The study of the relationship between psychological variables and injuries has shown the importance of psychological preparation for the mental and physical health of the athlete, offering a holistic understanding of the psychological intervention and care for injuries in sport from a biopsychosocial approach. Several investigations have obtained evidence of the dependency of injuries on negative emotional states such as anxiety and low coping resources in the face of the stresses of sports activity [1-6].

Although the Stress and Injury Model [7, 8] guides the studies by offering a general explanation of the relationship between psychological variables and injuries, this field of research requires a greater degree of systematization of the results to determine which are the most relevant variables that they constitute risk factors in a general and specific way according to the type of sport and the competitive level of the athletes.

It is essential to determine which are the most consistent relationships over time and what are the possible factors that condition these relationships. All this has not been possible due to the theoretical-methodological dispersion that has characterized the study of the subject, being expressed by several authors [9-11]. However, psychological injury prevention programs have been developed based on general results of studies in large populations of athletes of different modalities, experience, and competitive levels [12, 13].

Although these interventions have shown moderate effects on injury prevention, they have not been generalized, which means thinking about the development of compressive programs based on specific data in particular sports to maximize the results of psychological interventions given the principle of individualization of the sports training.

Before achieving the development and implementation of these specific programs, it is necessary to obtain criteria that support such a proposal, which is feasible and laudable by obtaining empirical findings that show the general trends and particularities of the relationships between psychological variables and injuries in different sports. For this, the common and differentiating characteristics that suppose psychological demands of the specific sports activity must be considered [14].

In this sense, the study of anxiety and the psychological variables of sports performance in their relationships with injuries has gone from having few studies [1, 3, 15, 16] to having a growing body of evidence in recent years, especially in Cuban athletes of high performance [6]. Although the results are still insufficient to establish trends and generalizations, they do allow a critical approximation of the characteristics of the relationships between these variables, which is why the present investigation was designed with the purpose of characterizing the relationships between anxiety and the psychological skills with the history of injuries in high-performance athletes of team sports.

A correlational and cross-sectional study was carried out in the collective sports of the province of Villa Clara that have national championships in Cuba. The study was carried out between November 2019 and January 2022, always coinciding with the beginning of the preparation stage for the competitions of each year (2019, 2020, 2022). Data could not be obtained in 2021 because the COVID-19 pandemic did not allow championships to be held in that year and the teams were not integrated.

Tables 1 and 2 describe the distribution of the variables under study. Most athletes experience high anxiety in competition, although high-level mental skills predominate. It is observed that negative and visuo-imaginative coping control are the psychological skills with the lowest distribution at high levels. There is a high presence of athletes with a history of injuries. The injuries suffered have been mostly moderate, occurring more frequently in competitions. The variables under study do not follow a normal distribution.

Table 3 shows the analysis of the relationship between psychological variables and the injury history of athletes without specifying the sport they practice. It is appreciated that the motivational level, attention control, negative and positive coping establish an inverse relationship with the occurrence of the injury. The number of injuries suffered showed no relationship with psychological variables, while the severity of injuries established a positive relationship with anxiety in competition and a negative relationship with attention control and negative coping. On the other hand, the context of occurrence was negatively related to attitude control.

Table 4 and Fig. (1) show that in basketball athletes only self-confidence establishes an inverse relationship with the number of injuries suffered. On the other hand, in baseball athletes, attention control, negative coping and positive coping are related to the occurrence of the injury. In these same athletes, the severity of the injuries suffered is positively related to competition anxiety and negatively related to attention control and negative coping.

Fig. (1). Shows the relationships of the psychological variables with the history of injury, number, severity, and context of occurrence in each sport. Note. Blue Arrow= Positive Relationships; Red Arrow= Negative Relationships; ASC= Anxiety state in competition; SC= Self-confidence; ML= Motivational level; AC= Attention control; NCC= Negative coping control; PCC= Positive coping control; VIC= Visual and imaginative control; ATC= Attitude control; HSI= History of sports injury; SIN= Sports injury number; SIS= Sports Injury severity; SIC= Sports injury context.

In soccer players, being injured is negatively related to motivational level, attention control and negative coping, while the severity of injuries is inversely related to attention control. In softball athletes, the occurrence of the injury is inversely related to self-confidence, the number of injuries is directly related to competition anxiety and inversely to self-confidence, negative and positive coping, while the severity of the injury it was inversely related to the control of the attitude, and the context of occurrence in a direct way with the level of anxiety in the competition.

The high presence of athletes who have suffered injuries is consistent with the findings of epidemiological studies that have confirmed the high prevalence of this relevant medical problem in sports [22-24]. The propensity to experience high anxiety in competition and the high development of psychological skills to compete is an expected finding in high-performance athletes who have achieved sports mastery, coinciding with several investigations [25-28].

In this heterogeneous population of high-performance ball game athletes, presenting low levels of motivation, attention control, negative and positive coping are risk factors for the occurrence of the injury. In addition, high competition anxiety and insufficient skills to control this negative emotion and stay focused on competitive activity are related to more serious injuries, while being injured during competition is related to poor attitude control.

Previous studies that have analyzed these same psychological variables in heterogeneous populations of athletes do not coincide with the results obtained in the present investigation, although the findings of previous studies are fundamentally like each other in terms of the number of injuries suffered. Berengüí-Gil et al. [15] determined in a study carried out on 34 male athletes in the technification process of Olympic Wrestling and Taekwondo, that the number of injuries suffered is related to the presence of less self-confidence, negative and positive coping control, while in a later study carried out on 84 athletes also in the process of technification of four individual disciplines (athletics, cycling, canoeing and taekwondo) found that the number of injuries was related to low control of negative coping and high anxiety in competition [16].

In another study also carried out in a heterogeneous population of 115 female and male athletics, cycling, canoeing and taekwondo athletes, also in the technification process, the authors determined that the number of injuries suffered is related to lower self-confidence and greater anxiety in competition, becoming psychological predictors of the number of times an athlete is injured [1]. On the other hand, an investigation carried out later 50 amateur triathletes of both sexes determined that the higher incidence of injuries is related to less positive coping control and attitude and that competition anxiety and low negative coping control explained 33% of the causes of injuries even when controlling the effect of other variables [3].

The previous studies [1, 3, 15, 16] have analyzed the relationships between anxiety and psychological skills in individual sports and athletes of both sexes in the technification process or amateurs. The most consistent findings are that high anxiety in competition and fewer skills to control negative emotions are risk factors for a greater number of injuries and, to a lesser extent, agree that low self-confidence and positive coping control are relevant risk factors.

A recent investigation with 63 high-performance male athletes (softball, soccer and baseball) also obtained divergent results, although the findings coincide in terms of the severity of the injuries suffered. Severity was related to low attention control and negative coping. These divergences, even in populations of similar athletes, may be due to the influence of other uncontrolled factors, such as the relationship established between the psychological variables analyzed [6].

Regarding the relationships between anxiety in competition and psychological skills with injuries depending on the type of sport, specific and differentiating correlation matrices were obtained in the present study, even though the findings differ markedly between each sport and the correlation matrix overall obtained. These results denote the intrinsic complexity of the relationships between both groups of variables. Even notable divergences were obtained when comparing the findings in the same sport with different subjects. In this regard, it was obtained that the results coincide to a greater extent in softball athletes [29], since in both analyses, it was obtained that the occurrence of the injury is related to less self-confidence, the number of injuries is also related to less self-confidence and less emotional control, while greater severity is related to less control of attitude.

The results obtained in baseball athletes partially coincide with the findings of a previous investigation on baseball pitchers of different sports levels. The occurrence of the injury is related to lower self-confidence, negative and positive coping control. In addition, more serious injuries are related to greater anxiety in competition [30]. On the other hand, the results in basketball athletes differ almost completely from the findings in a similar investigation, only agreeing that the greater number of injuries suffered is related to lower self-confidence [31].

The divergences with the results of other investigations in heterogeneous and specific populations not only denote the complexity of the relationships between psychological variables and sports injury but also pose a problem for the generalization of psychological injury prevention programs following the Stress and Injuries model. Although the psychological preparation of the athlete must contain actions aimed at preventing injuries and their effect on the subjectivity of the athlete, the results obtained allow us to infer that preventive psychological intervention must be carried out in specific sports according to the relationships obtained between psychological variables and injuries.

These findings go beyond the conception of stress as an antecedent of the injury, establishing the need to reorient research in this field of study. Future research should have as its purpose the explanation of the causes and consequences of the relationships between the psychological variables that configure the risk of injury and vice versa. In this sense, a future line of research could be the analysis of how the type of sport mediates the relationships between anxiety, mental skills and injuries depending on their differentiating characteristics. In addition, it is necessary to determine how the intrinsic relationships between psychological variables can explain the complex and specific nature of the relationship with past and future injuries.

Despite the value of the results obtained in this research to glimpse the complexity of a phenomenon of notable relevance in sport, it is considered that the type of cross-sectional study and its descriptive-correlational scope constitute the main limitations of the findings, as well the low representation of the athletes analyzed over the Cuban sports population, which does not allow the results to be generalized at the national level. Therefore, it is considered that these limitations must be overcome to arrive at generalizable and more conclusive results.