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Kew ME, Dave U, Marmor W, Olsen R, Jivanelli B, Tsai SHL, Kuo LT, Ling DI. Sex Differences in Mental Health Symptoms in Elite Athletes: A Systematic Review and Meta-analysis. Sports Health 2024:19417381241264491. [PMID: 39129353 DOI: 10.1177/19417381241264491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024] Open
Abstract
CONTEXT Mental health is a growing area of concern for elite athletes. OBJECTIVE To determine the sex differences in mental health symptoms in elite athletes. DATA SOURCES PubMed, EMBASE, and Cochrane Library databases were used. STUDY SELECTION Included studies included comparisons of mental health symptoms of athletes by sex. STUDY DESIGN Systematic review and meta-analysis were conducted following the PRISMA guidelines. LEVEL OF EVIDENCE Level 2a. DATA EXTRACTION The rate ratio (RR) was calculated as the rates in female and male athletes. Data were pooled using a random-effects model. RESULTS Of 1945 articles identified, 60 articles were included. Male athletes reported higher alcohol misuse (RR, 0.74; CI, 0.68-0.80), illicit drug abuse (RR, 0.82; CI, 0.75-0.89), and gambling problems (RR, 0.14; CI, 0.08-0.25). Female athletes reported higher overall anxiety (RR, 1.17; CI, 1.08-1.27), depression (RR, 1.42; CI, 1.31-1.54), distress (RR, 1.98; CI, 1.40-2.81), and disordered eating (RR, 2.19; CI, 1.58-3.02). Sleep disturbances were reported at similar rates in male and female athletes (RR, 1.13; CI, 0.98-1.30). CONCLUSION Female and male athletes have significant differences in reported mental health symptoms. Female athletes are more likely to report anxiety, depression, distress, and disordered eating, while male athletes report more alcohol misuse, illicit drug abuse, and gambling. Monitoring and evaluation of mental health is a necessary part of any sport, including access to resources. Longitudinal studies following athletes over time to determine the development and causation for mental health symptoms should be included in future research directions.
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Affiliation(s)
- Michelle E Kew
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Udit Dave
- Tulane University School of Medicine, New Orleans, Louisiana
| | - William Marmor
- University of Miami, Department of Orthopaedics, Miami, Florida
| | - Reena Olsen
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Bridget Jivanelli
- Kim Barrett Memorial Library, HSS Education Institute, Hospital for Special Surgery, New York, New York
| | - Sung Huang Laurent Tsai
- Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi County, Taiwan and School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Tseng Kuo
- School of Medicine, Chang Gung University, Taoyuan, Taiwan and Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | - Daphne I Ling
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Department of Population Health Sciences, Weill Cornell Medical College, New York, New York
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Guillot CR, Moore EWG, Petrie TA. Drinking among college student athletes during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1326-1330. [PMID: 35658017 PMCID: PMC9718885 DOI: 10.1080/07448481.2022.2076100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 04/07/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: To investigate demographics, sport type, athletic identity, and COVID-19 sport season cancelation in relation to alcohol consumption among college student athletes shortly after the pandemic emerged. Participants: College student athletes recruited from U.S. athletic departments. Methods: Survey data were collected from 5,915 college student athletes in April/May 2020. Results: Being female, Latinx, and in a relationship were associated with lower alcohol consumption. Among males, team sport participation was related to greater alcohol consumption. Among females, athletic identity was inversely related to drinking, which was moderated by sport type, such that alcohol consumption was lower as athletic identity strengthened in individual (vs. team) sport athletes. However, we did not find a relationship of COVID-19 sport season cancelation with drinking. Conclusions: Our gender-specific findings are novel and generalizable based on a large, national sample of college student athletes, and may inform strategies for alcohol consumption education among college team sport athletes.
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Affiliation(s)
| | | | - Trent A. Petrie
- Department of Psychology, University of North Texas, Denton, TX
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De Leon AN, Dvorak RD, Perrotte JK, Klaver SJ, Peterson R, Magri TD, Burr EK, Leary AV, Aguilar B. The role of sociocultural factors on alcohol self-efficacy and protective drinking behaviors among Hispanic/Latinx young adults. ETHNICITY & HEALTH 2024; 29:553-577. [PMID: 38714915 DOI: 10.1080/13557858.2024.2345916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/16/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES Hispanic/Latinx drinkers have been found to experience more adverse alcohol-related consequences than any other racial/ethnic group. Due to this, researchers have looked at the connection between drinking and cultural factors, alongside discrimination, to further analyze what sociocultural factors lead to negative outcomes when drinking. DESIGN Researchers used a sample of Hispanic/Latinx young adult drinkers (n = 710) with an average age of 22.43 (SD = 6.69), recruited through social media and assessed on several factors, including protective behavioral strategies (PBS), alcohol use severity, bicultural self-efficacy, discrimination, acculturation, and enculturation. RESULTS Utilizing an observed variable path analysis, results showed perceived discrimination to have a significant effect on all variables in the model (bicultural self-efficacy, acculturation, enculturation, PBS self-efficacy, PBS use, and alcohol use severity). Acculturation was positively associated with PBS self-efficacy, while enculturation was positively associated with PBS use. PBS self-efficacy was positively correlated with PBS use and negatively associated with alcohol use severity. There was a significant total indirect effect from perceived discrimination to alcohol use severity through various paths (i.e. PBS self-efficacy, acculturation, and bicultural self-efficacy), with the strongest path to occur through PBS self-efficacy. CONCLUSIONS Findings showcase the risk and protective effects of various sociocultural factors on drinking behaviors among young adults. PBS self-efficacy was found to have robust protective effects against alcohol use severity. Future research should continue to investigate these sociocultural and behavioral factors in order to develop efforts to mitigate hazardous alcohol use among Hispanic/Latinx young adult drinkers.
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Affiliation(s)
- Ardhys N De Leon
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Robert D Dvorak
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | | | - Samantha J Klaver
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Roselyn Peterson
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Tatiana D Magri
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Emily K Burr
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Angelina V Leary
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Bradley Aguilar
- Department of Psychology, University of Central Florida, Orlando, FL, USA
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Zamboanga BL, Merrill JE, Olthuis JV, Martin JL, Cannon M, Jarrell JT, Meca A, Milroy JJ, Wyrick DL. Racial, ethnic, and sex differences in heavy drinking and negative alcohol-related consequences in a national sample of NCAA student-athlete drinkers. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1250-1258. [PMID: 34242533 DOI: 10.1080/07448481.2021.1926265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/21/2021] [Accepted: 05/02/2021] [Indexed: 05/31/2023]
Abstract
Objective: Athletic involvement is linked to increased risk for heavy alcohol use among college students. We examined whether student-athletes from diverse racial/ethnic backgrounds differ with respect to heavy drinking and related consequences. Method: Participants were 15,135 student-athlete drinkers (50.7% female) from 170 NCAA member institutions who participated in an online study. Results: Findings from our hierarchical linear models indicated that being a male student-athlete was associated with an increased likelihood of high intensity drinking (10/8 + drinks/per sitting for males/females) for White, Asian American/Pacific Islander, and Black student-athletes, but not for Hispanic student-athletes. Additionally, being a female student-athlete was associated with higher levels of negative alcohol-related consequences across all racial/ethnic groups. Finally, at similar drink quantities, compared to being a White student-athlete, being an Asian American/Pacific Islander student-athlete was associated with higher levels of alcohol-related consequences. Conclusions: Student-athlete drinkers are not homogeneous with respect to heavy drinking and related consequences.
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Affiliation(s)
- Byron L Zamboanga
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Jennifer E Merrill
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Jessica L Martin
- Department of Educational and Counseling Psychology, University at Albany-SUNY, Albany, New York, USA
| | - Margeaux Cannon
- Department of Educational and Counseling Psychology, University at Albany-SUNY, Albany, New York, USA
| | - Juliet T Jarrell
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Alan Meca
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Jeffrey J Milroy
- Department of Public Health Education, Institute to Promote Athlete Health & Wellness, University of North Carolina-Greensboro, Greensboro, North Carolina, USA
| | - David L Wyrick
- Department of Public Health Education, Institute to Promote Athlete Health & Wellness, University of North Carolina-Greensboro, Greensboro, North Carolina, USA
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Perrotte JK, Martin JL, Piña-Watson B. Traditional feminine gender roles, alcohol use, and protective behavioral strategies among Latina college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:644-652. [PMID: 32101096 PMCID: PMC9121806 DOI: 10.1080/07448481.2019.1705836] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/17/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Studies conducted with Latina/o populations suggest there are gendered norms surrounding drinking behavior, but research examining alcohol use among Latina college students in the context of traditional feminine gender role (TFGR) norms, is scarce.Participants and Methods: 405 Latina undergraduates completed a web-based study of sociocultural factors and alcohol use. Path analyses assessed the relation between TFGR , alcohol use, and alcohol-related protective behavioral strategies (PBS). RESULTS A dimension of TFGR characterized by purity was related to (a) reduced alcohol use in general, and (b) PBS designed to modify the manner of drinking among drinkers. In turn, this dimension of PBS related to a lower likelihood of experiencing drunkenness. CONCLUSIONS These findings support the notion that enacting some dimensions of TFGR among Latina college students may limit general alcohol use (directly) and high-risk drinking (indirectly through use of PBS), while enacting other dimensions may place Latinas at risk of alcohol misuse.
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Affiliation(s)
| | - Jessica L. Martin
- University at Albany – State University of New York, Department of Counseling Psychology
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Martin JL, Colvin KF, Madson MB, Zamboanga BL, Pazienza R. Optimal assessment of protective behavioral strategies among college drinkers: An item response theory analysis. Psychol Assess 2020; 32:394-406. [PMID: 31999144 PMCID: PMC7163160 DOI: 10.1037/pas0000799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
College student alcohol use and related consequences continue to warrant significant concern. Extant research demonstrates protective behavioral strategies (PBS; self-regulatory strategies that can be employed before, during, or after drinking to prevent intoxication or negative consequences) have promise for preventative interventions. Variations in conceptualization and measurement of the construct limit generalization of PBS research. To advance generalization of PBS research, there is a need for a brief, comprehensive, content valid, PBS measure that demonstrates equivalence in measurement across demographically diverse college students. The present study aimed to develop a psychometrically robust measure of PBS using item response theory (IRT) to address measurement and methodological issues including identifying optimal response anchors and items that represent the full range of the PBS construct for use with college men and women from different racial backgrounds. Participants were 503 college students enrolled in a midsized university in the Southern United States. IRT and differential item functioning (DIF) analyses of 68 PBS items extracted from 6 existing PBS measures resulted in a 20-item instrument, the Protective Drinking Practices Scale, with items that functioned equivalently for White and Black/African American college men and women. The measure also demonstrated good internal and external validity. Widespread use of this measure will help enhance the comparability of findings in PBS research, allowing for more targeted and impactful research on PBS as a mechanism of change. Suggestions for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Jessica L. Martin
- Department of Educational and Counseling Psychology, University at Albany-State University of New York
| | - Kimberly F. Colvin
- Department of Educational and Counseling Psychology, University at Albany-State University of New York
| | | | | | - Rena Pazienza
- Department of Educational and Counseling Psychology, University at Albany-State University of New York
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