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. 2022 Oct 13;8(10):e11040.
doi: 10.1016/j.heliyon.2022.e11040. eCollection 2022 Oct.

An exploration of the antecedents and mechanisms causing athletes' stress and twisties symptom

Guishen Yu  1 , Kuei-Feng Chang  2 , I-Tung Shih  3
Affiliations

An exploration of the antecedents and mechanisms causing athletes' stress and twisties symptom

Guishen Yu et al. Heliyon. .

Abstract

Research background: Twisties symptoms have attracted the world's attention in the sports field since the 2020 Tokyo Olympics.

Aim: However, studies on the symptoms and causes, inducing mechanisms, and relationships between DP/DR (Depersonalization/Derealization Disorder) and anxiety and depression for athletes have been sparse for both the general population and athletes. The literature on the twisties issue of athletes is quite scarce in the past.

Research method: Adopting the criteria appealing to PRISMA Items to review the subject twisties in a broader mode and combing with the IPO (Input-Process-Output) model for triangulation testing purpose, this study categorized the literature to explore input variables causing athletes' twisties and identified process variables in psychological mechanisms bridging suppression and finally discussed the existing possible ways in helping athletes to solve problems caused by twisties.

Results: The authors formed 6 propositions in summarizing twisties' influential factors and mechanisms and tried to propose solutions to reduce the stress and the relevant twisties symptom of athletes. (1) Promotion of Athletes' Mental Toughness to Resist Stressors. (2) Interventions that correct for cognitive misinterpretations and appropriate relaxation and mindfulness practice in correcting a range of attention might reduce DP/DR. (3) Monitoring the athlete's HRV test results to ensure the Athlete's ability to resist pressure. (4) Avoid organizational stressors. (5) Written Emotional Disclosure method. (6) Improve various support systems for athletes: dual career paths. (7) Athletes' Stressful Awareness about the impact of gender, seniority, and environment.

Conclusion: Through the theoretical dialogue on the symptom of twisties, this study helps promote the development of the research of "twisties" and depersonalization-derealization symptoms (DDS); both have been under-researched.

Keywords: Athletes psychology; Depersonalization-derealization; Mental health; PTSD; Twisties.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prospective Categorization of literature via IPO model in terms of Athletes psychological stress coping strategies.
Figure 2
Figure 2
The triangulation test framework of this study.
Figure 3
Figure 3
Statistical distributions of articles founded with implications of dissociation, depersonalization-derealization, dystonia, posttraumatic, treatments like hypnosis.
Figure 4
Figure 4
Databases of the selected articles of above-mentioned literature for twisties
Figure 5
Figure 5
Databases used for review of PTSD.
Figure 6
Figure 6
Databases of the selected articles of above-mentioned literature for PTSD.
Figure 7
Figure 7
The six propositions. Note: basketball image is by Alexander Lesnitsky from Pixabay; Image of the player by David Stephanus from Pixabay
Figure 8
Figure 8
Nine grid basketball-pattern stressor of athletes (the stressful work environment).
Figure 9
Figure 9
Conceptual framework on antecedents that cause twisties for future studies.
Figure 10
Figure 10
The structured solutions proposed.
Figure 11
Figure 11
The influences of stakeholder involvement on antecedents of the mental toughness of athletes.
Figure 12
Figure 12
a. Review on mental toughness in terms of geography of research. b. Review on mental toughness in terms of types of research. c. Review on mental toughness in terms of year of publication. d. Review on mental toughness in terms of sources of databases.
Figure 13
Figure 13
Cause and effects between Trauma events and PTSD
See this image and copyright information in PMC

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