Designing, implementing and evaluating the RETURN protocol for physical and psychological support of injuries in performance sport.

运动员心理健康最重要的危险因素是损伤、过渡以及损伤和过渡相结合（Reardon et al., 2019; Moesch, Kentta, Kleinert, Quignon-Fleuret, Cecil, & Bertollo, 2018）。先前的严重伤害被发现与荷兰运动员的常见精神障碍（CMD）症状有关（Gouttebarge, Jonkers, Moen, Verhagen, Wylleman & Kerkhoffs, 2017），并且在以后的生活中接受CMD支持的运动员被发现有伤害作为先决条件（Gervis, Pickford & Hau, 2018）。受伤的心理影响不是一个短期的问题，其影响可以延伸到身体康复之外。受伤和常见精神健康问题之间的联系已经得到了很好的研究，并在下面简要概述。焦虑和抑郁是普通人群中常见的心理健康问题，但受伤的运动员尤其容易受到伤害。抑郁症状在受伤运动员中比健康运动员更常见（Appaneal, Levine， Perna和Roh, 2009; Trojian, 2016），并且可能与自杀意念一样严重（Smith & Milliner, 1994, nyg<s:1> rd, 2017）。受伤的运动员比健康的运动员表现出更多的焦虑症状（Gulliver, Griffiths, Mackinnon, Batterham & Stanimirovic, 2015）。对受伤后果（如被淘汰或被迫退役）的体育特定焦虑被术语“再受伤焦虑”所涵盖（Hsu等人，2017）。Wadey, Podlog, Hall, Utley, Hicks-Little & Hammer（2014）发现再伤焦虑会对运动员的心理结果产生积极或消极的影响。那些将再伤焦虑理解为消极的运动员倾向于关注他们的痛苦，陷入“消极的向下螺旋”（Wadey et al., 2014, p. 262）。相比之下，Wadey等人（2014）发现，以“更新的体育视角”积极解读重返运动的运动员更有可能体验到积极的心理结果。

The most significant risk factors for athletes' mental health are injury, transition, and injury and transition combined (Reardon et al., 2019; Moesch, Kentta, Kleinert, Quignon-Fleuret, Cecil, & Bertollo, 2018). Previous serious injuries have been found to be related to Common Mental Disorder (CMD) symptoms in Dutch athletes (Gouttebarge, Jonkers, Moen, Verhagen, Wylleman & Kerkhoffs, 2017), and athletes who received support for CMD in later life were found to have injury as an antecedent (Gervis, Pickford & Hau, 2018). The psychological impact of injury is not a short-term issue, and effects can extend beyond physical rehabilitation. The links between injury and common mental health problems are well researched and outlined briefly below.Anxiety and depression are common mental health problems in the general population, but injured athletes are particularly vulnerable. Depressive symptoms are more common in injured athletes than healthy ones (Appaneal, Levine, Perna and Roh, 2009; Trojian, 2016), and can be as severe as suicidal ideation (Smith & Milliner, 1994, Nygård, 2017). Injured athletes exhibit more symptoms of anxiety than healthy athletes (Gulliver, Griffiths, Mackinnon, Batterham & Stanimirovic, 2015). Sport specific anxiety about the consequences of injury such as de-selection or forced retirement is covered by the term re-injury anxiety (Hsu et al., 2017). Wadey, Podlog, Hall, Utley, Hicks-Little & Hammer (2014) found that reinjury anxiety could have a positive or negative effect on psychological outcomes for athletes. Those athletes who interpreted reinjury anxiety as negative tended to focus on their distress, getting caught in a 'negative downward directional spiral' (Wadey et al., 2014, p. 262). In contrast, Wadey et al. (2014) found that athletes who interpreted return to sport positively with a 'renewed perspective on sport' were more likely to experience positive psychological outcomes.