Athlete Burnout: A Physiological Perspective

Abstract

Dr. Gould has defined athlete burnout as a syndrome characterized by emotional and physical exhaustion, reduced sense of accomplishments, and sport devalua-tion. It results in physical, emotional and social withdrawal from a formerly enjoy-able sport activity. In his paper, he has done an excellent job in describing the sources and consequences of athlete burnout among college athletes from a psy-chological perspective. In my reaction, I will comment on some measurement issues and provide a physiological perspective on some aspects of athlete burnout, including its relation to the overtraining syndrome. Dr. Gould made clear in his paper that athlete burnout is a phenomenon dif-ficult to define, measure, diagnose and study. There is no universally accepted definition; different definitions have been adopted by sport psychologists who have studied the syndrome, depending on their perspective Thus, the nature of the phenomenon studied by different investigators has varied depending on how it has been defined and conceptualized. There also has not been a uniform approach to the measurement of athlete burnout. Several questionnaires, including the Maslach Burnout Questionnaire, the Maslach Burnout General Inventory General Survey (Cresswell & Eklund, 2006), and the Eades Burnout Inventory (Gustafsson, 2007), as well as other scales assessing related constructs (Raedeke, 1997), have been used to determine the extent to which individuals possess characteristics and symptoms of athlete burnout. As a result, the constructs actually measured have varied, depending on the measurement instrument. Finally, and perhaps most importantly, there has been no consensus on diagnostic criteria for the syndrome. As a result, most research on athlete burn-out has not been conducted on individuals who have been diagnosed with the condition. Lack of specific diagnostic criteria for a multifaceted syndrome is not an unusual situation. For example, a similar situation existed for major depres-sive disorder, a syndrome with many symptoms very similar to those of athlete 32 Cureton burnout, before specific diagnostic criteria were published by the American Psy-chiatric Association in 1994 (Association, 1994). Similarly, research and treat-ment of the metabolic syndrome was greatly hampered until a consensus scien-tific statement was issued by the American Heart Association and National Heart Lung and Blood Institute (Grundy et al., 2005) proposing specific diagnostic criteria based on cut points for each of the major symptoms of this multifaceted medical syndrome. The lack of universally accepted definition, measurement instrument and diagnostic criteria is a major barrier to progress related to understanding and treat-ment of athlete burnout. Diagnostic criteria similar to those that exist for major depressive disorder and the metabolic syndrome are needed. Without diagnostic criteria, it will be difficult to make progress on the important unresolved problems related to athlete burnout identified by Dr. Gould, including determining the prev-alence of the disorder, identifying causes and underlying mechanisms, developing treatments or interventions that reduce the risk of development, and studying the long-term consequences. Dr. Gould pointed out that overtraining can contribute to the development of athlete burnout. Progressive increases in training intensity and volume to optimize adaptations that improve sport performance can lead to a state of overtraining, in which there is an unexplained, sustained decrement in performance, usually accompanied by physiological and psychological changes reflecting maladapta-tion. This condition is referred to as the overtaining syndrome, or staleness. Exer-cise physiologists have long been interested in the overtraining syndrome (Karpo-vitch, 1941), and many reviews on the topic The signs and symptoms of the overtraining syndrome are very similar to those of athlete burnout. They include an unexplained, sustained decrease in phys-ical performance; general fatigue, malaise and loss of vigor; insomnia; decrease in appetite; irritability, restlessness, excitability and anxiousness; loss of body weight; loss of motivation; lack of mental concentration, and feelings of depres-sion (Armstrong & VanHeest, 2002). Although athlete burnout is not always caused by overtraining, it can be a contributing factor. Despite extensive research by exercise physiologists, the specific cause(s) of the overtraining syndrome remain unknown. It is hypothesized to reflect the effects of chronic stressors integrated by the hypothalamus of the brain, and resembles the stage of exhaustion of the General Adaptation Syndrome described by Hans Selye (1952). In this stage, attempts by the body to adapt to chronic stres-sors through specific adaptations that increase resistance to the stressor and com-plex nonspecific neuroendocrine and immune system changes are overwhelmed. The body no longer adapts to the stress of training, and physical and mental exhaustion, and other symptoms of the syndrome ensue. Alterations in the central nervous system, especially in the hypothalamic-pituitary-adrenalcortical axis and sympathetic-adrenal-medullary axis, disturbances in endocrine function (cortisol, catecholamines, and reproductive hormones), and impaired immune function are involved. But exactly how these changes result in impaired physical performance and other symptoms of the syndrome remains to be clarified (Armstrong & Van-Heest, 2002).