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Injured athletes' psychological distress has been explored using a stress-response paradigm and through a variety of research methodologies. Despite growing interest in psychophysiological stress-response research (Gatchel, 1997), physiological features of psychological distress have not yet been explored among injured athletes (Flint, 1998). Psychological distress has been associated with delayed healing among other medical populations (Kiecolt-Glaser, Page, Marucha, MacCallum, & Glaser, 1998), and physiological features of distress have lead to increased reports of a variety of health-related problems (Baum, Gatchel, & Krantz, 1997). The present research consists of two studies designed to validate preliminary reports and advance current knowledge regarding the presence of posttraumatic distress among injured athletes through sampling younger athletes and utilizing psychophysiological indices of distress. In the first study, high school athletes (n = 162) reported frequency of experiencing two common cognitive-affective and behavioral features of posttraumatic distress, intrusive thoughts and avoidance behavior. ANOVA indicated that athletes who had incurred injuries the previous year experienced greater frequency of intrusive thoughts and avoidance behavior regarding prior injuries than athletes who had not incurred injuries the prior year. In the second study, Varsity male athletes (n = 7) who incurred a severe injury within the past 2 years and matched controls (n = 5) were compared on both psychological and physiological indices of distress. Specifically, injured and non-injured athletes' self-reported distress and autonomic arousal, as measured by heart rate and electrodermal activity, in response to a series of injury and non-injury-related video clips was measured. A priori planned contrast analyses revealed that injured athletes' had a greater degree of physiological reactivity and experienced more subjective distress than non-injured controls, and reactivity was greatest during injury-related stimuli than during non-injury or neutral stimuli. Correlation analyses indicated that athletes' self-reported and physiological responses were related. Results are discussed in relation to existing literature regarding the nature of athletes' post-injury response as well as provide novel information regarding athletes' physiological reactivity to stimuli indicative of the competitive sport environment to which they must return following a severe injury.