
Playing for Freedom: A Phenomenological Exploration Into Team Sports’ Perceived Influence on PTSD Symptoms in Military Veterans
By: Jeffrey M. Ward
References
- Adler, R. F. (2022). Trustworthiness in qualitative research. Journal of Human Lactation, 38(4), 598–602. 10.1177/08903344221116620
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. APA. 10.1176/appi.books.9780890425787
- American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition (5th ed.). American Psychiatric Publishing. 10.1176/appi.books.9780890425596
- American Psychological Association. (2018). Resilience. APA Dictionary of Psychology.
https://dictionary.apa.org/resilience - Americans for Prosperity Foundation. (2022, January 28). More evidence the VA is improperly delaying or denying community care to eligible veterans. Americans for Prosperity.
https://americansforprosperity.org/va-denying-delaying-care/ - Andersen, M. H., Ottesen, L., & Thing, L. F. (2018). The social and psychological health outcomes of team sport participation in adults: An integrative review of research. Scandinavian Journal of Public Health, 47(8), 832–850. 10.1177/1403494818791405
- Atkinson, M., & Young, K. (Eds.) (2008).
Tribal Play: Subcultural Journeys through sport . Medical Entomology and Zoology (Vol. 4). Emerald Group Publishing.http://ci.nii.ac.jp/ncid/BA87420304 - Averill, L. A., Averill, C. L., Pietrzak, R. H., Charney, D. S., & Southwick, S. M. (2021).
Psychoneurobiology of resilience . In M. J. Friedman, P. P. Schnurr, & T. M. Keane (Eds.), Handbook of PTSD (3rd ed., pp. 551–569). Guilford Press. - Baillie, T., Gardner, P., & Church, H. (2024). Delays in treatment initiation for post-traumatic stress disorder in the Canadian Armed Forces: a scoping review. Journal of Military Veteran and Family Health, 10(3), 2–15. 10.3138/jmvfh-2023-0029
- Bale, J., Cheska, A., Chick, G., Guttmann, A., Holt, R., Kyle, D. G.,
Jr. , J. L. W., Park, R., Christensen, K., & Levinson, D. (2012). Encyclopedia of world sport: From ancient times to the present. Berkshire Publishing. - Bandura, A. (1976). Social learning theory (1st ed.). Prentice-Hall.
- Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory (1st ed.). Prentice Hall.
- Bandura, A. (2004). Health promotion by social cognitive means. Health Education Behavior, 31(2), 143–164. 10.1177/1090198104263660
- Bandura, A. (2005).
The evolution of social cognitive theory . In K. G. Smith & M. A. Hitt (Eds.), Great minds in management (pp. 9–35). Oxford University Press. - Beauchamp, M. R., Crawford, K. D., & Jackson, B. (2019). Social cognitive theory and physical activity: Mechanisms of behavior change, critique, and legacy. Psychology of Sport and Exercise, 42, 110–117. 10.1016/j.psychsport.2018.11.009
- Benight, C. C., & Bandura, A. (2004). Social cognitive theory of post-traumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42(10), 1129–1148. 10.1016/j.brat.2003.08.008
- Bezner, J. R., & Held Bradford, E. C. (2020).
Integrating health promotion and wellness into neurorehabilitation . In R. T. Lazaro, S. G. Reina-Guerra, & M. U. Quiben (Eds.), Umphred’s neurological rehabilitation (7th ed., Vol. 33, pp. 938–952). Elsevier. - Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. SAGE. 10.1007/978-3-319-69909-7_3470-2
- Brittain, I., Bunds, K., & Bocarro, J. (2022). The contribution of sport in the rehabilitation process of disabled military veterans: A case study of the 2016 Invictus Games. Journal of Global Sport Management, 1–24. 10.1080/24704067.2022.2031249
- Brooks, S. K., & Greenberg, N. (2017). Non-deployment factors affecting psychological well-being in military personnel: Literature review. Journal of Mental Health, 27(1), 80–90. 10.1080/09638237.2016.1276536
- Browne, J., Medenblik, A., Pebole, M., Gregg, J. J., & Hall, K. S. (2021). Qualitative analysis of a supervised exercise program for older veterans with PTSD. The American Journal of Geriatric Psychiatry, 29(6), 565–572. 10.1016/j.jagp.2020.10.014
- Bustamante, D., Bountress, K., Sheerin, C., Koenen, K. C., Guffanti, G., Yan, L., Haloossim, M., Uddin, M., Nugent, N., & Amstadter, A. B. (2021).
Genetics of PTSD . In M. J. Friedman, P. P. Schnurr, & T. M. Keane (Eds.), Handbook of PTSD (3rd ed., pp. 192–210). The Guilford Press. - Caddick, N., & Smith, B. (2014). The impact of sport and physical activity on the well-being of combat veterans: A systematic review. Psychology of Sport and Exercise, 15(1), 9–18. 10.1016/j.psychsport.2013.09.011
- Caddick, N., Smith, B., & Phoenix, C. (2015). The effects of surfing and the natural environment on the Well-Being of combat veterans. Qualitative Health Research, 25(1), 76–86. 10.1177/1049732314549477
- Campbell, D. G., Bonner, L. M., Bolkan, C. R., Lanto, A. B., Zivin, K., Waltz, T. J., Klap, R., Rubenstein, L. V., & Chaney, E. F. (2016). Stigma predicts treatment preferences and care engagement among veterans affairs primary care patients with depression. Annals of Behavioral Medicine, 50(4), 533–544. 10.1007/s12160-016-9780-1
- Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Rep. 100, 126–131.
- Chambliss, T., Hsu, J., & Chen, M. (2024). Post-traumatic Stress Disorder in Veterans: A Concept Analysis. Behavioral Sciences, 14(6), 485. 10.3390/bs14060485
- Choi, K. W., Zheutlin, A. B., Karlson, R. A., Wang, M., Dunn, E. C., Stein, M. B., Karlson, E. W., & Smoller, J. W. (2019). Physical activity offsets genetic risk for incident depression assessed via electronic health records in a biobank cohort study. Depression and Anxiety, 37(2), 106–114. 10.1002/da.22967
- Creswell, J. W., & Poth, C. (2017). Qualitative inquiry and research design: Choosing among five approaches.
https://openlibrary.org/books/OL28633749M/Qualitative_Inquiry_and_Research_Design - Crocq, M. A., & Crocq, L. (2022). From shell shock and war neurosis to post-traumatic stress disorder: A history of psychotraumatology. Dialogues in Clinical Neuroscience, 2(1), 47–55. 10.31887/dcns.2000.2.1/macrocq
- Davis, L. L., Schein, J., Cloutier, M., Gagnon-Sanschagrin, P., Maitland, J., Urganus, A., Guerin, A., Lefebvre, P., & Houle, C. R. (2022). The economic burden of post-traumatic stress disorder in the united states from a societal perspective. The Journal of Clinical Psychiatry, 83(3). 10.4088/jcp.21m14116
- Eather, N., Wade, L., Pankowiak, A., & Eime, R. (2023). The Impact of sports participation on mental health and social Outcomes in Adults: A systematic review and the ‘Mental Health Through Sport’ Conceptual model. Systematic Reviews, 12(1). 10.1186/s13643-023-02264-8
- Eime, R., Harvey, J., Brown, W., & Payne, W. (2010). Does sports club participation contribute to Health-Related quality of life? Medicine & Science in Sports & Exercise, 42(5), 1022–1028. 10.1249/mss.0b013e3181c3adaa
- Eime, R., Young, J., Harvey, J., & Payne, W. (2013a). Psychological and social benefits of sport participation: The development of health through sport conceptual model. Journal of Science and Medicine in Sport, 16, e79–e80. 10.1016/j.jsams.2013.10.190
- Eime, R., Young, J. A., Harvey, J. T., Charity, M. J., & Payne, W. R. (2013b). A systematic review of the psychological and social benefits of participation in sport for adults: Informing development of a conceptual model of health through sport. International Journal of Behavioral Nutrition and Physical Activity, 10(1), 135. 10.1186/1479-5868-10-135
- Ein, N., Gervasio, J., St Cyr, K., Liu, J. J. W., Baker, C., Nazarov, A., & Richardson, J. D. (2024). A rapid review of the barriers and facilitators of mental health service access among veterans and their families. Frontiers in Health Services, 4, 1426202. 10.3389/frhs.2024.1426202
- Elbogen, E. B., Molloy, K., Wagner, H. R., Kimbrel, N. A., Beckham, J. C., Van Male, L., Leinbach, J., & Bradford, D. W. (2020). Psychosocial protective factors and suicidal ideation: Results from a national longitudinal study of veterans. Journal of Affective Disorders, 260, 703–709. 10.1016/j.jad.2019.09.062
- Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., Kim, J. S., Heo, S., Alves, H., White, S. M., Wojcicki, T. R., Mailey, E., Vieira, V. J., Martin, S. A., Pence, B. D., Woods, J. A., McAuley, E., & Kramer, A. F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017–3022. 10.1073/pnas.1015950108
- Fetzner, M. G., & Asmundson, G. J. (2014). Aerobic exercise reduces symptoms of post-traumatic stress disorder: A randomized controlled trial. Cognitive Behaviour Therapy, 44(4), 301–313. 10.1080/16506073.2014.916745
- Fletcher, S., Elklit, A., Shevlin, M., & Armour, C. (2017). Predictors of PTSD treatment response trajectories in a sample of childhood sexual abuse survivors: The roles of social support, coping, and PTSD symptom clusters. Journal of Interpersonal Violence, 36(3–4), 1283–1307. 10.1177/0886260517741212
- Friedman, M. J. (2019, October 14). PTSD history and overview. Veteran’s Affairs.
https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp - Friedman, M. J. (2022, March 22). History of PTSD in veterans: Civil war to DSM-5. Veteran’s Affairs.
https://www.ptsd.va.gov/understand/what/history_ptsd.asp - Friedman, M. J., Schnurr, P. P., & Keane, T. M. (2021).
PTSD from DSM-III to DSM-5: Progress and challenges . In Handbook of PTSD (3rd ed., pp. 3–18). Guilford Publications. - Galovski, T. E., Street, A. E., Creech, S., Lehavot, K., Kelly, U. A., & Yano, E. M. (2022). State of the Knowledge of VA Military Sexual Trauma Research. Journal of General Internal Medicine, 37(S3), 825–832. 10.1007/s11606-022-07580-8
- Glaser, B. G. (1965). The constant comparative method of qualitative analysis. Social Problems, 12(4), 436–445. 10.2307/798843
- Hallmann, K., & Giel, T. (2017). eSports – competitive sports or recreational activity? Sport Management Review, 21(1), 14–20. 10.1016/j.smr.2017.07.011
- Havlick, D. G., Cerveny, L. K., & Derrien, M. M. (2019). Therapeutic landscapes, outdoor programs for veterans, and public lands. Social Science & Medicine, 268, 113540. 10.1016/j.socscimed.2020.113540
- Hawkins, B. L., Cory, A. L., & Crowe, B. M. (2011). Effects of participation in a paralympic military sports camp on injured service members: Implications for therapeutic recreation. Therapeutic Recreation Journal, 45(4).
https://js.sagamorepub.com/trj/article/view/2438 - Hegberg, N. J., Hayes, J. P., & Hayes, S. M. (2019). Exercise intervention in PTSD: A narrative review and rationale for implementation. Frontiers in Psychiatry, 10. 10.3389/fpsyt.2019.00133
- Hendrick, A., Binks, E., Ferguson, N., & Di Lemma, L. (2024). Unveiling the influence of competitive sports on the sense of self and identity of disabled Veterans: A Systematic Review and Mixed-Methods Synthesis. Identity, 24(3), 194–212. 10.1080/15283488.2024.2346257
- Hitch, C., Toner, P., & Armour, C. (2023). Enablers and Barriers to military veterans seeking help for mental health and alcohol difficulties: A Systematic review of the quantitative evidence. Journal of Health Services Research & Policy, 28(3), 197–211. 10.1177/13558196221149930
- Hoppen, T. H., & Morina, N. (2019). The prevalence of PTSD and major depression in the global population of adult war survivors: a meta-analytically informed estimate in absolute numbers. European Journal of Psychotraumatology, 10(1), 1–11. 10.1080/20008198.2019.1578637
- Hoppen, T. H., Priebe, S., Vetter, I., & Morina, N. (2021). Global burden of post-traumatic stress disorder and major depression in countries affected by war between 1989 and 2019: a systematic review and meta-analysis. BMJ Global Health, 6(7),
e006303 . 10.1136/bmjgh-2021-006303 - Horigian, V. E., Schmidt, R. D., & Feaster, D. J. (2020). Loneliness, mental health, and substance use among U.S. young adults during COVID-19. Journal of Psychoactive Drugs, 53(1), 1–9. 10.1080/02791072.2020.1836435
- Hruby, A., Lieberman, H. R., & Smith, T. J. (2021). Symptoms of depression, anxiety, and post-traumatic stress disorder and their relationship to health-related behaviors in over 12,000 U.S. military personnel: Bi-directional associations. Journal of Affective Disorders, 283, 84–93. 10.1016/j.jad.2021.01.029
- Inoue, Y., Sato, M., & Filo, K. (2020). Transformative sport service research: Linking sport services with well-being. Journal of Sport Management, 34(4), 285–290. 10.1123/jsm.2020-0102
- Invictus Games Foundation. (2024).
Beyond the finish line . In fim-trust.org. Forces In Mind Trust.https://s31949.pcdn.co/wp-content/uploads/Beyond-the-Finish-Line_ONLINE-COPY_FINAL.pdf - Kachadourian, L. K., Tsai, J., Harpaz-Rotem, I., Southwick, S. M., & Pietrzak, R. H. (2019). Protective correlates of suicidality among veterans with histories of post-traumatic stress disorder and major depressive disorder: Results from the national health and resilience in veterans study. Journal of Affective Disorders, 246, 731–737. 10.1016/j.jad.2018.12.058
- Kaniasty, K., & Norris, F. H. (2008). Longitudinal linkages between perceived social support and post-traumatic stress symptoms: Sequential roles of social causation and social selection. Journal of Traumatic Stress, 21(3), 274–281. 10.1002/jts.20334
- Kazlauskas, E. (2017). Challenges for providing health care in traumatized populations: Barriers for PTSD treatments and the need for new developments. Global Health Action, 10(1), 1322399. 10.1080/16549716.2017.1322399
- Kehle-Forbes, S. M., Meis, L. A., Spoont, M., & Polusny, M. A. (2016). Treatment initiation and dropout from prolonged exposure and cognitive processing therapy in a VA outpatient clinic. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 107–114. 10.1037/tra0000065
- Kelly, M. M., & Vogt, D. S. (2015).
Military stress: Effects of acute, chronic, and traumatic stress on mental and physical health . In M. S. Freeman, B. A. Moore, & A. Freeman (Eds.), Living and surviving in harm’s way: A psychological treatment handbook for pre- and Post-Deployment of military personnel (201) (1st ed., pp. 85–106). Routledge. - Kline, A. C., Straus, E., Lyons, R. C., Angkaw, A. C., Davis, B. C., Haller, M., Hien, D., & Norman, S. B. (2021). Substance use predictors of attendance among veterans in integrated PTSD and alcohol use disorder treatment. Journal of Substance Abuse Treatment, 124, 108278. 10.1016/j.jsat.2021.108278
- Knappe, F., Colledge, F., & Gerber, M. (2019). Impact of an 8-Week exercise and sport intervention on Post-traumatic Stress Disorder symptoms, mental health, and physical fitness among male refugees living in a Greek refugee camp. International Journal of Environmental Research and Public Health, 16(20), 3904. 10.3390/ijerph16203904
- Korte, K. J., Jiang, T., Koenen, K. C., Galea, S., & Gradus, J. L. (2021).
Epidemiology of trauma and PTSD in adults . In M. J. Friedman, P. P. Schnurr, & T. M. Keane (Eds.), Handbook of PTSD, (3rd ed, pp. 61–75). The Guilford Press. - Labov, W., & Waletzky, J. (1997). Narrative analysis: Oral versions of personal experience1. Journal of Narrative and Life History, 7(1–4), 3–38. 10.1075/jnlh.7.02nar
- Lawrence, S., De Silva, M., & Henley, R. (2010). Sports and games for post-traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, 1. 10.1002/14651858.cd007171.pub2
- Levinson, D., & Christensen, K. (1999). Encyclopedia of world sport: From ancient times to the present (First Edition). Oxford University Press.
- Ley, C., Rato Barrio, M., & Koch, A. (2017). “In the sport I am here”: Therapeutic processes and health effects of sport and exercise on PTSD. Qualitative Health Research, 28(3), 491–507. 10.1177/1049732317744533
- Li, H., Tofigh, A. M., Amirfakhraei, A., Chen, X., Tajik, M., Xu, D., & Motevalli, S. (2022). Modulation of astrocyte activity and improvement of oxidative stress through blockage of NO/NMDAR pathway improve post-traumatic stress disorder (PTSD)-like behavior induced by social isolation stress. Brain and Behavior, 12(7). 10.1002/brb3.2620
- Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage Publications. 10.1016/0147-1767(85)90062-8
- Malm, C., Jakobsson, J., & Isaksson, A. (2019). Physical activity and Sports—Real health benefits: A review with insight into the public health of Sweden. Sports, 7(5), 127. 10.3390/sports7050127
- Manger, T. A., & Motta, R. W. (2005). The impact of an exercise program on post-traumatic stress disorder, anxiety, and depression. International Journal of Emergency Mental Health, 7(1), 49–57.
- May, C. (2021, July 8). What is sport? Sport Australia.
https://www.ausport.gov.au/clearinghouse/evidence/what-is-sport - McDonagh, K., Bennett, J. L., & Geden, S. (2024). Physical activity participation, quality of life, and behavioral health disorders for veterans with PTSD. Therapeutic Recreation Journal, 58(1). 10.18666/trj-2024-v58-i1-12055
- Meir, D., & Fletcher, T. (2017). The transformative potential of using participatory community sport initiatives to promote social cohesion in divided community contexts. International Review for the Sociology of Sport, 54(2), 218–238. 10.1177/1012690217715297
- Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E. (2013). The Behavior Change Technique Taxonomy (V1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46(1), 81–95. 10.1007/s12160-013-9486-6
- Miles, M., Huberman, M., & Saldana, J. (2018). Qualitative data analysis: A methods sourcebook (4th ed.). SAGE Publications.
- Moore, B., & Penk, W. (2019).
PTSD in the military . In B. Moore & W. Penk (Eds.), Treatment of PTSD in military personnel, 2nd ed (pp. 1–6). The Guilford Press. - Morgan, P. S., Fletcher, D., & Sarkar, M. (2019). Developing team resilience: A season-long study of psychosocial enablers and strategies in a high-level sports team. Psychology of Sport and Exercise, 45, 101543. 10.1016/j.psychsport.2019.101543
- Moustakas, C. (1994). Phenomenological research methods. SAGE.
- Na, P. J., Schnurr, P. P., & Pietrzak, R. H. (2022). Mental health of U.S. combat veterans by War Era: Results from the National Health and Resilience in Veterans Study. Journal of Psychiatric Research, 158, 36–40. 10.1016/j.jpsychires.2022.12.019
- Olvhøj, R., Jensen, T. K., Wienecke, J., & Winther, H. (2022). Dream team – team sports in a community of adults with intellectual disability. Sport in Society, 25(10), 2162–2177. 10.1080/17430437.2022.2097072
- Park, C. L., Sacco, S. J., Finkelstein-Fox, L., Sinnott, S. M., Scoglio, A. a. J., Lee, S. Y., Gnall, K. E., Mazure, C., Shirk, S. D., Hoff, R. A., & Kraus, S. W. (2021). Post-9/11 military veterans’ adjustment to civilian life over time following separation from service. Journal of Clinical Psychology, 77(9), 2077–2095. 10.1002/jclp.23144
- Patterson, E. (2022, October 18). Why aren’t veterans getting help: How stigma hurts. Greenhouse Treatment Center.
https://greenhousetreatment.com/veterans-and-addiction/military-culture-stigma/ - Piggin, J. (2020). What is physical activity? A holistic definition for teachers, researchers and policy makers. Frontiers in Sports and Active Living, 2. 10.3389/fspor.2020.00072
- Pluhar, E., McCracken, C., Griffith, K. L., Christino, M. A., Sugimoto, D., & Meehan III, W. P. (2019). Team sport athletes may be less likely to suffer anxiety or depression than individual sport athletes. Journal of Sports Science and Medicine, 18(3), 490–496.
- Rafferty, L. A., Wessely, S., Stevelink, S. A. M., & Greenberg, N. (2020). The journey to professional mental health support: A qualitative exploration of the barriers and facilitators impacting military veterans’ engagement with mental health treatment. European Journal of Psychotraumatology, 10(1), 1700613. 10.1080/20008198.2019.1700613
- Ramalingam, N. S., Barnes, C., Patzel, M., Kenzie, E. S., Ono, S. S., & Davis, M. M. (2023). “It’s like finding your way through the labyrinth”: A qualitative study of veterans’ experiences accessing healthcare. Journal of General Internal Medicine, 39(4), 596–602. 10.1007/s11606-023-08442-7
- Ramos-Sanchez, C. P., Schuch, F. B., Seedat, S., Louw, Q. A., Stubbs, B., Rosenbaum, S., Firth, J., Van Winkel, R., & Vancampfort, D. (2021). The anxiolytic effects of exercise for people with anxiety and related disorders: An update of the available meta-analytic evidence. Psychiatry Research, 302, 114046. 10.1016/j.psychres.2021.114046
- Reis, D. J., Gaddy, M. A., & Chen, G. J. (2022). Exercise to reduce post-traumatic stress disorder symptoms in veterans. Federal Practitioner, 39(4), 158–166. 10.12788/fp.0248
- Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. P & T: A Peer-reviewed Journal for Formulary Management, 41(10), 623–627.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/ - Resick, P. A., Wachen, J. S., Dondanville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., Mintz, J., Borah, E. V., Brundige, A., Hembree, E. A., Litz, B. T., Roache, J. D., & Young-McCaughan, S. (2017). Effect of group vs individual Cognitive Processing therapy in Active-Duty military seeking treatment for post-traumatic stress disorder. JAMA Psychiatry, 74(1), 28. 10.1001/jamapsychiatry.2016.2729
- Rhodes, R. E., Beauchamp, M. R., Carson, V., Courtnall, S., Wierts, C. M., & Blanchard, C. M. (2024). Effect of recreational sport and physical activity participation on well-being during early parenthood: a randomized controlled trial. Annals of Behavioral Medicine, 59(1). 10.1093/abm/kaae081
- Roberts, G. A., Arnold, R., Gillison, F., Colclough, M., & Bilzon, J. (2020). Military veteran athletes’ experiences of competing at the 2016 Invictus games: A qualitative study. Disability and Rehabilitation, 43(24), 3552–3561. 10.1080/09638288.2020.1725655
- Rosenbaum, S., Vancampfort, D., Steel, Z., Newby, J. M., Ward, P. B., & Stubbs, B. (2015). Physical activity in the treatment of post-traumatic stress disorder: A systematic review and meta-analysis. Psychiatry Research-neuroimaging, 230(2), 130–136. 10.1016/j.psychres.2015.10.017
- Saldana, J. (2021). The coding manual for qualitative researchers (Fourth). SAGE Publications.
- Schaeffer, K. (2023). The changing face of America’s veteran population. Pew Research Center.
https://www.pewresearch.org/short-reads/2023/11/08/the-changing-face-of-americas-veteran-population/ - Schnurr, P. (2023, February 2). Epidemiology and impact of PTSD. PTSD: National Center for PTSD.
https://www.ptsd.va.gov/professional/treat/essentials/epidemiology.asp - Shah, E., Fransen, K., Slater, M. J., & Barker, J. B. (2022). The impact of intra-team communication and support relationships on team identification and collective efficacy in elite team sport: A social network analysis. International Journal of Sport and Exercise Psychology, 21(4), 1–22. 10.1080/1612197x.2022.2084761
- Shah, R. (2024). Challenges of doing gender research as a male researcher in Pakistan: Reflections from Online and In-Person fieldwork. International Journal of Qualitative Methods, 23. 10.1177/16094069241230021
- Shaw, S. C. (2020). Hopelessness, helplessness and resilience: The importance of safeguarding our trainees’ mental well-being during the COVID-19 pandemic. Nurse Education in Practice, 44, 102780. 10.1016/j.nepr.2020.102780
- Silverman, M. N., & Deuster, P. A. (2014). Biological mechanisms underlying the role of physical fitness in health and resilience. Interface Focus, 4(5), 20140040. 10.1098/rsfs.2014.0040
- Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. British Journal of Sports Medicine, 57, 1203–1209. 10.1136/bjsports-2022-106195
- Smith, R. E., & Smoll, F. L. (2006).
Social cognitive approach to coaching behaviors . In S. Jowett & D. Lavallee (Eds.), Social psychology in sport (pp. 75–90). Human Kinetics. 10.5040/9781492595878.ch-006 - Sommer, J. L., Roy, R., Holens, P. L., & El-Gabalawy, R. (2020). Post-traumatic stress disorder and chronic pain in the military. Overlapping Pain and Psychiatric Syndromes, 189–202. 10.1093/med/9780190248253.003.0014
- Spaaij, R., Oxford, S., & Jeanes, R. (2016). Transforming communities through sport?: Critical pedagogy and sport for development. Sport, Education and Society, 21(4), 570–587. 10.1080/13573322.2015.1082127
- Stahlman, S., & Oetting, A. A. (2018). Mental health disorders and mental health problems, active component, U.S. armed forces, 2007-2016. MSMR, 25(3), 2–11.
- Statista. (2025, November 28). U.S. Veterans 2024, by gender.
https://www.statista.com/statistics/250271/us-veterans-by-gender/ - Steenkamp, M. M., Litz, B. T., Hoge, C. W., & Marmar, C. R. (2015). Psychotherapy for Military-Related PTSD. JAMA, 314(5), 489. 10.1001/jama.2015.8370
- Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., Salum, G. A., & Schuch, F. B. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249, 102–108. 10.1016/j.psychres.2016.12.020
- Teo, A. R., Marsh, H. E., Forsberg, C. W., Nicolaidis, C., Chen, J. S., Newsom, J. T., Saha, S., & Dobscha, S. K. (2018). Loneliness is closely associated with depression outcomes and suicidal ideation among military veterans in primary care. Journal of Affective Disorders, 230, 42–49. 10.1016/j.jad.2018.01.003
- Thoits, P. A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51(1_suppl), S41–S53. 10.1177/0022146510383499
- Townsend, J., Hawkins, B. L., Bennett, J. L., Hoffman, J., Martin, T. P., Sotherden, E., & Bridges, W. C. (2018). Preliminary long-term health outcomes associated with recreation-based health and wellness programs for injured service members. Cogent Psychology, 5(1), 1444330. 10.1080/23311908.2018.1444330
- U.S. Census Bureau. (2021). Explore census data. Census.gov.
https://data.census.gov/table?q=B21001&tid=ACSDT1Y2021.B21001 - U.S. Department of Veteran’s Affairs. (2023, February 3). How common is PTSD in adults?
https://www.ptsd.va.gov/understand/common/common_adults.asp - U.S. Department of Veteran Affairs National Center for PTSD. (2025). What is PTSD? U.S. Department of Veteran Affairs.
https://www.ptsd.va.gov/understand/what/ptsd_basics.asp - Vagle, M. D. (2018).
Crafting phenomenological research . In Routledge eBooks (2nd ed.). Routledge. 10.4324/9781315173474 - Waldhauser, K. J., O’Rourke, J. J., Jackson, B., Dimmock, J. A., & Beauchamp, M. R. (2021). Purpose after service through sport: A social identity-informed program to support military veteran well-being. Sport, Exercise, and Performance Psychology, 10(3), 423–437. 10.1037/spy0000255
- Walter, K. H., Otis, N., Hose, M. K., Ober, K. M., & Glassman, L. H. (2023). The effectiveness of the National Veterans Summer Sports Clinic for veterans with probable post-traumatic stress disorder. Frontiers in Psychology, 14. 10.3389/fpsyg.2023.1207633
- Ward, J. M. (2024). Safe at home: a phenomenological exploration into team sports’ perceived influence on PTSD symptoms in military veterans. ThinkIR: The University of Louisville’s Institutional Repository.
https://ir.library.louisville.edu/etd/4426/ - Wheeler, M., Cooper, N. R., Andrews, L., Hacker Hughes, J., Juanchich, M., Rakow, T., & Orbell, S. (2020). Outdoor recreational activity experiences improve psychological well-being of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial. PLOS ONE, 15(11),
e0241763 . 10.1371/journal.pone.0241763 - Wong, C., & Monaghan, M. (2020).
Behavior change techniques for diabetes technologies . In D. C. Klonoff, D. Kerr, & S. A. Mulvaney (Eds.), Diabetes digital health (1st ed., pp. 65–75). Elsevier. 10.1016/C2018-0-01557-1 - Wounded Warrior Project. (2021). 2021 annual warrior survey executive summary.
https://www.woundedwarriorproject.org/media/ixqbka3q/2021-executive-summary.pdf - Yuan, Z., Peng, C., Yang, L., & Chen, H. (2025). Effects of physical activity on patients with post-traumatic stress Disorder: a systematic review and meta-analysis of randomized controlled trials. Medicine, 104(3),
e41139 . 10.1097/md.0000000000041139 - Zhao, F., Liu, C., & Lin, Z. (2025). A Narrative review of exercise intervention mechanisms for post-traumatic stress Disorder in Veterans. Frontiers in Public Health, 12, 1483077. 10.3389/fpubh.2024.1483077
- Zuckerman, S. L., Tang, A. R., Richard, K. E., Grisham, C. J., Kuhn, A. W., Bonfield, C. M., & Yengo-Kahn, A. M. (2020). The behavioral, psychological, and social impacts of team sports: a systematic review and meta-analysis. Physician and Sports Medicine, 49(3), 246–261. 10.1080/00913847.2020.1850152
DOI: https://doi.org/10.21061/jvs.v12i1.814 | Journal eISSN: 2470-4768
Language: English
Page range: 36 - 54
Submitted on: Sep 22, 2025
Accepted on: Nov 4, 2025
Published on: Feb 13, 2026
Published by: Virginia Tech Publishing
In partnership with: Paradigm Publishing Services
Keywords:
© 2026 Jeffrey M. Ward, published by Virginia Tech Publishing
This work is licensed under the Creative Commons Attribution 4.0 License.