Does altered emotional regulation modify visual attention among injured athletes
Date
2018
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Publisher
University of Delaware
Abstract
Context: Growing evidence suggests both orthopedic and mild traumatic brain injuries (mTBI), such as concussions, may be related to underlying neuropsychological factors potentially affecting sport performance. The ability of a person to visually assess their physical surroundings, fixate on relevant cues and make expedient decisions, can potentially affect the way an individual reacts to certain situations. Within athletics, this visual attention may influence emotional regulation and alter responses that shift a person’s focus, thus affecting decision-making. Past injuries are strong predictors for athletes who tend to get hurt repeatedly, despite physical rehabilitation, and the cause may be due to neuroplastic changes in the brain that affect their attention to images in their visual field and emotional regulation, such as arousal, anxiety and fear. This sequence of events may explain the high incidence of re-injury related to errors in coordination or judgment. Objective: The purpose of this study was to examine the interactions between visual attention, emotional regulation, and injury history/severity among athletes. Design: Post-test only control group design. Participants: 38 NCAA DI student-athletes and club sport athletes (males n=6, females n=32) from the University of Delaware between the ages of 18-30, were recruited into two groups, previously injured (n=29) and healthy controls (n=9). Methods: Each participant completed the Nordic Musculoskeletal Questionnaire (NMEQ-E), Concussion History Questionnaire, Competitive State Anxiety Inventory-2 (CSAI-2), and Extended Sheehan Disability Scale to assess injury history, psychological state, and current physical state. Participants then viewed and rated 30 IAPS images based on valance, arousal, and fear. Visual attention was measured using eye tracking instrumentation (Pupil Labs), which captured pupil dilation, eye fixations/duration and blinks. Statistical Analysis: A two (group) by three (neutral, fear, injury images) analysis of variance (ANOVA, p<0.05) was used to determine if there was a difference between injured and control groups for anxiety, levels of fear, pupil dilation, blinks, number of image fixations, and duration of image fixation among the different types of images. A one-way ANOVA was used to compare group differences in anxiety (CSAI-2). An alpha level of .05 was set a priori to represent statistical significance. An independent t-test was used to assess all dependent variables against both injured and control groups as well as to assess severity (surgery/season ending injury) and frequency (days out of activity) within the control group. Chi square analysis was used when necessary when dependent variables were binary. Results: Individuals with one injury or greater, including season ending injuries and/or surgery, reported significant more total days out and total number of injuries when compared to the control group (p<0.05). The experimental group had a significantly larger pupil diameter when viewing pictures, however the control group reported a greater number of blinks during picture viewing. The experimental group had significantly higher arousal and fear scores (p<0.05), in addition to higher cognitive and somatic anxiety score, and lower self-confidence. The control group had significantly higher valance scores. Tukey post hoc tests showed several significant differences between picture types among the visual attention and emotional regulation variables, but no significant interactions were found between groups. Athletes with more severe injuries also had greater disability, arousal and fear, anxiety, and both fixation number and pupil diameter scores, but lower self-confidence. Conclusion: In aim one, athletes with a history of injuries present with different visual attention characteristics based on pupil diameter, fixation duration and blinks, as well as increased arousal, anxiety and current disability. In aim two, injury severity was also linked to differences in visual attention and emotion regulation. Clinicians and researcher should explore future studies and/or intervention strategies to ameliorate these characteristics, with the aspiration of minimizing the phenomena of recurring injury and disability among athletes.
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Keywords
Health and environmental sciences, Athletes, Emotion regulation, Eye tracking, Past injury, Visual attention