ABSTRACT Performing hurt is a complex but common phenomenon among high-performing athletes, musicians, and dancers. Previous research has analyzed this health risk behavior from different perspectives, predominantly focusing on psychological aspects and the influence of the social and cultural context. The diversity of existing research underscores the need for a synthesis informed by a psychosocial approach. With this systematic review, we aimed to synthesize research on the role of psychosocial factors in performing hurt. Forty studies from three high-performance domains, namely sports, music, and dancing, were included. Our convergent thematic analysis identified two overarching psychosocial factors from current research that contributed to performing hurt: (1) Personal characteristics of the high-performer such as performance identity or fearing the consequences of not performing hurt, and (2) Characteristics of the high-performance setting such as the sociocultural trivialization of pain and injuries or intensive practice and competition schedules. Whereas most included studies examined the role of psychological and social factors in performing hurt separately, we highlight the potential interplay between characteristics of the high-performer and the high-performance setting. Future performing hurt research should focus on these interconnections, as such knowledge might help to identify high-performers at risk and organizational factors that contribute to performing hurt.
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