This is partly
affected by a culture of male dominance combined with a lack of female role models in sport
(Toriola, 2010). In addition, financial, structural, and equipment barriers also limit higher youth
sport participation levels (Huysmans et al., 2017; Ndlangamandla et al., 2012; Toriola, 2010).
Therefore, despite youth enjoyment of sport and awareness of its positive benefits, there are
significant systemic and cultural barriers that limit youth sport participation, especially for girls.
Further, there is negligible programming that utilizes sport as a context for youth life skills
development in eSwatini.
Although there is limited sport for development programming in eSwatini, successful
implementation of sport-based life skills initiatives in South Africa suggests there is potential for
these programs to create meaningful developmental outcomes for emaSwati youth. South Africa
is a comparable context to eSwatini given that 66% of the population is below the age of 35 and
youth face similar developmental challenges (UNFPA South Africa, 2011). These include high
unemployment, teenage pregnancy, poverty, HIV, and youth-led households (UNFPA South
Africa, 2011). In the Kayamandi township of South Africa, research indicates that sport
participation helped youth develop valuable intrapersonal, and interpersonal, life skills as well as
overcome significant community challenges (Whitley, Hayden, & Gould, 2016). Sport
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
5
participation helped youth overcome community challenges by creating an environment of
positive peer influences and support, keeping youth out of trouble, and giving them a reason not
to make bad decisions (Whitley, Hayden, & Gould, 2013).
These findings are further supported in the Buffalo Soccer Coaching Club (BSCC) in the
Eastern Cape province of South Africa (Draper & Coalter, 2016). That is, youth experienced
personal development across several life skills and also reported positive experiences in the
program including social connection with peers and a sense of safety and belonging (Draper &
Coalter, 2016). Burnett’s (2014) work with Might Metres in South Africa also emphasizes the
positive impact of sport-based programming on youth pro-social behavior and building teacher
learner relationships built on trust and enjoyment (Burnett, 2014). These findings from South
Africa are consistent with studies from North America that support the role of youth sport
participation in facilitating cognitive, emotional, and social life skills outcomes for normal
adolescent development as well as for socially vulnerable or at-risk youth (Camiré, Trudel, &
Bernard, 2013; Danish, Forneris, & Wallace, 2005; Gould, Collins, Lauer, & Chung, 2007;
Hermens et al., 2017; Holt et al., 2017; Martinek & Hellison, 2016).
The work of sport for development (SFD) and life skills programming in South Africa
(Burnett, 2014; Whitley et al., 2013; Whitley, Wright, & Gould, 2016) and in Western contexts
such as the USA and Canada (Hermens et al., 2017; Martinek & Hellison, 2016) support the
value of investing in sport-based youth development programs in under-privileged contexts.
However, sport participation does not automatically result in life skills outcomes (Coakley,
2011). Positive development outcomes associated with sport are contingent upon a wide range of
factors. These include the culture of the sport environment, the social connections established
during sport participation, the meaning and values associated with sport participation, and the
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
6
coach-athlete relationship (Coakley, 2011; Holt et al., 2017). Therefore, the people in charge of
establishing the sport climate such as the coach become especially important in ensuring life
skills learning (Gould et al., 2007).
Coaches are the gatekeepers of the youth sport experience and are also often viewed by
athletes as important mentors in their development (Bean & Forneris, 2016; Giges, Petitpas, &
Vernacchia, 2004; Gould et al., 2007; Holt et al., 2017; Vella, Oades, & Crowe, 2011). Coaches are
therefore in a unique position to be facilitating life skills development through sport (Gould et
al., 2007). Specifically, when the coach is able to foster a caring and supporting sporting
environment, personal development and positive developmental outcomes are more likely to
occur (Spaaij, 2009; Vella et al., 2011). This is consistent with the positive youth development
(PYD) framework that states that every adolescent is capable of positive developmental change
but that the interaction between the individual and their sport context will heavily influence their
personal development (Holt & Neely, 2011). This means that the extent to which coaches
carefully craft a nurturing sport environment and include intentional life skills building activities
will determine the resultant life skills outcomes (Bean & Forneris, 2016; Gould et al., 2007; Holt
et al., 2017; Vella et al., 2011).
In South Africa, coaching effectiveness frameworks explicitly outline the role of coaches in
engendering outcomes in youth participants that are more holistic than just sport-specific
outcomes (International Council for Coaching Excellence, Association of Summer Olympic
International Federations, & Leeds Metropolitan University, 2013). Several studies have
explored the role of youth coaches in intentionally facilitating life skills learning and positive
youth development in South Africa (Meir, 2017; Whitley et al., 2013; Whitley, Wright, & Gould,
2016). These studies have found that coaches were cognizant of the challenges facing youth in
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
7
the community and therefore intentionally employed strategies to build life skills (Whitley et al.,
2013). These strategies included building close relationships with youth, creating safe and caring
sport climates, engaging youth in discussion, and providing opportunities to practice skills.
Further strategies identified were encouraging self-reflection, modeling behavior, and
empowering youth to problem-solve. (Whitley et al., 2013; Whitley, Wright, & Gould, 2016).
These findings support empirical and review research in North America that emphasize the two
fold role of coaches in creating a caring and positive sport climate and using explicit life skills
building strategies (Collins, Gould, Lauer, & Chung, 2009; Gould & Carson, 2008; Gould et al.,
2007; Holt et al., 2017; Santos, Camiré, & Campos, 2016).
Despite the valuable role of coaches in facilitating life skills outcomes for youth sport
participants, coaches often struggle to articulate the explicit strategies that they employ to build
life skills (Camiré et al., 2013; Gould et al., 2007; Santos et al., 2016) or they face significant
barriers to emphasizing life skills in their coaching (Whitley, Gould, Wright, & Hayden, 2017).
Coaches have voiced concerns over the incompatibility of performance and life skills foci and
the pressure to teach tactical and technical sport skills over life skills (Santos et al., 2016;
Whitley et al., 2017). Further, coaches have expressed that coaching education curricula are
lacking in PYD emphases and do not effectively communicate how to facilitate personal
development outcomes (Santos et al., 2016). In addition, life skills development is often absent
from coaching philosophies to begin with (Whitley et al., 2017). Therefore, although there is
justification for the use of coaches as implementers of youth life skills programming, there is a
need to first identify the barriers that prevent coaches from adequately emphasizing life skills in
their coaching (Whitley et al., 2017) as well as for further coach education on the successful
integration of life skills and performance foci (Santos et al., 2016). Coaches may also benefit
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
8
from training that develop teaching strategies to facilitate youth life skills learning and provides
opportunities to practice those strategies (Santos et al., 2016; Whitley et al., 2013). In addition,
there is limited research on this topic in non-Western contexts where youth could benefit from
positive coach mentors and sport-based life skills programs. One possible solution to equipping
coaches with the skills they need to deliver youth development programming would be to train
them in the use of a more structured model that integrates physical and life skills objectives.
One of the most well-known instructional models for life skills education through sport in
North America is Hellison’s (2011) Teaching Personal and Social Responsibility model (TPSR;
Hellison, 2011). The TPSR model is designed to help youth develop the necessary skills to take
more responsibility for their well-being and for the welfare of others (Hellison, 2011; Martinek
& Hellison, 2016). It is an intentionally structured model that employs active learning strategies
to help youth achieve small successes that build confidence and self-efficacy to engage in their
own development. The TPSR framework includes five responsibility levels, or goals, that youth
need to take ownership of along their developmental journey: 1) respecting the rights and
feelings of others; 2) effort and cooperation; 3) self-direction; 4) helping others and leadership;
and 5) transfer. In helping youth attain these responsibility goals, program instructors are
expected to use the following strategies: empowerment, self-reflection, integration of physical
activity and life skills, being relational with kids, and transfer to life outside sport. In addition,
there is a standard daily structure for TPSR sessions that allow for relationship building, group
and individual reflection, life skills awareness-building, and physical activity time (Hellison,
2011; Martinek & Helison, 2016).
The TPSR model has been used as the guiding framework in a multitude of youth
development programs (Gordon & Doyle, 2015; Hellison, 2011; Martinek & Hellison, 2016).
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
9
These programs have primarily targeted underprivileged or at-risk youth and have been
implemented in numerous settings ranging from in-school physical education classes to
community-based programs (Caballero-Blanco, Delgado-Noguera, & Escartí Carbonell, 2013;
Gordon & Doyle, 2015; Martinek & Hellison, 2016). The effectiveness of TPSR programs in
engendering positive developmental outcomes is supported by significant literature. Multiple
studies have demonstrated improvements in self-control, effort, reaching goals, leadership, and
helping or cooperative behaviors (Bean, Kendellen, & Forneris, 2016; Caballero-Blanco et al.
2013; Cryan & Martinek, 2017; Escarti, Gutiérrez, Pascual, & Marín., 2010). Further, qualitative
accounts of participant experiences during TPSR programs indicate high levels of enjoyment,
experiencing caring adult relationships, developing a sense of belonging, and feeling safe
(Caballero-Blanco et al. 2013; Escarti et al., 2010; Hellison & Walsh, 2002; Whitley, Coble &
Jewell, 2016). In addition, studies also support the transfer of intrapersonal and interpersonal
skills such as self-control, emotion regulation, effort, respect, and social skills to domains such as
school, home, and peer groups (Bean et al., 2016; Caballero-Blanco et al. 2013; Hellison &
Walsh, 2002; Hemphill & Richards, 2016; Whitley, Coble, & Jewell, 2016).
Two noteworthy TPSR programs are the ‘Girls Just Wanna Have Fun’ (GJWHF) program in
Ontario, Canada (Bean, Forneris, & Halsall, 2014; Bean et al., 2016) and the Refugee Sport Club
(RSC) in Lansing, Michigan (Whitley & Gould, 2010; Whitley, Coble, & Jewell, 2016). Both
programs successfully created safe, empathetic and supportive youth environments for sport
participation and contributed to the holistic development of youth participants. These programs
provided key lessons for future TPSR programming including useful program design elements
and coaching strategies that contribute to positive youth development outcomes. Further, the
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
10
RSC program illustrated the value in adapting the program to the cultural context of the
participants through taking a collaborative approach to program design.
The aforementioned research indicates that the TPSR model may be a useful guiding
framework to help coaches deliver life skills-focused sport programming across multiple youth
contexts. In eSwatini, the TPSR model could provide the foundation for the design of sport
based youth development initiatives that use coaches as primary program implementers.
Moreover, there is justification for exploring this type of programming given the significant need
to find more creative and effective platforms to address the developmental challenges facing
emaSwati youth. In addition, there is evidence for the success of sport-based youth life skills
development programs in South Africa where youth face similar developmental challenges.
However, any further explorations of sport-based youth life skills programming should be
theory-driven and need to employ more rigorous monitoring and program evaluation as weak
methodologies have been over-relied on (Coalter, 2015; Levermore, 2011; Spaaij, 2009). In
addition, although the TPSR model has demonstrated significant success in fostering life skills
with at-risk youth, the majority of TPSR programs have been implemented in Western contexts
where youth challenges are culture-specific (Caballero-Blanco et al., 2013; Gordon & Doyle,
2015; Whitley, Coble, & Jewell, 2016). An exploration of TPSR programming in eSwatini
would therefore provide an opportunity to explore how the model might operate differently in a
distinct youth context (Wright, Jacobs, Ressler, & Jung, 2016).
The multitude of research in North America supporting the value of the TPSR model in
cultivating positive developmental outcomes for underprivileged youth suggests that it would be
an appropriate framework for sport-based youth life skills programming in eSwatini. The main
aim of this feasibility study was therefore to explore the youth participation experiences and
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
11
successes/challenges associated with implementing a TPSR sport program for underprivileged
youth in a community in eSwatini. A secondary aim of the study was to examine the positive
youth outcomes and changes in life skills associated with participating in a TPSR sport program.
The specific research questions were as follows: RQ1: What is the youth participation experience
in a TPSR-based youth sport program in eSwatini?; RQ2: What are the coaching strategies and
program design elements (strengths, weaknesses, and improvements of program and coach
training) that contribute most strongly to life skills learning in a TPSR-based youth sport
program in eSwatini?; RQ3: To what extent was fidelity to the TPSR model achieved in terms of
daily structure, youth responsibility behaviors, and coaching strategies?; and RQ4: What positive
developmental outcomes and changes in life skills are associated with youth participation in a
TPSR-based youth sport program in eSwatini?
Chapter 2: Methods
Paradigm
The current study was guided by a social constructionist paradigm (Crotty, 1998). Social
constructionism is grounded in the belief that there is no singular objective truth. Rather, we
create and construct meaning through our interactions with our social and cultural context. This
means that individuals may experience the same phenomenon differently and construct varying,
and equally valid, “truths” related to those experiences (Crotty, 1998; Ponterotto, 2005). One of
the central aims of constructionist research is therefore to understand the lived experience of the
research participant as expressed from their viewpoint (Ponterotto, 2005). This epistemological
stance was chosen because the author posited that the youth experience in the sport program, and
the successes and challenges encountered in implementing the program, would be influenced by
the social and cultural context of the community.
Positionality
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
12
The emphasis on co-construction of meaning in social constructionism makes it
necessary to examine the background of the primary researcher that may influence the
interpretations made along the research journey (Creswell, 2007; Ponterotto, 2005). I was born
and raised in eSwatini, Southern Africa, but my ethnic heritage is European, as my parents grew
up in Belgium. Consequently, I was raised with a mixture of Swati and Belgian cultural
influences, in a home environment that subscribed to European belief systems and a school and
social environment that was rooted in Swati culture and beliefs. From a young age I experienced
life in eSwatini both as an insider as well as an outsider. That is, I grew up in eSwatini, I
attended a public primary school and had majority emaSwati (Swazi) friends, but I was also
White in a nation where 97% of the population is Black.
After attending a local public primary school in eSwatini, I attended a United World
College (UWC) for high school. Waterford Kamhlaba, a UWC located in eSwatini, is an
international high school that attracts students of over 60 nationalities. Being surrounded by
students from all over the world was a pivotal experience in shaping what I consider to be a
multicultural worldview. However, this worldview is sometimes at odds with the more
traditional beliefs in Swati culture. Waterford was then the stepping stone to gain a scholarship to
attend college in the United States, at Duke University.
At 19, I left eSwatini to start my tertiary education in the United States. My educational
experiences at Duke, and then at West Virginia University as a doctoral student, have
significantly shaped my identity as an academic and a scholar. However, throughout my
undergraduate, and graduate, educational experiences, I have made strong efforts to connect the
material I was learning to life in eSwatini, and to the belief systems that are valued there.
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
13
Nonetheless, I am aware that the majority of my higher education was experienced in a culture
different from my home country, where I conducted my doctoral research. These experiences
were likely to influence how I interacted with the research process; from choice of methodology,
to program implementation and data analysis. From the participants’ perspective, it was also
likely that I was considered an outsider (ethnicity and identity as a researcher). However, my
ability to speak conversational SiSwati and the fact that I was born and raised in eSwatini may
have given me, somewhat of, an insider status.
Setting
The feasibility study took place at a community-based children’s organization that
operates in the Lobamba region of eSwatini. The children’s organization is a non-profit that
provides psychosocial services and school funding support for underprivileged youth in the
community including orphans and vulnerable children (OVC’s). In addition, the organization
offers parenting skills programs for members of the community and infrastructure support for
local schools. The organization also facilitates skill-building workshops in local schools on
topics surrounding school administration, HIV/AIDS, abuse, grief, health, and basic counseling
interventions. On a daily basis, the organization also provides pre-school education for OVC’s in
the community and afternoon clubs (i.e. classes) to assist primary school-aged children with
literacy development. During these afternoon clubs, children are provided with a light meal
(mahewu – a maize-based drink). The grounds of the children’s organization have a vegetable
garden, a sheltered outdoor play area as well as a soccer field.
Needs assessment/pilot phase
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
14
Based on the preliminary results from the needs assessment/pilot phase, several decisions
were made to guide the development of the feasibility study (current dissertation). First, sport is
a beloved and creative context through which to engage emaSwati (Swazi) youth in positive
development. Using sport as the platform for youth programming in the feasibility study was
therefore an appropriate path forward. Second, HIV/AIDS prevention is an immensely complex
issue that requires long-term investment, strong community connections, and a multidisciplinary
approach. The feasibility study therefore took out the HIV/AIDS component and instead focused
on developing the life skills that HIV/AIDS experts identified as most valuable for HIV/AIDS
prevention i.e. the PRE factors from phase 3. These included: self-belief, social & personal
responsibility, goal-setting, decision-making, self-efficacy, and emotional expression. Third,
youth within the 15-24 years old demographic have already developed a strong set of beliefs
related to relationships, gender roles, sexual intimacy etc. It would therefore be more effective to
engage younger age demographics in youth development programming.
Fourth, emaSwati youth are lacking caring and empathetic adult mentors. Given that
coaches believed in their role as mentors and educators for youth athletes, they were an
appropriate population to engage with to implement sport-based positive youth development
feasibility programming. Fifth, coaches were keen to learn strategies and approaches to
strengthen their ability to facilitate life skills learning for their athletes. Using the Teaching
Personal and Social Responsibility (TPSR) model to guide coach education for the feasibility
study was therefore a viable option. Sixth, emaSwati youth were interested in engaging in mixed
gender sport-based programming where they could learn multiple sports. The feasibility study
was therefore designed to include these elements. Last, social cognitive theory and the positive
youth development (PYD) framework were used as the theoretical foundation of the feasibility
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
15
study. The emphasis of PYD on creating positive sporting environments and treating youth as
inherently capable of becoming successful complemented the emphasis of social cognitive
theory on human agency and the active role that youth may play in their development. The use of
both implicit and explicit PYD learning pathways also provided the right social environment for
self-efficacy beliefs to emerge in youth sport participants.
Participants
Youth participants were thirty-three students (N=33, 22 females and 11 males) aged 11
15 years old (M=12.6 years old, range=11-15) who attended the grades 6 and 7 afternoon club
(grade 6 (n=24), grade 7 (n=9)) at the community-based children’s organization. Sample size at
the outset was intended to be 15 youth participants as this has been found to be optimal for group
activities and to create a caring climate (Cryan & Martinek; Whitley & Gould, 2010). However,
all youth who attended the afternoon class at the time were keen to participate so the primary
researcher decided not to deny participation to any youth given the ethos of the program.
Eligibility criteria for participation included: 1) current enrollment in a primary school in the
Lobamba area of eSwatini; 2) current attendance at the afternoon club at the children’s
organization; 3) conversational English language proficiency; 4) aged 10-15 years old; and 5)
signed parental consent and youth assent to participate in the study. Although all youth who
attended the organization were either single or double orphans, they all lived in a household
where there was an adult guardian who could sign a consent form. Youth were recruited through
convenience sampling from an afternoon club at the community-based children’s organization
that they attended.
Coach participants in the study were three (N=3) male youth coaches (2 emaSwati, 1
Zimbabwean; M=27.3 years old) from the Lobamba region of eSwatini. This sample size was
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
16
chosen given recommendations that the ratio of coaches to youth participants should not exceed
1:5 to provide the opportunity for quality one-on-one interaction (Cryan & Martinek; Whitley &
Gould, 2010). Evidently this coach to youth ratio could not be retained given the significant
increase in the number of youth participants. In addition, after one week of the sport program a
coach had to drop out because he finally got a full-time job after two years of unemployment.
The remaining two coaches ran the last 2 weeks of the program on their own. Coach eligibility
criteria included: 1) at least two years of experience coaching a youth or adolescent sport team;
2) at least 18 years old; 3) English language proficiency; and 4) SiSwati language proficiency.
The coaches included in the study had an average of 5.5 years of coaching experience and
previous expertise coaching a range of sporting codes including basketball, soccer, volleyball,
athletics, badminton, and aerobics. All coaches had a background coaching a similar age-group
(U12 and U14) to the youth participants in the sport program. Two of the coaches had grown up
in the same community as the youth participants while the third coach shared a similar socio
economic background to the youth although he had grown up in a different country. Two of the
three coaches had no prior training in positive youth development while the third coach had
partially completed a training course in positive youth development.
Initial contact with coaches began via phone and email while the primary researcher was
still in the United States. This was reasonable given the connections that were established
through the researcher’s study the previous summer on youth coaches in eSwatini. Every effort
was made to recruit at least one male and female coach, but this was not possible given the
limited number of female coaches in the country. The primary researcher also aimed to recruit
coaches who were relatable (i.e. similar ethnicity and gender, and less than 20 years older than
youth) to the youth and could be viewed as mentors. Relatability and the mentorship role of
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
17
coaches has been found to be an important predictor of positive youth development outcomes
through sport participation (Gould, Collins, Lauer, & Chung, 2007). Moreover, during
recruitment, the primary researcher emphasized the youth participant demographics with the
coaches to highlight the privileged role they would be in as role models and trusted adults in the
lives of the youth participants. Only coaches who seemed invested in that mentorship and
educator role were asked to participate in the study. Coaches received a financial incentive and
certificate for participating in the program, which they were informed of during the consent
process.
Sport Program Design
The overall research objectives of the sport program (intervention) were to: 1) explore the
youth participation experiences and successes/challenges associated with implementing a
Teaching Personal and Social Responsibility (TPSR) sport program in eSwatini; and 2) examine
the positive youth outcomes and life skills associated with participating in a TPSR-based sport
program. Separate from these research objectives, the goals of the sport program for the youth
and coach participants were to: 1) provide youth with opportunities to be physically active; 2)
provide youth with opportunities to participate in a range of different sports and physical
activity-based games; 3) provide youth with opportunities to have fun; 4) facilitate youth life
skills development through sport; and 5) provide coaches with the opportunity to learn new
coaching strategies to promote life skills development through sport. The sport program was
named “Talabasha - Temidlalo Nemfundvo”, which means “Youth time - Of sports and
education/learning” in SiSwati. This name was chosen together with the coaches during the
coach training.
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
18
The sport program took place for 75-100 min every week day for three weeks with a total
of 15 sessions. This was consistent with recommendations from prior TPSR programs that sport
sessions occur at least two to three times per week for 60 minutes (Cryan & Martinek, 2017;
Whitley & Gould, 2010). Although three weeks was a short amount of time to achieve
sustainable program outcomes (Bean, Kendellen, & Forneris, 2016), the current program was
intended to be a feasibility study. The successes and challenges of implementing this type of
youth sport programming will be used to inform more long-term programming in eSwatini.
Sessions took place either on the soccer field or in the outdoor play area of the children’s
organization during the afternoon club slot between 2:30 and 4:10 pm every day. Sport
equipment was purchased for use in the program thanks to the Association for Applied Sport
Psychology (AASP) Gualberto Cremades International Research Grant. This included
volleyballs, basketballs, soccer balls, netballs, frisbees, pinnies, cones, a volleyball net, and a
video camera. This equipment was gifted to the children’s organization after the end of the sport
program.
The sport program was designed, and implemented, according to the key programmatic
features of the TPSR model as well as using the information gathered during the needs
assessment/pilot phase. The program was therefore grounded in the foundational TPSR
principles of holistic youth positive development, youth centered approaches, and fostering
human decency (Hellison, 2011; Martinek & Hellison, 2016). The TPSR model was chosen over
other life skills education through sport models for the following reasons: 1) the option to tailor
the life skills focus to values and skills that are appropriate to the cultural and youth context that
the program operated in; 2) the focus on teaching coaches how to use intentional strategies to
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
19
facilitate the learning of life skills; and 3) the emphasis on transfer of life skills learning in the
sport setting to domains outside of sport (Hellison, 2011; Martinek & Hellsion, 2016).
As a brief overview, the sport program was designed using the standard TPSR daily
structure (relational time, awareness talk, physical activity, group reflection, and individual
reflection) and responsibility levels/goals (respecting others, effort and cooperation, self
direction, helping and leadership, and transfer). Specific design elements from several successful
TPSR-based youth sport programs also informed the development of the program. These TPSR
based programs included the ‘Girls Just Wanna Have Fun’ (GJWHF) program in Ontario,
Canada (Bean, Forneris, & Halsall, 2014; Bean et al., 2016), the ‘Refugee Sport Club’ in
Lansing, Michigan (Whitley & Gould, 2010; Whitley, Coble, & Jewell, 2016), and the Soccer
Coaching Club in central North Carolina (Cryan & Martinek, 2016). Each day of the program
followed the same TPSR daily structure except for session one. Session one was used for ice
breakers and to briefly introduce youth to all the responsibility levels and the expectations for the
program. The remaining 14 sessions used the same daily structure: 1) relational time (10
minutes); 2) awareness talk (20-45 minutes); 3) physical activity (30 minutes); 4) group
reflection (10 minutes); and 5) individual reflection (5 minutes). Details of the program design
will now be described.
Each day started with a brief period dedicated to building the relationship between the
coaches and the youth i.e. relational time. Coaches made an effort to briefly chat with as many
youths as possible and build a caring and meaningful coach-youth relationship. Various pieces of
sport equipment were available for the youth to play around with as they relaxed and refocused
after their day at school. To encourage timeliness, youth were given a small piece of candy for
arriving on time. A local maize-based drink (emahewu) was also made available for the youth to
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
20
consume as this was something that was normally provided by the children’s organization for
their afternoon club classes.
The awareness talk followed the relational time and was an opportunity for the coaches
to teach the youth a life skill or responsibility that is valuable to develop. Awareness talks took
place under a large tree on the sport field as it is customary in Swati culture to have group
discussions under the shade of a tree. Although the awareness talks were intended to be
facilitated in a mixture of English and SiSwati, it became apparent very quickly that youth
confidence was very low in English so SiSwati was used as the primary means of
communication. This decision ultimately promoted higher youth participation in discussion.
Each day of the program focused on a specific responsibility level and main life skill. As the
weeks progressed, the responsibility level foci shifted to the more complex responsibility
behaviors i.e. moving from respect (level 1) to effort (level 2) to self-direction (level 3) and to
caring and leadership (level 4). The final level, transfer (level 5), was included in every session
given that this is an integral component of the TPSR model and previous programs have
recommended integrating transfer into as many sessions as possible (Bean et al., 2016; Whitley,
Coble, Jewell, 2016; Walsh, Ozaeta, & Wright, 2010). Transfer was operationally defined as any
individual conversations, reflection opportunities or discussions related to applying life skills and
responsibility concepts learned in the program to other domains of life such as school. Visual
posters defining each life skill in English and siSwati were hung on and around the tree to aid
learning. Using visual aids is an effective teaching strategy that accommodates for differences in
the developmental needs and learning styles of youth (Allison & Rehm, 2007). A whiteboard
was also used in most sessions where the poster for the life skill focus of that day was placed for
easy reference. Although the sport program was delivered primarily in SiSwati, the use of the
COACHING LIFE SKILLS THROUGH SPORT IN ESWATINI
21
visual aids that translated each SiSwati concept into English nonetheless helped youth learn
about how the concepts could be referred to in English.
In an effort to make the awareness talk an interactive and engaging component of the
daily structure, there was always an activity integrated into the awareness talk that focused on the
responsibility level and life skills of the day. These structured life skills learning activities were
drawn from the Sports United to Promote Education and Recreation (SUPER) model (Danish,
Forneris, Hodge, & Heke, 2004) of life skills education through sport (e.g. Dare to Dream
activity) as well as sport psychology literature (e.g. deep breathing and muscle relaxation). An
extended version of the awareness talk was used to provide time for the integration of those
activities into the awareness talk. However, although the awareness talk was intended to be 20
minutes, most days had awareness talks that lasted between 30 and 45 min
Use of Four Predictive Screening Variables for Determination of Sacroiliac Joint Dysfunction in Adolescent Soccer Athletes : Use of Four Predictive Screening Variables for Determination of
Sacroiliac Joint Dysfunction in Adolescent Soccer Athletes
Brian Hanson
Follow this and additional works at: https://researchrepository.wvu.edu/etd
Recommended Citation
Hanson, Brian, "Use of Four Predictive Screening Variables for Determination of Sacroiliac Joint
Dysfunction in Adolescent Soccer Athletes" (2018). Graduate Theses, Dissertations, and Problem
Reports. 5759.
https://researchrepository.wvu.edu/etd/5759
This Thesis is protected by copyright and/or related rights. It has been brought to you by the The Research
Repository @ WVU with permission from the rights-holder(s). You are free to use this Thesis in any way that is
permitted by the copyright and related rights legislation that applies to your use. For other uses you must obtain
permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license
in the record and/ or on the work itself. This Thesis has been accepted for inclusion in WVU Graduate Theses,
Dissertations, and Problem Reports collection by an authorized administrator of The Research Repository @ WVU.
For more information, please contact researchrepository@mail.wvu.edu.
Use of Four Predictive Screening Variables for Determination of Sacroiliac Joint Dysfunction in
Adolescent Soccer Athletes
Brian Hanson, ATC, CES
Thesis submitted to the
College of Physical Activity and Sports Sciences
At West Virginia University
In partial fulfillment of the requirements for the degree of
Master of Science in
Athletic Training
Michelle A. Sandrey, PhD, ATC, Chair
Jean L. McCrory, PhD
Benjamin Moorehead, MD
Department of Sport Sciences
Morgantown, West Virginia
2018
Keywords: sacroiliac joint dysfunction, adolescent soccer athlete, functional movement screen,
injury risk
Copyright 2018 Brian Hanson
i
ABSTRACT
Use of Four Predictive Screening Variables for Determination of Sacroiliac Joint Dysfunction in
Adolescent Soccer Athletes
Brian Hanson, ATC, CES
Context: Chronic onset of sacroiliac joint dysfunction (SIJD) is increasing in adolescent athletic
populations including soccer. However, there is currently no pre-season screening tool for SIJD
in this population. There are variables that are currently associated with SIJD, however, it is
unknown if these variables developed into a screening tool can accurately predict the risk of
sustaining SIJD. Objective: The purpose of this study was to create an effective screening tool
for SIJD in adolescent soccer athletes and establish predictive values for SIJD injury risk.
Design: A retrospective exploratory study to screen for risk factors contributing to SIJD in the
adolescent soccer athletes. Setting: The testing took place in an athletic training facility at a mid
Atlantic high school. Only one clinician administered the testing procedures. Patients or other
participants: This study included members of the varsity and junior varsity boys’ (n = 6,
16.33±1.37 yrs, 176.50±6.98 cm, 72.12±9.92 kg) and girls’ (n = 14, 16.00±1.11 yrs, 165.93±6.39
cm, 61.11±6.92 kg) soccer teams from one high school in north central West Virginia. All
participants were members of these teams with a sports physical on file. Inclusion criteria
included those subjects who are healthy, have no disorders affecting ability to perform any of the
tests included in this study, no history of acute injury to the lower extremity or back in the past
six months, and no history of surgeries to the core or back within the past year. Exclusion criteria
included subjects who have a history of surgery to the core or back within the past year, and
those who have a disorder affecting ability to perform any of the tests included in this study.
Interventions: Each participant performed during one testing session the Functional Movement
Screen (FMS), including all 7 functional movements and the 3 clearing tests, active knee
extension test, Palpation Meter (PALM) measurement for pelvic angle, and goniometry
assessment of active hip range of motion (flexion/extension/abduction/adduction /internal
rotation/external rotation). Main outcome measures: The dependent variables that were measured
are the final composite score of the FMS, angle measurement in degrees from the active knee
extension test, pelvic tilt angle in degrees from the PALM, and angle measurement in degrees for
active hip flexion, extension, abduction, adduction, internal rotation, and external rotation.
Results: A significant correlation with large strength (PCC = 0.545, p = .013) was found between
SIJ injury and active hip abduction. A significant correlation with large strength (PCC = 0.732,
p
Exploring the Use of Sport as a Platform for Health Promotion with Youth in Africa: A Scoping Review. Exploring the Use of Sport as a Platform for Health Promotion
with Youth in Africa: A Scoping Review.
Adam H. Hansell
Follow this and additional works at: https://researchrepository.wvu.edu/etd
Recommended Citation
Hansell, Adam H., "Exploring the Use of Sport as a Platform for Health Promotion with Youth in Africa: A
Scoping Review." (2018). Graduate Theses, Dissertations, and Problem Reports. 8209.
https://researchrepository.wvu.edu/etd/8209
This Thesis is protected by copyright and/or related rights. It has been brought to you by the The Research
Repository @ WVU with permission from the rights-holder(s). You are free to use this Thesis in any way that is
permitted by the copyright and related rights legislation that applies to your use. For other uses you must obtain
permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license
in the record and/ or on the work itself. This Thesis has been accepted for inclusion in WVU Graduate Theses,
Dissertations, and Problem Reports collection by an authorized administrator of The Research Repository @ WVU.
For more information, please contact researchrepository@mail.wvu.edu.
Exploring the Use of Sport as a Platform for Health Promotion with
Youth in Africa: A Scoping Review
Adam H. Hansell
Master’s Thesis submitted to the College of Physical Activity and Sport Sciences at West
Virginia University in partial fulfillment of the requirements for the degree of Masters of Science
in Sport and Exercise Psychology
Peter Giacobbi Jr., Ph.D., Chair
Dana K. Voelker, Ph.D.
Ed Jacobs, Ph.D.
Department of Sport and Exercise Psychology
Morgantown, West Virginia
2018
Keywords: sport, health promotion, Africa, youth development, disease, community,
intervention
Copyright 2018 Adam H. Hansell
ABSTRACT
Exploring the Use of Sport as a Platform for Health Promotion with Youth in Africa: A
Scoping Review
Adam H. Hansell
According to the World Health Organization, Africa has the highest rates of disease and
child mortality in the world. Previous research suggests that sport may be an effective vehicle to
enhance health knowledge and behaviors among at-risk youth. The primary purpose of this
review was to analyze and synthesize published interventions exploring the use of sport or
physical activity for health promotion with children and youth in Africa. A total of 916 articles
were retrieved from ten electronic bibliographic databases with 28 meeting inclusion criteria.
Targeted health outcomes in sport-based interventions included HIV-related knowledge and
behaviors, essential health practices, physical and mental health, physical activity, and overall
fitness levels. Statistically significant improvements in targeted health outcomes were observed
in 23 of the 28 interventions included. However, the authors conducted risk of bias ratings for
each study, and 23 articles were rated as having a “serious” or “critical” risk of bias. Our
findings suggest that the use of sport- and physical activity as a health promotion intervention
may be an effective with children and youth in Africa. However, future researchers must
incorporate more rigorous methodological approaches, such as randomized controlled trials with
wait-list control or crossover design.
iii
Table of Contents
Page
Introduction 1
Methods
Overview 7
Study Identification and Data Sources 8
Identification and Selection of Relevant Studies 8
Data Charting and Synthesis 9
Risk of Bias 10
Consultation with Practitioners 11
Results
Outcomes 12
Contextual Considerations 14
Funding 18
Risk of Bias 21
Practitioner Feedback 21
Discussion
Characteristics of Interventions 32
Recommendations for Future Research 35
Recommendations Based on Practitioner Feedback 38
Limitations 39
References 43
Appendices
Expanded Literature Review 52
Limitations 88
Definition of Terms 92
Coding Sheet 93
IRB Approval 94
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
1
Exploring the Use of Sport as a Platform for Health Promotion: A Scoping Review
Infectious diseases such as pneumonia, diarrhea, and malaria are the primary cause of
child mortality in Africa (Black et al., 2010; Liu et al., 2015). It has been estimated that more
than ten million children under the age of five die every year, and nearly all of these deaths occur
in poor, developing countries (Black, Morris, & Bryce, 2003). In 2000, 36 of the 42 countries
with the highest global rates of under-five child mortality were in Africa (Black et al., 2003).
Since the 1990s, many countries in sub-Saharan Africa have experienced increases in child
mortality rates, while others have experienced stalled or slowed progress in this domain (Fotso,
Ezeh, Madise, & Ciera, 2007). Another recent report highlighted sub-Saharan Africa as having
the world's highest child mortality rate with over three million deaths of children under the age
of five, meaning that one child out of every 12 dies before their fifth birthday (United Nations,
2015). Since 2000, 64.3% of deaths in children under five were attributed to infectious diseases,
reflecting nearly five million premature deaths (Liu et al., 2015). Infectious diseases were also a
leading cause of death for older children and adolescents in Africa, with pneumonia (14.7%),
diarrhea (9.9%), and malaria (7.4%) serving as the three biggest culprits (Liu et al., 2015).
The World Health Organization reported that Africa has the highest incidence rates of
infectious diseases in the world, which include HIV and AIDS, tuberculosis, and malaria (World
Health Organization, 2016). Compared to other global regions, HIV incidence rates were over
seven times higher in the African Region in 2014 with an average of 2.6 people out of 1000
being infected (World Health Organization, 2016). Globally, of a total of 438,000 deaths caused
by malaria in 2015, roughly 90% of fatalities occurred in sub-Saharan Africa, and approximately
70% of deaths were children under the age of five. Africa also had the highest incidence rates of
tuberculosis in 2014, with 281 cases per 100,000 people (World Health Organization, 2016).
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
2
Therefore, Africa has the highest incidence and mortality rates of three of the world’s most
deadly infectious diseases, which highlights the urgent need for interventions and resources.
The World Health Organization (2016) reported that Africa also had the highest number
of deaths caused by exposure to unsafe drinking water and inadequate sanitation and hygiene
practices. Nearly half of an estimated total of 871,000 global deaths caused by unsafe water
exposure occurred in Africa in 2012. The vast majority of these deaths were caused by infectious
diseases contracted from contaminated drinking water and inadequate or non-existent hygienic
facilities (World Health Organization, 2016). Another study estimated that unsanitary water was
responsible for approximately 1.5 million deaths in children in 2000 (Black et al., 2003). Clearly,
exposure to, and the use of, contaminated water is a risk factor for early mortality. Due to the
dangers posed by exposure to and use of contaminated water, tangible and educational resources
should be allocated to communities that are exposed to unsafe water.
Socioeconomic status is one of the primary risk factors for acquiring infectious diseases
as individuals living in poverty are far more likely to contract these ailments (World Health
Organization, 2016). In addition to being at higher risk of contracting infectious diseases,
individuals living in poverty often have limited access to resources that can treat infectious
diseases after they are contracted (World Health Organization, 2016). Given the disproportionate
amount of people living in poverty in Africa compared to the rest of the world, interventions and
resources aimed at improving these conditions should be allocated to at-risk communities.
Although education and awareness initiatives may have the most long-term preventative impact,
there are numerous tangible resources that could both prevent and treat different infectious
diseases. These include condoms to prevent the spread of HIV and AIDS, bed nets to help
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
3
protect against malaria and other mosquito-borne illnesses, and water filtration systems to help
reduce the instances of infectious diseases caused by contaminated water.
It has been noted that 63% of child deaths caused by disease could have been prevented
by implementing known and effective interventions, such as vaccines (Bryce et al., 2003).
However, many poor and middle-income African countries have unacceptably low accessibility
to these essential health resources (Bryce et al., 2003). Thus, it is imperative for researchers to
develop feasible health promotion interventions that align with the health-system development of
the countries they are aiming to help (Bryce et al., 2003). For example, initiatives could focus on
collecting data at the community level to assist and inform public health planning in an attempt
to promote widespread accessibility to known and effective interventions such as condoms,
water filters, and vaccines (Bryce et al., 2003). Therefore, one plausible direction for future
health initiatives would involve a shift in focus away from medical services in hospitals and
clinics towards community-based approaches, particularly in countries where the overall access
to public health services is poor or non-existent.
One example of a preventative, educational approach to health promotion that also can
provide tangible resources involves the use of sport. Sport for development initiatives, which use
sport as a vehicle to promote positive social change, have become increasingly popular in recent
years (Schulenkorf, Sherry, & Rowe, 2016). Specifically, sport for development programs use
the popularity of sport to attract large groups of individuals, and use sport-related themes to
discuss and initiate positive development (Jones et al., 2017; Schulenkorf et al., 2016). Previous
researchers have used sport as a platform to achieve a broad range of positive outcomes for
individuals and communities, including disease management and prevention, improved physical
and mental health outcomes, life skills development, gender equity, and social cohesion (Jones et
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
4
al., 2017; Schulenkorf et al., 2016). Based on this approach, sport-based programs have potential
to play a significant role in helping at-risk youth navigate their environments.
Previous research suggests that participation in sport promotes the development of important life
skills such as goal-setting, teamwork, discipline, decision-making, time management, and
emotion regulation (Theokas et al., 2008). Life skills that are deliberately taught through sport
can steer youth away from various risk-taking behaviors that may lead to lifelong consequences,
such as substance abuse, sexual activity, and crime (Kulig, 2003). For instance, sport programs
can help youth develop essential life skills such as self-efficacy, confidence to withstand peer
pressure, and the ability to develop healthy coping strategies, all of which can significantly
reduce the chances of contracting an infectious disease (Balfour et al., 2013; Whitley et al.,
2016). A recent review of sport for positive youth development research found that sport
involvement was most commonly linked to confidence and positive identity, which may
contribute to the avoidance of risk-taking behaviors among at-risk youth (Jones et al., 2017). In
addition to protecting against non-communicable diseases through life skills development,
previous research also suggests that sport is an advantageous platform to educate youth about
common infectious diseases and essential health practices as well (Fuller et al., 2010; Kaufman,
Spencer, & Ross, 2013).
Considering the inherent physical, mental, and social benefits that are associated with
playing sport, sport for development initiatives have significant potential to help at-risk youth in
Africa (Jones et al., 2017). Instead of physical activity, children and adolescents often engage in
maladaptive and self-destructive behaviors such as substance abuse and petty crime, which are
often accompanied by unemployment and poverty (Draper et al., 2010; Uys et al., 2016). Using
sport as a health promotion platform could also encourage youth to engage in positive and
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
5
adaptive behaviors with their peers while also being physically active (Schulenkorf et al., 2016).
For instance, individuals who are involved in a sport-based health promotion initiative may be
more likely to play sport in their spare time instead of engaging in risky behaviors such as
substance abuse or crime. It has also been well established that exercise and other forms of
physical activity can reduce risk factors associated with obesity, diabetes, and cardiovascular
disease (Booth, Gordon, Carlson, & Hamilton, 2000; Pedersen, 2006). Therefore, using a health
promotion program that engages youth in physical activity can reduce the risks of developing
non-communicable diseases through physical activity as well as promote the development of
adaptive life skills.
Given the worrying statistics regarding infectious diseases in Africa, researchers have
also explored using sport for development initiatives to provide youth with resources to protect
themselves against infectious diseases such as HIV and malaria (Fuller et al., 2010). The results
of a recent systematic review found strong evidence that sport-based health promotion
interventions can positively influence HIV-related knowledge, attitudes, stigma, self-efficacy,
and communication skills with children and youth in Africa (Kaufman et al., 2013). Although it
is unclear how long these improvements are sustained beyond the intervention, it is evident that
sport-based initiatives can be effective in educating youth in Africa about infectious diseases and
equipping them with protective skills and resources (Kaufman et al., 2013).
Although improving national health systems should be the ultimate goal to reduce rates
of child mortality, small-scale community-based interventions have been successful in improving
overall and disease-specific health knowledge and awareness for children, adolescents, and
adults (Balfour et al., 2013; Clark et al., 2006; Fuller et al., 2010; 2011; 2015; Maro, Roberts, &
Sørensen, 2009). For instance, three studies used soccer as a platform to educate 5,128 youth
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
6
participants about various infectious diseases, the use of clean water, safe sex, basic sanitary
health practices, getting vaccinated, taking prescribed medications, and nutrition (Fuller et al.,
2010; 2011; 2015). Following the sport-based interventions, participants’ mean health
knowledge scores were 14.3% higher in South Africa, 18.4% higher in Zimbabwe, and 17.8%
higher in Mauritius, which highlights the effectiveness of these programs in improving the health
awareness and knowledge among children in rural, low-income communities (Fuller et al., 2010;
2011). In the study conducted by Fuller et al. (2015), participants’ mean health knowledge scores
following the sport-based intervention were 25.1% higher in Ghana, 10.3% higher in Malawi,
27.4% higher in Namibia, 15.1% higher in Tanzania, and 17.2% higher in Zambia. Furthermore,
it has been noted that the use of sport at schools in South Africa can provide a safe place for
students to learn and participate in organized activities (Struthers, 2011). The use of sport is an
innovative and fun way to promote positive and sustainable health changes with potentially large
numbers of youth in communities throughout Africa. Future research that targets the use of
soccer and other types of sport as platforms to educate children about essential health practices
warrants further exploration.
As discussed, previous research suggests that the use of sport as a platform to educate
children and adolescents can be a successful vehicle for improving health and disease-specific
knowledge among children and youth in many African countries. Based on the observed
improvements in health knowledge among youth participants following sport-based health
promotion interventions, it is worth investigating the use of sport as a platform for health
promotion in a more systematic manner. As this body of research continues to expand, it is
important to analyze and synthesize effective components of previous interventions to inform
future efforts. A close analysis of the long-term sustainability of these types of programs,
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
7
theoretical considerations, how these interventions were delivered and by whom, and other
aspects of the interventions (e.g., gender) could inform future efforts that maximize impact with
limited resources. Scoping reviews are ideally suited to address these issues because they provide
researchers with a descriptive analysis about the breadth and the depth of a research field and
provide justification for future systematic and quantitative reviews (Levac, Colquhoun, &
O'Brien, 2010).
Although there have been several attempts to promote necessary public health practices
that could significantly reduce the high rates of child mortality in Africa, a structured synthesis
of this literature could guide future interventions. This is particularly true for rural areas and
communities where public health services are hard to access (Bryce et al., 2003). Considering the
urgent need for effective interventions to improve rates of child mortality in Africa, a detailed
review of the effectiveness of previous health promotion interventions using sport as a delivery
mechanism would be helpful for directing future research endeavors in this domain. Specifically,
the primary aim of this scoping review is to provide a detailed summary of the measured
outcomes observed in previous studies that investigated the use of sport as a platform for health
promotion with youth in Africa. Secondary purposes are to identify characteristics of
interventions related to the length, nature, content, and methods employed in previous sport
based interventions targeting children and youth in Africa. A third purpose was to conduct a risk
of bias assessment to thoroughly analyze the methodologies employed in each intervention
(Sterne et al., 2016). Finally, to increase the translational utility or practical impact of this study,
the major findings will be presented to practitioners in the field for their feedback.
Method
Overview
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
8
In line with recommendations by Levac et al. (2010), the steps for the current scoping
review included the following: (1) identification of the research question; (2) identification of
relevant studies; (3) study selection; (4) charting of the data; (5) data synthesis; and (6)
consultation with practitioners (e.g., coaches and staff members of sport-based non-profit
organizations in Africa). Additionally, the first author independently coded each article included
in our review for Risk of Bias using the ROBINS-I tool for assessing risk of bias in non
randomized studies of interventions (Sterne et al., 2016).
Study Identification and Data Sources
Citations were retrieved from ten electronic bibliographic databases (Academic Search
Complete, CINAHL, eHRAF, ERIC, Google Scholar, Physical Education Index, PsycInfo,
PubMed, SportDiscus, and Web of Science). Keywords included sport, health promotion, Africa,
youth, children, adolescents, youth development, disease, community, mortality, and
intervention. A range of health terms and disease processes including HIV, AIDS, malaria, and
clean water were included in this search, and relevant Medical Subject Headings (MeSH) terms
were included. MeSH terms contain all relevant search terms identified by the United States
National Library of Medicine’s thesaurus (USNLM, 1999). All searches were conducted in
consultation with a West Virginia University Librarian in order to identify all appropriate
databases and ensure the use of relevant MeSH terms. Studies were not bound by a specific date
range in order to gain a comprehensive assessment of sport-based interventions targeting health
promotion outcomes among youth in Africa.
Identification and Selection of Relevant Studies
For purpose one of the scoping review, the inclusion criteria included the following: (1)
the use of sport as the intervention method; (2) the study being conducted in Africa; (3) youth
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
9
participants 24 years of age or younger, or families that included individuals that were 24 years
old or younger; (4) pre/post measurements conducted before and following an intervention, and
(5) publications in English. Studies were selected by the first author and were reviewed in
consultation with the senior investigator.
Data Charting and Synthesis
To address the second purpose of this study we focused on articles that included sport
based interventions. A codebook was developed by the first author which is shown in Appendix
D. Variables included the following: (1) study author(s); (2) journal publication and year; (3)
study design; (4) study outcomes; (5) country in Africa where study was conducted; (6) total
sample size; (7) number of completers; (8) age range and mean age of participants; (9)
participant gender; (10) setting of intervention; (11) duration of study; (12) theoretical
foundation of interventions; and (13) source of funding. The first author independently coded,
with input from the second author, all studies that met our review’s inclusion criteria.
Study outcomes were charted and synthesized in three steps. First, the first author read
each abstract and documented the outcomes being investigated from terms used in the study
titles, abstracts, and key words. This process allowed the first author to observe thematic
similarities in measured outcomes across studies which led to the development of a coding
template. This template was used in a second round of coding by the first author to qualitatively
describe the outcomes observed. A list of outcomes was developed by the first author in
consultation with the senior investigator and each outcome was given a dummy code. The
outcome frequencies were then calculated among all the included studies using the frequency
command in IBM's Statistical Package for the Social Sciences (IBM SPSS).
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
10
Levac and colleagues (2010) suggest that scoping reviews are ideally suited to map the
range, extent, and nature of previous research initiatives, and they may inform future research
endeavors, including quantitative reviews. Importantly, scoping reviews differ from systematic
reviews in the wider breadth of research questions that can be addressed as well as an emphasis
on the narrative integration of extant research evidence (Levac et al., 2010). Given that the use of
sport-based health promotion interventions with youth in Africa is a relatively new line of
research with a clear scope of inquiry and a broad range of research questions, scoping reviews
are ideally suited to review existing research regarding the use of sport-based interventions
targeting health promotion outcomes for children and youth in Africa (Levac et al., 2010).
Risk of Bias
All articles were coded for risk of bias using the ROBINS-I tool for assessing risk of bias
in non-randomized studies of interventions (Sterne et al., 2016). The ROBINS-I tool was
developed over a three-year period by methodological experts and systematic review authors and
editors (Sterne et al., 2016). The ROBINS-I tool allows for a comprehensive analysis of risk of
bias in relation to a hypothetical randomized control trial, and the categories for risk of bias
assessments are low risk, moderate risk, serious risk, and critical risk. If an article does not
provide sufficient information to receive a risk of bias rating, it should be coded as no
information (Sterne et al., 2016). In addition to addressing important confounding domains and
co-interventions, the ROBINS-I tool asks a series of signaling questions across seven domains of
bias; baseline confounding, selection of participants into the study, classification of
interventions, deviations from the intended intervention, missing data, measurement of
outcomes, and selection of the reported result (Sterne et al., 2016). Importantly, the judgments
made for each of these seven domains of bias carry forward to an overall risk of bias for the
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
11
study. For example, if a study is deemed to have a moderate risk of bias in six domains and a
high risk of bias in the seventh domain, then the article would be considered as high risk of bias.
To receive a low risk rating, the risk of bias should be similar to that of a high quality
randomized control trial (Sterne et al., 2016). Therefore, most non-randomized control trials are
likely to earn a rating of at least a moderate risk of bias.
Consultation with Practitioners
The sixth and final step of scoping review methodologies is to incorporate consultation
with relevant stakeholders to acquire additional insight beyond what is available in published
literature (Levac et al., 2010). The first author contacted Grassroot Soccer, which is a non-profit
organization that uses soccer to build resiliency in children and adolescents to help protect
against the infection of HIV and other infectious diseases (Peacock-Villada, DeCelles, & Banda,
2007). The researchers created an anonymous survey on Qualtrics with a brief description of our
preliminary findings and the following questions: (1) What is your role at Grassroot Soccer? (2)
What is your gender?; (3) How many years of experience do you have working in Africa?; (4)
Please share your general thoughts or observations about these research findings. What stands
out to you?; (5) What steps could be taken to help sport-based health promotion?; and (6) What
would you like to see in future sport-based health promotion interventions? An anonymous
survey link was sent via email to staff members and coaches at Grassroot Soccer working in
South Africa, Zambia, and Zimbabwe. Results from this survey were synthesized and exemplar
quotations are presented to highlight the potential contributions of sport in future health
promotion efforts.
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
12
Results
A total of 916 articles were collected and screened for eligibility. The initial
comprehensive database search yielded 322 duplicate publications, and a total of 594 articles
remained after these were identified and removed. Following the removal of duplicate articles,
the first author screened 540 titles and abstracts of the remaining search results to determine if
they met the inclusion criteria for our review. Full texts of the remaining 54 articles were
evaluated by the first author. Following this final review process, a total of 28 articles were
deemed to meet the study’s eligibility criteria. If there was uncertainty about the eligibility of a
specific article based on title and abstract alone, the first author obtained and evaluated a full text
of the paper. A PRISMA flow diagram of this process is shown in Figure 1 that summarizes
reasons for inclusion/exclusion throughout the review process.
Outcomes
Specific outcomes of each of the 28 articles that met inclusion criteria for this review are
included in Table 1. Targeted outcome variables examined in these studies included HIV-related
outcomes (n = 8); knowledge and awareness of nine essential health behaviors (physical activity,
clean water use, proper sanitation practices, substance abuse, nutrition, malaria prevention,
vaccinations, taking prescribed medications, HIV awareness, gender equality, and social support
(n = 3); physical fitness (n = 9); physical activity levels (n = 6); social protective factors (n = 3);
physical health (n = 4); mental health (n = 1); and injury prevention (n = 2). A total of 36
outcomes were examined in this review.
The countries where each intervention was conducted are included in Table 1. Over half
of the interventions included in this review were conducted in South Africa (n = 18). Other
African countries Mauritius (n = 1), Namibia (n = 1), Nigeria (n = 1), Uganda (n = 1),
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
13
Identification
Screening
Eligibility
Included
Figure 1: PRISMA 2009 Flow Diagram
Records identified through database
searching
(n=916)
Records after duplicates removed
(n=594)
Assessment of titles and
abstracts
(n=594)
Full-text articles assessed for
eligibility
(n=54)
Studies included in qualitative
synthesis
(n=28)
Articles excluded with reasons (n=540)
Did not include sport (n=86)
Did not include an intervention (n=360)
Study was not conducted in Africa (n=21)
Study did not include health promotion (n=12)
Study did not include youth participants (n=61)
Full-text articles excluded with reasons
(n=26)
Did not include sport (n=2)
Did not include an intervention (n=11)
Study was not conducted in Africa (n=2)
Study did not include health promotion (n=4)
Study did not include youth participants (n=7)
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
14
Zambia (n = 2), and multiple (n = 5). Eleven of 28 studies reported using specific theoretical
frameworks to guide their efforts as shown in Table 1. These theories included Achievement
Goal Theory (n = 3), Social Learning Theory (n = 3), the Social-Ecological Model (n = 2), Self
Determination Theory (n = 1), the Theory of Planned Behavior (n = 1), and Psychosocial Theory
(n = 1). The authors of the remaining 17 articles did not explicitly mention incorporating a
theoretical foundation into their interventions.
Contextual Considerations
Additional contextual considerations for the studies included in our review are included
in Table 2. Fifteen of the 28 interventions were conducted with youth in a school setting either as
part of the existing school curriculum or immediately after school (See Table 2). Twelve
interventions were conducted in community settings such as gyms, sporting venues, and health
centers. One intervention included both in-school and community-based components (See Table
2). The majority of interventions were delivered by individuals from the community in which the
research initiative took place who were trained in the intervention protocol. Specifically, trained
peer coaches (n = 12), trained athletic coaches (n = 2), trained school staff members (n = 4),
professional soccer players (n = 1), university students (n = 3), fitness trainers (n = 1), untrained
teachers (n = 1), and principal investigators (n = 2) delivered the intervention to program
participants (See Table 2). Two articles did not report who administered the intervention to
participants.
Based on the information provided in Table 2, the average sample size across all the
interventions was 704 participants. There was an average of 199 dropouts across the
interventions, leaving an average of 505 participants who completed the intervention. Of
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
15
Table 1.
Results in selected studies
Authors
Outcomes
Measured
Country
Theoretical
Foundation
Results
Fuller et al. (2010)
Fuller et al. (2011)
Fuller et al. (2015)
Clark et al. (2006)
Maro et al. (2009)
Maro & Roberts (2012)
Hershow et al. (2015)
Sørensen et al. (2016)
Awotidebe et al. (2014)
Bloemhoff (2006)
Bloemhoff (2012)
Nine essential health
practices
Nine essential health
practices
Nine essential health
practices
HIV/AIDS
knowledge + stigma;
awareness of local
resources
HIV prevention
knowledge, attitudes,
and awareness
Effect of mastery
motivational climate
on HIV prevention,
knowledge, and
awareness
HIV/AIDS
knowledge, attitudes,
communication
skills, and HCT
uptake
Gender differences in
HIV/AIDS
prevention,
knowledge, and
awareness
HIV knowledge and
communication skills
Resiliency and
protective factors
Resiliency and
protective factors
None
None
None
Social Learning
Theory
Achievement
Goal Theory
Achievement
Goal Theory
Social Learning
Theory
Achievement
Goal Theory
Theory of
Planned
Behavior
None
None
South Africa
Mauritius and
Zimbabwe
Ghana, Malawi,
Namibia,
Tanzania, Zambia
Zimbabwe
Tanzania
Tanzania
South Africa
Tanzania
South Africa
South Africa
South Africa
Significant improvements in
knowledge of all measured
outcomes
Significant improvements in
knowledge of all measured
outcomes
Significant improvements in
knowledge of all measured
outcomes
Significant improvements in
HIV/AIDS knowledge
Significant improvement in HIV
knowledge and awareness
No significant improvement in
measured outcomes due to
mastery motivational climate
Significant Improvements in all
measured outcomes
No significant differences in
measured outcomes between
boys and girls
Significant improvements in
HIV knowledge and negotiation
skills
Significant improvements in all
measured outcomes
Significant improvements in all
measured outcomes
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
16
Table 1 Cont.
Results in selected studies
Authors
Outcomes
Measured
Country
Theoretical
Foundation
Results
Kaufman et al. (2016)
Voluntary Medical Male
Circumcision (VMMC)
uptake
Chetty & Edwards (2007) Mental health promotion
(self-esteem, depressive
symptoms, behavioral
problems)
Ferguson et al. (2015)
Motor skills, fitness
Lennox & Pienaar (2013) Aerobic fitness; PA levels
Monyeki et al. (2012)
Naidoo et al. (2009)
Body composition
PA levels; sport
participation; fitness tests;
nutrition
Naidoo & Coopoo (2012) PA levels; sport
participation; fitness tests
Owoeye et al. (2014)
Parker et al. (2016)
Richards et al. (2014)
Injuries; injuries by type
of exposure; injuries to
lower extremities
Pain severity; pain
interference; self-efficacy;
depression; quality of life
Physical fitness; body
composition; mental
health
Social
Learning
Theory
Psychosocial
Theory
Social
Ecological
Model
None
None
None
None
None
None
None
Zimbabwe
South
Africa
South
Africa
South
Africa
South
Africa
South
Africa
South
Africa
Nigeria
South
Africa
Uganda
Significant increase in
VMMC uptake among
participants
Significant
improvements in self
esteem and physical
self-perception;
significant reduction
behavioral problems
Significant
improvements in all
measured outcomes
No significant
improvements in all
measured outcomes
No significant
improvements in
intervention condition
Significant
improvements in
health behaviors and
PA at school
Significant
improvements in all
measured outcomes
Significant reduction in
all measured outcomes
for participants’ in the
intervention condition
Significant reduction in
pain for both
conditions
Significant
improvements in
cardiovascular fitness
for both conditions;
Significant decrease in
positive mental health
outcomes for boys
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
17
Table 1 Cont.
Results in selected studies
Authors
Outcomes
Measured
Country
Theoretical
Foundation
Results
Starzak et al. (2016)
Tian et al. (2017)
Ley et al. (2014)
Kemp & Pienaar
(2009)
Uys et al. (2016)
Walter (2014)
Peacock-Villada et
al. (2007)
Saliva tests for mucosal
immunity and SNS
activation; body
composition;
cardiovascular fitness
PA levels
Strength; cardiovascular
fitness; weight; BMI
Fitness outcomes; body
composition
PA levels; PA
knowledge; fitness tests
PA levels during school
Resiliency; Decision
making skills
None
Self
Determination
Theory
None
None
Social
Ecological
Model
None
None
South Africa
South Africa
South Africa
South Africa
South Africa
South Africa
South Africa;
Zambia
Significant
improvements in
measured salivary
and fitness outcomes,
significant reduction
in BMI, body fat %,
and waist
circumference
Significant
improvements in
MVPA
Significant
improvements in
strength, no
significant
improvements in
cardio fitness, BMI,
weight
Significant
improvements in all
measured outcomes
Significant
improvements in PA
knowledge and
fitness test outcomes,
no significant
improvement in PA
levels
Significant
improvements in
MVPA levels among
participants
Significant
improvements in all
measured outcomes
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
18
these 505 participants, an average of 280 participants were males and 225 were females.
Additionally, the average age of participants across the included interventions was 14.08 years.
Lastly, the average sport-based health promotion intervention included in our review lasted 21.23
weeks.
Funding
Of the 28 articles included in our review, 22 reported receiving funding for their
intervention (Awotidebe et al., 2014; Chetty & Edwards, 2007; Clark et al., 2006; Ferguson et
al., 2015; Fuller et al., 2010; 2011; 2015; Hershow et al., 2015; Kaufman et al., 2016; Kemp &
Pienaar, 2009; Ley, Leach, Barrio, & Bassett, 2014; Maro et al., 2009; Maro & Roberts, 2012;
Monyeki et al., 2012; Naidoo & Coopoo, 2012; Naidoo et al., 2009; Parker, Jelsma, & Stein,
2016; Richards Foster, Townsend, & Bauman, 2014; Sørensen et al., 2016; Starzak, Konkol, &
McKune, 2016; Uys et al., 2016; Walter, 2014). Funding sources included FIFA (n = 3 articles),
the International Development Research Center, Ottawa, Canada (n = 1 article), the Bill and
Melinda Gates Foundation (n = 1 article), EMIMA Kicking AIDS Out Program (n = 3 articles),
VLIR (n = 1 article), 3ie (n = 1 article), South African National Research Foundation (n = 1
article), University of Cape Town Research Committee (n = 1 article), Universidad Politécnica
de Madrid (n = 1 article), the National Research Foundation (n = 2 articles), KwaZulu-Natal
Department of Health and Education (n = 2 articles), the Dphil Scholarship: University of
Oxford (n = 1 article), the Medical Research Council of South Africa (n = 1 article), the World
Diabetes Foundation (n = 1 article), and the Nelson Mandela Metropolitan University (n = 1
article). One article mentioned receiving four sources of funding, including Imago Dei, the Elton
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA 19
Table 2.
Contextual Considerations
Authors Setting Sport Personnel Sample
Size
Completed Age Gender Duration
(Weeks)
Fuller et al.
(2010)
School Soccer Trained peer
coaches
492 370 13.3 M: 180
F: 190
11
Fuller et al.
(2011)
School +
Community
Soccer Trained peer
coaches
822 784 12.3 M: 390
F: 394
11
Fuller et al.
(2015)
School Soccer Trained peer
coaches
3,814 3,814 12.4 M:1873
F:1941
11
Clark et al.
(2006)
School Soccer Professional
soccer players
304 304 12-14 M:151
F:153
2
Maro et al.
(2009)
Community Soccer Peer coaches 950 764 13.7 M:555
F:209
8
Maro &
Roberts
(2012)
Community Soccer Peer coaches 950 764 13.7 M:555
F:209
8
Hershow et
al. (2015)
Community Soccer Peer coaches 4260 514 14.2 M:0
F:514
48
Sørensen et
al. (2016)
Community Soccer Peer coaches 950 764 13.7 M:555
F:209
8
Awotidebe
et al. (2014)
School Soccer Peer coaches 430 340 15.2 M:204
F:226
12
Bloemhoff
(2006)
Ropes
Course
Ropes
Course
Researcher 106 106 15.7 M:106
F:0
0 (4 hours)
Bloemhoff
(2012)
Ropes
Course
Ropes
Course
Researcher 92 67 16.8 M:0
F:67
0 (4 hours)
Kaufman et
al. (2016)
School Soccer Trained peer
coaches
1226 878 16.2 M:1226
F:0
0 (1 hour)
Chetty &
Edwards
(2007)
Children’s
Institutional
Homes
Soccer and
Netball
Unknown 33 33 10.7 M: 14
F: 19
12
Ferguson et
al. (2015)
School Playground
games
Undergraduate
students
41 41 7.8 M: 18
F: 23
9
Lennox &
Pienaar
(2013)
School Aerobic,
strength,
flexibility,
sports
(soccer and
netball)
Postgraduate
students
318 279 14.5 M: 137
F: 181
26
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA 20
Table 2 Cont.
Contextual Considerations
Authors Setting Sport Personnel Sample
Size
Completed Age Gender Duration
(Weeks)
Monyeki et al.
(2012)
School Strength, speed,
balance, stretching PE teacher 322 322 10.7 M: 322
F:0 43
Naidoo et al.
(2009)
School Active learning
during school
Trained
teachers
256 185 Not
reported
M: 81
F: 104
26
Naidoo &
Coopoo (2012)
School Active learning
during school
Trained
teachers
798 270 Not
reported
M: 147
F: 123
78
Owoeye et al.
(2014)
Sports’ field Warm-up
activities
Trained
soccer
coaches
416 385 17.7 M: 385
F:0
26
Parker et al.
(2016)
Community
health center
Aerobic and
strength exercises
Trained
peer
leaders
27 27 30.8 M: 0
F: 27
6
Richards et al.
(2014)
Community
sports’ fields
Soccer Trained
peer
coaches
1462 1447 12.9 M: 618
F:844
11
Starzak et al.
(2016)
Community
sports’ fields
Soccer Trained
soccer
coaches
50 34 12.2 M: 34
F:0
12
Tian et al.
(2017)
School Aerobic exercise
(including soccer),
strength training
Trained PE
teachers
110 Not
reported
Not
reported
M: 33
F: 77
12
Ley et al.
(2014)
Community
gym
Aerobic exercise,
strength training,
stretching
Fitness
trainers
50 23 30 M: 3
F:20
10
Kemp &
Pienaar (2009)
School Dancing,
stretching
Not
reported
38 38 12.5 M:0
F: 38
10
Uys et al.
(2016)
School No prescribed
activities
Trained
school
staff
1088 997 9.9 M: 471
F: 526
156
Walter (2014) School Games,
playground
materials, sport
equipment
(soccer, rugby,
netball)
University
students
120 79 10.3 M: 38
F:41
6
Peacock
Villada et al.
(2007)
School Soccer Trained
peer
coaches
670 Not
reported
Not
reported
Not
reported
6
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
21
John AIDS Foundation, the MAC AIDS Fund, and the USAID-New Partners Initiative (Hershow
et al., 2015). Lastly, one intervention stated that they used the 3rd author’s own research funding
to finance their intervention (Starzak et al., 2016).
Risk of Bias
Ratings of risk of bias for each article were conducted by the first author. The final risk of
bias ratings for each of the 28 interventions are reported in Table 3. Ten articles were deemed to
be at critical risk of bias, thirteen articles were considered serious risk of bias, four articles were
rated as moderate risk of bias, and one article was rated as no information (See Table 3). Most of
the ratings of serious risk and critical risk resulted from the interventions missing a significant
amount of participant data due to exclusion or attrition. Other reasons for ratings of serious or
critical risk of bias were due to baseline confounding, lack of blinding of participants’
intervention status to researchers during the intervention, different start and follow-up times
among participants, interventions not being classified appropriately, bias in the measurement of
the outcome(s), and bias in terms of selecting the results that were reported. The article that
received a rating of no information did not report sufficient information to make a risk of bias
judgement.
Practitioner Feedback
Finally, in order to increase the translational utility and practical impact of the major
findings presented above, five coaches and staff members employed by Grassroot Soccer
responded to our survey and offered feedback on our findings. The five survey respondents
included three females and two males with an average of 3.75 years of experience working with
the organization. When asked to provide feedback on our results regarding the use of sport for
health promotion with children and youth in Africa participants provided the following
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA 22
responses: “I would confirm the outcomes are quite true, it’s something that’s on the ground. To
me what stands out is ‘improving social protective factors such as resiliency and ability to cope
with peer pressure.’” Another participant discussed how sport can be an effective teaching tool,
stating “sport is a good tool for learning if you use it for demonstration of activities...What stands
out is educating young people on matters that affect them using the power of soccer…Young
people find it fun, exciting, and interactive.” Lastly, one Grassroot Soccer staff member
highlighted the impact of sport-based interventions with regards to HIV and AIDS
Table 3.
Risk of bias
Article ROB1 ROB2 ROB3 ROB4 ROB5 ROB6 ROB7 ROBoverall
Awotidebe et al. (2014) Serious Mod Mod Serious Mod Mod Serious Serious
Bloemhoff (2006) Serious Mod Mod NI Mod Serious Mod Serious
Bloemhoff (2012) Mod Mod Mod NI Serious Serious Mod Serious
Chetty & Edwards (2007) Mod Mod Mod NI Mod Mod Mod Mod
Clark et al. (2006) Serious Mod Mod NI Mod Serious Mod Serious
Ferguson et al. (2015) Mod Mod Mod NI Serious Mod Mod Serious
Fuller et al. (2010) Serious Serious Mod NI Critical Mod NI Critical
Fuller et al. (2011) Serious Serious Mod Mod Serious Mod Mod Serious
Fuller et al. (2015) Serious Serious Mod Mod Serious Mod Mod Serious
Hershow et al. (2015) Serious Serious Serious Mod NI Serious Mod Serious
Kaufman et al. (2016) Mod Mod Mod NI Mod Mod Mod Mod
Kemp & Pienaar (2009) Mod Mod Serious NI Low Serious Mod Serious
Lennox & Pienaar (2013) Serious Mod Serious Critical Serious Serious Mod Critical
Ley et al. (2014) Serious Mod Serious NI Mod Mod Serious Serious
Maro et al. (2009) Low Mod Mod NI Critical Mod Serious Critical
Maro & Roberts (2012) Low Mod Mod NI Critical Mod Critical Critical
Monyeki et al. (2012) Serious Mod Mod NI NI Serious Mod Serious
Naidoo & Coopoo (2012) Serious Mod Mod Serious Critical Serious Mod Critical
Naidoo et al. (2009) Serious Mod Mod NI Critical Serious Mod Critical
Owoeye et al. (2014) Mod Mod Mod NI Low Serious Mod Serious
Parker et al. (2016) Low Low Low NI Low Mod Mod Mod
Peacock-Villada et al. (2007) NI NI NI NI NI NI NI NI
Richards et al. (2014) Low Low Mod NI Mod Mod Mod Mod
Sorensen et al. (2016) Low Mod Mod NI Critical Mod Critical Critical
Starzak et al. (2016) Serious Mod Critical NI Critical Serious Mod Critical
Tian et al. (2017) Serious Mod Mod NI Low Critical Mod Critical
Uys et al. (2016) Mod Serious Mod NI Mod Serious Mod Serious
Walter (2014) Serious Mod Serious NI Critical Serious Mod Critical
Note: ROB1) Bias due to confounding; ROB2) Bias in selection of participants; ROB3) Bias in
classification of interventions; ROB4) Bias due to deviations from intended interventions; ROB5) Bias due
to missing data; ROB6) Bias in measurement of outcomes; ROB7) Bias in selection of reported result
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
23
prevention with youth, stating “HIV-related outcomes…stand out because sport is playing a huge
role in reducing new HIV infections and also changing attitudes and knowledge of beneficiaries.
This [suggests] that sport-based education involves everyone even in the hard to reach areas.”
When asked what steps could be taken to help sport-based health promotion, one
participant reported: “increase its buy-in in all societies by engaging all communities. Engage
key stakeholders and ministries. Make sport education an ongoing process not a once off event in
societies.” A second participant discussed the potential role that sport can have in strengthening
communities: “Support the role of sports in strengthening communities where young people
come from—use sport as a vehicle to communicate about priority health matters.” Additionally,
a participant stated that they wanted to “advocate for health services through sport-based health
activities.”
Lastly, participants provided the following responses when asked what they would like to
see in future sport-based health promotion initiatives: “A more inclusive way of addressing
harmful gender norms that have a large effect on the development of young aspiring female
sports players and females in general.” Other participants stated that they would like to see
“more stakeholders to come on board and support sport-based health” and “more free health
services with sport-based health.” Lastly, one participant shared that they would like to see
“increased participation in sport especially for females—increased social connections—
increased healthy eating habits—reduce smoking and alcohol intake in young people.”
Discussion
The results of the present study suggest that sport can be an effective platform for health
promotion with children and youth in Africa pending improvements in the methodology of future
studies. Statistically significant improvements in health-related outcomes were observed in 23 of
the 28 articles that met our study’s inclusion criteria. Targeted health outcomes included HIV
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
24
related knowledge and behaviors, essential health practices, physical activity, physical and
mental health outcomes, and overall fitness levels. Considering the broad range of health
outcomes in interventions included in this review, our results suggest that sport-based
interventions may improve multiple physical and mental health outcomes with youth in Africa.
We conducted risk of bias assessments for the included articles to enhance the quality of
our review. The results of our risk of bias ratings for the 28 studies included in our review report
that ten articles were deemed to be at critical risk of bias, 13 were at serious risk of bias, four
were at moderate risk of bias, none of the articles were rated as low risk of bias, and one article
was coded as no information. These findings are similar to those of a meta-analysis of sport
based HIV prevention interventions, which found that only two of the 21 studies included in their
analyses could be considered “good quality” (Kaufman et al., 2013). However, it is important to
note that the ROBINS-I tool rating protocol involves comparing each intervention to a
hypothetical randomized control trial (Sterne et al., 2016). Considering that many of these
interventions were conducted with at-risk youth in low socio-economic communities, strictly
adhering to a randomized control trial procedure would have been difficult. Furthermore, it could
be argued that using a true control group in health promotion interventions with at-risk children
is not ethical, as it requires researchers to not administer a potentially life-saving program to a
group of youths. Ethical issues notwithstanding, future researchers should target conducting
more scientifically rigorous studies to gain a more comprehensive understanding of how, why,
and under what circumstances sport-based health promotion interventions are successful to
maximize and sustain impact with limited resources.
Bearing in mind the above methodological considerations in the reviewed studies,
participants in this review demonstrated statistically significant improvements in HIV-related
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
25
outcomes (Awotidebe et al., 2014; Clark et al., 2006; Hershow et al., 2015; Kaufman et al., 2016;
Maro & Roberts, 2012; Maro et al., 2009; Peacock-Villada et al., 2007; Sørensen et al., 2016).
Specific HIV-related outcomes included knowledge and attitudes (Awotidebe et al., 2014; Clark
et al., 2006; Hershow et al., 2015; Maro & Roberts, 2012; Maro et al., 2009; Sørensen et al.,
2016), communication skills (Awotidebe et al., 2014; Hershow et al., 2015; Peacock-Villada et
al., 2007), awareness of local preventative resources and treatment facilities (Clark et al., 2006;
Hershow et al., 2015; Kaufman et al., 2016), and uptake of preventative treatments (Hershow et
al., 2015; Kaufman et al., 2016). Therefore, our results support the findings of a recent meta
analysis of 21 sport-based HIV-prevention initiatives that found strong evidence of positive
effects with regards to HIV-related knowledge, stigma, self-efficacy, communication, and recent
condom use (Kaufman et al., 2013).
To our knowledge, our review is the first to suggest that sport-based health promotion
interventions can significantly improve the uptake of HIV prevention and treatment procedures.
Participants in two interventions included in our review demonstrated statistically significant
improvements in the uptake of HIV-related services. Specifically, one soccer-based intervention
led to a significant increase in HIV counseling and testing (HCT) services among adolescent
girls in South Africa (Hershow et al., 2015). Another soccer-based intervention led to a
statistically significant increase in voluntary medical male circumcision (VMMC) uptake among
a group of adolescent males in Zimbabwe (Kaufman et al., 2016). Taken together, the results of
these studies suggest that sport-based health promotion initiatives can be effective in promoting
the uptake of HIV-related prevention services among children and youth in Africa. However,
additional research is warranted to provide further evidence of this relationship.
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
26
One common theme among the sport-based interventions included in our review that
targeted HIV-related outcomes and essential health knowledge is that they were conducted in
collaboration with existing non-profit organizations (Awotidebe et al., 2014; Clark et al., 2006;
Delva & Temmerman, 2006; Fuller et al., 2010; 2011; 2015; Hershow et al., 2015; Kaufman et
al., 2016; Maro et al., 2009; Peacock-Villada et al., 2007). Specifically, eight studies included in
our review were administered in collaboration with Grassroot Soccer, which uses a sport-based
teaching model to build resilience in children and youth to help protect themselves against HIV
(Peacock-Villada et al., 2007). Based on the promising results of each intervention, partnering
with existing non-profit organizations is a promising avenue for future researchers, as the
organizations’ knowledge and experience can enhance the development and implementation of
effective sport-based health promotion interventions targeting children and youth in Africa.
Furthermore, collaborating non-profit organizations can have experienced staff members conduct
the intervention or provide comprehensive training sessions for the individuals who will
administer the interventions to participants (Fuller et al., 2010; 2011; 2015).
As part of these partnerships, Grassroot Soccer and other non-governmental
organizations have increasingly utilized peer-led interventions with HIV-prevention initiatives in
Africa, and the results have been promising (Maticka-Tyndale & Barnett, 2010). This approach
is based on the assumption that adolescents rely on their peers to learn from and model their
behavior after, and norms and behaviors are most likely to change when those of the group
change (Campbell, 2004; Maticka-Tyndale & Barnett, 2010). In our review, trained peer-leaders
or peer coaches were used to deliver a sport-based intervention in eleven of the articles.
Participants in each study that utilized peer-coaches to deliver the intervention demonstrated
statistically significant improvements in HIV-related outcomes (Awotidebe et al., 2014; Fuller et
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
27
al., 2010; 2011; 2015; Hershow et al., 2015; Kaufman et al., 2016; Maro & Roberts, 2012; Maro
et al., 2009; Peacock-Villada et al., 2007; Sørensen et al., 2016), cardiovascular fitness outcomes
(Richards et al., 2014), and reductions in pain (Parker et al., 2016). Therefore, our results support
the use of trained peer coaches and peer leaders in sport-based interventions with children and
youth.
Our review also included three studies that used an 11-week soccer-based intervention to
improve knowledge and awareness of essential health practices among children and youth from
eight different African countries (Fuller et al., 2010; 2011; 2015). Participants in all eight
countries demonstrated statistically significant improvements in health knowledge scores from
baseline to post-intervention in outcomes related to physical activity, HIV prevention, malaria
prevention, substance abuse, personal hygiene, clean water use, nutrition, vaccinations, and
prescribed medication usage. These findings suggest that sport-based health promotion
interventions that focus on a broad range of health behavior practices may be effective for
children and youth in many different African countries. Although additional research is needed,
these results speak to the potential generalizability and translational utility that sport-based
interventions may have throughout Africa.
One critique of previous sport-based health promotion interventions is that there has been
an over-emphasis on HIV-related outcomes (Fuller et al., 2015). In our review, 39% of the
included articles targeted HIV-related outcomes. Although HIV/AIDS is a public health
epidemic, research suggests that rates of HIV/AIDS are much lower in children and adolescents
in sub-Saharan Africa compared to adults (Delva & Temmerman, 2006). A recent systematic
analysis suggested that HIV was responsible for approximately 8% of child deaths in sub
Saharan Africa compared to 25% for neonatal disorders, 22% for malaria, 21% for pneumonia,
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
28
and 20% for diarrhea (Black et al., 2010). However, statistics relating to sub-Saharan Africa may
be misleading, as health issues vary from country to country (Black et al., 2010). Therefore, one
direction for future sport-based health promotion initiatives is to adapt program structures and
protocols so they can address the specific needs of the countries and communities they are
hoping to serve. Considering the significant amount of evidence supporting the use of sport
based health promotion interventions targeting the prevention and treatment of HIV, additional
research is warranted to understand the impact of sport-based health promotion interventions
with other diseases and essential health behaviors as well.
Sport- and physical activity-based interventions can be used to target other important
health topics. For instance, it has been well documented that participation in physical activity and
exercise is associated with improved fitness outcomes among youth (Armstrong, Tomkinson, &
Ekelund, 2011). Our review included ten articles that investigated the impact of a sport- or
physical-activity-based intervention on participants’ fitness levels. Specifically, seven studies
resulted in statistically significant improvements, including improved muscular strength and
endurance (Ferguson et al., 2015; Kemp & Pienaar, 2009; Ley et al., 2014; Naidoo & Coopoo,
2012; Naidoo et al., 2009), cardiovascular fitness (Ferguson et al., 2015; Kemp & Pienaar,
2009), anaerobic fitness (Ferguson et al., 2015), flexibility (Kemp & Pienaar, 2009; Naidoo &
Coopoo, 2012), and lean body mass (Starzak et al., 2016). Two interventions resulted in
statistically significant improvements in participants’ fitness levels in both the experimental and
control conditions, but no statistically significant differences were found between the conditions
at post-intervention (Richards et al., 2014; Uys et al., 2016). One study did not observe
statistically significant improvements in participants’ fitness levels following a sport-based
intervention, but the researchers hypothesized that this was due to low program compliance from
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
29
participants in their program (Lennox & Pienaar, 2013). Therefore, the results of our review
suggest support for the notion that participation in sport and physical activity can enhance
multiple fitness outcomes for youth.
Additionally, participants in five studies demonstrated statistically significant
improvements in physical activity levels (Lennox & Pienaar, 2013; Naidoo & Coopoo, 2012;
Naidoo et al., 2009; Tian et al., 2017; Walter, 2014). Only one study found no significant
improvements in participants’ physical activity levels, which the researchers hypothesized was
due to the structure of the physical activity portion on their intervention (Uys et al., 2016).
Physical activity is an inherent component of sport-based health promotion interventions, so it is
not surprising that participants in these programs demonstrated higher levels of physical activity
throughout the study. However, additional research is needed to determine whether participants’
increased levels of physical activity are sustained beyond the intervention.
Aside from the physical benefits derived from physical activity, previous research also
suggests that youth participation in sport and exercise may enhance mental health functioning
(Kulig, 2003; Theokas et al., 2008). For example, it has been suggested that there is a strong
positive relationship between physical activity and positive mental health outcomes with children
and adolescents, including decreased symptoms of depression and anxiety and improved levels
of self-esteem and cognitive functioning (Biddle & Asare, 2011). Our findings support the notion
that sport- and physical activity-based interventions can improve mental health outcomes for
children and youth in Africa. Six articles investigated the impact of sport- or physical-activity
based interventions on mental health outcomes, and four studies resulted in statistically
significant improvements in mental health outcomes among participants. Specifically, sport
based interventions were found to be effective in reducing participants’ symptoms of depression
SPORT FOR HEALTH PROMOTION WITH YOUTH IN AFRICA
30
and anxiety (Parker et al., 2016) and behavioral problems (Chetty & Edwards, 2007). Sport
based interventions also resulted in higher levels of self-efficacy (Parker et al., 2016), self
perception (Chetty & Edwards, 2007), and coping skills (Bloemhoff, 2006; 2012; Peacock
Villada et al., 2007). Therefore, the results of our review suggest that physical activity and
participation in sport can significantly improve several mental health outcomes with children and
youth in Africa.
In addition to the mental health benefits associated with physical activity, it has also been
suggested that youth participation in sport promotes the development of important and adaptive
life skills such as discipline, confidence to withstand peer pressure, goal-setting, and the ability
to develop healthy coping strategies (Theokas et al., 2008). Engaging at-risk youth in sport can
foster the development of essential life skills that may help them avoid risk-taking behaviors that
can lead to lifelong consequences such as substance abuse, crime, and sexual activity (
Functional Movement Screen Composite Scores for Collegiate : Functional Movement Screen Composite Scores for Collegiate
Field Club Sport Athletes at One University
Daniel Camillone
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Recommended Citation
Camillone, Daniel, "Functional Movement Screen Composite Scores for Collegiate Field Club Sport
Athletes at One University" (2018). Graduate Theses, Dissertations, and Problem Reports. 5304.
https://researchrepository.wvu.edu/etd/5304
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Functional Movement Screen Composite Scores For Collegiate Field Club Sport Athletes at One
University
Daniel Camillone, ATC, CSCS
Thesis Submitted to the
College of Physical Activity and Sport Sciences
at West Virginia University
in partial fulfillment of the requirements for the degree of
Master of Science in
Athletic Training
Michelle A. Sandrey, PhD, ATC, Chair
Jean L. McCrory, PhD
Patricia Riley, MS, ATC, PES
Department of Sport Sciences
Morgantown, West Virginia
2018
Keywords: functional movement screen, composite score, club sports
Copyright 2018 Daniel Camillone
i
ABSTRACT
Functional Movement Screen Composite Scores For Collegiate Field Club Sport Athletes at One
University
Daniel Camillone, ATC, CSCS
Context: Functional screening tools to detect musculoskeletal asymmetries and limitations
present in functional movement patterns are available to use for the athletic population.
Unfortunately, field club sport athletes do not have the opportunity to utilize functional screening
tools. Further, normative data of Functional Movement Screen Composite Scores (FMS CS) has
yet to be established in this population. Objective: The purpose of this study was to establish
normative FMS CS among field club sport athletes, and determine if years of participation and
current hours spent per week training have a significant effect on FMS CS. Foot type and
orthotic use was also compared with FMS CS. Design: The study was a descriptive screening
study. Setting: The assessments took place at a weight room and athletic training room at a DI
Mid-Atlantic university. Patients and Other Participants: Thirty-one athletes (age 19.61±1.56
yrs, height 169.58±8.66 cm, weight 72.77±17.42 kg) participating in club soccer, rugby and
lacrosse at a Division I Mid-Atlantic university during the 2017-2018 season volunteered for this
study. Inclusion criteria for the study consisted of college students who are field club sport
athletes between 18-23 years old who had not sustained an injury in the past twelve months that
required removal from participation and training and completed the consent form. Exclusion
criteria for the study consisted of an injury occurring in the past twelve months that required
removal from participation and training and individuals not between the ages of 18-23 years old.
Intervention: All participants completed the demographic questionnaire and seven movements of
the FMS. A demographic questionnaire was completed to determine self-reported years of
participation in the sport, number of hours spent training per week, foot type, and orthotic use.
The participants were asked to complete the seven movements and three clearing tests of the
FMS. Each participant completed three trials for each movement. Scores were calculated to
determine FMS CS. Main Outcome Measures: The dependent variables were the Functional
Movement Screen Composite Score and seven individual movement scores. Results: The mean
FMS CS and standard deviation for all participants was 15.1±1.49. Women’s Lacrosse (n=4) had
the highest average FMS CS (16.0±0.0). Participants with fewer years in sports (15.29±1.2
vs14.94±1.71) and hours of participation (15.17±1.63 vs 15±1.36) scored higher on the FMS CS.
Those not wearing orthotics (n=28, 15.2±1.34) scored higher than those who do wear orthotics
(n=3, 14.0±0.0). The one participant that reported a pes planus foot (15.0±0.0) scored higher than
the seven participants with a pes cavus foot (14.7±1.98). Conclusions: Collegiate field club sport
athletes score higher or comparable to varsity collegiate athletes on the FMS. More years of
participation and hours per week were associated with decreased FMS.
ACKNOWLEDGEMENTS
I would like to first start by thanking my parents. Everything about me is the amazing joint effort
of two wonderful, loving parents. Having you as parents will never be taken for granted. I love
you both.
Second, I want to thank my girlfriend Nicole. Our competitiveness has helped drive me to
become a better person. Your love, along with an understanding of my pursuits, is something that
I will always be thankful for. I love you hun.
My classmate Brian Hanson must be thanked, for he was my only classmate to join me on this
endeavor. Your work ethic encouraged me to hold a higher standard for myself. I know you will
do great things my friend.
My roommates DJ and Adam need to be thanked. They were a monumental part of my graduate
experience. I know the three of us have created a friendship that will not fade with time.
To my supervisor, Dr. Vincent Stilger, thank you for providing the opportunity over the last two
years for me to develop as an instructor and clinician. I am beyond fortunate to have worked with
you.
Thank you to my committee members, Dr. Jean McCrory and Patti Riley. Your time and
dedication are greatly appreciated.
Lastly, this opportunity would not be possible without my committee chair and Graduate Athletic
Training Program Director, Dr. Michelle Sandrey. Thank you creating the opportunities and
experiences for my classmates and I, and the copious hours spent diligently reading my drafts. I
am thankful for the level of excellence you pushed me to reach.
iii
iv
TABLE OF CONTENTS
ACKNOWLEDGEMENTS............................................................................................................iii
LIST OF TABLES...........................................................................................................................v
INTRODUCTION...........................................................................................................................1
METHODS......................................................................................................................................3
RESULTS......................................................................................................................................10
DISCUSSION................................................................................................................................11
CONCLUSION..............................................................................................................................18
REFERENCES..............................................................................................................................20
APPENDICIES..............................................................................................................................24
APPENDIX A: THE PROBLEM......................................................................................25
APPENDIX B: LITERATURE REVIEW.........................................................................33
APPENDIX C: ADDITIONAL METHODS.....................................................................54
APPENDIX D: ADDITIONAL RESULTS.......................................................................70
APPENDIX E: RECOMMENDATIONS FOR FUTURE RESEARCH..........................72
ADDITIONAL REFERNCES.......................................................................................................73
v
LIST OF TABLES
Table C1. Consent Information and HIPAA Form........................................................................41
Table C2. Subject Demographic Questionnaire.............................................................................45
Table C3. Verbal Instructions for the Functional Movement Screen............................................46
Table C4. Functional Movement Screen Score Procedures...........................................................50
Table C5. Functional Movement Screen Scoring Sheet................................................................54
Table D1. Most Frequent, Frequency, and Mean For FMS CS and Individual Movements.........70
Table D2. Descriptive Statistics and ANOVA for Year in Sport..................................................70
Table D3. Descriptive Statistics and ANOVA for Hours per Week..............................................70
Table D4. Individual FMS Scores Related To Orthotics and Foot Type......................................71
INTRODUCTION
The obesity epidemic has created awareness for the importance of an active lifestyle.
Thus, athletic participation has been increasing at all competition levels. One place where this
has become apparent is at the university setting. Universities and colleges offer numerous types
of physical activity. College students, in general, have the opportunity to participate in
recreational sports or club sports. An increase in participation at this level has unfortunately
resulted in a rise of injury rates across club sports. Eight and eight tenths million recreation
related injuries were reported between 2011-2014 in the United States.1 There were 1.4 million
emergency department (ED) visits caused by recreational activity from 2000-2001.2 There are
approximately 11,000 ED visits each day in the U.S. related to recreational injury.2
Field club sports offered at colleges and universities include soccer, rugby, and lacrosse.
Compared to varsity collegiate sports, field club sport athletes lack similar levels of commitment
and access to sports medicine and strength and conditioning professionals. Six and three tenths
injuries occurred per 1,000 athlete exposures among youth lacrosse players.3 Six hundred fifty
nine injuries were experienced among 369 intercollegiate rugby players during a five year span.4
There were 12,974 injuries to collegiate male soccer players between 1988-2003.5
Despite decreased commitment and availability of resources, field club sport athletes are
persistently seeking methods to improve performance and reduce risk of injury. Increasing speed,
power, and strength are given priority over recovery and injury prevention measures.6 Increased
training demands reinforce existing musculoskeletal asymmetries and limitation that lead to poor
functional movement patterns.7-11 These compensation patterns build fitness upon dysfunction.7
11 Deficient movement patterns can lead to injury overtime. Clinicians rehabilitating injuries
cannot disregard functional movement patterns to prepare an athlete for return to play. One such
1
screening tool that can be used is the Functional Movement Screen (FMS). The FMS was
originally developed to serve as an inexpensive, simple screening tool for functional movement
quality.12 The seven movements were selected to recreate the demands of athletic performance
and activities of daily living.12 Screening tools, like the FMS, are designed to assess
musculoskeletal asymmetries and limitations displayed during functional movement patterns.7-11,
13, 14
High injury rates and deficient movement patterns have encouraged athletic trainers and
strength and conditioning coaches to implement movement screenings. High school athletes,
varsity collegiate athletes and professional athletes participating in the field sports of rugby and
soccer have received significant attention for musculoskeletal assessments using FMS composite
scores (CS). 15-20 Twenty-two male recreational team sport athletes participating in soccer,
basketball, rugby league, rugby union, Australian football, or touch football were assessed.15, 16
The mean FMS CS equated to 15.09+2.18.15, 16 In contrast, 62 South African professional rugby
union players completed the FMS to compare CS between injured and non-injured athletes. 17
The FMS CS was 13.2+1.7 vs. 14.5+1.5, which is lower than in the Lockie15, 16 study. Seventy
six male union rugby players completed the FMS at the beginning of each half of a season. An
insignificant difference in FMS CS was noted between the first and second half of the season,
15.2+1.94 vs. 15.4+2.05.18 Twenty-three U16 and twenty-five U19 youth elite soccer players
completed the FMS.21 Functional movement scores were 13.87+2.93 vs. 14.96+2.07.21
Negligible differences were noted within individual FMS movements between the two age
groups.21 A comparison between NCAA Division II men’s and women’s soccer players was
conducted to assess differences in FMS CS.19 Men’s soccer scored slightly higher than women’s
soccer, 16.16+1.54 vs. 15.78+1.85.19 Forty-seven Division II men’s and women’s soccer players
2
averaged a 15.84+1.73 FMS CS.20 Sixty-two Division I women’s soccer players had an average
FMS CS of 14.22
The collegiate field club sport athlete population has not been thoroughly examined
throughout the literature. There is no specific screening tool for the club sport athlete, but the
FMS could serve the needs of this population. The FMS is a simple, quick movement screening
tool to develop an individualized functional movement profile. There is little evidence of
screening tools that have examined field club sport athletes in the literature. Application of the
FMS and its utility with this population needs further investigation. There are a lack of normative
data examining how collegiate field club sports score on the FMS. The rise of athletic
participation and subsequent injuries must be matched with injury prevention programs. The
movement deficiencies discovered during the FMS can be used to develop an individualized
intervention to correct musculoskeletal asymmetries and limitations.
As the number of field club sport athletes grows, the need to detect movement
deficiencies increases. Implementation of a functional movement screening tool is required to
detect these deficiencies. Therefore, the purpose of this study is to establish normative FMS CS
among field club sport athletes, and determine if years of participation and current hours spent
per week training have a significant effect on FMS CS.
METHODS
This study was descriptive screening study to determine Functional Movement Screen
Composite Scores (FMS CS) across field club sport athletes at a Mid-Atlantic university.
Participants were tested during one session. The participants were in-season and out of season.
The FMS was used to detect compensation patterns and movement deficits in field club sport
athletes. The dependent variable was the FMS CS of each sport (Lacrosse, Soccer, Rugby).
3
Independent variables were the self-reported number of years playing (>10, 12,
Competitive Aggressiveness, Anger, and the Experience of Provocation in Collegiate Athletes : Competitive Aggressiveness, Anger, and the Experience of
Provocation in Collegiate Athletes
Michael E. Berrebi
Follow this and additional works at: https://researchrepository.wvu.edu/etd
Recommended Citation
Berrebi, Michael E., "Competitive Aggressiveness, Anger, and the Experience of Provocation in Collegiate
Athletes" (2018). Graduate Theses, Dissertations, and Problem Reports. 5194.
https://researchrepository.wvu.edu/etd/5194
This Dissertation is protected by copyright and/or related rights. It has been brought to you by the The Research
Repository @ WVU with permission from the rights-holder(s). You are free to use this Dissertation in any way that is
permitted by the copyright and related rights legislation that applies to your use. For other uses you must obtain
permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license
in the record and/ or on the work itself. This Dissertation has been accepted for inclusion in WVU Graduate Theses,
Dissertations, and Problem Reports collection by an authorized administrator of The Research Repository @ WVU.
For more information, please contact researchrepository@mail.wvu.edu.
Competitive Aggressiveness, Anger, and the Experience of Provocation in Collegiate Athletes
Michael E. Berrebi, M.S.
Dissertation submitted to the
College of Physical Activity and Sport Sciences
at West Virginia University
in partial fulfillment of the requirements for the degree of
Doctor of Philosophy in
Sport & Exercise Psychology
Edward Etzel, Ed.D., Chair
Jack Watson II, Ph.D.
Scott Barnicle, Ph.D.
David Mitchell, Ph.D.
Department of Sport Sciences
Morgantown, West Virginia
2018
Keywords: anger, aggression, aggressiveness, provocation, college athletes
© 2018 Michael E. Berrebi
ABSTRACT
Competitive Aggressiveness, Anger, and the Experience of Provocation in Collegiate Athletes
Michael E. Berrebi
In sport, aggressive behavior is a potentially harmful byproduct of uncontrolled anger. In
addition, it is known that provocation can lead to both anger and aggressive retaliation. However,
despite the potential consequences of aggressive behavior, little is known about levels of
competitive anger and aggressiveness in athletes, and it is unclear if differences exist by gender
or type of sport. Little research has also explored intervention approaches to help athletes better
manage anger and aggression. Therefore, the purpose of this study was to explore competitive
aggressiveness, anger, and the experience of provocation among collegiate athletes. Participants
were 243 male and female contact or collision sport athletes competing at NCAA Division I, II,
and III universities across the country. Participants filled out questionnaires assessing both
competitive aggressiveness and anger and the experience of provocation. Overall, it was found
that male athletes scored significantly higher than female athletes on competitive aggressiveness,
as well as experiencing more frequent provocative behavior and more negative and intense
responses to provocation. Collision sport athletes were also found to be higher in competitive
aggressiveness and anger, regardless of gender. Division I and II athletes were found to be
significantly higher than Division III athletes in competitive aggressiveness and anger.
TABLE OF CONTENTS
iii
Page #
1. INTRODUCTION……………………………………………………………………….........1
2. METHODS……………………………………………………………………………….......11
2.1. Participants………………………………………………………………………....11
2.2. Research Design and Sampling…………………………………….……………....11
2.3. Instrumentation…………………………………………………………………......12
2.3.1. Demographic questionnaire…………………………………………........12
2.3.2. Competitive aggressiveness and anger…………………………………...12
2.3.3. Provocation…………………………………………………………….....14
2.3.4. Pilot study…………………………………………………………….......15
2.4. Procedure……………………………………………………………………….......16
2.5. Data Analysis…………………………………………………………………….....17
3. RESULTS……………………………………………………………………....….………....20
3.1. Demographics and Descriptive Statistics ………………………………….............20
3.2. Data Cleaning and Assumption Testing ……………………...…….……………...21
3.3. Bivariate Statistics……………………………………………………………….....22
4. DISCUSSION……………………………………………………………………...….…......27
4.1. Competitive Aggressiveness and Anger……………………………………..…....27
4.1.1. Gender comparisons………………………………………………….......27
4.1.2. Sport type comparisons………………………………………………......28
4.1.3. Division level comparisons…………….....………………………….......32
4.2. The Experience of Provocation………………………………………………........35
iv
4.2.1. Gender comparisons………………………………………………….......35
4.2.2. Sport type comparisons………………………………………………......36
4.2.3. Division level comparisons…………………………………………........38
4.3. Future Research and Directions…………………………………….……......…....39
4.3. Study Strengths and Limitations……………………………....…………......…....42
5. REFERENCES…………………………………………………………………………….....44
6. APPENDICES……………………………………………………………………………......53
6.1. Appendix A: Data Tables………………….…………………………..………........53
6.2. Appendix B: Extended Review of Literature…………………………..……….......75
6.2.1. Part I: Competitive Anger in Sport………………………………….......75
6.2.2. Part II: Aggressive Behavior in Sport…………………………………...88
6.2.3. Part III: Managing Anger and Aggressive Behavior in Sport…….........107
6.2.4. Significance of Study…………………………………………………..115
6.2.5. References…………………………………………………...................121
6.3. Appendix C: Assistant and Head Coach Recruitment Letter……..…………….....139
6.4. Appendix D: Participant Cover Page………………………………..….................140
6.5. Appendix E: Demographic Questionnaire…………………………….…..............141
6.6. Appendix F: Competitive Aggressiveness and Anger Scale………………….......142
6.7. Appendix G: Sport Provocation Questionnaire…………….……………….…….143
6.8. Appendix H: SPQ Pilot Data and Feedback…………………………..………......146
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
1
Introduction
In sport, there is sufficient anecdotal and empirical evidence that suggests being able to
manage one’s emotions is a key factor in influencing performance (e.g., Hanin, 2010; Lane,
2007; Woodcock, Cumming, Duda, & Sharp, 2012). In addition to athletic ability, teamwork,
and strategy, sport performance also hinges upon the ability of the athlete to regulate emotions.
Throughout a competition, athletes experience a variety of positive and negative emotions that
can influence motivation and change both physical and cognitive performance (Botterill &
Brown, 2002). More recently, it has been suggested that being able to regulate emotions in sport
is an important determinant of performance outcomes both for individual athletes (e.g., Lane,
Beedie, Jones, Uphill, & Devonport, 2012) and teams (Wagstaff & Weston, 2014).
Anger has been described as “an emotional state that consists of feelings that vary in
intensity, with associated activation or arousal of the autonomic nervous system” (Spielberger &
Reheiser, 2009, p. 281). A key component of this definition is the lack of judgment regarding
whether anger is a “good” or “bad” thing, but rather a normal, human emotion. In fact,
experiencing anger is somewhat unavoidable, especially in high-stress, pressure-packed
environments that competitive sports embody. Whether an athlete’s anger becomes problematic
appears to be less about the fact that it is present and more about the nature and severity of
behavioral outcomes (Kassinove & Tafrate, 2002). In fact, researchers who have explored
whether anger helps or hurts performance in sport have presented mixed results (e.g., Robazza &
Bortoli, 2007; Ruiz & Hanin, 2011). It seems the most important factor is how anger is
interpreted and managed by athletes (Hanin & Syrja, 1995).
Despite a growing body of research focused on exploring emotions in sport, anger has not
been thoroughly investigated. This is in spite of the knowledge that anger is one of the most
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
2
common emotions that athletes experience during competitive play (Sofia & Cruz, 2016). While
anger is an emotion expressed by a high percentage of athletes, researchers suggest gender,
competition level, and type of sport may play a factor in the level of anger experienced by
athletes (Maxwell, Visek, & Moores, 2009). Some findings suggest the possibility that athletes
with a perfectionist orientation are at a greater risk for experiencing anger when the pressure is
on (Vallance, Dunn, & Dunn, 2006). It has also been identified that male and female athletes
may cope with anger in similar ways (Bolgar, Janelle, & Giacobbi, 2008). Overall, the nature and
degree of differences among gender and level/type of sport is still largely unknown.
Anger has been associated with a number of negative performance outcomes such as
misuse of energy, a decrease in achievement and motivation, and the possibility of violent
behavior (Robazza et al., 2006). The fact that uncontrolled anger can lead to aggressive or
violent behavior has been known for decades (e.g., Berkowitz, 1993; Feindler & Ecton, 1994).
However, few studies have been published in the years since that explore the relationship
between competitive anger levels and aggressive behavior. Maxwell (2004) found that simply
ruminating about past experiences that have caused anger could increase the possibility of
aggression. In addition, being provoked and having thoughts of revenge have been found to be
significantly related to self-reported aggression (Maxwell, Moores, & Chow, 2007).
Unfortunately, it remains difficult to assess competitive anger, which is required to
provide a more clear understanding of how it impacts aggression. Part of the problem stems from
how to accurately assess anger and aggressive behavior. Outside of sport, instruments such as the
State Trait Anger Expression Inventory (STAXI; Spielberger, 1988) have been constructed to
help assess the experience, expression, and control of anger. However, nearly thirty years since
the introduction of the STAXI, it still has not been normed on athletes or become a standard form
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
3
of measurement in sport psychology research. There currently exists no standard method to
assess anger or aggressive acts in sport. Being able to utilize trained observers to identify
aggression would be ideal. This would help identify what led to the aggressive act, the act itself,
and the resulting consequences. This is unfortunately a time-consuming and potentially
expensive process. In addition, aggressive behavior may not always be noticeable on a game-to
game basis (Maxwell & Moores, 2007).
The Competitive Aggressiveness and Anger Scale (CAAS) is a notable instrument used
to assess both competitive anger and aggressiveness, or the tolerance of aggressive behavior and
inclination to aggress. The CAAS (Maxwell & Moores, 2007) is a 12-item instrument that
assesses anger (e.g., frustration from missed calls from referees) and aggressiveness in a sport
setting. While aggressiveness is a trait rather than a behavior (like aggression), it is one of the
better ways to assess the probability of aggressive behavior in a proactive way (i.e., before it
actually happens). Few researchers have utilized the CAAS since its inception (e.g., Visek
Maxwell, & Hurst, 2011), but it appears to be an efficient and promising instrument for use in
the exploration of anger and aggressiveness in athletes.
Another consideration in the study of aggression is the lack of a clear consensus on how
to define and differentiate assertive and aggressive behavior, and also what constitutes
“violence” (Abrams, 2010; Kirker, Tenenbaum, & Mattson, 2000). Currently, one of the more
common methods to help understand aggression is to split these types of behaviors into
instrumental and hostile types (Husman & Silva, 1984). The major difference is the distinction
that instrumental aggression may cause harm, but has the overarching goal of pursuing a
nonaggressive goal (such as scoring points). Hostile aggression suggests a primary intent of
injuring another person physically or psychologically. Abrams (2010) suggested that violence
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
4
can be spontaneous or planned, with the end goal to hurt another person. Spontaneous violence
seems to be a result of being provoked, while planned violence is intentional and a “complete
system failure” (p. 6). Abrams went on to suggest that athletes displaying this type of behavior
should be immediately removed from the playing field and, in extreme instances, even
prosecuted.
With these definitions as resources, hostile and planned violence are the most dangerous.
What must happen for athletes to feel it necessary to display these types of behaviors? There is
no doubt that feeling frustrated and angry are important factors in understanding aggressive
behavior (Berkowitz, 1993; Feindler & Ecton, 1994; Robazza et al., 2006;). However, simply
feeling angry does not automatically cause one to lash out aggressively. What other factors come
into play?
To help answer this question, a number of theories have been put forth to help understand
the potential causes of aggression. Examples include the instinct theory, frustration aggression
theory (Dollard, Doob, Miller, Mowrer, & Sears, 1939), social learning theory (Bandura, 1973),
theory of moral reasoning (Bredemeier, 1994), and revised frustration-aggression theory
(Berkowitz, 1965; 1993). Instinct theory suggests aggression is an innate human instinct that
builds up until it must be expressed either directly or cathartically (through sports for example).
Based on Albert Bandura’s seminal work, social learning theory predicts aggression is learned by
observation, and aggression that is reinforced is likely to reoccur if not penalized. The theory of
moral reasoning postulates that how likely a person is to aggress is based on their level of moral
development. One of the more widely held views, Berkowitz’s revised frustration-aggression
theory suggests frustration only leads to aggression when an individual encompasses the social
cues that indicate aggression is appropriate in a particular instance. This theory is important in
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
5
understanding how frustration in competition can play an important factor in determining
aggressive behavior, based on the individual and his/her environment.
One of the least understood experiences related to being frustrated and taking it out
aggressively, is the act of provocation. According to Maxwell, Moores, and Chow (2007),
provocation is “any behavior [of another person or persons] that is judged by the victim as
aversive or unpleasant, normally with intent on the part of the perpetrator implicitly assumed,
and rousing feelings of anger, frustration, or fear” (p. 11). This definition suggests that
provocation is assumed to involve intent by the perpetrator. This is a key distinction, as it should
not be considered provocation if an athlete, simply by competing hard and without harmful
intent, frustrates or angers an opponent to the point of him/her lashing out.
In his work on revised frustration-aggression hypothesis, Berkowitz (1989) suggested
that provocation, along with frustration and aversive stimuli, could lead to aggression through
the generation of negative affect that is interpreted by the individual as anger. Provocation is one
of the clearest antecedents of aggression in both non-sporting (e.g., Harris, 1993) and sporting
(e.g., Huang, Cherek, & Lane, 1999) environments. Outside of sport, researchers have suggested
that provocation may cancel out any inhibitory effects that empathy can have on aggressive
behavior (Phillips & Giancola, 2007; Stranger, Kavusannu, McIntyre, & Ring 2016). Other
research suggests that provocation itself is frequently interpreted as offensive and has been
linked to increases in overall anger levels (Mohr et al., 2007).
Maxwell (2004) was one of the first researchers to focus on understanding the experience
and consequences of provocation in athletics. He reported that provocation might be positively
associated with aggression in athletes. This mirrored similar findings of research on norm
breaking behaviors in sport, in which Kirker, Tenenbaum, and Matteson (2000) observed that
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
6
mild aggressive acts often followed provocation acts in a vengeful manner. In the worst cases,
this sometimes resulted in more severely violent aggression. Maxwell (2004) claimed athletes
from team sports report greater frequency of provocation than athletes who compete in
individual sports. A few years later, Maxwell and Moores (2007) suggested that males
experience provocation at a greater frequency than females, suggesting that males may perceive
more incidences as provoking in sport. Maxwell, Visek, and Moores (2009) found that athletes
who competed in high contact team sports tended to experience higher provocation while playing
sport. Findings of this study suggested that provocation can be seen as a justification for
retaliatory aggression, but not always between the original combatants, at least in team sports.
Importantly, it has also been suggested that individuals with high trait anger are more
likely to feel more readily provoked and endorse aggressive acts as a result (Maxwell, Visek, &
Moores, 2009). This hypothesis was originally put forth by Spielberger (1988), who suggested in
his state-trait anger theory that high trait anger individuals experience anger more frequently and
longer than low trait anger individuals. In addition, these people are more likely to express this
anger in an aggressive or harmful manner. Unfortunately, this theory has not been explored in
the realm of athletics, and little knowledge exists regarding the characteristics of athletes that are
more or less likely to have high trait anger (or respond aggressively when triggered or provoked).
Clearly, some research exists that suggests provocation is an important factor in
determining anger and aggressive behavior (e.g., Maxwell, Visek, & Moores, 2009; Stranger et
al., 2016). However, assessing provocation is difficult since ideally (as with aggressive
behavior), provocation is assessed by observation. However, this method is timely and
unpredictable, in addition to somewhat subjective. An act perceived as provocative to one athlete
may not necessarily be perceived the same way by others. Furthermore, sometimes provocation
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
7
is verbal, which can be difficult to assess by outside observers. Currently, neither observer
assessment or provocation nor adequate self-report measures have been documented in the
literature.
Maxwell and Moores (2006) attempted to meet the need of a self-report assessment in
sport by crafting the Provocation in Sport Questionnaire (PSQ), a six-item self-report
questionnaire that inquires about incidences of provocation common in many sports. These
statements were scored by athletes on a five-point Likert-type scale to help understand the
frequency of each provocation type and the corresponding intensity of anger. Unfortunately, this
scale is no longer available and no other known instrument exists in which to assess the
experience of provocation in sport. Since provocation seems to be a key factor in understanding
anger and aggressive behavior in sports, a novel assessment of provocation is needed to help
develop this area of sport psychology research.
Therefore, the purpose of this study was to explore the relationship between self-reported
competitive aggressiveness, anger, and provocation in collegiate male and female contact and
collision sport athletes. Contact and collision sport athletes are an important population to
investigate because they are frequently in close proximity with opponents during competition
and are therefore more likely to engage in aggressive behavior. Non-contact sport athletes were
not included in this investigation.
Based on the modest amount of research available on anger, aggression, and provocative
behavior in sport, this study explored these variables while controlling for gender and type of
sport (i.e., contact vs. collision). It has been suggested that gender and type of sport have
significant competitive anger and aggression differences based on previous research (e.g.,
Maxwell, Visek, & Moores, 2009). For example, some studies have suggested that male athletes
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
8
are more aggressive than their female counterparts, both on and off the field (e.g., Burton &
Marshall, 2005; Coulomb-Cabagno & Rascle, 2006). Male athletes have also been found to
perceive aggression as more legitimate than females (e.g., Bredemeier, 1985; Gardner & Janelle,
2002; Tucker & Parks, 2001). Other research has disputed these findings (e.g., Bolgar, Janelle, &
Giacobbi, 2008; Keeler, 2007). Ultimately, aggression studies that focused on gender have
revealed conflicting findings, with no significant differences being reported between males and
females (Kimble et al., 2010).
With this knowledge in mind, the first major research question in the study was: “Does
competitive anger, aggressiveness, and experience of provocation vary between male and female
college athletes?” The second major research question was: “Does competitive anger,
aggressiveness, and provocation vary between contact and collision sport college athletes?”
Based on prior research, there were two main hypotheses in this study. The first was that
male athletes would score higher on the CAAS anger and aggressiveness subscales, in addition
to experiencing (and responding negatively to) more provocation than female athletes. The
second was that collision sport athletes would score higher on the CAAS anger and
aggressiveness subscales, in addition to experiencing more provocation and more frequently
responding to provocation than contact athletes.
There were a number of assumptions made by the researcher in this study. For example,
although prior research was ambiguous (e.g., Coulomb-Cabagno & Rascle, 2006, Keeler, 2007),
it was assumed that gender does play a significant role in the relationship between anger,
aggressiveness, and provocation. It was also assumed that contact and collision sport athletes
differed in aggressiveness, anger, and/or experiences of provocation. Closely related to that is the
assumption that provocation played a significant role in determining one’s level of competitive
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
9
anger and aggressiveness. Finally, it was assumed that the original sport provocation
questionnaire being used in this study adequately assessed the experience of provocation in
collegiate sport.
There is currently a major gap in the understanding of how anger, aggressive behavior,
and provocation interact in sport settings. There exists no valid assessment tool for the
experience of provocation in sport. In order to develop interventions to mitigate anger responses
to provocation, a more clear understanding of the interaction of aggression, anger and
provocation is required. Understanding the characteristics of athletes who are prone to high anger
levels, aggressiveness, and experiencing provocation will help in the development of more
focused interventions for these individuals. Male athletes may not actually be more aggressive
than female athletes, despite popular perception, and therefore interventions for one gender could
be utilized effectively for the other. However, anger levels and aggressiveness may be
significantly different, in which case gender-specific programming and interventions may be
required.
While the current study is largely exploratory, increasing the understanding of
provocation can be helpful for athletes, coaches, sport psychology consultants, and even referees.
Being able to understand how frequent provocative behavior occurs, how it is being displayed,
how it affects athletes, and how often it is reciprocated is valuable both theoretically and
practically. Team sport contact and collision athletes can better understand what to expect in
competition and coaches may be able to better prepare athletes for provocative behavior.
Coaches of certain types of teams (e.g., male teams or collision sports) need better information,
education, and programming to help promote an environment more conducive to safe, sanctioned
play.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
10
It is vital to understand who the at-risk athletes may be so they can be provided better
education and emotional regulation resources, as it is possible high trait anger athletes are more
likely to be involved in aggressive on-field acts (Maxwell, Visek, & Moores, 2009). Similarly,
coaches and sport psychology consultants can use the findings to better understand aggression
and where and why it is likely to occur. Referees could foster a better sense of how to officiate
sport to eliminate provocative behavior before it turns into dangerous reciprocation. Nearly all
stakeholders involved in collegiate sport could benefit from the findings of this study, as a better
understanding of the relationship between provocation and competitive anger and aggression in
sport is necessary.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
11
Methods
Participants
Participants were 243 (M = 124) male and female athletes from NCAA Division I, II, and
III universities throughout the continental United States. The age range of participants was
between 18-23 years. Participants were sampled from both contact and collision team sports. To
be considered a contact sport, in-game contact is allowed, but extreme contact or direct collisions
are not implicit or required by the rules of the sport (Keeler, 2007; Silva, 1983). For the purposes
of this study, men’s and women’s basketball, field hockey, women’s lacrosse, and men’s and
women’s soccer were all considered contact sports. For collision sports, collisions are necessary
and integral, and they are also considered a predesigned aspect of appropriate goal-directed
behavior in that sport (Keeler, 2007; Silva, 1983). Collision sports sampled for this study
included football, men’s lacrosse, men’s and women’s rugby, and men’s and women’s ice
hockey.
Research Design and Sampling
This study employed a quantitative, survey-based approach to investigate the
relationships between three phenomena of interest: 1) competitive anger, 2) aggressiveness, and
3) provocation in collegiate sport. The researcher used purposive sampling to select participants
who met the inclusion criteria for the study (Creswell, 2014). This criterion was being a current
NCAA Division I, II, or III athlete and competing in selected contact or collision sports. This
was also a sample of convenience due to the researcher using personal contacts at various
universities to gain access to athletes competing at those universities. Sampling began during the
2017 summer “off-season” period and ended in October of the Fall 2017 competitive season.
After the initial sampling period, additional attempts at recruiting participants were implemented
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
12
every two weeks. This entailed follow-up email reminders to coaches requesting that they pass
along the survey link to their athletes.
Instrumentation
Coaches were contacted via email and asked to forward the survey link to athletes on
their team (see Appendix C). If participants were willing to partake, they clicked on the survey
link to find an informational cover page (see Appendix D), followed by the online survey that
consisted of a short demographics questionnaire, a sports-based competitive anger and
aggressiveness assessment, and a provocation questionnaire. The order of the questionnaires was
randomized for participants to help reduce the possibility of an order effect (Creswell, 2014).
The provocation assessment was an original questionnaire that focused on the participant’s
experience of provocation during athletic competition. It was detailed in the participant cover
page that consent was implied by completing the online survey. All three sections of the online
survey was predicted to take approximately fifteen minutes to fill out.
Demographic questionnaire. The researcher used a demographic survey to gather the
following seven variables of interest: 1) age, 2) gender, 3) race/ethnicity, 4) year in school, 5)
type of sport, 6) name of university, and 7) NCAA division level. While some identifying
information such as school of enrollment was collected, all information was kept confidential
and secured online using password-protected software. Once downloaded, study data was stored
in encrypted files on the researcher’s personal computer. Demographic information was also
collected at the beginning of the survey, which has been shown to increase item response rate for
participants who begin the survey (Teclaw, Price, & Osatuke, 2011). (See Appendix E)
Competitive aggressiveness and anger. The Competitive Aggressiveness and Anger
Scale (CAAS; Maxwell & Moores, 2007) is a 12-item self-report questionnaire designed to
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
13
assess competitive anger and aggressiveness, or the tolerance of aggression and inclination to
aggress, in sport settings. The CAAS is divided into two subscales: a) anger, and b)
aggressiveness subscales, with six items in each subscale rated on a five-point Likert type scale
from 1=almost never to 5=almost always. A sample item from the anger subscale is: “I find it
difficult to control my temper during a match”. A sample item from the aggressiveness subscale
is: “It is acceptable to use illegal physical force to gain an advantage”.
Using confirmatory factor analysis (CFA), the authors reported good internal
consistencies for each subscale and the total scale score. These Cronbach alphas include: anger
(α = .78), aggressiveness (α = .84), and total (α = .87; Maxwell & Moores, 2007). These values
all fall within the generally accepted reliability levels as determined by Nunnally and Bernstein
(1994). Concurrent validity was established with subscales of the Buss-Perry Aggression
Questionnaire (BPAQ; Buss & Perry, 1992). In addition, the authors found adequate one-month
test-retest statistics for the subscales and total scale score. Discriminant validity was established
using peer perception of aggressive orientation. The anger and aggressiveness subscales were
also found to be moderately correlated to each other (e.g., α = .59 and .60), suggesting that they
are related but not too similar in nature. This is in agreement with literature that suggests a
relationship exists between anger and aggression (e.g., Buss & Perry, 1992; Maxwell, 2004), in
addition to a clear link with aggressiveness.
When crafting and examining the psychometric properties of the scale, the authors found
differences in gender and type of sport, with males and contact sport athletes reporting a higher
tendency to aggress than females and non-contact athletes (Maxwell & Moores, 2007). The
CAAS is one of the only known sport-specific scales to assess competitive anger and
aggressiveness in athletes. However, the factor structure of the CAAS has been found to be
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
14
replicable with both Americans and English-speaking Chinese athletes. It has been identified as
an appropriate way of assessing athletes most likely to display acts of aggression (Visek,
Maxwell, Watson, & Hurst, 2011). The CAAS was intended to be a trait measure, so it does not
take into account fluctuations in state anger and aggressiveness throughout an athletic
competition. Other limitations include that it lacks a social desirability check and was
constructed using a non-elite sample of athletes. (See Appendix F)
Provocation. To assess participants’ experience of provocation during competition, an
original questionnaire was utilized in this study. This questionnaire is based on the Provocation
in Sport Questionnaire (PSQ; Maxwell & Moores, 2006), which was a scale that contained six
short statements representing incidences of provocation that are common in sports. In the only
confirmed published study utilizing it, the PSQ was translated to use in Chinese (Maxwell,
Moores, & Visek, 2009). The scale measured the frequency at which respondents experienced
various types of perceived provocation and the corresponding self-reported intensity of
associated anger on five-point Likert type scales. The PSQ was the only known instrument to
study the experience of provocation in sport.
Unfortunately, the full version of the PSQ is no longer available for use as it cannot be
located. Instead, a new provocation questionnaire was created to assess the experience and
response of various incidences of provocation (i.e., verbal, gestures, and physical). The Sport
Provocation Questionnaire was constructed using the original PSQ by Maxwell and Moores
(2006) as a foundation, in addition to information collected from current and former athletes
about their experiences. The author’s own experiences and observations of athletic competition
also factored into the construction of the questionnaire. Specifically, the items assess the
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
15
frequency of experienced provocation, the frequency of one’s response to provocation, the level
of anger felt by provocation, and the intensity of one’s response to being provoked.
For each item, scores range from 1 (lowest) to 5 (highest). Higher scores represent greater
frequency of provocation and response to provocation, as well as more intense anger felt by
provocation. The intensity of provocation is assessed as ordinal data and will be analyzed
separately from the other categories of the questionnaire. An example of an item assessing
frequency of provocation is: “In competitive sports, how likely do you experience the following
types of verbal provocation? a) the use of curse words or verbal abuse; b) the use of racial/ethnic
slurs; c) the use of violent threats”. An example of an item assessing anger level from
provocation is: “In competitive sports, what is your level anger when an opponent: a)
aggressively or inappropriately touches you; b) purposefully shoves or trips you; c) punches or
kicks you; d) purposefully strikes you with an instrument (like a helmet or stick)”. (See
Appendix G).
Pilot study. After obtaining IRB approval, the sport provocation questionnaire was
piloted with a sample of twenty-two former high school and collegiate athletes. The mean age for
all participants was 25.23 (SD = 4.33); 7 participants were male. Nearly half (45.5%) of all pilot
participants played at the NCAA collegiate level, while the remaining played high school sports.
Just over two-thirds of participants (68.2%) played contact sports, while the second biggest
group (18.2%) played collision sports. The majority (63.4%) of participants played soccer, while
the rest played a variety of contact or collision team sports such as basketball, hockey, or
football.
All participants filled out the questionnaire based on their prior sport experiences
involving provocation. Open-ended feedback obtained from the pilot research was used to
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
16
improve the content and structure of the questionnaire and can be found in Appendix H. The four
provocation scales were found to have adequate internal reliability, and the scales were
moderate-highly correlated to each other (Field, 2009). These values suggest the scales are
related to each other but still assessing different concepts in the experience of provocation. This
information, in addition to the descriptive and correlational data obtained from the pilot study,
can also be found in the tables in Appendix H. At this time, no standardized assessment of
provocation in sport exists. With adequate internal reliability and sufficient face validity, it is
expected that this new questionnaire will help build the foundation for future research to explore
this important phenomenon.
Procedure
IRB approval was obtained before data collection began. Both assistant and head
coaches from selected sport teams were contacted via email to explain the study and request
participation from the athletes on their teams. As a small incentive, coaches were informed that
participation in the study would grant them access to a general summary of the study findings
once the researcher has compiled and analyzed all data. If they chose to participate, coaches were
asked to forward the Qualtrics survey link to all of the athletes on their team.
After the initial introductory email, all assistant and head coaches were contacted every
two weeks with follow-up emails requesting their athletes participate in the study. Towards the
end of the data collection period, a small number of other university athletic department
personnel (e.g., athletic director or sport psychology consultant) were contacted at some schools
to try to increase the sample size and generate adequate statistical power.
All participants who opened the survey link first saw an informative cover letter detailing
the purpose of the study and an explanation of participant rights (i.e., confidentiality, right to
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
17
withdraw at any time). There was also an option to print a copy of the cover letter for personal
records. If participants agreed to continue, they were then asked to enter basic demographic
information. Participants were then presented with online versions of both the CAAS and the
sport provocation questionnaire. Successful completion of the demographic information and two
surveys was predicted to take approximately fifteen minutes. Finally, the participants received
the primary investigator’s contact information so that participants could communicate with the
researcher about any issues related to the collection procedures, their data, or any other study
related concerns.
Data collection began during the summer off-season period but continued into the
competitive Fall 2017 season. The off-season was decided as the best time to sample since most
athletes were not as busy with school and training obligations. Collecting data at this time may
also have helped avoid any bias due to abnormally high or low frustration or anger being
experienced by athletes in the middle of the competitive season (for example, after a particularly
disappointing or successful game or overall season).
Data Analysis
A G*Power 3.1 analysis (Faul, Erdfelder, Lang, & Buchner, 2007) revealed
approximately 120 total participants would be the minimum sample size required to see a
significant gender effect at the 95% level. After an adequate sample was collected, data analysis
included both descriptive (e.g., frequencies, correlations, measures of central tendency, and
standard deviations) and inferential statistical tests (e.g., internal reliability analyses and
ANOVAs) to investigate the study hypotheses. All collected data was cleaned in Microsoft Excel
and entered into the IBM Statistical Package for Social Sciences version 24 (SPSS, 2016).
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
18
The independent variables in this study included gender and type of sport. These were
assessed on the demographic page. There are three dependent variables in the study:
1) competitive anger, 2) aggressiveness, and 3) provocation. These variables were assessed using
the CAAS and sport provocation online questionnaires. Frequencies, means, standard deviations,
and other descriptive data were calculated for demographic information such as age, gender,
race/ethnicity, school, division, and type of sport. Overall means and standard deviations were
calculated for all CAAS and provocation subscales. Standard bivariate correlations were also
calculated among gender, type of sport, and the competitive anger, aggression, and provocation
data.
There were two primary research questions in this study. The first was: “How does
competitive anger, aggressiveness, and experience of provocation vary among male and female
athletes?” The second primary research question was: “How does competitive anger,
aggressiveness, and provocation vary among contact and collision sport athletes?” These primary
research questions were examined using a general linear model (GLM) to run multiple one-way
analysis of variance (ANOVAs). To investigate the possibility of an interaction between the
independent variables of gender and type of sport, two-way ANOVAs was used. Two-way
ANOVAs helped answer the question of how scores on the dependent variables of CAAS or
sport provocation questionnaire scores differed by gender and type of sport.
For correlations, anger and aggressiveness subscale scores from the CAAS and
provocation subscale scores were run together in a correlational matrix to examine the strength
of the relationship between the variables. This was completed for the male and female data, as
well as type of sport, to compare correlation strengths among the different variables.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
19
Additional ad hoc analyses were completed to assess other study variables such as NCAA
Division level or year in school. For example, differences in anger, aggressiveness, and
experience of provocation were examined between NCAA Division I and Division III athletes.
No current research suggests there are anger or aggressiveness differences among NCAA
Division levels, but it is possible that at higher competitive levels, more competitive anger and
aggressive behavior is produced due to the rising stakes, pressure, and fanfare.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
20
Results
Demographics and Descriptive Statistics
A total of 243 NCAA athletes from 18 universities participated in the current study. From
the final data aggregate, any participants who completed less than 40% of the survey
questionnaire items were excluded from the final data analyses. The mean participant age was
19.53 (SD = 1.36). Participants were composed of 124 males and 119 females. At the time of
data collection, they were playing one of ten different male or female team sports that included
basketball, soccer, lacrosse, hockey, football, and rugby. Approximately 38% of participants
were freshmen, with 20% sophomores, 21% juniors, and 15% seniors. In addition, 5% of
participants identified as fifth-year seniors or graduate students. Over one-fourth (26%) of
participants were enrolled in NCAA Division I universities, with 29% attending Division II
schools and the remaining 44% attending Division III schools. Just over half (53%) of all
participants played contact sports, while the rest (47%) were involved in collision sports. This
demographic information is summarized in Table A1.
Subsequent to data collection, Cronbach’s alpha analyses of internal consistency were
calculated for the four provocation and CAAS scales (see Table B1). Review of these analyses
revealed that all four provocation scales had adequate internal consistency, and were moderate
highly correlated to each other (Field, 2009). These Cronbach’s alphas coefficients provided
evidence to support the interpretation that the scales are appropriately related to each other but
addressing different parts of the experience of provocation in collegiate sport. Internal reliability
analysis was also utilized for the six-item Anger and Aggressiveness subscales of the CAAS,
which were found to have moderate-high correlations.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
21
Data Cleaning and Assumption Testing
The following adjustments were made on the data in SPSS to ensure the ensuing bivariate
analyses were accurate. The first change was to code an additional “6” Likert-type response (i.e.,
N/A or have not experienced) as a discrete missing variable. This ensured that these responses
were not included in the standard scaled data for the provocation items. The second adjustment
was to multiply all of the CAAS scores by the proper mean intensity of each item (following the
procedures outlined by Maxwell & Moores, 2007). The authors conducted this step during the
development of the CAAS because individual items on the two subscales are not equally
weighted, with some impacting the anger or aggressiveness score more than other items. Finally,
a total score variable was created for both the CAAS and SPQ instruments. The CAAS total
score was created by summing the six-item Anger and Aggressiveness subscales. The
provocation total score was calculated as the average of the four provocation scales, using data
from participants who filled out at least three out of four mean responses. This decision was
made to ensure the anger level provocation subscale data was included despite having to code for
the “6” missing data choice. Overall, this resulted in a total of 18 participants being removed
from the final database before final analyses were conducted.
Before conducting inferential statistical analyses, the data were examined using SPSS to
ensure that it met the appropriate assumptions needed for valid two-way ANOVA results. The
assumptions of a continuous dependent variable, independence of observations, and independent
variables with categorical groups were all satisfied based on random sampling and the type of
variables (e.g., continuous, ordinal) utilized in the study. Using box and whisker plots (Field,
2009), only one outlier was identified from the CAAS Anger subscale data and five from the
CAAS Aggressiveness subscale data. These were not considered extreme outliers, (i.e., over
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
22
three times the Interquartile Range) so they were retained in the database. Up to three outliers
were identified for the four different provocation subscales, but these were also included in the
final data aggregate since they did not constitute extreme outliers that would likely have a
significant detrimental effect on the analyses.
The normality of the data was examined using kurtosis/skewness values as well as
histograms and Q-Q plots. Overall, the data for nearly all of the subscales followed a normal
distribution, with only slight departures from normality found on the CAAS Aggressiveness and
negative response to provocation subscale data. These departures consisted of slight floor effects,
meaning the subscales had a clear lower limit of possible participant’s responses. This caused a
larger than usual number of scores to congregate near this limit. However, ANOVA is known to
be particularly robust to violations of normality, so the analyses were carried out despite these
aforementioned slight departures. Levene’s test, as well as assessing the data spread vs. Q-Q
plots, was utilized to test the homogeneity of variances (Field, 2009). While the CAAS
aggressiveness and negative response to provocation subscales varied more than expected in
normally distributed data, the standard deviation spread was not large compared to the mean
differences. This suggested that running the ANOVA using the data would not be overly
problematic, and it would be unnecessary to run non-parametric tests of ANOVA.
Bivariate Statistics
The first primary research question in this study was: How does competitive anger,
aggressiveness, and the experience of provocation vary among male and female athletes? To
answer this question, a one-way between subjects ANOVA was conducted to compare scores on
the CAAS among male and female athletes (see Table C1). For all ANOVAs, SPSS was used to
calculate effect size, represented as partial eta square (η2). To compare magnitude of effect
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
23
sizes, rule of thumb values (small = .01, medium = .06, and large = 0.14) were used based on
recommendations set forth by Vacha-Haase and Thompson (2004). There was a statistically
significant effect of total CAAS score among gender [F(1, 237) = 23.68, p < 0.001, η2 = .091],
with males (M = 55.79, SD = 19.41) scoring significantly higher than females (M = 45.52, SD =
12.12).
Additional one-way between subjects ANOVAs were conducted to compare scores on
the CAAS Anger and Aggressiveness subscales by gender. There was no statistically significant
effect of CAAS Anger scores among gender [F(1, 241) = 1.35, p = 0.247, η2 = .006], although
males (M = 26.43, SD = 8.59) scored non-significantly higher than females (M = 25.23, SD =
7.47) (see Table C2). There was, however, a significant effect for CAAS Aggressiveness
subscale scores among gender [F(1, 237) = 46.27, p < 0.001, η2 = .163], with males (M = 29.36,
SD = 12.60) scoring significantly higher than females (M = 20.29, SD = 7.02) (see Table C3).
There was not a statistically significant effect of total SPQ score among gender [F(1, 217)
= 2.49, p = 0.12, η2 = .011], although males (M = 2.38, SD = 0.68) scored slightly higher than
females (M = 2.24, SD = 0.55) (see Table C4). However, when separated into the four
provocation subscales, statistically significant differences were found among all four provocation
subscales between male and female athletes. Specifically, males scored significantly higher than
females on frequency of provocation experienced, frequency of negative response to
provocation, and intensity of response to provocation. Females scored significantly higher than
males on anger felt from provocation (see Table C5).
The second primary research question in this study was: How does competitive anger,
aggressiveness, and the experience of provocation vary among contact and collision sport
athletes? To answer this question, a one-way between subjects ANOVA was conducted to
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
24
compare scores on the CAAS among type of sport (see Table C6). There was a statistically
significant effect for total CAAS score among type of sport [F(1, 237) = 31.17, p < 0.001, η2 =
.116], with collision sport athletes (M = 56.98, SD = 18.85) scoring significantly higher than
contact sport athletes (M = 45.35, SD = 13.13).
Additional one-way between subjects ANOVAs were conducted to compare scores on
the CAAS Anger and Aggressiveness subscales by type of sport. There was a statistically
significant effect for CAAS Anger subscale scores among type of sport [F(1, 241) = 4.04, p =
.046, η2 = .016], with collision sport athletes (M = 26.95, SD = 8.35) scoring significantly higher
than contact sport athletes (M = 24.88, SD = 7.72) (see Table C7). There was also a significant
effect for CAAS Aggressiveness subscale scores among type of sport [F(1, 237) = 52.25, p <
0.001, η2 = .181], with collision sport athletes (M = 30.03, SD = 12.30) scoring significantly
higher than contact sport athletes (M = 20.48, SD = 7.84) (see Table C8).
There was also a statistically significant effect for total SPQ score among type of sport
[F(1, 217) = 7.39, p = .007, η2 = .033], with collision sport athletes (M = 2.43, SD = 0.65)
scoring significantly higher than contact sport athletes (M = 2.21, SD = 0.57) (see Table C9). To
better understand what aspects of provocation were significantly different, one-way ANOVAs
were run for each of the four subscales of the SPQ. The results of these analyses can be found in
Table C10. Specifically, collision sport athletes scored significantly higher than contact sport
athletes on the frequency of provocation experienced and frequency of negative response to
provocation.
A two-way ANOVA was conducted to examine the effect of gender and type of sport on
total CAAS scores (see Table C11). The results of the two-way ANOVA provided evidence to
indicate there was no statistically significant interaction effect between gender and type of sport.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
25
This suggests that any total CAAS score differences between contact and collision sport athletes
were not dependent upon the gender identified with by the participants and that any total CAAS
score differences between females and males were not dependent upon which type of sport they
played.
A separate two-way ANOVA was conducted to examine the effect of gender and type of
sport on total SPQ scores (see Table C12). The results of the two-way ANOVA provided
evidence to support the notion that there was no significant interaction effect between gender and
type of sport. This indicates that any total SPQ score differences between contact and collision
sport athletes were not dependent on the gender identified with by the participants, and any total
SPQ score differences between male and female athletes were not dependent upon which type of
sport they played.
Statistical analyses regarding the division level of participants were not part of the
researcher’s original research questions. However, since data was collected from athletes in all
three NCAA division levels, additional statistical analyses were conducted to explore possible
differences among the dependent variables. There was a statistically significant effect of total
CAAS score among NCAA Division level [F(2, 236) = 4.96, p = .008, η2 = .040] (see Table D1).
Post hoc comparisons using the Tukey HSD test provided evidence to suggest that the mean total
CAAS score for Division I athletes (M = 54.74, SD = 19.21) was significantly higher than
Division III athletes (M = 47.11, SD = 14.36), but not Division II (M = 53.13, SD = 17.94)
athletes (see Table D2).
One-way, between subjects ANOVAs were conducted to compare scores on the CAAS
Anger and Aggressiveness subscales among NCAA Division level. There was a statistically
significant effect of CAAS Anger subscale scores among NCAA Division level [F(2, 240) =
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
26
5.48, p = .005, η2 = .044] (see Table D3). Post hoc comparisons were conducted using Tukey’s
HSD test (Field, 2009). The results of this analysis provided support for the interpretation that
the mean CAAS Anger subscale score for Division I athletes (M = 27.68, SD = 8.66) was
significantly higher than Division III athletes (M = 23.98, SD = 6.94), but not statistically
different from Division II (M = 27.01, SD = 8.60) athletes. Division II athletes were also found
to score significantly higher than Division III athletes on CAAS Anger subscale scores (see
Table D4). There was also a statistically significant effect for CAAS Aggressiveness subscale
scores among NCAA Division level [F(2, 236) = 3.12, p = .046, η2 = .026] (see Table D5). Post
hoc comparisons using Fisher’s LSD test (Field, 2009) indicated that Division I athletes (M =
27.16, SD = 12.50) scored significantly higher than Division III athletes (M = 23.05, SD = 9.79),
but not Division II (M = 26.05, SD = 11.80) athletes (see Table D6).
There were no statistically significant differences in total SPQ scores between NCAA
division levels [F(1, 216) = .574, p = .564, η2 = .005] (see Table D7). One-way between subjects
ANOVAs were conducted for all four provocation subscales to look for differences by NCAA
division level. As displayed in Table D8, no significant differences were found by division level
among any of the four provocation subscales.
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
27
Discussion
The primary goal of this study was to investigate and better understand competitive
aggressiveness, anger, and the experience of provocation in collegiate sport athletes. In
particular, it was important to understand if these variables differed among male and female
contact and collision sport athletes, and if any further differences occurred among NCAA
division level. Both male and female collegiate athletes participating in contact and collision
sports were surveyed electronically using questionnaires that assessed the variables of
competitive aggressiveness and anger, and the experience of provocation. The two hypotheses
proposed at the beginning of the study were that: 1) male athletes would score higher on the
CAAS anger and aggressiveness subscales, and would report experiencing (and responding
negatively to) more provocation than female athletes; and 2) collision sport athletes would score
higher on the CAAS anger and aggressiveness subscales, and would report experiencing more
provocation and more frequently responding to provocation than contact athletes.
Competitive Aggressiveness and Anger
Gender comparison. Based on the results of the current study, the first hypothesis was
partially supported. Male collegiate athletes scored significantly higher overall on the CAAS
than female athletes, and they were significantly more likely to tolerate aggressiveness and be
inclined to aggress in an athletic setting. However, while male athletes scored slightly higher on
competitive anger, this difference was not statistically significant. These findings point to the
notion that the amount of anger felt during competitive sports was not significantly different
based on gender. Some researchers have suggested that males are more prone to anger than
females (e.g., Maxwell & Moores, 2007; Maxwell, Visek, & Moores, 2009). However, the
results of the current study suggest that the female athletes in these types of sports may simply be
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
28
less likely to act on anger than male athletes. For example, female athletes were found to have
significantly higher anger levels from provocation by opponents, but males had more negative
and intense responses to the same types of provocative behavior. This finding seems to be in
disagreement with some previous research on high school tennis athletes who reported that male
and females tended to cope with anger in similar ways (Bolgar, Janelle, & Giacobbi, 2008).
The notion that male athletes are, in general, more inclined to aggress than female
athletes has been suggested in previous literature (e.g., Bredemeier, 1978; Coulomb-Cabagno &
Rascle, 2005; Maxwell, 2004). Even at the middle school level, some male athletes displayed
significantly more aggression off the field than female athletes, with participation in sport being
a risk factor for antisocial behavior (Burton & Marshall, 2005). Further, during the development
of the CAAS questionnaire, the authors found that male CAAS scores were higher than female
scores on both the Anger and Aggressiveness subscales (Maxwell & Moores, 2007). This result
was consistent for both contact and non-contact sport athletes. On the other hand, not all
researchers have found evidence to support the classic aggressive male athlete stereotype. For
example, Keeler (2007) found that males and females did not differ in hostile or instrumental
sport aggression, and this finding was consistent among non-contact, contact, and collision sport
athletes. However, males did score higher on questions assessing life assertion and assault
aggression. Overall, the finding that male athletes (regardless of sport type) displayed more
competitive aggressiveness is in agreement with most of the previous research on gender
differences in aggressive behavior.
The results of the current study parallel a number of findings from previous research
studies (Burton & Marshall, 2005; Coulomb-Cabagno & Rascle, 2006; Gardner & Janelle, 2002).
One example is males reporting that they were more inclined to aggress than female athletes,
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
29
regardless of what type of sport they played. However, unlike research conducted in the creation
of the CAAS (Maxwell & Moores, 2007), the current findings support the idea that male and
female college athletes are not significantly different in the amount of anger experienced in
competitive environments. It should be noted that Maxwell and Moores (2007) also utilized
participants from non-contact sports. Therefore, the current study is unique in that it is the first
known study to explore competitive aggressiveness and anger differences between only contact
and collision sport athletes. It is important to differentiate these types of sports from non-contact
ones, since contact and collision sport athletes compete as members of teams, in environments
that produce consistent physical contact with opponents.
The finding that males participating in contact and collision sports reported higher
competitive aggressiveness could have important implications for educational programs, such as
ones that focus on anger management skills. Aggression has been shown numerous times to be a
possible byproduct of anger, especially when anger is unable to be controlled (e.g., Feindler &
Ecton, 1994; Maxwell, Visek, & Moores, 2009; Robazza et al., 2006). While the male and
female athletes in the current study experienced similar levels of anger during competition, males
said that they would be more inclined to justify aggressive behavior as a means of dealing with
that anger. It appears that male athletes might benefit more from resources intended to teach
athletes other ways to deal with competitive anger, especially under the stressful conditions seen
in sport competition.
Sport type comparison. The second hypothesis was supported based on the findings of
the current study. Collision sport athletes were found to have significantly higher competitive
aggressiveness and anger than contact sport athletes. This finding was consistent irrespective of
gender. What seems to be one of the clearest predictors of competitive aggressiveness and anger
AGGRESSIVENESS, ANGER, AND PROVOCATION IN SPORT
30
is the type of sport an athlete plays. Although all sports involved in the current study featured
contact between opponents, the key difference between collision and contact sports is that the
latter allows in-game contact, but extreme contact or direct collisions are not implicit (or
required) by the written rules of the sport (Keeler, 2007; Silva, 1983). In contrast, collision sports
generally involve high-speed collisions as an integral part of the sport. Simply put, they are
necessary to achieve appropriate goals needed for success.
A few previous studies have prod
Being Mindful of Perfectionism and Performance Among Athletes in a Judged Sport : Being Mindful of Perfectionism and Performance Among Athletes
in a Judged Sport
Erika D. Van Dyke
edv0001@mix.wvu.edu
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(2019). Graduate Theses, Dissertations, and Problem Reports. 7428.
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Being Mindful of Perfectionism and Performance Among Athletes in a Judged Sport
Erika D. Van Dyke
Dissertation submitted
to the College of Physical Activity and Sport Sciences
at West Virginia University
in partial fulfillment of the requirements for the degree of
Doctor of Philosophy in
Sport, Exercise, and Performance Psychology
Sam J. Zizzi, Ed.D., Chair
Scott Barnicle, Ph.D.
Edward F. Etzel, Ed.D.
Aaron Metzger, Ph.D.
Department of Sport Sciences
Morgantown, West Virginia
2019
Keywords: mindfulness, perfectionism, performance, personality, elite athletes,
sport psychology
Copyright 2019 Erika D. Van Dyke
ABSTRACT
Being Mindful of Perfectionism and Performance Among Athletes in a Judged Sport
Erika D. Van Dyke
Literature pertaining to mindfulness and perfectionism in sport has expanded greatly in recent
years. However, little research has integrated mindfulness and perfectionism, particularly within
sports where athletes are judged on performance to a standard of perfection. The current study
had two primary aims: (1) to explore profiles of mindfulness and perfectionism among
intercollegiate gymnasts through a person-centered approach, and (2) to analyze differences in
objective performance measures across the resulting profiles. The analytic sample consisted of
244 NCAA gymnasts representing NCAA Division I, II, and III institutions. Gymnasts
completed self-report measures of mindfulness and perfectionism. Competitive performance
records (i.e., national qualifying scores) were then gathered for participating gymnasts. Cluster
analyses revealed a three-cluster solution: a moderate mindfulness, high perfectionism profile; a
low mindfulness, low/moderate perfectionism profile; and a high mindfulness, very low
perfectionism profile. Although competitive performance differences were not observed among
the three profiles, exploratory post hoc pairwise comparisons indicated potential performance
differences on vault and bars. Interestingly, gymnasts in different profiles performed more
favorably on each event. Small to moderate effect size estimates provide some evidence that
perfectionism may be adaptive to gymnastics performance. Elite level gymnasts were
represented across three distinct profiles, suggesting that more than one profile of characteristics
may be adaptive for reaching high levels of performance. Further, the sport context might be
considered when interpreting the practical significance of the findings. The results can be used to
help coaches, researchers, and practitioners better understand how mindfulness and
perfectionism are expressed among athletes in a judged sport, and how these tendencies may be
impactful in different ways. Future research exploring determinants of performance and mental
health concurrently could provide further understanding of whether the characteristics that
facilitate performance are congruent with those that facilitate wellbeing.
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
iii
Acknowledgements
Many people have crossed the path of my life during this project, and I will be forever grateful
for the indelible footprints they have left there. Some of those people have simply left deeper
imprints than others. These words acknowledge my gratitude for your presence on my journey.
I would like to share an immense amount of appreciation for my advisor, Dr. Sam Zizzi. Thank
you for extending me an invitation to join this esteemed doctoral program. Your supportive
guidance and mentorship throughout this climb up research mountain has been invaluable, and
has allowed me to grow as a scholar and more importantly as a person. Thank you for always
inviting my curiosity, for your patience with my “thorough” process, for your white board check
boxes of accountability, and for your gentle nudges to step back and get some perspective every
so often. You have a remarkable way of seeing each of your students for who they are as
learners. Thank you for seeing me. You have helped me to embrace the value in letting go, in
imperfection, and in embracing my sunshine. Thank you for walking every step of the path along
with me. The view from the top of this climb is spectacular.
I would also like to thank Dr. Aaron Metzger for his incredible knowledge of the world of
multivariate statistics. You provided the foundational learning that inspired many of the
statistical directions taken throughout the course of this research project. Thank you for
challenging me to explore interesting and complex questions, for making statistics accessible,
and for giving me the skills and confidence necessary to carry out the analyses contained within
these pages. I so appreciate you joining me for this glimpse into the experiences of athletes.
My dissertation committee members, Dr. Etzel and Dr. Barnicle, have been such wonderful
sources of support throughout this project and more broadly throughout my time here in the halls
of CPASS. Thank you, Dr. Etzel , for greeting me each day with, “Ah little miss sunshine.” Your
endearing reminders to “be well, and do good work,” to “walk between the raindrops,” and to
know that “we’ll keep the light on for you” always made me smile and feel a valued member of
our learning community. Your lovely words of wisdom and encouragement have and continue to
mean so much to me. I am grateful to have been among the many students whose lives you have
touched. Thank you, Dr. Barnicle, for always keeping your door open to my many many
questions – often multiple in a given day. You have been such a supportive mentor, both in this
project and in my growth as a teacher and consultant. I appreciate you being there for me
throughout this learning journey.
I am forever grateful that Dr. Zizzi crossed our paths, Candice (Clay) Brown. Thank you so
incredibly much for the generous time and energy that you devoted to helping with my research
project. From thoughtfully entering and checking data, to playing with statistical analyses, to
reading drafts of the document, to presenting a poster together during CPASS research day. Your
enthusiasm, dedication, and desire to learn and grow is inspiring, and I appreciate you lending
some of your sparkle to our collaboration. Your presence throughout this project has been a
blessing, and has brought me the joy of beginning my journey as a mentor. Thank you for your
support. I am so excited to see what your very bright future will hold.
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
iv
Thank you to all of the faculty in our Sport, Exercise, and Performance Psychology program for
your belief in me, and for giving me the opportunity to pursue this path. One of the things that
drew me here to WVU was the learning community cultivated by faculty and embraced by
students in our program. I appreciate the legacy that you have built, and am so glad to have had
the opportunity to be a part of this place.
To my SEPP family. Thank you for your endless support, encouragement, smiles, and hugs
throughout this journey, especially on days when the process felt daunting. A special note of
appreciation for my cohort members, Adam, Carra, and Seth. What an amazing group of people
with whom to share this experience. I am so grateful to have created so many memories with
each of you – thank you for touching my life. I will continue to do my best to supply the
sunshine and rainbows.
A very special thank you must be extended to the roommates who have helped make this place
feel like home during these past four years. Tammy, you led the way and I can only hope to
follow in your footsteps to become a real professor someday. Carra, I am beyond grateful to be
doing this journey along with you. Thank you for sharing all the laughs, tears, and moments of
growth with me. I will forever remember our road trip to New York just after our first semester
as doctoral students, and making a pact to do this thing together all the way through. We are so
close now #HancockPact. Matt and Jordan (and Hunter), thank you for welcoming me into your
little family these past three years, and for making Morgantown feel a little more like Northern
California. I love you all.
Thank you to my partner, Ben, for his love, laughter, and support. What a ride this has been!
Whether living together or at a distance, your belief in me has shaped the course of this journey
in a beautiful way. I appreciate you for your love of learning, endless curiosity, and for always
being there by my side to go chasing waterfalls. Here’s to the adventure ahead.
On a final note, to the people who gave me life, who instilled in me a joy of learning, and who
have been my foundation through it all – my parents, Ivan and Anne Marie. I appreciate your
unconditional love and support of my aspirations more than these simple words can express.
Thank you for always believing that I can accomplish anything I set my mind and heart toward.
You two are the best cheerleaders and consultants a daughter could ever wish for. I am so lucky
you picked me.
“And now that you don’t have to be perfect, you can be good.” – John Steinbeck
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
v
Table of Contents
Introduction…………………………………………………………………………….………….1
Pilot Study…………………………………………………………………………………………7
Method……………………………………………………………………………………….……8
Research Design and Sampling……………………………………………………………8
Instruments………………………………………………………………………………...8
Mindfulness……………………………………………………………………….8
Perfectionism………………………………………………………………….…...9
Demographic Questionnaire……………………………………………………...10
Competitive Gymnastics Performance…………………………………………...10
Procedures……………………………………………………………………………...…11
Statistical Analyses……………………………………………………………………….11
Results……………………………………………………………………………………………13
Determining the Analytic Sample………………………………………………………13
Descriptive Statistics on the Analytic Sample………………………………………….14
Cluster Interpretation…………………………………………………………………..15
Comparing Performance Across Clusters………………………………………………16
Discussion………………………………………………………………………………………..17
Tables and Figures………………………………………………………………………………..27
Literature Review……………………………………………………………………….………..31
Mindfulness: A Brief Backdrop………………………………………………………….31
Historical Roots…………………………………………………………………..32
Mindfulness-Based Approaches……………………………………………….....33
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
vi
Mindfulness in Sport and Performance Psychology…………………………………….34
Mindfulness-Based Approaches in Sport………………………………………..35
Linking Mindfulness-Based and Traditional PST Approaches…………………37
Mindfulness, Performance, and Psychological Aspects of Sport……………….39
Perfectionism in Sport and Performance Psychology…………………………………..56
Measurement……………………………………………………………………………66
Mindfulness………………………………………………………………….….66
Perfectionism…………………………………………………………………….70
Performance……………………………………………………………………...75
Directions for Future Research……………………………………………………..........77
References………………………………………………………………………………………..82
Table 1: Mindfulness Measurements…………………………………………………………….95
Table 2: Perfectionism Measurements…………………………………………………………...96
Table 3: Adapted Mindfulness-Flow-Performance Model in Sport………………………………97
Appendix A: Athlete Mindfulness Questionnaire………………………………………………..98
Appendix B: Sport Multidimensional Perfectionism Scale-2…………………………………...100
Appendix C: Demographic Questionnaire……………………………………………………...102
Appendix D: Email to Gymnastics Coaches…………………………………………………….104
Appendix E: Cover Letter and Informed Consent……………………………………………….105
Appendix F: IRB Approval……………………………………………………………………..106
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
1
Introduction
Researchers studying mindfulness and acceptance-based evidence among athletes support
a cautious yet optimistic view regarding the efficacy of such approaches in the context of sport
(e.g., McAlarnen & Longshore, 2017; Noetel, Ciarrochi, Van Zanden, & Lonsdale, 2017;
Sappington & Longshore, 2015). In a recent systematic review, Noetel et al. (2017) analyzed
over 60 studies of mindfulness and acceptance-based approaches intended to promote positive
sport outcomes, including athletic performance. Despite finding large effect sizes for the
performance benefits of such interventions, the findings were deemed low in quality, lacking
precision in effect sizes and consistency. Among the individual studies reviewed, researchers
found preliminary support for mindfulness and acceptance-based interventions across a variety
of sport outcomes (e.g., performance, flow, present-moment awareness, confidence, injury
prevention, competitive anxiety, and burnout). Continued research efforts with increased rigor
are thus needed to support mindfulness as an approach for enhancing sport performance and
related outcomes.
At their core, mindfulness and acceptance-based approaches focus on modifying the
relationship one has with internal experiences (e.g., physical sensations, emotions, cognitions),
rather than deliberately aiming to change, consciously control, suppress, or reduce internal
experiences (e.g., Gardner & Moore, 2004, 2007; Hayes, Strosahl, & Wilson, 1999; Kabat-Zinn,
1982). Such mindfulness approaches cultivate present-focused awareness and attention, a
nonjudgmental and accepting approach to situations, openness and curiosity toward experience,
and compassion for self and others – elements that comprise the flavor of mindfulness (Zizzi,
2017). Recognizing the applicability of mindfulness-based approaches to the context of sport,
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
2
researchers examined the link between mindfulness and objective measures of sport performance
using a variety of study designs.
In support of a mindful approach to facilitating sport performance, researchers found that
a greater number of athletes who engaged in a mindfulness and acceptance-based program
improved their national performance ranking compared to those who took part in a traditional
change-based program (Bernier, Thienot, Codron, & Fournier, 2009). Authors of another study
found that elite shooters in a mindfulness meditation group experienced significant increases in
shooting performance (i.e., mean performance score increase from 528 to 544, SD = 13) and
significant decreases in pre-competition anxiety (i.e., mean salivary cortisol level decrease from
1.33 to 0.66, SD = 0.07) from pre- to post-test compared to a control group (John, Verma, &
Khanna, 2011). In a non-intervention study, Gooding and Gardner (2009) found that collegiate
athletes’ levels of mindfulness significantly predicted basketball free throw shooting percentage
in games across the competitive season (i.e., one standard deviation increase in mindfulness
scores resulted in a 5.75% increase in free throw shooting percentage). When competitive
experience was controlled for, however, mindfulness no longer arose as a significant predictor of
competitive performance. Gooding and Gardner noted that competitive experience and
mindfulness may predict sport performance through shared variance. Taken together, researchers
suggest that mindfulness may influence objectively measured performance in sport among high
level athletes. Further research may provide additional clarity regarding the utility of
mindfulness for real-world competitive performance.
As mindfulness research continues to evolve, studies that take a more nuanced approach
to studying the mindfulness-performance relationship are needed. These kinds of studies can
clarify how, when, and by whom mindfulness could be most useful. In a sport like gymnastics
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
3
for instance, in which athletes are judged to a standard of perfection in their skills and technique,
perfectionism may be considered contextually relevant to the study of mindfulness-performance
relationships. Thus, the study of mindfulness and perfectionism among judged sport athletes may
provide more nuanced insights regarding how these constructs are experienced together among
individuals, and how those unique experiences may be related to individual differences in sport
performance.
Perfectionism has been defined as “a personality disposition characterized by striving for
flawlessness and setting exceedingly high standards for performance, accompanied by tendencies
for overly critical evaluations” (Stoeber, 2012, p. 294). Although different frameworks of
perfectionism have been proposed in the literature (e.g., Frost, Marten, Lahart, & Rosenblate,
1990; Hewitt & Flett, 1991), researchers acknowledge that perfectionism is a multidimensional
construct. Stoeber and Otto (2006) provided a way to conceptually integrate different proposed
frameworks based on two higher-order dimensions of perfectionism – perfectionistic strivings
and perfectionistic concerns. Although a point of some debate among perfectionism researchers
in recent years (e.g., Flett & Hewitt, 2005), perfectionistic strivings have often been considered
adaptive and facilitative of performance, whereas perfectionistic concerns have often been
considered maladaptive and debilitative of performance in sport (e.g., Gotwals, Stoeber, Dunn &
Stoll, 2012; Stoeber, 2012). In a recent meta-analytic review of multidimensional perfectionism
in sport, the researchers further highlighted the complexity of these relationships, noting that
perfectionistic concerns seem to be clearly maladaptive, while perfectionistic strivings may be
adaptive or maladaptive for athletes (Hill, Mallinson-Howard, & Jowett, 2018). Considering
potential contrasts between elements of perfectionism (e.g., self-critical evaluations) and
elements of mindfulness (e.g., acceptance and self-compassion), further research integrating the
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
4
two constructs is needed to understand how mindfulness and perfectionism may interact in
athletes’ experiences.
Many researchers have examined relationships between perfectionism and competitive
sport performance among high level athletes (e.g., Gotwals et al., 2012; Hill et al., 2018).
Relatively few researchers, however, have explored the intersection of mindfulness and
perfectionism in sport. In their follow-up study of the long-term impact of mindfulness-based
programming for sport performance, Thompson, Kaufman, De Petrillo, Glass, and Arnkoff
(2011) found significant performance improvements in long-distance runners’ mile times from
pre- and posttest to follow-up. In addition, the authors found negative associations between
performance improvements and aspects of perfectionism, including overall trait perfectionism (r
= .74), concern over mistakes (r = .69), and doubts about actions (r = .75). It is important to note
that negative relationships are reflected in the positive correlations reported because performance
improvement is measured through decreased mile time. Although the links between mindfulness,
perfectionism, and performance should be interpreted with care due to the correlational nature of
the study, Thompson et al. (2011) support the notion that mindfulness may be related to
performance benefits, and that certain dimensions of perfectionism may negatively influence
athletic performance.
A recent critical evaluation of mindfulness research has raised questions regarding the
varied definitions and measurements of mindfulness found in the literature, as well as the
proposed, seemingly unquestioned, benefits of mindfulness without regard for potential adverse
effects (Van Dam et al., 2018). Rather than leaping with naïve enthusiasm into the application of
mindfulness interventions within a new population, researchers might first aim to understand the
typical mindfulness experiences of those athletes. Taking a person-centered analytic approach to
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
5
the study of mindfulness may help bring that explicit attention to salient features of mindfulness
among athletes in a specific sport setting. Further, new insights gained about the athletes’
mindfulness experiences will be highly influenced by the specific core concepts measured in the
selected instruments. Considering the work of Van Dam et al. (2018), researchers are encouraged
to clearly define the flavor(s) of mindfulness assessed to enhance interpretability of future
research findings.
Person-centered approaches to data analysis allow the researcher to better understand
unique profiles of the key constructs measured among individuals. Although person-centered
approaches have been used in the study of mindfulness (e.g., Kee & Wang, 2008) and
perfectionism (e.g., Gucciardi, Mahoney, Jalleh, Donovan, & Parkes, 2012), these constructs
have yet to be studied concurrently through cluster analytic approaches. In their person-centered
approach to the study of mindfulness in sport, Kee and Wang (2008) identified a four-cluster
solution based on university athletes’ mindfulness scores (Mindfulness/Mindlessness Scale,
MMS; Bodner & Langer, 2001). Individuals in the profile highest in mindfulness showed the
most frequent use of psychological skills in sport. Specifically, athletes in the cluster highest in
mindfulness had significantly higher goal setting, positive self-talk, and imagery compared to
those in clusters lower in mindfulness characteristics. In addition, the researchers found
significant differences in flow dispositions across the four mindfulness clusters. Thus, Kee and
Wang identified a stable mindfulness cluster solution, and found significant differences among
those mindfulness profiles on the outcome variables of psychological skill use and flow
dispositions.
Along this line of person-centered research, Gucciardi et al. (2012) explored profiles of
perfectionism within a heterogeneous sample of elite athletes through a cluster analytic
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
6
approach. The researchers found three distinct profiles of perfectionism among athletes based on
the Sport Multidimensional Perfectionism Scale (Sport-MPS; Dunn, Causgrove Dunn, &
Syrotuik, 2002): (1) adaptive perfectionists – high personal standards, low concern over
mistakes, moderate perceived parent/coach pressures, (2) maladaptive perfectionists – high
concern over mistakes and perceived parent/coach pressures, moderate/high personal standards,
and (3) non-perfectionists – low personal standards and concern over mistakes, moderate
perceived parent/coach pressures. Gucciardi et al. further revealed significant differences in
motivational orientations among the perfectionism profiles. Specifically, adaptive perfectionists
reported significantly lower levels of fear of failure, performance approach and avoidance goals,
and mastery avoidance goals, and significantly higher levels of mastery approach goals than did
maladaptive perfectionists. Non-perfectionists reported significantly lower levels of the
motivational orientations assessed than did maladaptive perfectionists, and lower levels of
mastery approach goals, performance approach goals, and intrinsic motivation than did adaptive
perfectionists. The researchers thus supported a stable three cluster conceptualization of
perfectionism, and found differences in motivational outcomes across those perfectionism
profiles. Gucciardi et al. highlighted that among these elite athletes both adaptive and
maladaptive perfectionists had high levels of personal standards, and that it was primarily the
presence or absence of overly critical self-evaluations that differentiated maladaptive from
adaptive perfectionists, respectively.
Many existing studies that have examined mindfulness and links to performance
outcomes have done so following programming and interventions (e.g., John et al., 2011;
Thompson et al., 2011). Little research has explored athletes’ typical tendencies toward
mindfulness and perfectionism qualities, and how together these characteristics may relate to
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
7
performance in unique ways. The current study will thus explore mindfulness, perfectionism, and
performance among gymnasts – athletes in a judged sport. Aims of the research will be twofold:
(1) to examine whether unique profiles of mindfulness and perfectionism constructs exist among
the athlete participants, and (2) to assess whether objective measures of competitive performance
differ across the unique mindfulness and perfectionism profiles.
Pilot Study
The purpose of the pilot study was to assess the psychometric properties of mindfulness
and perfectionism measures, and to explore relationships between mindfulness and perfectionism
among intercollegiate gymnasts. Participants were female gymnasts (N = 301), ranging in age
from 18 to 22 years (M = 19.46, SD = 1.20), who attended NCAA Division I, II, or III colleges
and universities in the United States. Gymnasts completed the Athlete Mindfulness
Questionnaire (AMQ; Zhang, Chung, & Si, 2017), and the personal standards and concern over
mistakes subscales of the Sport Multidimensional Perfectionism Scale-2 (i.e., Sport-MPS-2;
Gotwals & Dunn, 2009). Results of the correlational analyses supported theoretically expected
associations among constructs (e.g., present-moment attention and awareness, r = .62;
acceptance and concern over mistakes, r = -.41), and internal reliability coefficients across the
mindfulness and perfectionism subscales ranged from .74 to .88. Confirmatory factor analyses
supported the original three-factor structure of the AMQ [RMSEA = .06, SRMR = .05, CFI =
.92]. The two-factor perfectionism model did not show good fit to the data. Modification indices
were reviewed to evaluate potential model fit improvements. When residual error terms of items
in the concern over mistakes factor were allowed to covary, the two-factor model fit improved
markedly [RMSEA = .08, SRMR = .08, CFI = .91]. Through the pilot study, the research team
supported the use of the AMQ among intercollegiate level gymnasts, and provided further
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
8
understanding about relationships between mindfulness and perfectionism among athletes in a
judged sport context.
Research Design and Sampling
Method
The current study built upon the pilot study to explore mindfulness, perfectionism, and
performance using a quantitative, descriptive correlational, research design. Female gymnasts 18
years of age or older attending National Collegiate Athletic Association (NCAA) Division I, II,
or III colleges and universities in the United States who took part in the pilot study also
participated in the present study. Prior to the pilot study, convenience sampling was used to
contact all NCAA collegiate women’s gymnastics coaches with available contact information to
seek permission to collect data with their teams. Gymnasts who previously completed the survey
and reported their name were included in the first part of the study exploring mindfulness and
perfectionism profiles. Participants who performed on at least one event during the 2019
competition season from January to April, and for whom a National Qualifying Score (NQS)
could be calculated, were included in the second part of the study assessing performance
differences among the resulting profiles.
Instruments
Mindfulness. The Athlete Mindfulness Questionnaire (AMQ; Zhang et al., 2017) was
used to measure mindfulness in the current study. The AMQ is a 16-item, 3-factor measure of
mindfulness for athletes. Mindfulness is assessed based on the subscales present moment
attention (e.g., When I find myself distracted, I gently bring my attention back to my training),
awareness (e.g., I am aware that my emotions during training and competition can influence my
thinking and behavior), and acceptance (e.g., During training and competition, it doesn’t matter
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
9
if the situation is good or bad, I can accept myself for who I am). Items are rated on 5-point
Likert scales ranging from 1 (never true) to 5 (always true). Confirmatory factor analysis (CFA)
revealed satisfactory fit indices for the 16-item, 3-factor structure of the instrument, X2(101) =
221.28, p < .001, CFI = 0.95, TLI = 0.94, WRMR = 1.04, RMSEA = 0.06. Internal consistency
reliabilities for the three AMQ subscales ranged from 0.64 to 0.76. In the present study, internal
consistency reliabilities for the subscales were slightly higher, ranging from 0.75 to 0.77.
Convergent validity for the AMQ was supported through significant positive associations
between the present moment attention, awareness, and acceptance subscales of the AMQ and
mindfulness as measured by the Mindful Attention Awareness Scale (MAAS; Brown & Ryan
2003). Concurrent validity for the three subscales of the AMQ was also supported through
significant negative relationships with burnout and experiential avoidance, and significant
positive relationships with well-being, positive affect, and dispositional flow.
Perfectionism. The full version of the Sport Multidimensional Perfectionism Scale-2
(Sport-MPS-2; Gotwals & Dunn, 2009; Gotwals, Dunn, Causgrove Dunn, & Gamache, 2010) is
a 42-item, 6-factor measure assessing the multidimensional nature of perfectionism in sport. The
subscale dimensions include personal standards, concern over mistakes, perceived parental
pressure, perceived coach pressure, doubts about actions, and organization. Items are rated on 5
point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). Athletes are asked to
report how they “view certain aspects of their competitive experiences in sport.” For the purpose
of the present study, two subscales, namely personal standards (e.g., It is important to me that I
be thoroughly competent in everything I do in my sport) and concern over mistakes (e.g., I
should be upset if I make a mistake in competition), were used to measure the two higher-order
constructs of perfectionistic strivings and perfectionistic concerns, respectively. The personal
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
10
standards and concern over mistakes subscales were selected because they have been
recommended as indicators of perfectionistic strivings and perfectionistic concerns in sport
(Stoeber & Madigan, 2016). The reliability of the Sport-MPS-2 has been demonstrated among
athletes, with internal consistencies of .74 and .79 for the personal standards and concern over
mistakes subscales, respectively (Gotwals & Dunn, 2009). In the current study, internal
consistency reliabilities for the personal standards and concern over mistakes subscales were .77
and .88, respectively.
Demographic questionnaire. The demographic questionnaire assessed participants’
age, highest level in gymnastics attained before college, race, and ethnicity. Gymnast participants
were asked to report their name, and the college or university they attend so the research team
could access their publicly available competition scores from an online platform. Experience and
satisfaction working with a sport psychology professional, as well as experience with
mindfulness, were also assessed. All identifiable information was held confidential, and all data
gathered for the study was reported in aggregate to protect the anonymity of participants.
Competitive gymnastics performance. Measurement of competitive gymnastics
performance was based on the National Qualifying Score (NQS). The NQS is used in collegiate
gymnastics to determine placement in post-season competition, and is calculated based on the
following criteria: (1) three highest away scores on a given event, plus (2) next three highest
scores on a given event, whether home or away, (3) drop the highest of the six scores, (4)
average the remaining five scores. An NQS was calculated for each gymnast who participated in
the study for each event on which she competed during the regular meet season to allow for
comparison of mindfulness – perfectionism – performance relationships across events (i.e., vault,
uneven bars, balance beam, floor exercise).
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
11
Procedures
After gaining approval from the Institutional Review Board (IRB) to conduct the research
methods necessary for both the pilot and current studies, the researcher contacted college
gymnastics coaches through email correspondence to request permission to collect data with
their athletes. Coaches had the option to receive either paper copies of the counterbalanced
questionnaires via mail, or a Qualtrics link to an online version of the questionnaires via email.
Coaches then made the surveys available to their athletes to complete on a voluntary basis. All
athletes receiving the survey were initially presented with a cover letter description of the study,
and were asked to provide their consent to participate. Survey data were collected prior to, or in
the beginning of, the competition season for each participant. All data were reported in
aggregate, and any identifying information collected in the surveys was used for the sole purpose
of accessing the gymnasts’ publicly available competitive performance data. Event scores
ranging from 0.00 to 10.00 were retrieved online post-season from
https://roadtonationals.com/results/standings/ for gymnasts who completed the questionnaires
and who performed in a sufficient number of competitions throughout the season to have an
NQS on at least one event.
Statistical Analyses
For the pilot study, data cleaning and preliminary analyses were conducted and reviewed
to determine whether necessary assumptions for the substantive analyses were met. Missing
values across the mindfulness and perfectionism items were assessed using Little’s MCAR test
(p = .769), and no single item exceeded 1.3% missing data. Due to the low number and random
nature of missing values, Expectation-Maximization (EM) procedures were then used to impute
missing values. As expected, the gymnastics performance data on each of the four events were
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
12
negatively skewed. Reflection and log base 10 transformation approaches improved the
distribution of scores for use in later parametric statistical analyses. For the current analytic
sample, descriptive statistics were calculated on demographic and key study variables. Internal
consistency reliabilities were also assessed for the measures, as were correlational analyses for
the performance data and each of the subscales in the mindfulness and perfectionism
instruments.
For the current study, cluster analytic approaches were conducted to establish whether
unique profiles of mindfulness and perfectionism were present among the gymnast participants.
Gymnasts’ scores on the three mindfulness and two perfectionism subscales were submitted to
cluster analysis in a two-step procedure: (1) Ward’s hierarchical cluster analysis with squared
Euclidean distance was conducted to help determine an initial number of clusters present among
the participants, and (2) k-means iterative cluster analysis was used to further refine the cluster
solution suggested by the initial hierarchical cluster analysis. The use of both hierarchical and
iterative approaches to cluster analysis is supported in the literature (e.g., Gucciardi et al., 2012;
Hair, Anderson, Tatham, & Black, 1998; Kee & Wang, 2008). A series of chi square analyses
were then carried out to assess the number of athletes in each cluster who performed on each
gymnastics event. This step allowed the research team to determine whether a sufficient sample
size for each cluster/profile was met prior to conducting subsequent analyses. One-way analysis
of variance (ANOVA) was then used to assess differences among the resulting
mindfulness/perfectionism clusters in an objective measure of gymnastics performance (i.e.,
NQS) on each competitive event. Thus, four one-way ANOVAs were conducted to examine
competitive performance differences across the clusters on each gymnastics event (i.e., vault,
uneven bars, balance beam, floor exercise). Effect size estimates are reported as partial eta
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
13
squared for the ANOVA models, and as Cohen’s d for pairwise mean comparisons. All statistical
analyses were computed in recent versions of SPSS.
Results
Of the total number of participants who completed the mindfulness and perfectionism
survey measures (N = 301), 244 gymnasts provided their name. It was only possible to access
competition results for athletes who provided their names. Thus, the analytic sample for the
current study was 244 gymnasts.
Determining the Analytic Sample
Prior to conducting the substantive analyses for the study, the research team conducted a
series of preliminary analyses to assess potential differences between participants who would be
retained in the analytic sample (n = 244) and those who would be omitted from the sample (n =
57) on demographic and key study variables. T-tests indicated no statistically significant (p >
.05) differences between the gymnasts on the three mindfulness subscales. Statistically
significant (p < .05) differences were found, however, between the participants on the two
perfectionism subscales. Gymnasts who did not report their name indicated slightly higher
perfectionism scores than those who did report their name for both concern over mistakes (no
name: M = 3.18, SD = 0.78; name: M = 2.87, SD = 0.82) and personal standards (no name: M =
3.88, SD = 0.55; name: M = 3.61, SD = 0.58) subscales. Gymnasts who did not report their name
were also slightly higher in skill level than the larger group of participants who did provide their
name (mean difference = 0.22).
Given these differences, cluster analyses were conducted for both the full (N = 301) and
analytic (N = 244) samples. Chi square analyses were then assessed to determine the proportion
of athletes in each cluster who did and did not report their name. Although gymnasts who did not
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
14
provide their name were disproportionately found in clusters high in perfectionism dimensions,
parallel to the findings of the t-tests, the resulting cluster solutions were similar between the two
samples, indicating that the gymnasts who omitted their name were likely not driving the cluster
solution. The research team thus decided to move forward in reporting the cluster solution
established with the analytic sample of gymnasts who provided their name (N = 244), and who
would be included in the subsequent analyses incorporating performance data.
Descriptive Statistics on the Analytic Sample
Demographic information for the analytic sample of collegiate gymnasts is presented in
Table 1. Gymnasts in the present study ranged in age from 18 to 22 years (M = 19.46, SD = 1.22)
and were predominantly white (n = 196). A majority of the gymnasts reached level 10 prior to
college (n = 204), had previous experience with a sport psychology professional (n = 162) and
were satisfied with their experience (n = 130), and came into the study with no prior experience
with mindfulness (n = 150).
Correlations, descriptive statistics, and internal consistency coefficients for the
mindfulness and perfectionism subscale scores are outlined in Table 2. As expected, statistically
significant (p < .01) positive correlations arose among the three mindfulness subscales, and
between the two perfectionism subscales. Significant, weak positive correlations were also found
between personal standards perfectionism and both present moment attention (r = .28) and
awareness (r = .16); yet there was no relationship between personal standards and acceptance (r
< .01). Significant negative correlations arose between concern over mistakes perfectionism and
each of the mindfulness subscales, though only one was moderate in size: present moment
attention (r = -.14), awareness (r = -.15), and acceptance (r = -.42). The negative relationships
between mindfulness dimensions and concern over mistakes perfectionism, as well as the
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
15
positive relationships between aspects of mindfulness and personal standards perfectionism,
align well with previous research and theoretical perspectives of the constructs.
Cluster Interpretation
The five subscales were entered first into Ward’s hierarchical cluster analysis. Based on
visual inspection of the resulting dendogram and graphed coefficients from the agglomeration
schedule, a three- or five-cluster solution appeared to provide the best description of the data.
Together, the dendogram and agglomeration schedule help indicate points at which dissimilar
clusters were being forced to merge, and thus provide information to determine relatively distinct
groupings of individuals. Centroid values from both the three- and five-cluster solutions were
then taken forward to be used as initial seed points in the k-means iterative cluster analyses.
The hierarchical and iterative cluster analytic approaches were then compared for both
the three- and five-cluster solutions to assess the stability of the two solutions. Through
crosstabulation, the percentage of cases similarly assigned to each cluster across the two analytic
approaches could be assessed. Specifically, case classification for both the Ward’s and k-means
analyses indicated 69% similarity for the three-cluster solution, compared to a slightly improved
73% similarity for the five-cluster solution. Despite a small increase in stability for the five
cluster solution, power for subsequent statistical analyses would decrease notably given the
smaller number of athletes in each group when moving from three- to five-clusters. The three
cluster solution was therefore retained as it provided a nice explanation of gymnast mindfulness
and perfectionism characteristics while permitting heightened power for subsequent analyses.
Cluster means, standard deviations, and standardized scores for the final cluster solution are
shown in Table 3. A visual representation of the final cluster solution is depicted in Figure 1.
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
16
Interpretation of the subscale means for gymnasts in each cluster revealed the presence of
three distinct profiles of mindfulness and perfectionism tendencies. The first cluster consisted of
87 athletes (35.7%) with a moderate mindfulness and high perfectionism profile. The second
cluster consisted of 71 athletes (29.1%) with a low mindfulness and low/moderate perfectionism
profile. The third cluster consisted of 86 athletes (35.3%) with a high mindfulness and very low
perfectionism profile. A series of four crosstabulation analyses were conducted to preliminarily
assess the number of athletes in each profile who obtained an NQS on each competitive event
during the season. Across the analyses, clusters ranged in size from 17 to 34 gymnasts. The
group sizes were thus considered adequate for conducting subsequent one-way ANOVAs to
assess potential performance differences across the three mindfulness and perfectionism profiles.
Comparing Performance Across Clusters
Prior to conducting parametric statistics using the performance data, transformations
were made to improve the normality of the data. A series of four one-way ANOVAs were then
computed using the transformed performance data to assess differences among the profiles.
Event means, standard deviations, and sample sizes for each cluster are shown in Table 4.
Results of the ANOVAs may be found in Table 5. No statistically significant (p < .05)
differences in performance were found among the mindfulness and perfectionism profiles on the
four competitive events. Effect sizes (h2
p) across the four analyses ranged from 0.03 to 0.06, and
power estimates for this set of analyses was low.
Exploratory post hoc t-tests were then conducted between groups with the greatest mean
score differences on each event. The event NQS means compared, as well as the Cohen’s d effect
size for each pairwise comparison, are indicated in Table 4. Significant mean score differences
were found between clusters on vault and bars. On vault, the high mindfulness, very low
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
17
perfectionism cluster performed significantly better than the low mindfulness, low/moderate
perfectionism cluster. On bars, the moderate mindfulness, high perfectionism cluster performed
significantly better than the high mindfulness, very low perfectionism cluster. Small to moderate
effect sizes were found for each of the NQS comparisons across the four events. Statistically
significant correlations also arose between vault performance and acceptance (r = .24, p < .05),
between bars performance and both personal standards (r = .31, p < .01) and concern over
mistakes (r = .23, p = .05), between beam performance and personal standards (r = .23, p = .05),
and between floor performance and awareness (r = .24, p < .05). Thus, despite the lack of
significant findings when performance differences among the three profiles were considered
together, potential relationships may exist between the mindfulness and perfectionism tendencies
and competitive gymnastics performance.
Discussion
Three distinct profiles of mindfulness and perfectionism were observed among the
gymnasts. Previous researchers have contributed to our understanding of how athletes may be
grouped on each of these constructs independently (e.g., Gucciardi et al., 2012; Kee & Wang,
2008); however, this is the first study to our knowledge that used a cluster analytic approach to
understand how athletes in a judged sport experience mindfulness and perfectionism together.
Previously, researchers have supported stable three- and four- cluster solutions for perfectionism
and mindfulness, respectively. Thus, arriving at a three-cluster solution that helps to explain
gymnasts’ propensities for perfectionism and mindfulness concurrently aligns closely with
existing notions of the constructs.
Furthermore, the current finding that gymnasts were classified quite evenly across three
profiles indicates that mindfulness and perfectionism may be experienced in varied ways even
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
18
within a relatively homogeneous group of elite athletes performing at a very high level. This
gymnast-specific finding appears consistent with previous multi-sport research, as profiles of
mindfulness and perfectionism tendencies have independently been found to vary markedly
among high level athletes representing a broad range of sports (e.g., Gucciardi et al., 2012; Kee
& Wang, 2008). Although exploring a diverse set of personality characteristics was beyond the
scope of the present study, these findings could be used to support the idea that there may not be
just one adaptive personality profile for attaining an elite level of gymnastics. Furthermore, a
national qualifying score (i.e., successful and consistent performance across a season) was
achieved by athletes with and without notable levels of perfectionism and mindfulness.
When discussing differences observed across the mindfulness and perfectionism profiles,
for instance gymnasts “high in mindfulness” or “low in perfectionism,” scores are considered
relative to the other gymnasts who participated in the study rather than compared to some
normative criteria. Still, a basic understanding of how the current participants compared on the
measurements to athletes included in previous research can provide clarity and highlight points
of similarity and difference across studies. Zhang et al. (2017) found during development of the
AMQ that subscale means among team and individual sport athletes ranged from 3.54 to 3.73,
with standard deviations in the 0.82 to 0.99 range. Comparatively, the gymnasts in our sample
had slightly higher mindfulness scores overall, with means ranging from 3.63 to 4.11 across the
three subscales, and lower standard deviations in the range of 0.48 to 0.59. Taken together, the
single-sport sample of gymnasts who participated in the current study reported slightly higher
mindfulness tendencies with lower variation across responses than the multi-sport sample of
athletes used when developing the instrument.
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
19
In their research examining the validity of the Sport-MPS-2, Gotwals and Dunn (2009)
reported mean scores for intercollegiate team sport athletes on the personal standards and
concern over mistakes subscales were 3.68 (SD = 0.52) and 2.87 (SD = 0.68), respectively. In the
present sample, the perfectionism scores among the intercollegiate gymnasts were equivalent or
just slightly lower, with means of 3.61 (SD = 0.58) and 2.87 (SD = 0.82) for the personal
standards and concern over mistakes subscales, respectively. Previously, Dunn et al. (2006)
examined perfectionism among a sample of female figure skaters, a group slightly younger than
the athletes in our gymnast sample but in a similar individual, judged sport context. The
researchers found that the figure skaters’ scores for personal standards and concern over
mistakes were also lower than in the team sport sample, with subscale means of 3.33 (SD = 0.86)
and 2.37 (SD = 0.97) for personal standards and concern over mistakes, respectively. Thus, the
notion that certain sports may be considered more “perfectionistic” than others may not
necessarily equate to higher individual reports of perfectionism tendencies. Perhaps athletes in
such sport contexts have normalized the pursuit of perfection in a different manner than athletes
in team sports might, and thus may self-report their own perfectionism relative to a higher
standard resulting in lower scores. In any case, the gymnasts in the present study scored on the
perfectionism dimensions in ways that align closely with intercollegiate athletes in various team
sports studied previously.
Another primary aim of the current study was to assess potential performance differences
across the mindfulness and perfectionism clusters. When gymnastics performance was
considered on each of the four events across the three profiles, no significant differences were
observed. It is important to note that the performance metric selected for comparison was
relatively restricted in range given the calculation of the NQS as a snapshot of the better
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
20
performances for each gymnast during the competition season (i.e., best and worst performances
are dropped). Still, the NQS was selected intentionally as it is a practical performance metric
used in collegiate gymnastics for qualification/placement in post-season competition. Given the
utility of this performance score in the sport of gymnastics, the current findings may have
practical significance. Specifically, high level performance appears to be attainable for athletes
across competitive events, regardless of their propensities for mindfulness and perfectionism.
Gymnasts may learn coping strategies that allow them to perform successfully with varying
degrees of mindfulness and perfectionism tendencies. This finding may have practical utility for
coaches and athletes – that individuals with different personality characteristics are all capable of
high quality performance.
Despite the lack of statistically significant differences among the three profiles,
noteworthy patterns in mean differences in event performance were observed. Researchers have
argued that reliance on p values when determining the meaning of results may be problematic, as
the statistic is highly contingent on sample size and says relatively little about the real-world
meaning of findings (e.g., Gigerenzer, 2004; Kruschke, 2013; Wilkinson, 2014). In recent years,
researchers have recommended interpreting test statistics through a contextual lens to better
understand the practical significance of the results (Andersen, McCullagh, & Wilson, 2007). A
similar process was recently adopted in a study of mindfulness-based programming for injury
prevention (Ivarsson, Johnson, Andersen, Fallby, & Altemyr, 2015), and we have followed these
recommendations. In the context of gymnastics, very small differences in performance scores
may mean the difference between placing and not placing, between qualifying to post-season
competition and not qualifying.
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For example, the difference in NQS for the top 10 athletes on each competitive event
during the 2019 regular season was approximately five hundredths of a point, 0.05. The mean
score differences in the one to two tenth of a point range, 0.1 to 0.2, observed between profiles
established in the current study were therefore considered to have real-world meaning in the
context of gymnastics. For the comparison across profiles, h2
p effect size values ranged from
0.03 to 0.06, indicating that approximately three to six percent of variance in event performance
may be accounted for by profile membership. In our sample of gymnasts, NQS values had a
range of approximately one point on each event. Given the explained variance in event
performance we observed in the study, a three to six percent change in NQS may mean the
difference between first and tenth in the nation. Additionally, when effect sizes were computed
for event scores with maximum variation between profiles, Cohen’s d values ranged from 0.37 to
0.65 indicating the presence of some moderate effect sizes. Thus, it is possible that some
qualities of mindfulness and perfectionism serve athletes in more adaptive ways on certain
competitive events.
In support of this finding, statistically significant mean differences arose between the
profiles compared on vault and on bars in post hoc pairwise comparisons. On vault, gymnasts
highest in mindfulness performed best; whereas, on bars, gymnasts highest in perfectionism
performed best. When observing the mean score patterns on each event across profiles, gymnasts
highest in perfectionism performed relatively better than gymnasts in profiles lower in
perfectionism on bars, beam, and floor. These trends suggest that the degree of mindfulness and
perfectionism qualities most favorable for performance may vary by event, and that in contrast to
existing research (e.g., Hill et al., 2018) perfectionism may be adaptive for competitive
gymnastics performance in the context of the study.
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22
It seems possible that the mindfulness and perfectionism qualities favorable for
performance may also differ from those favorable for wellbeing. For instance, although the
findings of the current study lend initial, tentative support for the physical performance benefits
of perfectionism in gymnastics, high levels of concern over mistakes perfectionism has
previously been considered maladaptive for the emotion and wellbeing of athletes (e.g., Hill et
al., 2018). Researchers have provided some evidence of the potential benefits of mindfulness for
the wellbeing of athletes, including reduced competitive anxiety, stress, and burnout; injury
prevention; and increased confidence and self-efficacy (e.g., Noetel et al., 2017). Although the
question of athlete wellbeing was not within the scope of the current research, future researchers
might consider including such assessments when studying these constructs to better understand
both the quality of athletes’ experiences alongside their objective performance.
The current findings may also have practical implications for researchers and
practitioners interested in delivering mindfulness-based interventions to athletes such as those
who participated in our study. In light of some equivocal research findings in the mindfulness
literature, researchers have begun to question the efficacy of mindfulness-based interventions for
all participants, and have raised the potential for adverse effects of meditation-related
experiences (Van Dam et al., 2018). Understanding individual characteristics that may
predispose individuals to have more favorable versus adverse effects to meditation-related
practices may help to direct our research and applied efforts toward participants who may benefit
most from them. For instance, concern over mistakes perfectionism has been positively
associated with anxiety and depressive symptoms (Hill et al., 2018) – experiences that align with
the relatively rare albeit real meditation-related adverse effects that have been observed (Van
Dam et al., 2018). Future researchers might aim to understand if differences exist across profiles
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
23
of individual characteristics in athletes’ readiness or desire to engage in mindfulness-based
interventions, or in the effectiveness of such interventions among distinct profiles. By assessing
these constructs prior to interventions, researchers or practitioners might then have a clearer
understanding of who may benefit most from mindfulness-based interventions rather than
assuming that all athletes participating have the capacity to benefit equally from such practices.
We selected the NQS as our performance measure in the current research based on its
practical use in determining placement in post-season competition. We recognize, however, that
there may be potential limitations to this metric in our study. For instance, given the way the
NQS is calculated, only a portion of a gymnasts’ performances throughout the season may be
taken into consideration. Further, that portion of the season that is calculated into the NQS would
not account for poorer competitive performances if gymnasts competed in most meets during the
season. This performance measure may therefore be overly reductive and restricted in range,
potentially limiting our ability to notice performance differences across the profiles on the
different apparatus using inferential statistics. Future researchers might consider using a different
performance metric (e.g., true average of all performances or range of performance scores) or a
mix of measures to study the relationship between these concepts and performance.
Self-report measures were used to assess individual experiences of both mindfulness and
perfectionism among the gymnasts. When self-report measures are involved, there is a potential
for bias in the form of accurate recall or social desirability. The potential for social desirability
bias in the reported experiences may be especially salient given that athletes were asked to
provide identifying information. During the initial screening analyses, small but significant
differences in perfectionism scores were noted between gymnasts who did and did not provide
their name, with those who did not report their name scoring higher in dimensions of
BEING MINDFUL OF PERFECTIONISM AND PERFORMANCE
24
perfectionism than those who did. Although provision of names was a necessary component for
carrying out the current study with objective performance measures, it should be noted that
authentic self-report of perfectionism may be influenced to some extent when identifying
information is provided.
We accessed a large sample of elite level gymnasts to participate in the current study.
Still, only small effects were found across profiles relative to objective performance – likely due
to the restricted range in performance scores observed among this relatively homogeneous, high
level sample of athletes, and to the inherently small increments of change frequently observed in
the scoring system within gymnastics. With a larger sample of athletes, future researchers may
be able to heighten the power to detect small, meaningful differences in performance among the
different profiles. Still, that differences in performance outcomes were found between profiles
may hold meaning for coaches, athletes, and practitioners operating in a sport where exceedingly
small differences in scores often can have large practical consequences.
Several directions for future research stem from the present findings. In the current study,
we aimed to take a nuanced approach to studying the relationship between mindfulness and
performance among collegiate gymnasts by also considering perfectionism as a contextually
salient factor in the sport. We found individual profiles of mindfulness and perfectionism, and
assessed how those quantitative reports were associated with objective measures of gymnastics
performance. Still, further nuance in the contextually situated experiences of gymnasts seems
attainable. Researchers have previously acknowledged the importance of understanding impact
mechanisms of various facets of mindfulness (Birrer, Röthlin, & Morgan, 2012). By taking a
mixed method approach, fut