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

运动员心理健康的最重要的危险因素是损伤、过渡以及损伤和过渡的组合（Reardon等人，2019年; Moesch，Clutta，Kleinert，Quignon-Fleuret，塞西尔，& Bertollo，2018年）。先前的严重伤害已被发现与荷兰运动员的常见精神障碍（CMD）症状有关（Gouttebarge，Jonkers，Moen，Vernessy，Wylleman & Kerkhoffs，2017），并且在晚年接受CMD支持的运动员被发现有损伤作为前因（Gervis，Pickford & Hau，2018）。受伤的心理影响不是一个短期问题，影响可能超出身体康复。受伤和常见心理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，但受伤的运动员特别容易受到伤害。抑郁症状在受伤运动员中比健康运动员更常见（Appaneal，Levine，佩尔纳和Roh，2009; Trojian，2016），并且可能与自杀意念一样严重（Smith & Milliner，1994，Nygård，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）。关于诸如取消选择或被迫退役的受伤后果的运动特定焦虑由术语再受伤焦虑所涵盖（Hsu等人，2017年）的报告。Wadey，Podlog，Hall，乌特利，Hicks-Little & Hammer（2014）发现，再损伤焦虑可能对运动员的心理结果产生积极或消极的影响。那些将再受伤焦虑解释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等人，2014，第262页）。相比之下，Wadey et al.（2014）发现，以“重新看待体育”的方式积极解释重返体育运动的运动员更有可能经历积极的心理结果。

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.