Psychological stress disorders, such as depression and chronic anxiety contribute to increased risk of cardiovascular disease and mortality. Acute psychological and physical stress exacerbate the activity of sympathetic-adrenal-medullary system, resulting in the elevation of cardiovascular responses (i.e., heart rate and blood pressure), along with augmented inflammation and oxidative stress as major causes of endothelial and metabolic dysfunction. The potential health benefits of regular physical activity mitigate excessive inflammation and oxidative stress. Along with physical exercise, complementary interventions, such as dietary modification are needed to enhance exercise effectiveness in improving these outcomes. Specifically, dietary modification reduces sympathetic nervous system activity, improve mitochondrial redox function, and minimize oxidative stress as well as chronic inflammation.
Chun-Jung Huang, Matthew J. McAllister, and Aaron L. Slusher
Matthew P. Martens
Issues associated with athletics, alcohol abuse, and drug use continue to be salient aspects of popular culture. These issues include high-profile athletes experiencing public incidents as a direct or indirect result of alcohol and/or drug use, the role that performance-enhancing drugs play in impacting outcomes across a variety of professional and amateur contests, and the public-health effects alcohol abuse and drug use can have among athletes at all competitive levels. For some substances, like alcohol abuse, certain groups of athletes may be particularly at-risk relative to peers who are not athletes. For other substances, participating in athletics may serve as a protective factor. Unique considerations are associated with understanding alcohol abuse and drug use in sport. These include performance considerations (e.g., choosing to use or not use a certain substance due to concerns about its impact on athletic ability), the cultural context of different types of sporting environments that might facilitate or inhibit alcohol and/or drug use, and various internal personality characteristics and traits that may draw one toward both athletic activity and substance use. Fortunately, there are several effective strategies for preventing and reducing alcohol abuse and drug use, some of which have been tested specifically among athlete populations. If such strategies were widely disseminated, they would have the potential to make a significant impact on problems associated with alcohol abuse and drug use in sport and athletics.
Loneliness or perceived social isolation is a subjective experience relating to dissatisfaction with one’s social relationships. Most research has focused on the experience of loneliness in old age, but levels of loneliness are also known to be high among teenagers and young adults. While poor health may be associated with increased feelings of loneliness, there is now considerable evidence on the role of loneliness as a risk factor for poor mental and physical health. Studies show that loneliness is associated with an increased risk of developing dementia and chronic diseases, and also with a higher rate of mortality. Risky health behaviors, a poor cardiovascular profile and compromised immune functioning have all been proposed as potential pathways through which loneliness may affect health. However, much still remains to be understood about these mechanisms.
Stephen H. Boutcher
Cardiovascular disease has been estimated to be responsible for over 30% of deaths worldwide. The traditional cardiovascular risk factors of smoking, obesity, diabetes, physical inactivity, and family history predict about 50% of the variance of new cardiovascular disease cases; therefore, a number of other risk factors must contribute to cardiovascular disease development. One such factor is psychological stress, which has been identified as playing a role in the development of cardiovascular disease. The major research strategy for assessing the impact of psychological stress on cardiovascular disease development is to measure cardiovascular reactivity to laboratory mental stressors. Exaggerated mental stress-induced cardiovascular reactivity and slow stressor recovery have been associated with the development of cardiovascular disease. In contrast to exposure to psychological stress, there is strong evidence that participation in aerobic exercise leads to a reduction in cardiovascular disease. Participation in regular aerobic exercise generally reduces the cardiovascular response to acute exercise; therefore, researchers have hypothesized that the ability of aerobic exercise to enhance cardiovascular health works partly by modifying the cardiovascular reactivity response to mental stressors. There is mixed evidence to suggest that chronic aerobic exercise decreases or increases cardiovascular reactivity to mental challenge in normotensive, healthy individuals. A decrease in reactivity, however, has been found in those studies that have examined individuals at risk of disease or diseased adults. The optimal volume and intensity of aerobic exercise that brings about maximum decreases in cardiovascular reactivity has yet to be determined. The impact of other forms of exercise on reactivity such as resistance exercise and interval sprinting exercise is starting to be assessed. The challenge for researchers in this area is to identify the mode of exercise that takes the least amount of time but brings about the greatest reduction of levels of stress-induced cardiovascular disease.
Britton W. Brewer
In addition to the disruptive impact of sport injury on physical functioning, injury can have psychological effects on athletes. Consistent with contemporary models of psychological response to sport injury, aspects of psychological functioning that can be affected by sport injury include pain, cognition, emotion, and behavior. Part of the fabric of sport and ubiquitous even among “healthy” athletes, pain is a common consequence of sport injury. Postinjury pain is typically of the acute variety and can be exacerbated, at least temporarily, by surgery and some rehabilitation activities. Cognitive responses to sport injury include appraising the implications of the injury for one’s well-being and ability to manage the injury, making attributions for injury occurrence, using cognitive coping strategies, perceiving benefits of injury, and experiencing intrusive injury-related thoughts and images, increased perception of injury risk, reduced self-esteem and self-confidence, and diminished neurocognitive performance. Emotional responses to sport injury tend to progress from a preponderance of negative emotions (e.g., anger, confusion, depression, disappointment, fear, frustration) shortly after injury occurrence to a more positive emotional profile over the course of rehabilitation. A wide variety of personal and situational factors have been found to predict postinjury emotions. In terms of postinjury behavior, athletes have reported initiating coping strategies such as living their lives as normally as possible, distracting themselves, seeking social support, isolating themselves from others, learning about their injuries, adhering to the rehabilitation program, pursuing interests outside sport, consuming alcohol, taking recreational and/or performance-enhancing substances, and, in rare cases, attempting suicide. Psychological readiness to return to sport after injury is an emerging concept that cuts across cognitive, emotional, and behavioral responses to sport injury.
Katherine Nieweglowski and Patrick W. Corrigan
Stigma is a complex process that results from the interaction of stereotypes, prejudice, and discrimination. When applied to health conditions (e.g., mental illness, HIV/AIDS, diabetes, obesity), stigma can contribute to a lack of recovery and resources as well as devaluation of the self. People with stigmatized health conditions may be too embarrassed to seek treatment and others may not provide them with equal opportunities. This often results in discrimination in employment, housing, and health care settings. Strategies have been proposed to prompt stigma change with strategic contact between those with the health condition and everyone else likely to have the best effects.