| Summary: | Background: The association of psychological factors with athletic performance and proneness to injury and illness has been widely recognised as an integral part of athletic preparation, treatment and rehabilitation. The exact nature of this association is still not clear, but it can be hypothesised that better mental health leads to better performance, less injuries and illness and more rapid recovery. Psychological distress is a strong predictor of injury, illness and poor performance, but inherent personality traits have failed to show a constant association with these parameters. Advances in validated psychometric instruments of personality and resilience show promise in their application to further the understanding of the psyche in athletes. Objective: The aim of this study was to evaluate the predictive value of personality traits (novelty seeking, harm avoidance and reward dependence), resilience and general psychological distress in terms of injury, illness and performance in a group of triathletes competing in the 2007 lronman Triathlon. Methods: For this descriptive cross-sectional study, 166 entrants in the 2007 lronman Triathlon were recruited. Each subject completed a detailed, previously validated set of questionnaires during registration prior to the event. Contained in the questionnaire were sections on general demographic information, detailed previous and current medical conditions and injuries, and psychometric instruments (TPQ - a measure of personality, CD-RISC - a measure of resilience, K10). After the event, the official overall finishing times, as well as the split times for the swimming, cycling and running legs, were obtained from the race organisers. Results: Higher NS and RD scores were predictors for faster predicted performance times and higher psychological distress scores was a predictor for slower actual times (r=0.160, P=0.053) and particularly predicted slower cycling times (r=0.026, P=0.002). Higher K10 scores significantly predicted the presence of flu-like symptoms (P=0.019) and higher HA scores significantly predicted nervous system symptoms during exercise (P=0.035). Higher RD scores predicted the absence of nervous system symptoms (P=0.075). Higher K10 scores (P=0.093) and HA scores (P=0.070) were associated with medication use prior to and during the event. Higher resilience scores predicted the occurrence of exercise associated collapse (P=0.081) and absence of EAMC (P=0.075). Higher HA scores predicted GIT symptoms during exercise (P=0.091 ). Higher reward dependence predicted the presence of tendon / ligament injuries (P=0.039) and genital injuries were associated with lower resilience (P=0.098) and higher HA scores (P=0.065). Conclusion: Generally, the results showed only a few consistent findings in terms of identifying predictors, although interesting correlations and trends were observed. Studies on different athletic populations and on a larger scale are needed. Physicians should be aware of the cardinal importance of mental well-being, as this is as vital in the preventative and curative management of the injured, ill or poor performing athlete as optimal physical conditioning.
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