SPORTS AND PSYCHOPATHOLOGY


1. INTRODUCTION


Athletes, in today's society, are viewed at as role models. Everyone wants to be like them; that is, they want their body to be in tip-top shape, but they do not understand the conseqences an athlete may go through to get their body that way, and in most cases it is not dieting. Being an athlete does not protect one from everything, and just like non-athletes, they get sick and in most cases they are more prone to psychological disorders, especially those who play more intense sports such as football.
In this chapter, you will learn about the different disorders that may come along with being an athlete, the symptom that come with them, how to deal with each and which athletes, females or males, are diagnosed more frequently with each disorder.


2. MOOD DISORDERS

Athletes, unlike nonathletes, do not show major changes in thier mood. Instead they are show signs in their preformance, such as decreased energy, poor performance, and dissatifaction with in their performance. It is very important for the sports medicial team to watch for these signs so they can better help and understand the athlete and, if necessary, call a sports psychologist to do further testing. According to the National Institute Of Mental Health, approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder ((NIMH). The median age of onset for mood disorders is 30 years There are three common mood disorders that are affect an athletes, which include, depression, dysthymia and bipolar disorders.
  • Depression is characterized by feelings of sadness and loss of interest in the activities that a person normally enjoys. Additional symptoms include feelings of worthlessness, difficulty concentrating, and weight loss.
    • An example of this is shown in the New York Mets pitcher, Pete Harnisch. According to Kamm 2008, Harnisch was coming off of a shoulder injury and was expected to be the ace pitcher for the Mets. He stopped chewing tobacco and found himself losing weight, fatigued, and unable to sleep. Harnisch approached his manager saying he did not feel he could pitch opening day. The manager then ridiculed him in front of the team which caused a riff in the relationship between them. Harnisch approached another staff, to which he was given Benadryl, for his insomnia and misdiagnosed with Lyme disease, an inflammatory disease spread through a tick bite, before the proper diagnosis of depression was finally made. Once diagnosed, Harnisch was prescribed Paxil, underwent psychotherapy and made an excellent recovery. His pitching was just as good on Paxil as off. If a sports medical team had interviewed Harnisch they would have found that Harnisch had feelings of sadness and guilt as well as a lack of joy. Harnisch also had a history of depression in his family. A sports medical team can find and diagnose depression by observing the athlete for being down or sad, loss of appetite, concentration disturbances, irritability, lack of energy, lack of pleasure from things, and guilt. Also asking questions seeing if there is a history of depression in the family can be beneficial.
    • Although, depression is common in athletes, there arent many studies the show who, females or males, more more prone to the disorder. However, in a general population, woman are more likely then men to experience depression.(Mule, 2004).
    • Another issue that has drawn a lot of negative attention in the sport's world recently is that of concussions in pro football and the issues being had by the NFL. Over the past decade, the prevalence of concussions in football players has increased drastically, and it seems that older players with histories of concussions are seeing more and more complications. Due to the increase in concussions and the permanent and long term problems they bring about, the NFL and NCAA is most-likely going to adopt new rules to better protect those who have had concussions and all those who are at risk for a concussion.
    • Athletes may also suffer from Dysthymia which is a less intense form of depression where there is no prolonged well state or less episodic. In order of an athlete to be diagnosed with this disorder they must show two of the following signs: poor appetite, sleep disorder, low energy, low self-esteem, poor conentration and a feeling of hopelessness.
  • Bipolar Disorders: are characterized by manic and depressive episodes.
    • Althought the number of athletes who suffer with bipolar disorder is unknown, the National Institute of Mental Health has stated that about 5.7 million adults or 2.6 percent of the U.S population is affect with this disorder (NIMH).
    • Bipolar disorder has affected several professional athletes such as Ilie Nastase (tennis) and Dimitrius Underwood (football). In a hypomanic episode, athletes may seem only outrageous and overly aggressive, but something more may be laying underneath. For instances, Miami Dolphins Defensive Tackle, Dimitrius Underwood. In 1999, Underwood took a knife to his neck. Judgment becomes impaired and athletes frequently turn to drugs or alcohol, especially if there is a prior history of abuse. Barrett Robbins, (football) with the Oakland Raiders missed the super bowl in 2003 because he went on a drinking binge the night before. Robbins had already been diagnosed with bipolar disorder and the team was aware of his condition. Howver, he stopped taking his medicine during preseason camp and developed erratic behavior before the super bowl. Although the team noticed he had started drinking, a sign of bipolar, no one intervened.
    • It is important for the sport medical team to pay attention to the nuances of medical conditions such as bipolar disorder. Knowing about the disorder, Robbins should have been placed in a buddy system environment where someone mad sure he was ok. This person would have reported any problems or signs to the team physician. This would have been extremely important at the time of extreme stress such as the Super Bowl.

Related Articles, links and photo to the disorders described above:

Pete Harnisch
Pete Harnisch


Dimitrius Underwood
Dimitrius Underwood
Barrett Robbins
Barrett Robbins

 Ilie Nastase
Ilie Nastase






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3. ANXIETY DISORDERS

For most atheletes, performance comes easy on and off the field. However there are some athletes do well in practice and once a game day approahes they tend "freeze up". This is called performance anxiety, which is the most common form of Anxiety disorder that is found in sports world. However, they tend to find ways to avoid this anxiety, but what happens when they are diagnosed with other forms of anxiety such as Generalixed Anxiety disorder( GAD), panic disorder, social anxiety disorder, post tramutic stress disorder (PTSD) or obession complusion disorder (OCD). Approximately 40 million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder,a nd half of them have reacurrent anxiety disorders.(NIHM)

  • Generalized Anxiety Disorder ( GAD): is characterized by extreme worry of apprehension. Uncomfortable muscle tension and sleep disturbances are also associated with GAD.Many athletes have a normal state of anxiety, but some have trait anxiety.
    • Trait anxiety starts early in life. These athletes get stressed out before games and evaluations. They project catastrophic results such as not making the team or striking out. The best way to distinguish between GAD and normal anxiety is whether or not the person feels the anxiety is difficult to control. The athlete may present themselves to the trainer with headaches, upset stomach or diarrhea rather than anxiety. The athlete may also have difficulty concentrating or insomnia, but the most important symptom of GAD is the asking of what if questions, such as presenting with a headache saying what if I have a brain tumor.
    • There is no percentage was to who, females or males athletes, are more prone to GAD. However, as a general population, women tend to show a more problems with this than men, with a 6.6 % to 3.6% (Medindia Health, 2010)

  • Panic Disorder: also known as panic attacks, are spontaneous and unexpected feelings of being out of control. They are characterized by trembling, shortness of breath, sweating, and choking.
    • An example of this is a boxer who quits fighting in the middle of an important match. This boxer would panic and do illegal fouls on his opponent even while already ahead in the match. He had been disqualified for more than one match. Those in his corner wondered if he suffered from panic disorder and indeed he did.
    • During a panic disorder an athlete’s abilities are greatly diminished and judgment is impaired. During such attacks, an athlete reverts back to basic flight or fight instinct. If the sport medical team thinks that an athlete is having a panic attack during competition, it is best to pull the athlete to the sidelines and narrow the athlete’s field of vision and or auditory input. . This can be done by cupping one’s hand on the side of the face. Then make eye contact with the athlete and tell them everything will be alright. Using a paper bag to revive correct breathing and a quick break to the locker room can also be beneficial.

  • Social Anxiety Disorder: also known as Social Phobia, is a fear of social or performance situations where an individual perceives being judged by others. Symptoms of social anxiety disorder are similar to that of panic attacks. Typically the individual will try to avoid these situations at all costs.
    • Ricky Williams, a running back for the Miami Dolphins, is an example of an athlete with social anxiety disorder. Early in his career, Williams would give postgame interviews with the media while still wearing his helmet. His visor on his helmet would still be down. Williams always knew he was ‘Wired differently.” He would avoid social situations however, since he was a star athlete, his behavior would be shrugged off as the typical behavior of a coddled athlete. Williams said, “If I didn’t want to honor an obligation, I knew someone would cover for me. It was easy for me to hide.”
    • During his second professional season, Williams was playing with the New Orleans Saints and broke his ankle. The stress from this injury heightened the anxiety, and no one from the sport medical staff was paying attention to his emotional needs. Williams went to the internet and self-diagnosed social anxiety disorder and sought out a therapist. When he told his coach about his condition, he was yelled at to stop being a baby. An emotional disorder is still seen as just a weakness by many sports organizations. After psychotherapy, Williams was able to move on to the Miami Dolphins and become one of the most productive running backs in the league.
    • Another type of social anxiety disorder is performance anxiety.
      • Performance anxiety is a specific type of social anxiety disorder. An athlete who has performance anxiety “freezes up” during certain situations. It was present as the sudden inability to perform for no known reason what used to be a routine athletic task. An example of this is a pitcher who can throw well in practice, but freezes up during a game.
        • One example of someone who has this is Chuck Knoblauch, of the New York Yankees. His case was so bad that it actually ended his career. Rick Ankiel, a pitcher for the St. Louis Cardinals, went through a similar situation. Rick was the top prospect in the organization and had one great season on the mound. The next season, Rick couldn't even throw a strike and eventually was removed from his position and sent down to he minors. He was no longer able to deal with the pressure of being a major league pitcher and hasn't pitched since. He was able to recover and become a very good position player for the organization and currently plays outfield for the Kansas City Royals.
        • Another recent case is that of Vince Young, quarterback for the Tennessee Titans of the National Football League. This disorder caused him to vanish for a short period of time and brought up talks of suicide. Luckily, for Vince Young, he was able to bounce back from his disorder and became successful once again in the NFL.
  • Posttraumatic Stress Disorder (PTSD): An athlete with PTSD is someone who has seen or experienced a traumatic or life threatening event that caused them to have nightmares and intrusive memories. Athletes in high risk sports such as; football, auto racing, horse racing and boxing, possess a higher potential to develop PTSD.
    • An example of an athlete with PTSD is Julie Krone, a jockey. However, being a woman in a man’s sport, Julie’s symptoms went unnoticed because of her reputation of toughness which almost led her to committed suicide. Julie won the Belmont Stakes in 1993 and became the first and only woman to win a leg of the Triple Crown of horse racing. That summer she had a terrible fall, off her horse, in Sarasota, falling under several horses and being trampled. She ended up with 14 screws and 2 plates. She recovered from this well, almost as if it was a challenge for her to do so. The PTSD actually started 2 years later after a horse pitched her off in a race. To protect herself during the fall, she covered her head with her hands causing her hands to break. Krone stated that “It fried me and I couldn’t talk.” It was not the severity of the fall that caused the PTSD. It was the fact that she had been sensitized and the life events during the second fall made it have great psychological meaning. Julie said, “The heart and he hands are the biggest organs a jockey has. The first spill got my heart; the second one got my hands, my trademark, the way I uniquely communicated with my mounts.”
    • Krone started showing the symptoms of PTSD. She had flashbacks of the spill when approaching the starting gate, reoccurring nightmares of the spill, and experienced the event when someone swung a golf club near her, the feeling of the wind created by the club reminded her of the sensation of the horses passing over her. Krone sought help but no one diagnosed PTSD. She had blurred vision, which was caused by anxiety, but was told there was nothing wrong. One day she had another bad day at the track and was considering suicide. She spoke to a psychiatrist friend at the track and the psychiatrist suggested that they talk. Eventually this psychotherapy led to the prescribing of an SSRI which helped Krone return to normal
    • When an athlete has a minor injury and takes longer to return than normal, PTSD also needs to be considered. It should also be considered for vague medical conditions such as headaches, stomachaches, and backaches. An example of this is a runner showing above symptoms months after an injury has healed.
    • Women, as a general population, also tend to suffer with PTSD more often than men with a 10-14% to 5-6%. (Medindia,2010)

  • Obsessive-Compulsive Disorder (OCD): Athletes with OCD, experience intrusive or disturbing thoughts, impulses or images that cause anxiety or distress. Those with OCD try to suppress these thoughts, but no matter how hard they try, they cannot get these thoughts out of their mind. They may have compulsions as well such as hand washing or counting. These compulsions are done to alleviate the stress of the thoughts.
    • An example of an athlete with OCD is Julian Swartz who was diagnosed with OCD in the ninth grade. His senior year, Julian was the Associated Press High School Basketball Player of the Year. Julian attended the University of Wisconsin, and during his freshman year helped them make the Final Four. However doubt plagued him as to whether he was good enough or working hard enough. He developed depression and attempted suicide. Finally Julian transferred to a NCAA division III school where there was less pressure to perform. His OCD became controllable again. Given his disorder, choosing the smaller school would have been the best knowing his condition and the possible outcomes or triggers of events. Another famous sport star affected by OCD is Los Angeles Galaxy and English soccer Star David Beckham. He has been quoted saying the things must be in straight lines or in pairs.
      • There is a common question that is asked among athletes and that is wherther or not they, an athlete, is more prone to OCD. This question came about because of the daily rituals a player goes through everyday while in practice.
        • OCD can be separated from superstitious rituals in sports but the OCD interferes with the athlete's life. An example of this is obligatory running or exercise. The affected athlete will get into a “Have to do” attitude. The athlete will feel anxiety if he or she does not run or exercise to a certain level. These individuals will organize their lives around the activity and this can impact interpersonal relationships in a negative way. This athlete used the excuse that the running or exercise will help to maintain a certain weight or muscularity. They will even exercise when told not to by the sports medical team.
    • Both, male and female athletes, are likely to suffer with OCD because of the daily ritals they go through. Those with a "pracitice makes perfect" attitude are twice as likley to suffer than regular athletes.

  • Attention Deficit Hyperactivity Disorder (ADHD): is characterized by hyperactivity or inattention or the combination of these two. This disorder is usually diagnosed in childhood. The athlete has difficulty finishing projects, often loses things, and is forgetful. ADHD is also more common in athletes then non-athletes because several things are happeing at once and people with ADHD are more energetic and spontaneous, which in some sports can be helpful. However, there are some negative side effects that may come along with an athletes.
    • An example of ADHD negatively affecting an athlete is that of a goalie who is unable to have the patience to wait for the play to develop and tackles the striker or forward. However, AHDH can also work to a goalie’s advantage since they have to be aware and pay attention to everything that is happening on the field of play.
    • Another negative example is that of a hockey player who had his performance affected by the people in the stands who might be yelling his name and distracting him while the other team slides the puck into the goal. ADHD athletes tend to do well in sports where there is constant chaos such as hockey or soccer where the play is unpredictable and the athlete has to be aware and react throughout the entire duration of the contest. They tend to excel less in those sports that are slow paced such as baseball and football where there is significantly more down time.
    • ADHD can also interfee with the ability to focus on what the coach is wanting from the athlete, which in return, makes a coach frustrated.
    • An athlete can see a sports psychiatrist and get a prescription for a stimulant medication, but must be careful in regards to banned substances of the sport.
    • Treatment includes stimulats such as methylphenidate (Ritalin).


Related articles, links and photos

Ricky Williams
Ricky Williams
Chuck Knoblauch
Chuck Knoblauch
Vince Young
Vince Young
Rick Ankiel
Rick Ankiel


This is a video of the struggles experienced by Rick Ankiel that can easily be attributed to his Social Anxiety Disorder. He cannot throw strikes (The successful pitch in baseball and the goal of all pitchers) and is getting booed and harassed by the crowd. It was a very sad thing to witness because he has so much potential that was limited because of anxiety and pressure to perform. Rick's story as stated above did end well as he recovered from this disorder to go on and experience success once again. The video below shows this:

Julie Krone
Julie Krone

Julie Krone
PTSD.jpg
VIRTUAL IRAQ - Army Col. Michael J. Roy, left, who oversees the exposure therapy at Walter Reed Army Medical Center, conducts a demonstration of a life-like simulator that represents a new form of Post Traumatic Stress Disorder treatment with Army Sgt. Lenearo Ashford, Technical Services Branch, Uniformed Services University, on Sept. 16, 2008, in Washington, D.C. Defense Dept. photo by John J. Kruzel


David Beckham
David Beckham

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external image SamBradford11.jpg external image baseball.jpg
These sports above, are consider good for an athlete with ADHD because it requries about of energy.

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4.STRESS AND SPORTS INJURIES

Past research has seen the relationship between athletic injuries and psychological factors as essentially stress-related (1). In this sense, stress is predicted to produce increased state anxiety and consequently alterations in attentional focus and muscular tension. It is important to note that stress does not exist outside the individual not all people respond negatively to potentially stressful situations; one person may view a championship match as exciting and exhilarating while another becomes anxious and struggles. This will usually depend on the individual's personality traits (perceptual bias) and the coping response present

Related Video:


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5.PERSONALITY DISORDERS

Everyone, who has played sports before, has heard the saying "there is no I in Team." That means that noone is able to take all the blame for a win or lose, it is a team afford. However if a athlete suffers from a personality disorder, such as narcissism, more than likely its all about them, and what they do to make the team better. They tend to believe that without them, the team is nothing.
  • Narcissism: is essentially self love that is characterized by grandiosity, self-focus, self importance and self-absorption with a lack of compassion and empathy for others.
    • In regards to sport performance, a study in 2002 by Wallace and Baumeister, found that narcissists performed better in all conditions that provided greater self-enhancement opportunities. There is a reasonable expectation of those with higher narcissistic levels to have a different cognitive approach and behavior to the sport than those with low levels of narcissism.
    • Wallace and Baumeister did four studies and across them, narcissists were found to have a higher value of performance under conditions of high pressure, challenge, and evaluation compared to those with low levels of narcissism.
    • Narcissism is a very important variable in relationship to performance under pressure.
      • Pressure is defined as all situations in which there is a perceived importance in performing well.
    • Sport provides a stage upon which an opportunity for glory, public evaluation, admiration from others exhibitionism, demonstration of ability and focus on other’s attention can be fostered to extreme levels and exploited in a potentially acceptable manner.
    • Therefore, due to the amount of pressure placed upon the athlete to perform in sport, narcissists will strive to succeed in order to better foster their self image in their own eyes as well as the eyes of others.
    • Common symptoms include:
      • a lack of feeling, empathy, or concern for others
      • a willingness to take advantage of others
      • excessive feelings of self-importance
      • exaggerated personal achievements and abilities
      • an expectation to be seen as superior without cause
      • a fantasy or preoccupation with power, wealth, beauty, personal abilities, or success
      • a demand for favorable treatment without appropriate reasons
      • an insiststance on being the object of admiration and attention

Related Video:




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6.EATING AND BODY DYSMORPHIC DISORDERS

Like stated above, in the introduction, everyone, who looks at an athlete as a role model, tend to want the same body as that athlete; however, they do not understand the extermes an athletes goes though to get there bodies that way In some cases, those extremes arent safe. For intance, many athletes suffers from eating disorders such as anorexia or bulima nervosa, and binge-eating disorder, which are common in both males and females. Males tend to also suffer from muscle or body dysmorphic,but current study have shown that they suffer from eating disorders as well. Studies have shown that 16 -72% of female athletes suffer from an eating disorder (Montgomery,2010). While only 5- 15% of males suffer, however more men tend to suffer more with binge-eating,. Studies have shown the 35% of men have this disorder.(Chang)

  • Anorexia Nervosa: is an eating disorder characterized by unrealistic fear of weight gain, self-starvation, and conspicuous distortion of body image.
    • Athletes with Anorexia Nervosa refuse to maintain a healthy body weight. Their body weight is 85% lower than that of expected weight or fail to make expected weight gains. They experience an intense fear of gaining weight.
    • When an athlete becomes anorexic, their performance is affected by the weakness caused by the disorder. The athlete will say they are fat when they are clearly thin to everyone else. These athletes have difficulty admitting they have a problem.
    • An example of this is a gymnast who will strive to make herself thin by not eating or eating a diet of celery to maintain the thin stature expected in the sport. When a sport medical team observes an athlete that appears to be too thin, anorexia should be suspected. When dealing with anorexia, the sports medical team should focus on the distress the athlete currently has rather than focusing on the weight issue. Suggesting going to see if there is a problem is better perceived by the athlete than telling them to go to therapy.
    • A widely used diagnostic tool, the body mass index measures the body fat based on the weight and the height of an individual. Developed by a Belgian scientist Adolphe Quetelet, it helps to calculate how healthy a person is, based on his weight and identify whether the person is underweight, overweight or obese. The relation of BMI to fatness differs for people of different age and gender. For example, the BMI of women is likely to be higher than that of men.
      • To calculate your BMI, just take your weight in kilograms and divide it with your height in meters. The result has to be again divided by the height in meters. For example if your weight is 60 kg and height is 1.50 m, then the BMI would be 26.67 (60/1.50 = 40 and 40/1.50 = 26.67). Thereafter you can compare your BMI to the weight ranges set out by the World Health Organization (WHO). This applies to both adult men and women but varies for children and older people.
      • Calucating BMI,is the same for both. men and women. below is a chart for you to better understand the use of the BMI
        • Interpreting Your BMI
          • If your BMI is 19 to 24.9 you have a healthy weight.
          • If your BMI is 25 to 29.9 you are considered to be overweight and may incur moderate health risks.
          • If your BMI is 30+ you are considered to be obese. Obesity is linked to increased risk of cancer, heart disease and other health problems.
          • It is vital that while working out the BMI, the body frame and build also be taken into consideration. Therefore the BMI by itself may not be accurate for a weight trainer, a pregnant woman or an athlete. People who are over 60 years of age cannot calculate their BMI by this tool, as their bones start to weigh less due to old age. An athlete can use this test to figure out wheter they fall into the healthy or anorexic zone.


  • Bulimia Nervosa: is an eating disorder characterized by recurrent binge eating, followed by compensatory behaviors. Bulimia Nervosa is often seen in athletes who are of normal weight or can be slightly overweight.
    • Then these individuals will engage in compensatory behaviors such as laxative, self-induced vomiting, or excessive exercise to get rid of or makeup for what they ate. The food they eat is typically high in sweet and calories.
    • They frequently make wide fluxuations in weight.
    • One example of an athlete with bulimia is a jockey. Jockeys have to make a certain weight in order to be able to mount a horse and to work. It is a common practice of Jockeys to self-induce vomit to make weight.
    • Bulimia does not typically affect an athlete’s performance. The athlete may be affected from the stress of guilt, depression, and family conflicts caused by the disorder.

  • Binge-Eating: also known as compulsive overeating, is characterized by periodls of uncontrooled, impulsive or continuous eating beyond the poine of feeling comfortably fully. Althought there is no purging, there many be periods where the individual fasts, have repetitive diets. They often tend to have a feeling of shame or self hatred after a binge.
    • According to some studies, not all athletes are engaging in disorders. The video that is located at the in "related video" section will explain what sports are more susceptible to eating disorders (Kakaiya).
  • Muscle Dysmorphia: also called as bigorexia and is also known as reverse anorexia, because intead of trying to lose weight an athlete is trying to gain more weight.
    • Athletes, such as body builders are mostly affected with this disorder along with men who are involved in boxing and wrestling (Page,2010)
    • Signs and symptoms may include:
      • The feeling that he or she is small and underdeveloped.
      • Constantly check themselves in the mirror.
      • Getting anxious if they do not work out every day.
      • Doing resistance training, and exercise.
    • Side effects include:
      • Damaged muscles, joints, cartilage, tendons and/or ligaments.
    • This preoccupation can interfere with normal social and occupational lives. The sport medical team should ask the athlete if they are taking over the counter medications or creatine. Some of these supplements, especially those containing stimulants, can cause manic episodes in those prone to bipolar disorder.
    • Some athletes will not take the substance or stop if the sports medical team strongly points out that the governing body of the sport could disqualify them from competition for taking the substance.
    • Muscle Dysmorphis is common mainly amoug men, however, it is soon in both sexes.

  • Body Dysmorphic Disorder(BDD): this is a condition in which the athlete will have obsessions and distressing thoughts that repeatedly intrude into the persons awareness. Individuals with BDD experience problems with percieved apperance flaws that cause stress.
    • Just as people with eating disorders obsess about their weight, people with BDD become obsessed over an aspect of their appearance.
    • People with BDD may worry their hair is thin, their face is scarred, their eyes aren't exactly the same size, their nose is too big, or their lips are too thin.
    • Although the inperfections are small that people with BDD obsess over, they firmly believe that everyone notices that aspect and think everyone is looking at it. But for a person with BDD, the concerns feel very real, because the obsessive thoughts distort and magnify any tiny imperfection.
    • These extreme thoughts can cause the individual to not go out in piblic and think they are just too ugly to be seen in public.
    • Individuals with BDD will likely use compulsions to counteract the obsession over their physical appearance. An example would be, if a person with BDD thought their nose was ugly they would constantly check it in the mirroe, apply make up, or frequently ask people if their nose looks ugly. Compulsions are a way to temporarily release some amount of stress.
    • Treatment includes one of two things
      • Medications such as Serotoin reuptake inhibitors or antidepressants that decrease the obsessive and compulsive behaviors.
      • Cognitive behavioral therapy, which is a three step process.

Relative video:


Understanding Anorexia:
What sports have more susceptibility to anorexia?
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7.SUBSTANCE ABUSE DISORDERS

Current research has found that people who suffer with eating disorder, such as the ones previously listed, also suffer from substance abuse disorders such as alcohol abuse, and the most common, steroid abuse.
  • Alcohol Abuse: is characterized as the excessive use of alcohol and alcoholic drinks.
    • High school athletes have a higher tendency to abuse alcohol than their nonathletic classmates, and male athletes have a higher tendency for abuse than female athletes.
    • On the collegiate level, athletes have a higher tendency to consume large quantities per setting and were found to have three times more DUIs than their non-athletic counterparts.
    • Alcohol dependence can impact negatively the athlete’s performance as well as allegiance to the team. It can also have a negative effect on team moral as the player’s abuse is affecting the total performance of the team. It is the critical job of the sports medical team to educate the athletes on the affects of alcohol.
    • Younger athletes are usually unaware of the potential for abuse of alcohol. Education can help deter abuse. This counseling should not only include how it affects the athlete’s performance on the field, but how it can affect an athlete’s life and family.

  • Anabolic Steroid Abuse is charcaterized as are compounds, derived from testosterone, which promote tissue growth and repair. Because they have been used improperly by body builders and other athletes, they are controlled substances under United States federal law.

    • It is estimated that one billion people in the United States have at least once used illegal steroids. Half of these users started before the age of 16. Estimates for body builders range from 50-80%.
    • The athletes who have a higher potential for steroid use are those emphasizing strength and endurance such as weightlifting (80-90%) and track and field( 40-50%).
    • Ever wondered how those bulky weight lifters got so big? While some may have gotten their muscles through a strict regimen of weightlifting and diet, others may have gotten that way through the illegal use of anabolic-androgenic steroids.
    • "Anabolic" refers to a steroid's ability to help build muscle and "androgenic" refers to their role in promoting the development of male sexual characteristics. Other types of steroids, like cortisol, estrogen, and progesterone, do not build muscle, are not anabolic, and therefore do not have the same harmful effects.
    • While using the steroids, the athlete will experience a feeling of euphoria, irritability, and grandiosity. These feelings may reach the point of feeling invincible. This can lead to roid rage, the violent behavior sometimes a side effect of steroids. Steroids can cause this change in behavior; those with no history of antisocial behavior have been known to commit murder. Physical side effects of steroid use for men include shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer include prostate enlargement, shrinkage of testicles, reduced sperm count, impotence, difficulty or pain in urinating. Side effects for steroid use for women include growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, and a permanently deepened voice
    • . Steroids are also physically and psychologically addictive. When a steroid user stops use, he or she may become anxious, depressed, and overly concerned with his or her physical shape.
    • Another type of steroid is Steroid precursors. such as androstenedione ("andro") and dehydroepiandrosterone (DHEA), are substances that the body converts into anabolic steroids. They are used to increase muscle mass.
    • Symptoms for both male and femles include:
        • Acne, really bad acne, especially on face and back
        • Baldness
        • A slow down of growth in athletes who aren't done growing yet
        • High blood pressure, unhealthy cholesterol changes, and heart disease
        • Blood clots and stroke
        • Liver damage, jaundice, or liver cancer
        • Headaches, aching joints, and muscle cramps
        • Nausea, vomiting, and diarrhea
        • Sleep problems
        • Increased risk of ligament and tendon injuries, which can end your athletic career for good
    • Symptoms in guys include:
        • A low sperm count
        • Impotence (inability to get an erection)
        • Breast and nipple growth
        • Enlarged prostate (a gland in the penis)
    • Symptoms in girls include:
        • Breast shrinkage
        • More face and body hair
        • Voice deepening
        • Problems with menstrual periods
        • Clitoris enlargement
    • In addition to the above symptoms, there are also putting themselves at a higher risks for serious infections like hepatitis or HIV, which cause the AIDS virus.

Athletes may struggle to see that steroid use is very bad. They may say, “how can anything be wrong with something that will make me stronger and faster?" In 2005 Jose Canseco used this very justification for his steroid use in baseball. Steroid users are often reluctant to give up a drug that is perceived as good for enhancing performance and the way he or she looks. The sports medical teams need to take the approach of helping the athlete with his or her decision making skills. The Sports medical teams should be prepared to display how great athletes have made the positive decision to stay away from steroids so they could lengthen their careers, be more durable and decrease their likelihood to get hurt, be a better teammate for the team, and increase their decision making abilities. The athlete should be asked if the use of steroids is a viable choice in concurrence with the moral lessons of fair play learned by participation in the sport. Providing the athlete with this information and leading them down this road early in sports participation can help to curb steroid abuse later in life.

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8. OVER THE COUNTER DRUGS

Athletes need to be careful in regards to the over the counter drugs they use. These over the counter drugs should be tightly controlled by the team physician. Many of the drugs could be banned by the governing body of the sport and the use and testing positive for the drug could lead to disciplinary action up to a lifetime ban from the sport. Educating the athlete about the banned substances and what they can take is also necessary to ensure the athletes taking only those substances allowed by the governing body. The athlete’s primary care physician should also be aware of the sports an athlete is playing and of the substances banned by the governing body of the sport in order to assure that they are working in conjunction with the sports medical team to ensure the safe, legal, and ethical participation of the athlete when medical treatment is required.
  • Over the counter drugs offered:
    • Creatine. Creatine is a naturally occurring compound in the body that is also sold as an over-the-counter supplement. It's primarily used to enhance recovery after a workout and increase muscle mass and strength. Creatine is popular with athletes who participate in sports in which short bursts of power are required. Examples include football, gymnastics, hockey and wrestling. Side effects include weight gain, nausea and muscle cramps. High doses of creatine have the potential to harm the kidneys.


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9. REFERENCES


Kakaiya, Divya [video]: What sports have more susceptibilty to anorexia.

Medinda,Health (2010). Mental Health News. Recieved from: http://www.medindia.net/news/view_news_main.asp?x=14884.

Montgomery, Bridget (2010). Female Athlete Triad: An overview of Athletes and Eating Disorders. Recieved from: http://www.suite101.com/content/female-athlete-triad-a197539

Mule,Christina M. (2004).Why Women are More Susceotible to Depression: An Explaination for Gender Differences.Rochester Institution for Techology.
Recieved from: http://www.personalityresearch.org/papers/mule.html

Page, Kate, Le. (2010):What is Muscle Dysmorphia or "Bigorexia?": Understanding Male Suffered of Body Images and Eating Disoders.
Recieved from: http://www.suite101.com/content/what-is-muscle-dysmorphia-or-bigorexia-a209953

Wallace, H.M., & Baumeister, R.F. (2002). The performance of narcissists rises and falls with perceived opportunity for glory. Journal of Personality and Social Psychology, 82, 819-834.