By Ray Lapinski, Asst. Coach, Central Connecticut State University
Negative affectivity in an individual involves the frequent experience of negative emotions (fear, guilt, anger, etc.) and poor self-concept. The Type D personality described by Denollet is one that exhibits negative affectivity and social inhibition/introversion. This piece discusses the possible connection between Type D personality and the risk of injury to athletes.
In this article, I will attempt to summarize the findings of a study done by Annmarie Tuxbury, an honors student at Bryant University (2016). Tuxbury, herself a nationally ranked distance runner, examined Type D personality as a factor for injury risk in athletes across all three NCAA divisions. In the study, a four-part survey was sent out with 145 athletes (70 female/75 male) responding. Part one was made up of questions about injury history and training level. Part two consisted of a survey to assess negative affectivity and social inhibition. Part three was the Perceived Stress Scale (PSS). The final portion was the Athletic Coping Skills Inventory (ACSI))
Personality Types
Many are familiar with the work of Friedman and Rosenman (1976) who developed the Type A and B personality theory after studying 3000 men aged 35-59 over a nine year period. They determined that Type A, the competitive, hostile, time-centered subjects, were more likely to suffer coronary heart disease due to stress, than the Type B. The Type B were considered easy-going, relaxed and patient.Current theory suggests that Type A-B personality is a “normally distributed continuum” with relatively few people being strongly driven and competitive (A) or totally laid back (B) (Riggio 2012).
In 1987, Lydia Temoshok identified a third personality type that she called Type C that she linked with the incidence of cancer. It is similar to Type A; however, the Type C personality tends to suppress emotions, particularly negative ones such as anger. They tend to avoid conflict and display “pathological niceness.”
The Type D personality type was identified by John Denollet in 1996. It includes two primary traits: negative affectivity (NA) and social inhibition (SI) (Pederson, et al., 2004). Those with NA tend to exhibit anxiety, insecurity, depression, and self-pity. In addition, they are found to be overtly emotional. SI is related to introversion and these individuals tend to be reserved, quiet and shy. Schiffer (2005) found Type D personality to be associated with coronary heart disease, depression, and impaired quality of life.
In 1962 The Myers-Briggs Type Indicator (MBTI) was published. Originally designed to determine which jobs suit various personalities. The MBTI identified 16 personality types based on the following pairs of determiners:
- Introverted vs, Extroverted (I vs. E)
- Sensing vs. Intuition (S vs. N)
- Thinking vs. Feeling (T vs. F)
- Judging vs. Perceiving (J vs. P)
Using the MBTI, those individuals classified as ISFP, or ISTP would most closely fit the characteristics of a Type D personality.
Study Findings
Tuxbury recognized that there are both internal and external factors that can lead to injury. External factors would include, environment, competition surface, equipment, and trauma. Internal factors include both psychological and physiological variables. Andersen and Williams (1988), found the key psychological factor related to sport injury occurrence is the stress response. They stated that stress response is influenced by three major factors: personality, history of stressors, and coping resources.
The work of Zafra, et al. (2015) focused on the period before injury. They found the primary cause of stress related injury to be increased muscle tension and attention deficit.
Nideffer (1985) developed a psychological training program for elite athletes. While not specifically mentioning personality types, he does stress the point that individuals respond differently to levels of arousal and that the events in track & field each require different levels of attention, focus and concentration.
It is well established that both eustress and distress cause an increase in blood pressure, heart rate, and the secretion of epinephrine and norepinephrine in to the bloodstream. There is also a release of corticosteroids including cortisol.
In a Swiss study (Verner, et al. 2010) of elite female endurance athletes vs. female non-athletes, they found cortisol levels reach their peak approximately 20-30 minutes after exposure to the stress of a standardized intelligence test. This elevated cortisol secretion is a biological indicator of experienced stress. The athletes in the study showed much lower cortisol levels than the non-athletes. Therefore it
is reasonable to assume that athletes show lower cortisol levels during threatening or challenging situations compared to non-athletes. This difference was attributed to effective coping mechanisms developed through athletics.
Through Tuxbury’s research, she concluded that Type D Personality proved to be a significant predictor of athletic injury. However, when the components of Type D Personality were broken down, negative affectivity significantly predicted athletic injury while social inhibition did not. She also found that coping with adversity, coach ability, concentration, confidence, goal setting, peaking under pressure, and freedom from worry all had a relationship to negative affectivity implying that the lower the coping skills an athlete has, the higher the negative affectivity will be.
Interestingly, gender, year in school, collegiate division, scholarship, hours spent in training, and ageintroduced to track & field were not significant indicators of negative affectivity.
Implications
Tuxbury concluded that identifying the relationship between Type D Personality and athletic injury in collegiate track athletes can be useful to coaches in reducing the risk of injury. By putting in place methods to reduce negative affectivity, we can, in turn, reduce injury risk. These methods should include effective, proven coping mechanisms and, if deemed necessary, work with a qualified health care professional.This information would also prove invaluable to the athlete as it addresses athletic-related stressors and athlete-related coping mechanisms that can be strengthened to decrease athletic injury risk.
In The Sports Psychology Roundtable in Track Coach #197 (2011) Dr. Kevin Williams points to the coach and athlete developing SMART (Specific, Measurable, Acceptable, Realistic, and Time-based) goals as a means of improving mental focus. In the same roundtable, Dr. Ralph Vernacchia, who has always emphasized that individuals learn and perform in different manners, refers to his 5 C’s of high performance sport:
- Confidence—the ability to believe in ourselves and trust our talent and preparation.Remember: competence breeds confidence.
- Composure—we can’t always control what happens to us, but we can control our response.
- Concentration—the ability to perform with a clear focus. To be in the moment, while dealing with distractions inherent in performance settings.
- Commitment—the ability to invest time, energy and emotion in pursuit of a goal.
- Character—the quality of an athlete’s foundational beliefs, values and ethical decision-making ability will determine the quality of one’s performances, particularly under adverse conditions.
A necessary piece of the coaches tool box should be an athlete self-evaluation to see how they rank themselves in the six dimensions of health:
- Physical—including the athlete’s level of fitness, quality of diet, monitoring drug and alcohol use, and evaluating sleep patterns and recovery.
- Social—what interactions does the athlete have between himself and others?
- Intellectual—is the athlete expanding his knowledge, being creative, open minded and curious?
- Emotional—is the athlete mindful? Is he capable of understanding, accepting and expressing how he feels? Have you developed a positive self-image?
- Spiritual—has the athlete developed a sense of purpose? What can one do to make the world a better place? What is your purpose in life?
- Environmental—is the athlete respectful of the surrounding environment? Is he aware of how environment can affect not only performance in training and competition, but overall quality of life?
Optimal performance in sport, and life in general, can only be achieved when the individual attempts to attain the highest score possible in each of these areas. It is up to the coach to guide the athlete towards that goal. It is in the best interests of both coach and athlete to be aware of the principles of individuality, including personality differences and optimal levels of arousal. In addition, it is imperative that athlete and coach work with health care professionals to insure that the athlete who needs the help is getting the best possible advice and care.
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Nideffer, Robert M. Athletes Guide to Mental Training Human Kinetics. Champaign, IL 1985.
Zafra, Aurelio & Rubio, Víctor & Ortega, Enrique. (2015). In: Sports Injuries Predicting and Preventing Sport Injureis: The Role of Stress.
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Pedersen, S. S., van Domburg, R. T., Theuns, D. A., Jordaens, L., & Erdman, R. A. (2004). Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partners. Psychosomatic Medicine, 66(5), 714-719.
Schiffer, A. A., Pedersen, S. S., Widdershoven, J. W., Hendriks, E. H., Winter, J. B., & Denollet, J. (2005). The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure. European Journal of Cardiovascular Prevention & Rehabilitation, 12(4), 341-346.
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