Training Mental Toughness In Sport

Abstract

In January 2017, after a week of strenuous, military-style, and anecdotally-based workouts designed to test the level of mental toughness (MT), three Pac-12 football players were diagnosed with rhabdomyolysis. In sporting environments, are there any safe and effective, empirically-based MT interventions? To date, there has been no attempt to collate all available empirical evidence in regards to development of MT in Sport. PURPOSE: To summarize evidence relating to MT training programs in developing MT levels. METHODS: Cross-sectional designs and pre- and post-test experiments were included. No publication date restriction was imposed. Participants of any age, gender, sport, or level were included. This search was applied to Embase, Scopus, PubMed, and SPORTDiscus. Two reviewers assessed the risk of bias using: (a) for RCTs, the PEDro scale, (b) for before-after studies with no control group, the ‘Before-After (Pre-Post) Studies With No Control Group’, and (c) for single-subject research study, the ‘Quality Indicators’. The outcomes of primary interest were the scores of MT, which were translated into standardized variables (SMD). The meta-analysis was completed using a random-effects model. RESULTS: Nine studies were included in the systematic analysis and seven in the meta-analysis. The methodological quality of those nine studies was not high. Common areas that increased the risk of bias include: (a) RCT’s: allocation was not concealed, key outcomes were self-reported, no blinding of all subjects/assessors, and no random allocation of subjects; (b) Before-After Studies With No Control Group: No enrollment of all subjects who meet the inclusion/exclusion criteria, no blinding of assessors, and no reporting of relevant information; and (c) Single-subject design: fewer than three data points per phase without justification. MT scores increased by 0.88 standard deviations (95% CI). The values contained within the confidence interval were at least medium effect sizes and the variance of this estimate was 0.23. CONCLUSIONS: A strong positive effect was observed. Therefore, the results are promising. Nevertheless, the authors believe that conclusions cannot be drawn due to limited number of reliable results, which creates a high level of uncertainty. However, this finding itself is of value.