Responses to the Sports Inventory for pain among BASE jumpers.
The authors are not aware of any data regarding injuries or fatalities related to BASE jumping. There is, however, some information regarding injuries and fatalities resulting from skydiving. There are several studies (Amamilo, Samuel, Hesketh, & Moynthan, 1987; Baiju & James, 2003; Dawson, Asghar, Pryke, & Slater, 1998; Ellitsgaard, 1987; Ellisgaard & Ellitsgaard, 1988; Steinberg, 1988; Straiton & Sterland, 1986) that have examined civilian skydiving injuries. The incidence of civilian parachute injuries has been found to range from .02 to .20% (Ellitsgaard, 1987; Lee, Williams, & Hadden, 1999; Straiton & Sterland, 1986) although there are few consistencies among the studies regarding research designs, populations, and definitions of an injury. In other words, research has found that an injury occurred every 500-5,000 jumps among civilian skydivers. Most of what is known about skydiving injuries is from studies that assessed military training. A recent review reported the injury incidence to be 6 per 1,000 skydives (Bricknell & Craig, 1999). Gloriosa and his colleagues (1999) examined the type of injuries resulting from freefall parachute training and the most common injuries were fractures (35.5%), sprains/strains (34.7%), and dislocations (9.9%). The most commonly injured sites included the lower extremities (52.5%), upper extremities (19.8%), and spine (14.9%). By far, landing was the most frequent mechanism of injury (62%). Baiju and James (2003) argued that civilian skydivers are more likely to suffer an injury resulting from skydiving because of less rigorous training and poorer physical conditioning of civilians compared to military parachutists.
Individuals who partake in BASE-jumping face the reality and possible death or injury on each jump. This activity is essentially a risk management sport. In reality, a BASE jumper saves their own life during each jump because if the appropriate behavior fails to occur and the canopy is not deployed, the participant will strike the earth's surface at a very high rate of speed. As a BASE jumper waits to launch from a fixed object, there is little doubt that they must cope with some degree of stress and anxiety. Although no data exists on measuring levels of stress and anxiety among BASE jumpers, stress has been assessed in skydivers in a variety of settings using physiological measures as indicators. For example, several studies (Reid, Doerr, Doshier, & Ellerton, 1971; Shane & Slinde, 1968) examined EKG and respiratory-rate data and found extremely high recordings during actual jumps. In fact, several subjects in one study (Reid et al., 1971) were run to exhaustion on a treadmill without developing the heart rates they produced in freefall. It was found that the highest heart rate among experts to be during landing which is when the majority of injuries occur (e.g., Glorioso et al., 1999). In addition, others have documented stress-related changes in various hormone levels among jumpers (Deroanne, Cessin-Fossion, Juchmes, Servais, & Petit, 1975; Noel, Dimond, Earll, & Frantz, 1976; Paulo & Tessel, 1982). Thus, there is ample data collected from skydivers from which one may infer that BASE jumpers experience some degree of stress because there is a great degree of overlap with skydiving, yet it is a more dangerous activity compared to jumping out of planes.
Hart and Griffith (2004) reported that during between 1993 and 2001,308 individuals died while participating in civilian skydiving in the United States. Human error accounted for 86% of the fatalities in which inattention, decision errors, and action errors played a prominent role in these mishaps. Studies have demonstrated that psychological constructs related to successful performance (e.g., concentration, anxiety management, self-esteem) deteriorate as an athlete experiences increased levels of psychological and physical stress (Hanson, McCullagh, & Tonymon, 1992; May, Veach, Reed, & Griffey, 1985; Van Mechelen et al., 1996). Thus, increases in stressors are negatively correlated to abilities such as focusing on pertinent information, accurately making decisions regarding split-second physical maneuvers, and adjusting to physical challenges resulting in predisposition to musculoskeletal trauma (Bramwell, Masuda, Wagner, & Holmes, 1975; Van Mechelen, Hlobil, Kemper, Voorn, & de Jongh, 1993; Van Mechelen et al., 1996); all characteristics that are of crucial importance in making a successful BASE jump. There is evidence that perceptions and coping mechanisms of pain might be related to athletic performance (Crossman, 1997; Meyers, Bourgeois, Murray, & LeUnes, 1993; Meyers, Bourgeois, Stewart, & LeUnes, 1992).
Research has investigated the relationship between psychological indices of performance and injuries (Blackwell & McCullagh, 1990; Heil, 1993; Kerr & Minden, 1988; Petrie, 1993) although these efforts focused on perceptions following an injury. Meyers and his colleagues (Encarnacion et al., 2000; Meyers, Bourgeois, & LeUnes, 2001) have suggested a more proactive approach in understanding athletic injury by examining psychological indices prior to an injury in an effort to identify perceptions associated with injuries and performance. For example, one study (Meyers et al., 2001) examined pain coping responses of collegiate rodeo athletes. An interesting funding was that more experienced athletes who participated in a high injury sport (i.e., rodeo) showed more conservative pain coping skills compared to less experienced athletes.
As a BASE jumper experiences and learns to deal with stress that the sport entails, the manner in which they utilize pain coping strategies in view of the possibility of serious injuries remain unknown. The purpose of this study was to quantify pain coping styles of BASE jumpers and to investigate possible differences in regard to experience level. It was hypothesized that participants with high levels of experience would possess more conservative pain coping skills than less experienced BASE jumpers in line with prior findings involving a high injury potential sport (e.g., Meyers et al., 2001). In other words, experienced BASE jumpers may possess a more thorough understanding of the dangers involved in participation in the sport and may be less likely to ignore pain compared to less experienced BASE jumpers.
Participants included 134 individuals who have made at least one BASE jump by the end of the data collection period. Researchers attended Bridge Day in Fayetteville, West Virginia. This annual event occurs on the third Saturday of October of each year and allows for legal BASE jumping from the New River Gorge Bridge. There was a total of 390 registered BASE jumpers for the event, thus our sample captured 34% of the total number of jumpers attending the event. The sample consisted of 94% males, the average age was 33.3 years, and individuals had a mean of 1512 skydives and 44 BASE jumps.
The Sports Inventory for Pain (SIP) was used to assess pain coping responses (Meyers et al., 1992). The SIP is a 25-item sport-specific instrument that measures five domains relevant to competition: direct coping (COP), cognitive (COG), catastrophizing (CAT), avoidance (AVD), and body awareness (BOD). There is also a total coping response score (TCR = COP + COG -CAT), which serves as a composite indicator of the strategies used by participants to perform athletically while experiencing physical injury and pain. The scale uses a 5-point Likert-type format with responses ranging from 1 = strongly disagree.... 5= strongly agree. There is ample evidence for the psychometric properties of the SIP which has been shown to be a reliable, predictive indicator of pain-induced psychological distress and subsequent physical responses across a variety of diverse populations including traditional athletes, ballet dancers, and individuals participating in collegiate rodeo (Encarnacion et al., 2000; Meyers et al., 2001; Meyers et al., 1992; Tallman, Meyers, Skelly, LeUnes, & Bourgeois, 1998).
The first four subscales, e.g., direct coping, cognitive, catastrophizing, and avoidance, represent different types of coping strategies. The direct coping subscale consists of 8-items and measures how much immediate attention an athlete gives to pain, discomfort, and injury during competition. High scorers tend to ignore pain, realize that pain is part of competition, and "tough it out". A sample item is "When injured, I tell myself to be tough and carry on". The cognitive subscale consists of 5-items and measures whether a person uses mental strategies such as imagery in attempting to deal with pain. Individuals scoring high on the cognitive subscale may use a variety of mental techniques to maintain focus on the task at hand. A sample item is "When hurt, I play mental games with myself to keep my mind off the pain". The catastrophizing subscale consists of 4-items and measures the degree that an individual may despair when injured and dwell on the pain, perceive that it is unbearable, and have "given up". A sample item is "When injured, I feel that it's never gong to get better". A high score reflects an individual's inability to minimize catastrophic thinking and exhibit a pessimistic mindset while experiencing discomfort before or during athletic competition. The avoidance subscale consists of 4-items and measures the extent to which a person employs avoidant strategies to deal with pain. High scorers are thought to be less competitive when injured. A sample item is "When injured, I could perform as well as ever if my pain would go away". Recent data suggests, however, that exemplary athletes may also score high on this subscale since, if injured, they tend to reserve activity for more serious competition (see Encarnacion et al., 2000). The body awareness subscale contains 4-items and measures the degree of sensitivity to painful stimuli. A high score indicates hyposensitivity to pain or less awareness of it. It was designed to serve as a possible covariant in pain studies with athletic populations. A sample item is "I do not worry about being injured". The sixth subscale of the SIP is a composite. The TCR, or total coping response, is a composite scale derived by subtracting the CATASTROPHIZING score from the sum of DIRECT COPING and COGNITIVE (TCR = COP + COG--CAT). Initially referred to as HURT by Meyers and colleagues (1992), the calculation of the score has been modified from the original by omitting the AVD subscale. Although some individuals may consider avoiding pain to be beneficial to an athlete, others may deem avoidance detrimental in order to successfully achieve a competitive level of accomplishment. Thus, higher total coping response scores may better define overall capabilities during sports competitions and activities.
Two researchers arrived in Fayetteville, WV the day prior to Bridge Day. They approached participants after jumpers registered for the event and asked if they would be willing to participate in a study. A total of 158 individuals were approached and 134 agreed to participate (85%). Participants were told the about the nature of the study and were provided with a consent form and a 2-page survey and were asked to complete it. Participants were encouraged to answer all questions to the best of their ability according to written directions. Completed surveys were then collected by the research team.
The analytic plan called for a comparison of pain coping responses across experience levels of BASE jumpers. Experience was conceptualized as the total number of BASE jumps made prior to the survey. Three groups were constructed representing low, medium, and high levels of experience. The categorization was data driven such that the cutoff points represented the 33rd and 67th percentiles. The range of base jumps varied from 0-500. The experience categorization was as follows: low experience consisted of those who made 0-2 jumps (N=42), medium experience consisted of those who made 3-24 jumps N=46), and high experience consisted of those who made 25 or more jumps (N=46). The mean number of BASE jumps for the low, medium, and high experienced groups were .90, 9.22, and 118.52, respectively. A series of three independent t-tests were used to confirm that there were significant differences between the mean number of BASE jumps between groups. Comparisons were made between the low and medium experienced groups, t(86) = 8.97,p<.001, the medium and high experienced groups, t (90) = 6.39, p<.001, and the low and high experienced groups, t (86) = 6.57, p<.001, ensuring differences between groups.
A Multivariate Analysis of Variance (MANOVA) was conducted on the independent variable (i.e., experience) across the six subscales. The analyses yielded a significant effect for experience, F (10,226) = 6.382, p < .001, using the Wilkes' Lambda criterion. Because of the significant findings, a series of six analysis of variances (ANOVA) were performed on each the dependent variables. The univariate analyses indicated significant effects for direct coping, F (2, 117) = 10.09,p < .001, cognitive, F(2, 117) =.3.32,p < .05, catastrophizing, F (2, 117) =. 4.49, p <.05, avoidance F(2, 117)=.15.83,p < .001, and total coping response, F(2, 117) =.12.51,p< .001. For each significant effect, comparisons were made using Fisher's LSD procedure in order to examine group differences across each dimension. See Table 1 for group means for each subscale. Low experience BASE jumpers had higher direct coping (COP) scores than medium and high experienced groups. The cognitive subscale (COG) showed higher scores for the low experienced group compared to the high experienced group. The high experienced group had higher catastrophizing (CAT) scores compared to both lesser experienced groups. The avoidance (AVD) subscale had the high experienced group scores greater than both lesser experienced groups and the low experience group had higher scores than the medium experienced group. Finally, the low experience group had higher total coping (TCR) scores compared to both more experienced groups. There were no group differences on body awareness (BOD).
Significant differences were observed between groups on five of the six subscales. A consistent pattern of responses were observed such that experienced BASE jumpers tended to have more conservative pain coping styles as conceptualized by the SIP. Two of the findings were similar to the Meyers et al. (2001) study that sampled collegiate rodeo competitors. That is, more experienced BASE jumpers were more likely to have lower cognitive (COG) and higher avoidance (AVD) scores compared to less experienced BASE jumpers. In other words, experienced jumpers were less likely to use mental imagery to deal with pain compared to inexperienced jumpers. Although research (Cancio, 1991) has reported that 80% of experienced skydivers use mental imagery to help prepare for a jump, it is clear that more experienced BASE jumpers do not use that technique in helping them deal with pain as they may have a lower pain threshold that when reached, removes them from considering a jump. Inexperienced jumpers, on the other hand, may use a higher threshold and apply those skills to both the jump and dealing with pain, thus are more likely to ignore the pain and proceed to jump, whereas experienced jumpers tend to acknowledge the pain and wait for another day. The higher avoidance (AVD) scores among the more experienced BASE jumpers suggest that they are less competitive than less experienced jumpers according to the conceptualization of the subscale. There were also group differences on the direct coping (COP) and catastrophizing (CAT) subscales. BASE jumpers with more experience tend to acknowledge the pain and not ignore it and in fact, are more likely to dwell on the pain and possess a more pessimistic attitude while experiencing discomfort prior to jumping compared to less experienced jumpers. Finally, those with high experience scored significantly lower on the overall total coping (TCR) index. It is clear that experienced BASE jumpers use very different pain coping responses and are more conservative compared to less experienced jumpers. This may be the result of the realization of the extreme danger of the sport among experienced jumpers and naivety on behalf of the inexperienced jumpers. Experienced jumpers may also have a greater sense of self-preservation due to the fact they are more aware of the potential mishaps that may occur and they may have a better understanding of how various factors (including pain or a minor injury) are related to a successful BASE jump. Thus, jumpers with more experience may require a higher standard of physical and psychological preparedness compared to less experienced jumpers when considering a jump.
The SIP has been used to sample specific sport populations, although rodeo is the one investigated that involved a high contact, high injury environment (Meyers et al., 2001) that could be viewed as more similar to BASE jumping compared to more traditional sports in which it was used (e.g., Bartholomew, Edwards, Brewer, Van Raalte, & Linder, 1998; Meyers et al., 1992). When comparing the mean SIP subscale scores among BASE jumpers and rodeo athletes, a distinct pattern can be seen. That is, BASE jumpers scored much lower on direct coping (COP) and total coping response (TCR) subscales. This finding may be the result of prior traumatic experiences and a realization of the importance of the optimal conditions necessary for a successful BASE jump. In other words, consequences associated with decisions to make a BASE jump may be perceived as being more severe compared to most other sports including rodeo. In an extreme case, a bad BASE jump is not equivalent to a bad day of training for a distance runner. Thus, experienced BASE jumpers take into consideration an array of risk factors when jumping. Such conditions may include weather, equipment, challenging landing areas, the remoteness of some locations which are far from medical care, physical fitness, and mental preparedness. Based on the results of this data, it can be argued that experienced BASE jumpers may be aware how performance may be hampered under conditions in which they may be experiencing pain. Optimal performance when BASE jumping is a necessity rather than a recommendation. There is evidence that experienced BASE jumpers seem to be better at recognizing the possible negative consequences associated with jumping while injured more so than inexperienced jumpers.
BASE jumpers and skydivers are classified as being at the high end of a sports risk continuum, where risk is classified by consequences (Pedersen, 1997; Zuckerman, 1983). A fair amount of literature exists on the relationship between risk-taking, sensation seeking, and motivation (see Trimpop, 1994, for a review). This present report is the first to address pain coping strategies of athletes at the extreme end of the risk continuum. At present, there are less than 10 training centers for BASE jumping in the United States. In addition, there is little standardization between the existing training centers because there is not a strong governing body regulating these activities. The results of this study should certainly be taken into consideration by those who plan to BASE jump, instructors, and health care providers that may come in contact with jumpers. It is clear that the margin for error on most BASE jumps is minimal and an individual should not participate unless optimal climate, equipment, physical, and psychological conditions are present. Inexperienced BASE jumpers tend to show a pattern of not considering pain to be a factor in their performance which could certainly result in the possibility of engaging in irrational risk taking and not focusing on their own well-being. This may lead to an increased probability of a mishap and the potential to face bodily harm or even more serious consequences. Therefore, instructors should educate BASE jumping students on the relationship between injury and the potential risk factors that it may pose. Typically, the fixed objects that people jump off will be in existence and accessible for a very long time, so there should be no time urgency with regards to making a jump under less than optimal conditions.
The present study represents a step towards gaining a better understanding of pain coping responses of a group of extreme sport participants. Future research in this area could be explored in two obvious directions. First, the scope of participants should be expanded. Athletes from other extreme sports (e.g., kayaking, mountain biking, rock climbing) should be studied to determine variances in patterns of responses across the different types of dangerous activities rather than within sport comparisons as is most common within this literature. It would be of particular interest to examine the relationship between the probabilities of fatalities and serious injury as it relates to pain coping responses. A second avenue might explore the relationships between individual differences as measured by personality measures of thrill seeking (e.g., Farley, 1986; Zuckerman, 1983) and pain coping responses of extreme athletes. In other words, there may be thrill-seeking or risk-taking personality dimensions that may be related to patterns of pain coping responses within and across various extreme sports. Access to these extreme sport participants is often limited so studies need to be well planned out in advance of data collection. At present, our knowledge of these individuals is fairly limited and therefore presents many research opportunities to make contributions in this area of inquiry.
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James D. Griffith
Christian L. Hart
East Central University
Morgan Goodling and Jill Kessler
Penn State University
Address Correspondence To: James Griffith, Ph.D., Shippensburg University, Psychology Department, FSC-219, Shippensburg, PA, 17256.
Table 1 Mean SIP Subscale Scores of BASE Jumpers by Experience Level Experience Level Subscale Low (N = 42) Medium (N = 46) Direct Coping (COP) 23.17 (.66) (a,b) 19.86 (.60) Cognitive (COG) 16.39 (.57) (b) 15.32 (.52) Catastrophizing (CAT) 9.00 (.45) (b) 9.36 (.40) (c) Avoidance (AVD) 12.56 (.35) (a,b) 11.50 (.31) (c) Body Awareness (BOD) 14.56 (.46) 13.91 (.42) Total Coping (TCR) 30.56 (1.10) (a,b) 25.82 (.99) Experience Level Subscale High (N = 46) Direct Coping (COP) 19.40 (.63) Cognitive (COG) 14.35 (.54) Catastrophizing (CAT) 10.37 (.42) Avoidance (AVD) 14.05 (.33) Body Awareness (BOD) 13.15 (.44) Total Coping (TCR) 23.03 (1.04) Note: Standard deviations appear in parenthesis. (a) = significant difference between low and medium group. (b) = significant difference between low and high group. (c) = significant difference between medium and high group.
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|Author:||Griffith, James D.; Hart, Christian L.; Goodling, Morgan; Kessler, Jill; Whitmire, Andy|
|Publication:||Journal of Sport Behavior|
|Date:||Sep 1, 2006|
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