Psychological traits associated with mental and performance resilience in long-distance and ultra-endurance runners: a systematic review

Abstract

Objective:

Evidence on psychological traits in distance running remains fragmented across constructs, race contexts, and outcome definitions, while previous syntheses have generally addressed mental health, motivation, personality, or sport resilience separately. This review aimed to integrate and critically appraise psychological traits associated with both mental adaptation and performance continuity in long-distance and ultra-endurance runners while mapping concentrations and gaps in the evidence.

Methods:

This systematic review, reported in accordance with PRISMA 2020, searched PubMed, Scopus, and Web of Science on 10 June 2026. Eligible empirical studies examined distance-running populations and associations between psychological traits or trait-like constructs and mental or performance resilience outcomes. Risk of bias was assessed using Joanna Briggs Institute checklists. The evidence was synthesized narratively and mapped by construct and outcome domain.

Results:

The searches yielded 469 records; after 40 duplicates were removed, 429 records were screened, 89 full-text reports were assessed, and 53 studies were included. Most studies were observational, using cohort or cross-sectional designs; the remainder used qualitative or mixed-methods approaches. Maladaptive pain coping was most consistently associated with poorer pain adaptation and a lower likelihood of race completion. Emotional intelligence and emotion regulation were primarily associated with mood and stress outcomes, whereas motivation, personality, perfectionism, mental toughness, resilience, and self-efficacy showed heterogeneous associations. Critical appraisal identified minor concerns in three studies, moderate concerns in 36, and serious concerns in 14.

Conclusion:

By jointly mapping mental adaptation and performance continuity outcomes, this review clarifies recurring domain-specific associations and identifies major gaps in the endurance running psychology literature. However, 50 of the 53 included studies had moderate or serious methodological concerns, and the evidence was predominantly observational. The findings should therefore be interpreted as associations rather than causal effects and do not establish that modifying mental toughness or other psychological traits through training improves endurance running performance.

Systematic review registration:

https://osf.io/mxce4

1 Introduction

Long-distance and ultramarathon running are endurance disciplines in which performance depends on physiological capacity, training history, pacing, nutrition, and psychological regulation under sustained physical and cognitive demands (Berger et al., 2024; Knechtle and Nikolaidis, 2018). Ultra-endurance running is commonly defined as either a distance exceeding the marathon distance of 42.195 km or an event lasting approximately 6 h or longer (Knechtle, 2012; Scheer et al., 2022). In these contexts, resilience may help athletes respond adaptively to sport-related demands and adversity (Gupta and McCarthy, 2022; Sarkar and Fletcher, 2014). In sport psychology, resilience is conceptualized as adaptive functioning under stress, supported by interacting protective factors such as positive personality characteristics, motivation, confidence, focus, and social support (Gupta and McCarthy, 2022; Sarkar and Fletcher, 2014). Mental toughness is a related but distinct construct that has been studied as a psychological capacity relevant to coping with challenges, pressure, and sustained performance demands (Gucciardi, 2017; Gucciardi et al., 2017).

Accordingly, psychological adaptation in endurance running cannot be adequately represented by a single trait or performance endpoint. Relevant characteristics include mental toughness, self-efficacy, psychological resilience, emotional intelligence, motivation, passion, coping style, personality dimensions, pain-related beliefs, and cognitive control processes (Brace et al., 2020; Cona et al., 2015; Freund et al., 2013; Gameiro et al., 2023; Lane and Wilson, 2011; Partyka and Waśkiewicz, 2024). These characteristics have been examined in relation to mental adaptation outcomes, including mood, perceived stress, coping, recovery, and mental health symptoms, as well as performance continuity outcomes such as race completion, withdrawal, pacing, rank, finishing time, and performance satisfaction (Brace et al., 2020; Cona et al., 2015; Méndez-Alonso et al., 2021; Thuany et al., 2023). Distinguishing these domains is important because a psychological characteristic associated with more effective coping or better emotional regulation may not necessarily predict faster performance. Similarly, persistence cannot be assumed to be uniformly adaptive when continued effort may involve ignoring injury symptoms or other indicators of medical risk (Berger et al., 2024; Freund et al., 2013; Scheer et al., 2022).

The empirical literature reflects this complexity. Mental toughness, resilience, and self-efficacy have been associated with performance or completion in some running populations, but these relationships have not been consistently reproduced across events, athlete levels, or objective performance measures (Brace et al., 2020; Gameiro et al., 2023; Méndez-Alonso et al., 2021). Other studies have examined emotional intelligence, pain tolerance, coping, motivation, personality, and cognitive functioning, further demonstrating that the psychological demands of endurance running extend beyond mental toughness alone (Cona et al., 2015; Freund et al., 2013; Lane and Wilson, 2011). This variability in constructs, populations, and outcomes makes individual findings difficult to interpret in isolation and creates a need for a synthesis that retains their domain-specific and methodological context.

At the review level, related evidence has also remained compartmentalized. Previous syntheses have addressed mental health in ultra-endurance runners, motivation in marathon and ultramarathon runners, personality among marathon runners, and resilience across sport performers (Braschler et al., 2024; Gupta and McCarthy, 2022; Partyka and Waśkiewicz, 2024; Thuany et al., 2023). These reviews have advanced understanding within their respective domains, but they have not jointly examined how a broad range of trait-level psychological characteristics relate to both mental adaptation and performance continuity specifically in long-distance and ultra-endurance running.

The novelty of the present review lies in integrating these two previously separated strands of evidence within a single framework. In addition to synthesizing associations across long-distance, trail, ultramarathon, and ultra-endurance populations, the review distinguishes between mental resilience outcomes and performance resilience outcomes, incorporates qualitative evidence concerning runners’ experiences and interpretations, critically appraises studies using design-appropriate Joanna Briggs Institute checklists, and maps the distribution of evidence across psychological constructs and outcome domains. Its contribution is therefore not to establish that particular traits cause superior performance, but to clarify where associations recur, where findings remain inconsistent, and which construct–outcome relationships require more rigorous prospective or intervention-based investigation. Accordingly, this review aimed to identify, critically appraise, and synthesize empirical studies evaluating psychological traits and trait-like attributes associated with mental and performance resilience in long-distance and ultra-endurance runners.

2 Methods

2.1 Design

This systematic review was conducted and reported in accordance with the PRISMA 2020 statement, and the search reporting followed principles from the PRISMA-S extension (Page et al., 2021; Rethlefsen et al., 2021). The review examined empirical evidence on psychological traits and trait-like attributes associated with mental and performance resilience among long-distance and ultra-endurance runners. The protocol was registered prospectively on the Open Science Framework before the database searches were conducted (osf.io/mxce4; June 10, 2026).

2.2 Eligibility criteria

Eligible studies were original empirical investigations involving human participants described as long-distance, endurance, marathon, trail, ultramarathon, ultrarunning, or ultra-endurance runners. For this review, long-distance running encompassed samples explicitly described by the study authors as distance, endurance, marathon, trail, or long-distance runners; ultra-endurance running encompassed races longer than 42.195 km or events described as lasting at least 6 h. Studies of mixed endurance sport samples were eligible only when runner-specific data were reported separately or could be extracted without inference. Studies primarily examining non-running endurance disciplines, recreational physical activity without a distance-running classification, or clinical exercise programs that did not involve distance-running populations were excluded.

Eligible exposures were psychological traits or trait-like constructs assessed before, during, or after participation in running. These included, but were not limited to, mental toughness, resilience, self-efficacy, self-regulation, motivation, passion, grit, perseverance, hardiness, personality dimensions, emotional intelligence, coping style, pain tolerance, pain-related anxiety, mindfulness, optimism, confidence, and cognitive control characteristics when conceptualized as relatively stable individual differences or predictors of adaptation. Eligible mental resilience outcomes included psychological resilience scores, mental health symptoms, wellbeing, stress tolerance, affective stability, mood recovery, coping under adversity, pain coping, and recovery-related psychological outcomes. Eligible performance resilience outcomes included race completion or non-completion, withdrawal, rank, race time, pacing maintenance, performance satisfaction, maintenance of performance under fatigue or adverse conditions, and other explicitly defined outcomes reflecting performance continuity.

Eligible designs included quantitative observational studies, intervention studies reporting baseline or follow-up associations relevant to the review question, mixed-methods studies, and qualitative studies that directly addressed trait-related resilience in running contexts. Quantitative studies were required to report an association, comparison, prediction model, effect estimate, or sufficient data to characterize the relationship between at least one psychological trait and at least one eligible mental or performance outcome. Qualitative studies were synthesized separately unless they contained extractable quantitative data. Reviews, editorials, commentaries, letters without original data, conference abstracts lacking sufficient methodological information, case reports, and non-peer-reviewed material were excluded. No restrictions were imposed on publication date or language.

2.3 Information sources

PubMed, Scopus, and Web of Science were searched on June 10, 2026. The reference lists of included studies and closely related reviews were also screened.

2.4 Search strategy

The search strategy comprised three concept blocks: the running population, psychological traits or resilience-related constructs, and mental health or performance-related outcomes. The strategy was iteratively refined after reviewing terminology related to definitions and performance limits in ultra-endurance running; mental toughness and self-efficacy in ultramarathon runners; mental toughness and resilience in trail runners; psychological predictors in ultra-trail events; trait emotional intelligence; pain tolerance and personality; cognitive functioning; motivation; and mental health in ultra-endurance runners.

([Title/abstract or Topic] marathon OR ultramarathon OR ultra-marathon OR ultrarunner OR ultrarunning OR ultra-endurance OR ultraendurance OR “ultra endurance” OR “endurance running” OR “endurance run” OR “long-distance running” OR “long-distance run” OR “long distance running” OR “long distance run” OR “distance run” OR “distance running” OR “trail run” OR “trail running” OR “trail runner”)

AND

([Title/abstract or Topic] personality OR resilience OR resilient OR “self efficacy” OR “self-efficacy” OR “emotional intelligence” OR motivation OR motivational OR grit OR mindfulness OR passion OR perseverance OR persistence OR “self-regulation” OR “self regulation” OR “goal orientation” OR “pain tolerance” OR coping OR hardiness OR optimism OR “cognitive control” OR “executive function” OR “mental toughness”)

AND

([Title/abstract or Topic] performance OR “race performance” OR “race time” OR “finish time” OR completion OR rank OR ranking OR finish OR “did not finish” OR dropout OR adaptation OR recovery OR fatigue OR wellbeing OR stress OR anxiety OR mood OR “mental health” OR injury)

Search results were exported with full bibliographic data, abstracts, keywords, and database identifiers where available.

2.5 Selection process

Records retrieved from all databases were imported into EndNote and deduplicated using automated and manual procedures. Two authors independently screened titles and abstracts against the eligibility criteria using a standardized Excel form. Each author recorded an initial decision without access to the other author’s assessment. After completing the screening for titles and abstracts, the decisions were compared, and discordant records were discussed individually. For each disagreement, the authors jointly re-examined the title and abstract and applied the prespecified population, exposure, outcome, and design criteria. When the available information was insufficient to justify exclusion, the report was retained for full-text assessment. The same authors independently assessed the full texts of potentially eligible studies before comparing their eligibility decisions. Full-text disagreements were resolved by jointly re-examining the complete report, identifying the specific eligibility criterion responsible for the disagreement, and reaching a consensus decision based on the prespecified criteria. No third author was involved, and no disagreements remained unresolved after this process. Reasons for exclusion at the full-text stage were recorded and summarized in the PRISMA flow diagram.

2.6 Data extraction and data collection process

A standardized, pilot-tested extraction form was used. Two authors independently extracted data from each included study, with the initial extraction forms completed separately before comparison. Discrepancies were resolved by consensus through re-examination of the source report and the operational definitions in the extraction form. The form was piloted on a small sample of included studies and refined before full data extraction.

When information considered necessary for determining eligibility, characterizing the study, interpreting an eligible exposure–outcome association, or completing the methodological appraisal was missing or unclear, the corresponding author was contacted using the most recent email address available. An initial request was followed by one reminder after seven days if no response had been received. This time was provided to ensure the authors were fully aware of the request. Any information supplied by study authors was checked against the published report and incorporated into the extraction form with its source documented. When no response was received within this period, the study was retained and synthesized using the information available in the published report. Missing information was recorded as not reported or unclear, and no values were imputed. Corresponding authors were contacted for two included studies. Responses were received for both studies.

2.7 Data items

Extracted items included bibliographic details, country, study design, recruitment source, context, participant characteristics, sample size, age, sex distribution, competitive level, running distance or event type, surface or terrain, race format, prior running experience, training volume, inclusion and exclusion criteria, psychological constructs, measurement instruments, assessment timing, mental resilience outcomes, performance resilience outcomes, statistical methods, covariates, reported effect estimates, uncertainty intervals, p-values where provided, and the authors’ conclusions. For longitudinal or intervention studies, baseline characteristics, follow-up intervals, exposure timing, attrition, and intervention characteristics were also extracted. For qualitative studies and the qualitative components of mixed-methods studies, extracted information additionally included the stated qualitative methodology, data-collection approach, analytic method, reported themes or categories, and the authors’ principal interpretive findings.

2.8 Outcomes

The primary outcome domains were mental resilience and performance resilience. Mental resilience encompassed validated resilience scores, psychological adaptation to stressors, mental health symptoms, wellbeing, affective responses, mood recovery, perceived stress, coping effectiveness, pain coping, and related outcomes explicitly linked to adaptation or psychological functioning. Performance resilience encompassed race completion, withdrawal or non-completion, pacing maintenance, adaptive goal adjustment, performance satisfaction under demanding conditions, and the preservation of performance during fatigue, pain, sleep deprivation, environmental exposure, injury risk, or other race-related stressors. An outcome was classified as a direct indicator of performance resilience when it captured persistence, maintenance, adaptation, or successful task continuation in relation to an identifiable stressor or performance disruption. Race time, finishing position, rank, or average speed reported without an explicit adversity, deterioration, continuity, or adaptation component was classified as general performance outcomes. These measures were retained because they were relevant to the broader relationship between psychological characteristics and running performance, but they were interpreted as performance correlates rather than direct indicators of performance resilience.

2.9 Risk of bias and methodological quality assessment

Risk of bias and methodological limitations were assessed independently by two authors using design-appropriate Joanna Briggs Institute critical appraisal checklists. The authors completed their initial item-level judgments separately and without access to one another’s ratings. Analytical cross-sectional studies were assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies (Munn et al., 2023), while cohort and longitudinal studies were assessed using the JBI Critical Appraisal Checklist for Cohort Studies (Barker et al., 2025). Each checklist item was recorded as “Yes,” “No,” “Unclear,” or “Not applicable,” together with a brief rationale supporting the judgment. Disagreements were resolved through discussion and consensus, with the published report and the review-defined appraisal criteria re-examined before a final judgment was assigned. No external adjudicator was involved.

No numerical methodological quality score or percentage cut-off was calculated. Overall study-level judgments were review-defined and based on the nature, severity, and likely consequence of the identified limitations for the eligible exposure–outcome association or qualitative interpretation. Minor methodological concerns were assigned when the key validity domains were adequately addressed and any remaining limitations were unlikely to alter the findings. Moderate methodological concerns were assigned when one important limitation or several lesser limitations reduced confidence in the findings but did not seriously undermine the principal interpretation. Serious methodological concerns were assigned when a major limitation in a core domain or multiple interacting limitations were considered likely to distort the reported association or interpretation.

For quantitative studies, the principal domains considered were participant selection and temporal ordering, validity and reliability of exposure measurement, validity and reliability of outcome measurement, identification and management of confounding, follow-up and missing data, and appropriateness of the statistical analysis. For qualitative studies, the principal considerations were congruity among the research question, methodology, data collection, analysis, and interpretation; representation of participants’ voices; researcher positioning and reflexivity; ethical reporting; and whether the conclusions were supported by the analysis. When more than one checklist was applied to an article, the article-level judgment reflected the most consequential limitations across its eligible components rather than an average of checklist responses. Overall judgments were not used as automatic exclusion criteria; instead, the item-level and overall appraisal findings informed the interpretation of and confidence in the evidence.

Inter-author agreement was evaluated using the original decisions before consensus. For title/abstract and full-text eligibility decisions, observed Cohen’s kappa was κ = 0.93. At full-text assessment, agreement was κ = 0.95. Agreement estimates were calculated from the original independent decisions before consensus.

2.10 Effect measures

For quantitative studies, extracted effect measures included correlation coefficients, standardized beta coefficients, unstandardized regression coefficients, odds ratios, risk ratios, mean differences, standardized mean differences, and hazard ratios, as applicable. When sufficient information was available, correlations were transformed to Fisher’s z values for quantitative synthesis and back-transformed for interpretation. For dichotomous outcomes such as completion versus non-completion, odds ratios or risk ratios were extracted or calculated when possible. When both adjusted and unadjusted estimates were reported, both were extracted; adjusted estimates were prioritized in the primary synthesis when the covariate adjustment was conceptually appropriate and comparable across studies.

2.11 Synthesis methods

The primary synthesis was narrative and structured by psychological construct, population or race type, outcome domain, and study design. Tables summarized study characteristics, instruments, outcomes, effect estimates, and risk-of-bias judgments. A structured narrative synthesis described the direction, magnitude, precision, and consistency of the reported associations. Potential sources of heterogeneity were explored narratively. Given the predominance of observational designs and the heterogeneity of the psychological constructs and outcomes, the synthesis was intended to characterize associations and evidence gaps. It was not designed to estimate causal effects of psychological traits or the effects of interventions intended to modify those traits.

A secondary risk-of-bias sensitivity synthesis was conducted after excluding studies classified as having serious methodological concerns. Each principal synthesis finding was reassessed using only studies with minor or moderate methodological concerns. For each finding, we compared the number and design of contributing studies, the direction and consistency of associations, reported effect estimates and uncertainty where available, and the extent to which the original interpretation remained supported. Findings were classified as retained when their direction and interpretation remained supported, attenuated when the supporting evidence became substantially narrower or less consistent, and not robust when all or nearly all supporting evidence came from studies with serious methodological concerns. Studies with serious concerns remained in the primary evidence tables but did not contribute to the restricted sensitivity synthesis.

2.12 Certainty of the evidence

The certainty of the evidence supporting the principal quantitative findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach (Brignardello-Petersen and Guyatt, 2025). Certainty was evaluated at the level of each defined body of evidence rather than for individual studies or for the review as a whole. The evidence bodies were specified before the certainty ratings were assigned and represented the principal quantitative associations underpinning the review findings and conclusions, i.e., maladaptive pain coping with pain interference; maladaptive pain coping with race completion; emotional intelligence or emotion regulation with mood- and stress-related outcomes; motivational quality or irrational performance beliefs with psychological wellbeing, anxiety, or perceived health; mental toughness, resilience, or self-efficacy with completion or performance outcomes; perfectionistic characteristics with general running performance; and psychological characteristics with injury or risk-related continuation.

The target of each certainty assessment was to determine confidence in the presence and direction of an association between a psychological characteristic and an eligible outcome. It was not about confidence in a causal effect or in the effectiveness of an intervention intended to modify that characteristic. Because the studies reported heterogeneous effect measures and no common clinically meaningful effect threshold was available, the null association was used as the threshold of interest. The assessments, therefore, addressed whether the true association was likely to lie in the reported direction rather than whether it exceeded a common magnitude across studies. Consequently, a higher certainty rating for an association would not establish that the psychological characteristic caused the outcome or that changing the characteristic through training would improve performance or mental health.

Following the target-of-certainty approach, observational evidence was considered an appropriate starting source for evaluating the defined associations. Each evidence body initially entered the assessment at high certainty when the contributing study designs were appropriate to the associational question and was subsequently rated down when concerns were identified. Certainty could be reduced by one or two levels for serious or very serious concerns, respectively, across five domains: risk of bias, inconsistency, indirectness, imprecision, and publication bias. Final certainty was categorized as high, moderate, low, or very low.

Risk of bias was assessed using item-level judgments from the design-appropriate Joanna Briggs Institute critical appraisal checklists. The review-defined overall categories of minor, moderate, or serious methodological concerns were considered alongside the specific limitations affecting each exposure–outcome association; they were not used as automatic numerical rules for downgrading. Particular attention was given to participant selection, the validity and reliability of psychological and outcome measurements, temporal ordering, management of confounding, completeness of follow-up, missing data, and the appropriateness of the statistical analyses.

Inconsistency was evaluated by comparing the direction, magnitude, and statistical compatibility of associations across the studies contributing to each evidence body. Differences in the running population, competitive level, event format, psychological instrument, outcome definition, assessment timing, and covariate adjustment were considered when determining whether variation could be explained. When only one study contributed to an evidence body, inconsistency could not be evaluated directly; the absence of replication was documented but was not, by itself, treated as evidence of inconsistency.

Indirectness was assessed against the population, psychological exposure, outcome, and associational target specified for each finding. Ratings considered whether the available samples represented the long-distance and ultra-endurance running populations of interest, whether different instruments measured sufficiently comparable psychological constructs, and whether the outcomes directly represented mental or performance resilience. Generic performance outcomes (including race time, rank, placing, or speed without an explicit continuity, adaptation, or adversity component) were considered indirect measures of performance resilience.

Imprecision was evaluated using the number of contributing studies and participants, the number of outcome events where applicable, reported confidence intervals, and the extent to which the available results were compatible with materially different interpretations. Where confidence intervals were unavailable, imprecision was judged based on the sample size, distribution of outcomes, reported effect estimates, and statistical information presented by the primary studies. Certainty was reduced when the available evidence was too sparse or inadequately reported to distinguish a meaningful association from a null or substantially different association.

Publication bias was considered qualitatively because the number of studies within each evidence body was insufficient. Judgments considered the predominance of small or single-event studies, concentration of evidence within closely related research groups or settings, selective reporting of outcomes or analyses, and the possibility that null or unfavorable associations remained unpublished. No rating was increased based on large effects, dose–response gradients, or residual confounding unless these features were clearly demonstrated and could not be explained by methodological limitations.

Studies were grouped according to psychological exposure, outcome domain, and conceptual comparability. For each evidence body, the reviewers considered all available estimates, including their direction, magnitude, uncertainty, methodological context, and consistency, rather than relying on statistical significance or vote counting. A risk-of-bias sensitivity synthesis was also used to inform the certainty judgments. Each principal finding was reassessed after excluding the 14 studies classified as having serious methodological concerns. Stability after exclusion was considered when evaluating the risk-of-bias domain and the overall robustness of the finding but did not automatically prevent downgrading, because most studies remaining in the restricted synthesis still had moderate methodological concerns.

Two authors independently assessed each evidence body using a standardized GRADE evidence profile. They recorded the judgment for every domain, the number of levels downgraded, and an explicit rationale. The authors subsequently compared their assessments and resolved disagreements through discussion. The final ratings were presented in a summary-of-findings table together with explanatory footnotes supporting each downgrading decision.

GRADE terminology was used when interpreting the findings. High-certainty evidence was described as showing an association; moderate-certainty evidence as probably showing an association; low-certainty evidence as suggesting that an exposure may be associated with an outcome; and very-low-certainty evidence as indicating that the association was very uncertain. These expressions refer only to confidence in the defined association and do not imply causality.

3 Results

3.1 Study selection

The database searches yielded 469 records: 18 from PubMed, 428 from Web of Science, and 23 from Scopus. After 40 duplicates were removed, 429 unique records underwent title and abstract screening. Of these, 340 were excluded, leaving 89 reports for full-text eligibility assessment. At the full-text stage, 36 reports were excluded. The most common reason was the absence of an eligible psychological trait-like exposure or exposure–outcome relationship (22 reports), followed by the absence of an eligible association with a mental or performance resilience outcome (10 reports) and an ineligible publication type or study design (4 reports). The final synthesis included 53 studies. The selection process is summarized in Figure 1.

Figure 1

3.2 Characteristics of included studies

Table 1 summarizes the characteristics of the included studies. The studies were published between 1986 and 2026. Most used observational designs, including prospective or repeated-measures cohorts and analytical cross-sectional studies; the remainder used qualitative or mixed-methods designs.

Table 2 summarizes each study’s psychological exposure or concept, measurement approach or timing, and methodological context. The exposures were diverse and included pain-related coping, general coping and metacognitive self-regulation, mental toughness, self-efficacy, motivation, emotional intelligence, personality dimensions, perfectionism, resilience, pain tolerance, pain-related anxiety, and other trait-like or state-like psychological constructs assessed in distance-running or ultramarathon contexts.

3.3 Risk of bias and methodological quality within included evidence units

Critical appraisal was conducted using Joanna Briggs Institute checklists matched to each study design. The 53 included studies generated 55 checklist records because Masters and Ogles (1998) were appraised with both the cohort and analytical cross-sectional checklists, and Miller et al. (2023) were appraised with both the analytical cross-sectional and qualitative checklists. Methodological quality assessments indicated minor methodological concerns in 3 studies, moderate concerns in 36, and serious concerns in 14. Overall judgments for individual studies are presented in Table 3.

The sensitivity synthesis excluded the 14 studies classified as having serious methodological concerns and retained 39 studies: 3 with minor concerns and 36 with moderate concerns. This restriction did not change the principal finding that maladaptive pain coping was associated with greater pain interference and a lower likelihood of race completion, as these associations were supported by the repeated-measures studies of Alschuler et al. (2019, 2020), both of which had moderate methodological concerns.

The general association of emotional intelligence or emotion regulation with mood- and stress-related outcomes was also retained. Although the exclusion removed evidence from Howe et al. (2019) and Nicolas et al. (2022), related associations remained in Lane and Wilson (2011), Nicolas et al. (2019), and Urquijo et al. (2024). The restricted evidence, therefore, continued to support an association with affective and perceived stress outcomes, but evidence concerning cortisol responses and recovery resources became narrower and should be interpreted with greater caution (Table 4).

The conclusion that mental toughness, resilience, and self-efficacy show heterogeneous and context-dependent associations with performance was retained. The exclusion of Beattie et al. (2025), Christensen et al. (2018), and Graham et al. (2021) reduced the evidence concerning coping–performance satisfaction interactions, psychological prediction in individual ultramarathons, and mental toughness in relation to mood and injury. However, mixed positive and null associations remained across Brace et al. (2020), Corrion et al. (2018), Gameiro et al. (2023), Méndez-Alonso et al. (2021), and de la Vega et al. (2011). Thus, the restricted synthesis continued to argue against a uniform or deterministic relationship between resilience-related traits and objective performance.

Several secondary findings were not robust to the exclusion. The comparative evidence that ultramarathon runners have greater cold-pain tolerance and lower pain-related anxiety was derived from Freund et al. (2013) and Roebuck et al. (2018), both of which had serious methodological concerns. The association between motivational regulation and the willingness to continue running through pain depended on Chalabaev et al. (2017). Evidence concerning exercise addiction symptoms among runners with serious medical complications and alexithymia-related anxiety regulation depended on Gauld et al. (2024) and Woodman and Welch (2022), respectively. Similarly, selected associations involving physical self-efficacy and marathon time, mindfulness intervention responses, pre-race personality and mood, and psychological state in relation to running speed were no longer represented after the exclusion of Gayton et al. (1986), Kelemen et al. (2025), Krokosz et al. (2018), and Larumbe-Zabala et al. (2020). Overall, the restricted synthesis preserved the three central conclusions: maladaptive coping was associated with poorer pain adaptation and completion outcomes; emotion-regulation constructs were associated primarily with mood and perceived stress outcomes; and associations between resilience-related traits and objective performance were heterogeneous.

3.4 Results of individual studies

Individual-study results are grouped by outcome domain in Tables 5–9. Table 5 summarizes studies in the pain adaptation and perceived exertion domain.

Table 6 summarizes studies in the cognitive, attentional, and self-regulatory processes domain.

Table 7 summarizes studies in the mental health, mood regulation, psychological resilience, and stress–response domain.

Findings related to performance were grouped according to their conceptual proximity to performance resilience. Race completion, non-completion, withdrawal, pacing maintenance under fatigue, and performance satisfaction in demanding race contexts were treated as direct or proximal performance resilience outcomes. Race time, rank, placing, and speed were treated as general performance correlates when the original study did not explicitly evaluate maintenance, deterioration, adaptation, or continuity under adversity. Table 8 summarizes studies in the performance outcomes and performance resilience domain.

Table 9 summarizes studies in the health, injury, and risk appraisal domain.

3.5 Certainty of the evidence

GRADE assessments for the principal quantitative exposure–outcome associations are presented in Table 10. Certainty was rated as low for the associations of maladaptive pain coping with pain interference and race completion, motivational quality with psychological wellbeing, anxiety, or perceived health, and perfectionistic characteristics with general running performance outcomes. Very-low-certainty evidence was identified for associations of emotional intelligence or emotion regulation with mood and stress outcomes, resilience-related constructs with performance and completion outcomes, and psychological characteristics with injury or risk-related continuation. The principal reasons for downgrading were methodological limitations in the contributing studies, inconsistency across populations and outcome measures, indirectness arising from the use of heterogeneous or generic performance outcomes, and imprecision associated with small or context-specific samples. No evidence body reached moderate or high certainty. Although the sensitivity synthesis excluding studies with serious methodological concerns preserved several of the principal directional patterns, certainty remained limited because most retained studies still had moderate methodological concerns, and several findings were supported by only one or a small number of studies. These ratings concern confidence in the presence and direction of the reported associations and should not be interpreted as evidence that modifying a psychological trait would cause improved running performance or psychological health.

4 Discussion

This systematic review identified, appraised, and synthesized evidence on psychological traits and trait-like attributes associated with mental and performance resilience in long-distance and ultra-endurance runners. The evidence base was broad but unevenly developed. The most frequently studied constructs included motivation, coping, emotional intelligence or emotion regulation, mental toughness, psychological resilience, self-efficacy, personality dimensions, perfectionism, pain-related beliefs, and attentional or self-regulatory processes. Reported outcomes included pain adaptation, mood regulation, perceived stress, anxiety, cognitive function, race completion, race time, pacing, performance satisfaction, injury, and risk appraisal.

The principal contribution of this review is its integration of two strands of evidence that are often considered separately: psychological correlates of mental adaptation and psychological correlates of performance continuity under endurance stress. The synthesis indicates that psychological traits should not be interpreted as uniform predictors of superior running performance. Rather, they may influence how runners appraise exertion and pain, regulate affect, deploy coping strategies, make pacing and goal adjustment decisions, and persist or withdraw under adverse conditions. This distinction is important because the reported associations were often domain- and context-specific. For example, mental toughness, resilience, and self-efficacy were associated with performance or completion in some studies but were not consistently related to rank, finishing time, or outcomes in elite races (Brace et al., 2020; Corrion et al., 2018; Gameiro et al., 2023; Méndez-Alonso et al., 2021). Similarly, emotional intelligence and emotion regulation were more consistently associated with mood, perceived exertion, and stress-related outcomes than with objective performance endpoints (Howe et al., 2019; Lane and Wilson, 2011; Nicolas et al., 2019; Urquijo et al., 2024).

The evidence gap map further clarifies the field by showing that research is concentrated in a limited number of exposure–outcome pairs. Motivation, emotional intelligence or emotion regulation, psychological resilience, mental toughness, personality dimensions, coping, and perfectionism accounted for many mapped associations, whereas objective cognitive outcomes, psychophysiological stress responses, injury outcomes, risk-related persistence through pain, and processes leading to non-completion were comparatively understudied. The review therefore extends related syntheses of motivation, personality, mental health, and resilience in sport by focusing specifically on trait-level psychological attributes in long-distance and ultra-endurance running and by distinguishing mental resilience outcomes from performance resilience outcomes (Braschler et al., 2024; Gupta and McCarthy, 2022; Partyka and Waśkiewicz, 2024; Thuany et al., 2023; Waleriańczyk, 2023).

4.1 Pain adaptation and the psychological meaning of endurance discomfort

Evidence on pain suggests that resilience in endurance running involves more than just tolerating discomfort. In the repeated-measures RacingThePlanet cohort, maladaptive pain coping was consistently associated with a greater proportion of time spent thinking about pain and with greater pain interference during multistage ultramarathon stages, whereas experiential awareness was associated with less pain interference (Alschuler et al., 2019). In a related performance analysis of the same race series, lower maladaptive pain coping was associated with a greater likelihood of race completion, although coping composites were not associated with finishing-position quintile among finishers (Alschuler et al., 2020). These findings suggest that coping quality may be more relevant to maintaining engagement and reducing interference than to differentiating rank among athletes who complete the event.

Experimental and comparative studies have reported greater cold-pain tolerance and lower pain-related anxiety among ultramarathon runners than among comparison participants (Freund et al., 2013; Roebuck et al., 2018). However, both studies were classified as having serious methodological concerns and were therefore removed from the risk-of-bias sensitivity synthesis. Their findings should consequently be regarded as preliminary and should not be interpreted as stable evidence that participation in ultramarathon running produces greater pain tolerance or that pain-related psychological characteristics causally explain endurance performance. Freund et al. (2013) also found no association between general self-efficacy and cold-pain tolerance, suggesting that broad confidence-related constructs may not correspond directly to experimentally assessed pain responses. Overall, the more defensible signal in this domain concerns the association of maladaptive pain coping with pain interference and completion rather than a generalized pain-tolerance advantage among ultrarunners.

Qualitative studies provide an important interpretive counterpoint by showing that pain resilience is not simply a psychometric trait or sensory threshold. Bennett et al. (2026) described women ultrarunners’ pain experiences as relational, embodied, and dynamically reinterpreted during a six-day ultramarathon, with pain shifting from a problem requiring resolution to a chosen experience supported collectively. Gross (2025) similarly interpreted ultrarunners’ accounts of pain and suffering through moral language that linked suffering to self-discipline, perseverance, identity, and meaningful achievement. These findings help explain why the same physical sensations may be experienced as threatening, manageable, meaningful, or identity-confirming, depending on the context. They also caution against treating pain tolerance as inherently adaptive. In endurance settings, psychological strategies that support persistence may benefit performance continuity, but they may also encourage unsafe persistence if pain is normalized without adequate attention to injury signals or medical risk.

4.2 Cognitive control, attentional strategies, and self-regulatory flexibility

Evidence on cognitive, attentional, and self-regulatory processes indicates that endurance performance is partly shaped by how runners monitor internal cues, interpret discrepancies between goals and current performance, and adjust behavior under fatigue. Brick et al. (2015) identified metacognitive planning, monitoring, reviewing, feelings, and judgments as central processes through which endurance runners regulate discomfort and performance. Buman et al. (2008) showed that “hitting the wall” is a multidimensional experience and that runners use cognitive, physical or behavioral, and emotion-focused strategies, as well as willpower, although many reported limited or ineffective coping responses. Together, these studies suggest that cognitive resilience in running depends less on a single attentional style than on the ability to select and revise strategies flexibly as demands change.

The evidence also suggests that persistence and disengagement should not be treated as simple opposites. Jackman et al. (2024) found that runners who reported excellent performances used mental contrasting with implementation intentions to decide whether to persist with a goal, revise it, or disengage and re-engage with an alternative. By contrast, Philippe et al. (2016) characterized withdrawal as a progressive, cumulative process involving bodily, behavioral, cognitive, and social experiences. These findings imply that adaptive performance resilience may include goal revision and strategic disengagement when initial goals become unrealistic or unsafe. This consideration is particularly important in ultra-endurance contexts, where rigid persistence may sustain effort but also increase exposure to injury, medical complications, or psychological distress.

Quantitative evidence on attention and pacing is consistent with this interpretation. Deaner et al. (2019) found that pace-related risk-taking was the most robust psychological predictor of slowing during the second half of a marathon after adjustment for covariates; willingness to suffer, competitiveness, goal achievement, and broader risk-taking indices were not robust adjusted predictors. Masters and Lambert (1989) reported that associative strategies and drive or competition were associated with faster marathon performance, whereas dissociation was not linked to injury indicators. However, Masters and Ogles (1998) found that association or internal focus, particularly among more competitive and invested runners, predicted subsequent injury. This pattern underscores the ambivalent role of attentional focus: monitoring bodily cues may facilitate pacing and effort regulation, but sustained internal focus among highly driven runners may also be associated with injury risk. The most defensible interpretation is therefore not that association or dissociation is universally superior but that attentional strategies interact with motivation, goal demands, pain appraisal, and situational risk.

Objective evidence on cognitive outcomes remains limited. Boere et al. (2026) reported changes in behavioral and electroencephalographic indices of executive function after a 50-km ultramarathon, with pre-race motivation and psychological distress associated with larger neural reductions. Although race-induced changes do not establish causal associations between traits and outcomes, this study extends the literature beyond self-report by linking psychological attributes with neurocognitive adaptation after acute endurance load. Further research is needed to determine whether cognitive resilience under fatigue is predicted by stable traits, transient psychological states, training history, or interactions among these factors.

4.3 Mental resilience, emotional regulation, and psychological health

Evidence on mental resilience focused primarily on mood regulation, perceived stress, psychological wellbeing, anxiety, recovery resources, and mental health symptoms. Emotional intelligence and emotion regulation formed one of the clearest thematic clusters. Lane and Wilson (2011) reported that higher trait emotional intelligence was associated with more pleasant and fewer unpleasant emotions during a multistage event. Howe et al. (2019) found that trait emotional intelligence was associated with better mood regulation and lower perceived exertion at controlled velocities; however, it was also associated with higher post-ultramarathon cortisol, complicating a uniformly protective interpretation. Nicolas et al. (2019, 2022) suggested that emotional intelligence may be associated with positive affect and recovery resources but not with all trajectories of stress states. Urquijo et al. (2024) further found that emotion regulation was associated with lower perceived stress, partly through lower negative self-talk. The sensitivity synthesis retained the general association of emotional intelligence or emotion regulation with affective and perceived stress outcomes after studies with serious methodological concerns were excluded, although evidence concerning cortisol and recovery-related responses became narrower. The evidence supports emotional regulation as a plausible domain of relevance but does not establish that higher emotional intelligence produces better physiological recovery, mental resilience, or running performance.

Motivation and psychological wellbeing also emerged as important, although their interpretation depends on motivational quality and outcome context. Popov et al. (2019) found that motivation for endurance running was associated with emotional wellbeing; coping with negative emotional states was a prominent motive associated with poorer concurrent wellbeing. Tapia-Serrano et al. (2020) reported that intrinsic motivation mediated the association between a more favorable expected race outcome and perceived health status, whereas extrinsic motivation did not. Miller et al. (2023) found that irrational performance beliefs and less autonomous motivation were associated with greater anxiety symptoms in elite ultramarathon runners; qualitative accounts also suggested links with maladaptive behaviors, such as persisting through injury or withdrawing from sport. These findings are consistent with the interpretation that autonomous, meaning-based, or intrinsically regulated motives may be more compatible with mental resilience than externally controlled or anxiety-driven motives. Nevertheless, because most evidence came from cross-sectional mediation and profile analyses, the direction of causation remains uncertain.

Studies of resilience, mental toughness, and need satisfaction further emphasize the relational and contextual nature of mental resilience. Diotaiuti et al. (2021) linked autonomy, competence, self-regulatory locomotion, and resilience processes in endurance runners, suggesting that the satisfaction of psychological needs may support adaptive reintegration after stress. Graham et al. (2021) found that mental toughness was associated with better mood regulation during a multiday Arctic ultramarathon but not with injury rates. Beattie et al. (2025) found that coping effectiveness was more strongly associated with performance satisfaction when mental toughness or resilience was high, suggesting that trait-like resources may shape how coping translates into satisfaction. These findings are consistent with the interpretation that autonomous, meaning-based, or intrinsically regulated motives may be more compatible with mental resilience than externally controlled or anxiety-driven motives. Temporal ordering, therefore, remains uncertain since motivational regulation may influence wellbeing and anxiety, but previous experiences of performance, distress, injury, or participation in endurance running may also shape athletes’ reported motives and beliefs.

Evidence on mental health also indicates that endurance running may be associated with vulnerability as well as adaptation. Gauld et al. (2024) reported symptoms of exercise addiction among ultrarunners who were hospitalized or dialyzed after serious ultramarathon complications, although the small, selected rare-event sample limits generalizability. Woodman and Welch (2022) suggested that extreme endurance running may serve an anxiety-regulation function for runners with high alexithymia. These findings should not be interpreted as evidence that ultrarunning is inherently harmful or therapeutic. Rather, they indicate that psychological traits may influence why individuals engage in extreme endurance running and how that engagement relates to mental health. This dual role is important for practitioners because the same behavior that supports identity, emotion regulation, and community connection may become maladaptive when driven by uncontrolled motives, rigid beliefs, or a limited ability to disengage.

4.4 Performance resilience, completion, and the limits of trait-based prediction

Evidence on performance resilience indicates that psychological traits and coping processes are associated with race completion, race time, ranking, pacing, and performance satisfaction, but not uniformly or deterministically. In ultra-trail and multistage ultramarathon contexts, lower maladaptive coping, greater self-efficacy, a stronger intention to finish, mastery-approach goals, social support seeking, mental toughness, resilience, and harmonious passion were associated with completion or performance-related outcomes in some studies (Alschuler et al., 2020; Corrion et al., 2018; Méndez-Alonso et al., 2021). Gameiro et al. (2023) reported that mental toughness was positively associated with resilience and that resilience was associated with performance, suggesting a possible pathway linking psychological resources with performance indices. Beattie et al. (2025) further reported that mental toughness and resilience moderated the association between coping effectiveness and performance satisfaction. These findings suggest that psychological resources may be most relevant when performance is conceptualized as persistence, effective coping, or satisfaction under demanding conditions.

Interpretation of this evidence depends on the nature of the performance endpoint. Race completion, non-completion, withdrawal, and maintenance of pacing under fatigue directly or proximally represent persistence and continuity during endurance stress. By contrast, race time, rank, placing, and speed are general performance outcomes unless the study explicitly demonstrates maintenance, disruption, or adaptation under adversity. These outcomes are strongly influenced by physiological fitness, training history, biomechanics, nutrition, race strategy, environmental conditions, and the competitive field. Consequently, an association between a psychological trait and faster performance was not considered sufficient, in isolation, to demonstrate greater performance resilience.

An important interpretive difference concerns the nature of the performance endpoint. Completion, withdrawal, pacing maintenance, and performance satisfaction under demanding conditions more directly reflect persistence or adaptation during endurance stress. By contrast, race time, rank, placing, and speed may primarily reflect general performance capacity and are influenced by physiological fitness, training history, biomechanics, nutrition, race strategy, competition level, and environmental conditions. Accordingly, an association between a psychological trait and a faster finishing time was not considered sufficient, in isolation, to demonstrate greater performance resilience.

By contrast, evidence from elite and highly selected ultramarathon samples illustrates the limits of trait-based prediction. Brace et al. (2020) found that mental toughness and self-efficacy were strongly correlated but did not significantly predict Ultra-Trail World Tour rank, HURT100 completion, placing, or finishing time. This null pattern may reflect restricted variability among elite runners, the overriding influence of physiological capacity and race-specific experience, or the possibility that mental toughness and self-efficacy are threshold characteristics for participation rather than variables that discriminate performance within elite samples. Similarly, de la Vega et al. (2011) found high levels of hardiness in endurance running groups, but hardiness did not differentiate ultra-trail finishers from those who withdrew or distinguish faster from slower finishers. These findings argue against a simplistic model in which higher scores on resilience-related traits automatically translate into better performance.

Studies of race time and ranking also highlight the diverse pathways through which psychological traits may relate to performance. Gayton et al. (1986) found that general physical self-efficacy, particularly perceived physical ability, was associated with predicted and actual marathon finishing times. Rubaltelli et al. (2018) reported that trait emotional intelligence predicted faster half-marathon finishing times and more ambitious performance goals. Waleriańczyk (2023) and Waleriańczyk and Stolarski (2021) found that perfectionistic strivings were associated with better distance- or trail-running performance, whereas perfectionistic concerns weakened or eliminated this benefit. Gillet et al. (2012) identified a high-motivation profile associated with better ranking but also with greater emotional and physical exhaustion, suggesting a potential performance benefit accompanied by a psychological cost. Kilduff (2014) showed that rivalry was associated with a faster race pace, whereas Schüler and Brunner (2009) linked flow during training and racing with motivational and performance-related pathways. Thus, confidence, ambition, motivational intensity, rivalry, perfectionistic striving, and flow may influence performance resilience through training behavior, goal setting, pacing, and competitive arousal while carrying different implications for mental health.

The sensitivity synthesis retained the overall conclusion that mental toughness, resilience, and self-efficacy show heterogeneous and context-dependent associations with running outcomes. Positive associations remained for selected completion, satisfaction, or general performance outcomes, whereas null findings persisted for race time, placing, rank, and completion in elite or homogeneous samples. GRADE certainty for this body of evidence was very low because of methodological limitations, inconsistent findings, heterogeneous construct measurement, and indirectness arising from the inclusion of generic performance outcomes. Evidence concerning perfectionistic strivings and general performance was graded as low certainty and did not directly establish performance resilience under adversity. Psychological characteristics may therefore be relevant to coping, goal regulation, pacing decisions, and performance satisfaction, but the current evidence does not support their use as stand-alone predictors of objective endurance performance or demonstrate that increasing these traits would improve race outcomes.

4.5 Health, injury, and risk appraisal as underdeveloped but clinically important domains

Health, injury, and risk appraisal were among the least populated domains in the evidence map, yet they are central to a responsible interpretation of resilience. Chalabaev et al. (2017) found that self-determined motivation was associated with a lower perceived likelihood of continuing to run through pain, whereas controlled or external motivation was associated with a greater tendency toward risk-related continuation. Masters and Ogles (1998) reported that dissociation did not increase injury risk, but association or internal focus, particularly among more competitive and invested runners, predicted subsequent injury. Van Iperen et al. (2022a) identified psychological profiles characterized by passion, recovery, and resources; runners in the low-risk profile had fewer running-related injuries and less chronic fatigue than those in the high-risk profile. By contrast, Graham et al. (2021) found that mental toughness was associated with mood regulation but did not predict injury rates during an Arctic ultramarathon.

The available evidence raises the possibility that psychological characteristics supporting commitment and persistence may also contribute to unsafe continuation when athletes ignore warning signs, interpret withdrawal as failure, or normalize clinically relevant pain. Conversely, flexible coping and recovery-oriented profiles may assist runners in distinguishing tolerable discomfort from symptoms requiring adjustment or withdrawal. However, GRADE certainty for psychological characteristics in relation to injury or risk-related continuation was very low. The evidence was sparse, exposures and outcomes were not directly comparable, and several findings relied on self-reported injury, hypothetical continuation decisions, or studies with serious methodological concerns. The association between motivational regulation and willingness to continue through pain, for example, was no longer represented after the exclusion of studies with serious concerns. This domain should therefore be viewed as clinically important but hypothesis-generating. Current evidence does not support using psychological profiles to predict injury or determine whether an athlete will persist unsafely.

4.6 Interpretation in light of methodological quality and evidence mapping

The methodological appraisal substantially constrains confidence in the synthesized evidence. Of the 53 included studies, 36 had moderate methodological concerns, and 14 had serious concerns; only 3 were classified as having minor concerns. The minor-concern category should not be interpreted as a complete absence of potential bias. Rather, it indicates that the identified limitations were considered unlikely to materially alter the principal interpretation. Common concerns included convenience or highly selected sampling, limited control of confounding, uncertain temporal ordering, subjective or incompletely validated exposure and outcome measures, small samples, and incomplete reporting of follow-up or attrition. Qualitative studies generally demonstrated congruity among their research questions, methods, analyses, and conclusions, but researcher reflexivity, researcher influence, and ethical reporting were often incompletely described.

The risk-of-bias sensitivity synthesis clarified which findings remained after excluding the 14 studies with serious methodological concerns. The principal patterns involving maladaptive pain coping, emotional regulation and affective or perceived stress outcomes, and the heterogeneous relationship between resilience-related constructs and performance remained evident in the restricted synthesis. Their persistence indicates that these conclusions were not solely produced by the studies with the most consequential methodological limitations. However, 36 of the 39 retained studies still had moderate concerns, and only 3 had minor concerns. Stability after exclusion should, therefore, be interpreted as relative robustness rather than confirmation that the remaining evidence is free from bias.

Several secondary findings were not robust to this restriction. Comparative evidence concerning greater cold-pain tolerance and lower pain-related anxiety among ultramarathon runners was removed because the contributing studies had serious methodological concerns. The same applied to selected findings concerning motivational regulation and continuation through pain, exercise addiction symptoms in runners with serious medical complications, alexithymia-related anxiety regulation, and several isolated performance associations. These observations remain relevant for hypothesis generation, but they should not be presented as established characteristics of long-distance or ultra-endurance runners.

The GRADE assessment provided a separate evaluation of certainty across each principal body of quantitative evidence. Certainty was low for the associations of maladaptive pain coping with pain interference and completion, motivational quality with psychological wellbeing or anxiety, and perfectionistic characteristics with general performance. Certainty was very low for emotional intelligence or emotion regulation in relation to mood and stress responses, resilience-related constructs in relation to performance or completion, and psychological characteristics in relation to injury or risk-related continuation. No evidence body reached moderate or high certainty. The principal reasons for downgrading were methodological limitations, inconsistency, indirectness, and imprecision.

These ratings concern confidence in the existence and direction of an association, not confidence in causality. Most included studies were observational, and many were cross-sectional or retrospective. Temporal precedence was consequently unresolved, residual confounding remained plausible, and reverse causation could not be excluded. For example, an association between mental toughness and performance does not determine whether mental toughness influences subsequent performance, whether successful participation and previous performance alter self-reported mental toughness, or whether both reflect common determinants such as training history, competitive level, prior success, and self-selection into endurance running. The available evidence, therefore, does not establish that increasing mental toughness, resilience, emotional intelligence, or another psychological characteristic through training will improve endurance running performance or mental health.

The evidence map should be interpreted in conjunction with these certainty judgments. Motivation was the most frequently represented exposure category, but it encompassed conceptually different constructs, including autonomous and controlled motivation, achievement goals, rivalry, passion, and motives related to coping with negative emotions. Emotional intelligence and emotion regulation were concentrated around mood and stress outcomes, whereas objective performance, injury, and safe withdrawal outcomes were less frequently examined. Mental toughness and resilience were prominent constructs, but their associations with objective performance remained inconsistent.

4.7 Practical implications for sport psychology, coaching, and endurance running support

The findings have practical implications but should be applied cautiously. For sport psychologists, coaches, and endurance support teams, flexible coping, emotion regulation, self-talk, goal adjustment, autonomous motivation, and pain appraisal should be regarded as candidate domains for individualized assessment and future intervention testing, rather than as established performance-enhancing targets. The available associations may inform hypothesis generation and case formulation, but they do not demonstrate that changing these characteristics will improve race completion, pacing, finishing time, performance satisfaction, or mental health. Developing and testing approaches that help runners distinguish manageable discomfort from pain signaling clinically relevant risk may be particularly important in ultra-endurance contexts. Performance satisfaction and persistence may reflect not only levels of traits such as mental toughness or resilience but also the ability to deploy effective coping strategies under race-specific demands (Beattie et al., 2025; Corrion et al., 2018).

From an applied perspective, psychological assessment should guide individualized support rather than label athletes as resilient or non-resilient. Mental toughness, resilience, emotional intelligence, perfectionism, and self-efficacy may provide useful information when interpreted alongside training history, injury status, sleep, nutrition, race experience, environmental exposure, and current mental health. The review also cautions against portraying endurance-related suffering as inherently virtuous. Qualitative evidence indicates that meaning-making around suffering can support identity and persistence, whereas evidence on risk appraisal suggests that externally controlled motives, rigid beliefs, and difficulty disengaging may contribute to harmful persistence (Chalabaev et al., 2017; Gross, 2025; Miller et al., 2023). Where these skills are addressed in practice, psychological support should balance adaptive persistence with appropriate disengagement; however, their effects on performance, mental health, and athlete safety require direct evaluation in intervention studies.

The findings also support greater standardization of psychological constructs and outcome definitions in measurement and evidence synthesis. Performance resilience should not automatically be equated with a faster race time. Completion, maintenance of pacing, performance satisfaction, adaptive goal revision, recovery, and safe withdrawal may represent distinct but equally important forms of endurance adaptation. Similarly, mental resilience should be conceptualized in terms of distinct dimensions, including mood regulation, stress tolerance, wellbeing, anxiety, coping effectiveness, pain adaptation, and recovery resources. A more differentiated measurement approach would help practitioners and researchers avoid conflating desirable performance outcomes with psychologically healthy adaptation.

4.8 Limitations of the included evidence base and of the review process

The limitations of the evidence base constrain interpretation. Most studies were observational, and many were cross-sectional or retrospective; consequently, the direction of associations between psychological traits and outcomes is often uncertain. The available designs cannot distinguish whether psychological traits precede and influence running outcomes, whether running experience and performance or injury histories alter psychological self-perceptions, or whether both are explained by common determinants. They also do not permit the inference that modifying a psychological trait through training would improve performance. Several studies used self-selected or small samples, event-specific cohorts, male-dominated samples, or highly selected groups of ultramarathon runners. These sampling features limit generalizability across sex and gender groups, competitive levels, race distances, terrain types, cultural contexts, and recreational versus elite populations.

Measurement heterogeneity was another major limitation. Studies differed in how they defined and measured mental toughness, resilience, motivation, emotional intelligence, coping, personality, self-efficacy, and perfectionism. Some studies reported only race time, rank, placing, or speed without assessing whether performance was maintained or adapted under fatigue, pain, environmental exposure, or another identifiable stressor. These outcomes were therefore retained as general performance correlates but were not considered direct evidence of performance resilience. Although this distinction reduced construct overinterpretation, it also limited the amount of evidence that could be classified as directly addressing performance resilience. Together with heterogeneity in psychological constructs, outcome definitions, and analytical methods, this precluded a meta-analysis and necessitated a conservative narrative synthesis.

4.9 Research gaps and priorities for future studies

The most important research priority is to move from broad correlational evidence toward prospective, preregistered, and mechanistically informed studies. Future research should assess psychological traits before events, repeatedly capture state-level processes during events, and link these data with objectively measured completion, pacing, race time, injury, medical events, recovery, and mental health outcomes. Multilevel designs are particularly appropriate for ultramarathons and multistage races because they can distinguish between-runner differences from within-runner changes in pain, coping, affect, fatigue, and goal adjustment.

Future studies should also improve control of confounding variables. Psychological constructs should be analyzed alongside training volume, race experience, history of non-completion, injury history, baseline fitness, sleep, nutrition, environmental exposure, sex or gender, age, competitive level, and race difficulty. Performance studies should distinguish among predicting faster times, maintaining pacing, completing events, achieving personally meaningful goals, and withdrawing safely. Studies of mental resilience should distinguish among short-term mood regulation, recovery resources, anxiety, perceived stress, wellbeing, and clinically relevant symptoms. Without these distinctions, the field will continue to conflate different forms of adaptation.

Intervention research is also needed. The included evidence suggests plausible targets, including adaptive pain coping, emotion regulation, negative self-talk, goal revision, autonomous motivation, coping effectiveness, and risk appraisal. However, the current evidence does not establish which psychological skills-training approaches improve mental resilience, performance resilience, or safety in long-distance and ultra-endurance runners. Randomized trials and pragmatic field studies should test whether targeted psychological interventions improve coping, satisfaction, safe completion, recovery, or mental health without promoting harmful persistence despite injury or medical warning signs.

Greater population diversity is another priority. Women and gender-diverse runners, younger and older runners, athletes with disabilities, runners from non-Western contexts, and athletes across competitive levels remain insufficiently represented in many evidence clusters. Qualitative and mixed-methods studies can help clarify how identity, gender, culture, social support, race organization, and community norms shape the meaning of endurance-related suffering and resilience.

Future studies should define performance resilience prospectively and distinguish it from general running performance. Direct outcomes should include completion or non-completion, pacing maintenance under fatigue, adaptation following disruption, safe withdrawal, and recovery after adversity, rather than relying solely on race time, rank, placing, or speed. Prospective and multilevel designs should establish temporal ordering by assessing psychological characteristics before events and repeatedly measuring coping, affect, pain, pacing, and decision-making during competition. Randomized and pragmatic intervention studies are required before claims can be made that modification of a psychological characteristic improves performance, mental health, or safety.

Future systematic reviews should preserve all pre-consensus reviewer decisions, report stage-specific inter-reviewer agreement, use external adjudication for unresolved or conceptually ambiguous cases where feasible, and prespecify certainty and sensitivity procedures in the review protocol. Greater standardization of psychological constructs and outcome definitions would also permit more informative quantitative synthesis and stronger certainty assessments.

5 Conclusion

This systematic review indicates that psychological traits and trait-like attributes are associated with several dimensions of mental and performance resilience in long-distance and ultra-endurance runners, but the evidence is heterogeneous and predominantly observational. The clearest patterns indicate that maladaptive pain coping is associated with greater pain interference and a lower likelihood of completion; emotional intelligence and emotion regulation are associated with mood- and stress-related outcomes; motivational quality is relevant to wellbeing and risk appraisal; and resilience-related constructs may support coping effectiveness and performance satisfaction. Evidence that these traits directly predict objective performance, particularly among elite or highly selected runners, is less consistent. Methodological concerns were common, especially in relation to exposure measurement, confounding, attrition, and subjective outcomes. The findings therefore support a cautious, domain-specific interpretation: psychological traits are associated with how runners report and regulate pain, emotion, cognition, motivation, and persistence under endurance stress, but the current evidence neither establishes causal effects nor demonstrates that modifying these traits improves endurance running performance. Future research should prioritize prospective, standardized, diverse, and intervention-oriented designs that distinguish adaptive persistence from unsafe continuation.

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