Development of a psychological risk indicator and its association with sports injuries in football players

Evidence suggests that psychological factors such as stress, anxiety, perfectionism, coping resources, and sleep quality may modulate sport-injury risk, supporting an integrative approach to athlete monitoring beyond physiological indicators. This study aimed to develop a composite psychological injury-risk index grounded in the Psycholight framework and examine its association with injury burden in male and female football players. A total of 281 youth-to-senior players aged 16-32 years completed validated self-report measures assessing sport-related psychological characteristics, maladaptive perfectionism, trait anxiety, emotional symptoms, and sleep quality, including the CPRD, MPSI, STAI-Trait, DASS-21, and PSQI. Baseline assessments were completed at the start of the season, while emotional symptoms and sleep quality were monitored monthly. Time-loss injuries were recorded throughout the season by the club's medical staff using standardized procedures. Analyses included descriptive statistics, between-group comparisons, and Poisson generalized linear mixed models. Overall, higher composite risk-index scores were associated with higher injury rates across follow-up periods. In male players, high-risk scores in stress control were associated with higher injury incidence than low- and moderate-risk scores. In female players, higher depressive symptom scores and higher global risk-index scores were associated with higher injury incidence; additionally, moderate-risk scores in evaluation influence were linked to increased injury incidence. These findings support the potential utility of a composite psychological risk index for identifying players with heightened psychological vulnerability and highlight the potential value of incorporating systematic psychological screening into injury-prevention programmes in high-performance football.