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Ruffault A, Valverde S, Regnauld C, Podlog L, Hamonnière T. An examination of relationships between transdiagnostic psychological processes and mental health disorders in athletes. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 75:102727. [PMID: 39218276 DOI: 10.1016/j.psychsport.2024.102727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 08/05/2024] [Accepted: 08/30/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION The aims of this study were (a) to identify links between transdiagnostic psychological processes and mental health disorder (MHD) symptoms, and (b) to examine differences in MHD and transdiagnostic psychological processes as a function of demographic variables, including, gender, status as an athlete (elite vs. non-elite), number of training sessions per week, previous severe injuries, and use of medical care following severe injuries. METHODS A total of 159 competitive athletes aged between 18 and 40 years old (44% female; mean age = 24.20 ± 4.88 years) participated in this cross-sectional study. Participants completed a demographic questionnaire along with validated questionnaires evaluating MHD symptoms and transdiagnostic processes including: motivation to practice sport, emotional competencies, self-efficacy, repetitive negative thinking, meta-cognitive beliefs, and impulsive and perfectionist behaviors. RESULTS MHD symptoms were positively correlated with controlled forms of motivation, repetitive negative thinking, meta-cognitive beliefs, and impulsive and perfectionistic behaviors; and negatively correlated with emotional competencies and self-efficacy. Gender differences showed that women were more likely to experience MHD, higher levels of repetitive negative thinking, meta-cognitive beliefs, and lower levels of emotional competencies and self-efficacy than men. Finally, elite athletes showed higher personal standards than their non-elite counterparts and those training more than four times per week showed significantly higher perfectionistic behaviors. DISCUSSION These results are in line with previous findings in clinical psychology and shed light on the role of transdiagnostic processes and the risk of MHD in a sample of French athletes. Further research on the identification of key risk factors for MHD in competitive athletes is needed.
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Affiliation(s)
- Alexis Ruffault
- Laboratory Sport, Expertise, and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France; Unité de Recherche interfacultaire Santé et Société (URiSS), Université de Liège, Liège, Belgium.
| | - Simon Valverde
- Laboratory Sport, Expertise, and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France
| | - Coline Regnauld
- Medical center, French Institute of Sport (INSEP), Paris, France
| | - Leslie Podlog
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal; Sainte-Justine Hospital Research Centre, Montréal, Québec, Canada
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Stevens M, Cruwys T, Olive L, Rice S. Understanding and Improving Athlete Mental Health: A Social Identity Approach. Sports Med 2024; 54:837-853. [PMID: 38407748 PMCID: PMC11052891 DOI: 10.1007/s40279-024-01996-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/27/2024]
Abstract
Understanding and positively influencing athlete mental health have become key goals for researchers and sporting stakeholders (e.g. coaches, support staff, clubs and governing bodies). In this article, we outline a novel perspective for tackling these challenges, drawing on an influential theory of group processes. This social identity approach can, we argue, help explain when and why the characteristics and demands of sport, which is typically a collective endeavour, pose a threat to athlete mental health and provide a guiding framework for efforts to protect and enhance athlete mental health. Here, we seek to illustrate the value of a social identity analysis of athlete mental health through three key points that speak to its analytical and practical value. Specifically, we propose: (1) that social identities can act as psychological resources that support athlete mental health, (2) that social identities are critical to athlete mental health during and after sporting transitions and (3) that leadership informed by a social identity approach can facilitate athlete mental health. With a view to maximising the value of our analysis both for those working with athletes and for researchers, we also identify practical steps that relevant stakeholders could take to support athlete mental health, and key avenues for future research to further test our propositions and advance understanding. Our analysis provides a new lens through which all those invested in understanding and supporting athlete mental health can approach these challenges, and a foundation for novel solutions.
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Affiliation(s)
- Mark Stevens
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, 2601, Australia.
| | - Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, 2601, Australia
| | - Lisa Olive
- School of Psychology, Deakin University, Geelong, VIC, 3220, Australia
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia
| | - Simon Rice
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Elite Sports and Mental Health, Orygen, 35 Poplar Road, Melbourne, VIC, Australia
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Donohue B, Scott J, Goodwin G, Barchard KA, Bohall G, Allen DN. Initial examination of the mental health disorders: screening instrument for athletes. Front Psychol 2023; 14:1029229. [PMID: 37599751 PMCID: PMC10436329 DOI: 10.3389/fpsyg.2023.1029229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 06/06/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction There is a need to psychometrically develop assessment instruments capable of screening mental health disorders in athlete populations. The current study was conducted to determine reliability, validity and clinical utility of the Mental Health Disorders Screening Instrument for Athletes (MHDSIA). Methods and results 259 collegiate athletes completed the MHDSIA. Factor analysis determined a single factor with good internal consistency, and this factor was positively correlated with an established measure of psychiatric symptomology (Symptom Checklist 90-R), demonstrating its concurrent validity. An optimum clinical cutoff score (i.e., 32) was determined using Receiver Operating Characteristic (ROC) analyses to assist appropriate mental health referrals. Discussion Results suggest the MHSIA is a reliable, valid, and relatively quick and easy to interpret screen for the broad spectrum of mental health disorders in collegiate athletes. As expected, NCAA athletes reported lower MHDSIA scores than club and intramural athletes, while males reported similar severity scores as females.
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Affiliation(s)
- Brad Donohue
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Jesse Scott
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Grace Goodwin
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Kimberly A. Barchard
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Greg Bohall
- The Chicago School of Professional Psychology, Chicago, IL, United States
| | - Daniel N. Allen
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
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Filho E, Piasecki P, Groen M. Performance Recovery and Optimization for Teams (PRO-TEAMS): A Psychological Skills Training Program to Enhance Team Functioning. JOURNAL OF SPORT PSYCHOLOGY IN ACTION 2023. [DOI: 10.1080/21520704.2023.2186993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- Edson Filho
- Performance Recovery and Optimization Lab, Wheelock College of Education & Human Development, Boston University, Boston, Massachusetts, USA
| | - Piotr Piasecki
- Performance Recovery and Optimization Lab, Wheelock College of Education & Human Development, Boston University, Boston, Massachusetts, USA
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Phrathep D, Donohue B, Renn BN, Mercer J, Allen DN. Sport and mental health performance optimization in an adolescent gymnast: A case evaluation. Front Sports Act Living 2023; 5:1018861. [PMID: 36814896 PMCID: PMC9939460 DOI: 10.3389/fspor.2023.1018861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023] Open
Abstract
The Optimum Performance Program in Sports (TOPPS) is a multi-component, sport-specific Family Behavior Therapy that has demonstrated improved sport performance, relationships, and mental health outcomes in adult and adolescent athletes with, and without, diagnosed mental health disorders in clinical trials. The current case trial demonstrates successful implementation of a novel component of TOPPS (i.e., talk aloud optimal sport performance imagery leading to dream mapping) in a biracial Latina and White adolescent gymnast without a mental health diagnosis. The participant demonstrated significant improvements from baseline to both post-treatment and 3-month follow-up in severity of mental health functioning, factors interfering with sports performance, and her relationships with teammates, coaches, and family. Results suggest it may be possible to optimize mental health through sport performance optimization.
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Affiliation(s)
- Davy Phrathep
- Department of Psychology, University of Nevada, Las Vegas, NV, United States
| | - Brad Donohue
- Department of Psychology, University of Nevada, Las Vegas, NV, United States,Correspondence: Brad Donohue
| | - Brenna N. Renn
- Department of Psychology, University of Nevada, Las Vegas, NV, United States
| | - John Mercer
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, United States
| | - Daniel N. Allen
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Nevada, United States
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Neumann DL, Piatkowski TM, Moffitt RL, Minahan CL. The mental health of elite athletes in developing nations of the greater Oceania region. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2130027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- David L. Neumann
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Timothy M. Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, Australia
- College of Health & Human Sciences, Charles Darwin University, Darwin, Australia
| | | | - Clare L. Minahan
- School of Health Sciences & Social Work, Griffith University, Gold Coast, Australia
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Boudreault V, Labossière S, Gauthier V, Brassard S, Couture S, Dionne F, Laurier C, Durand-Bush N. Symptoms of mental illness among university student-athletes during the second wave of the COVID-19 pandemic lockdown in Canada. Front Sports Act Living 2022; 4:1017376. [PMID: 36339640 PMCID: PMC9627313 DOI: 10.3389/fspor.2022.1017376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/30/2022] [Indexed: 01/24/2023] Open
Abstract
The COVID-19 pandemic lockdown disrupted the university sports season and had negative consequences on the academic and personal life of university student-athletes, resulting in several psychological challenges. The goal of this study is to document the symptoms of mental illness among university student-athletes during the second wave of the COVID-19 pandemic lockdown in Canada. It aims to (a) assess the prevalence of mental illness symptoms (anxiety, depression, disordered eating, and dangerous drinking) among university student-athletes and (b) identify which sociodemographic and sports characteristics, pandemic impacts, and levels of perceived stress most influence these symptoms. A total of 424 university student-athletes completed an online survey, which included questions on mental illness and the impact of the pandemic lockdown. The results revealed a notable prevalence of the symptoms of mental illness; depressive symptoms are reported by 37.9% of the participants, anxiety symptoms by 24.9%, dangerous drinking symptoms by 10.1%, and disordered eating by 8.6%. In addition, being female [OR = 0.56, 95% CI (0.33, 0.95)] or a member of a visible minority group [OR = 2.63, 95% CI (1.02, 6.78)] are significantly associated with the presence of depressive symptoms. Low academic motivation has a significant negative influence on the presence of depressive [OR = 3.37, 95% CI (1.82, 6.25)] and anxiety symptoms [OR = 2.75, 95% CI (1.35, 5.62)]. However, the presence of perceived stress was strongly associated with depressive [OR = 7.07, 95% CI (3.26, 15.35)], anxiety [OR = 6.51, 95% CI (3.30, 12.84)], and dangerous drinking symptoms [OR = 5.74, 95% CI (2.51, 13.14)]. This study advocates for specific mental illness prevention and treatment resources tailored to the unique needs of university student-athletes. Accordingly, partnerships and practical interventions to support university student-athletes' mental health are presented.
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Affiliation(s)
- Véronique Boudreault
- Faculté des Sciences de l'Activité Physique, Université de Sherbrooke, Sherbrooke, QC, Canada,*Correspondence: Véronique Boudreault
| | - Sophie Labossière
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Véronique Gauthier
- Département des Sciences Humaines, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sophie Brassard
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sophie Couture
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédérick Dionne
- Département des Sciences Humaines, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Catherine Laurier
- Faculté d'Education, Université de Sherbrooke, Sherbrooke, QC, Canada
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Phrathep D, Donohue B, Renn BN, Mercer J, Allen DN. Controlled Evaluation of a Sport-Specific Performance Optimization Program in a Biracial Black and White Athlete Diagnosed with Social Anxiety Disorder and Agoraphobia. Clin Case Stud 2022. [DOI: 10.1177/15346501221117827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are a very limited number of sport-specific mental health and sport performance interventions available for athletes of color. This study examined The Optimum Performance Program in Sports (TOPPS) in a biracial adolescent athlete who was diagnosed with Agoraphobia and Social Anxiety Disorder. A multiple-baseline across behaviors case trial design was used to evaluate outcomes. A battery of psychological measures specific to mental health and sport performance was administered at baseline, post-intervention, and a 3-month follow-up. Social skill sets (i.e., positive assertion and negative assertion) were systematically targeted sequentially in a virtual format using HIPAA compliant video-conferencing technology to safeguard against contracting COVID-19. Results demonstrated improvement in negative and positive assertion skills when targeted by the intervention. Severity of concurrent symptoms associated with Social Anxiety Disorder and Agoraphobia Symptoms, general psychiatric functioning, relationships with coaches, teammates and family, and factors interfering with sports performance improved from pre- to post-intervention. These improvements were maintained at the 3-month follow-up. Athlete ratings indicated their satisfaction with TOPPS was high, and intervention components were implemented with high integrity.
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Affiliation(s)
| | | | | | - John Mercer
- University of Nevada, Las Vegas, Nevada, USA
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Kosirnik C, Antonini Philippe R, Pomini V. Investigating the Links Between Performers' Self-Compassion, Mental Toughness and Their Social Environment: A Semi-Systematic Review. Front Psychol 2022; 13:887099. [PMID: 35910958 PMCID: PMC9331924 DOI: 10.3389/fpsyg.2022.887099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
Being mentally tough while evaluating oneself in a compassionate way is still a difficult path for performers. Self-compassion, characterized by the ability to be kind to oneself, to see one's experiences as part of the larger human experience and have a balanced awareness to one's emotions and thoughts, was recently studied as a stepping stone to performance optimization and personal development. Despite a mistrust of this concept in the sports world, various studies show its benefits within athletes. A major question remains the environment that fosters or hinders the development of self-compassion: when role models extend compassionate attitudes, does it allow performers to respond in more self-compassionate ways? The relationship between self-compassion, mental toughness, and social environment is still unclear and is an important direction for future research within performers. This semi-systematic literature review aims at proposing an overview of the state of the art regarding self-compassion, mental toughness, and the influence of performer's, and social environments. Sixteen studies were retrieved. We conclude that the number of multi-day intervention programs and longitudinal studies should be increased. The studies should also consider assessing the specific aspects of performance culture and settings. In addition, overall performance-specific measures could be developed to assess general levels of self-compassion. The development of a theoretical framework explaining how self-compassion affects a performer, the role of their entourage and its link to other psychological resources, such as mental toughness, could help to better understand this concept.
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Affiliation(s)
- Celine Kosirnik
- Institute of Sports Sciences, University of Lausanne, Lausanne, Switzerland
| | | | - Valentino Pomini
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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Breslin G, Shannon S, Cummings M, Leavey G. An updated systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches, officials and parents. Syst Rev 2022; 11:99. [PMID: 35590425 PMCID: PMC9118780 DOI: 10.1186/s13643-022-01932-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/18/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Interventions designed to increase mental health awareness in sport have grown substantially in the last 5 years, meaning that those involved in policy, research and intervention implementation are not fully informed by the latest systematic evaluation of research, risking a disservice to healthcare consumers. Hence, our aim was to update a 2017 systematic review that determined the effect of sport-specific mental health awareness programmes to improve mental health knowledge and help-seeking among sports coaches, athletes and officials. We extended the review to incorporate parents as a source of help-seeking and report the validity of outcome measures and quality of research design that occurred since the original review. METHODS Sport-specific mental health awareness programmes adopting an experimental or quasi-experimental design were included for synthesis. Five electronic databases were searched: Psychinfo, Medline (OVID interface), Scopus, Cochrane and Cinahl. Each database was searched from its year of inception to June 2020. As all of the outcomes measured were derived from psychometric scales, we observed statistically significant quantitative effects on the basis of p < .05, and a small, medium or large effect size as d = .2, .5 or .8, respectively. Risk of bias was assessed using the Cochrane and QATSQ tools. RESULTS Twenty-eight articles were included from the 2048 retrieved, eighteen additional articles since the original review. Eighteen studies targeted athletes, five with coaches, one sport officials (i.e. referees), one 'at-risk children' and three with parents. One of the studies was a combination of athletes, coaches and parents. In terms of study outcomes, health referral efficacy was improved in seven studies; twelve studies reported an increase in knowledge about mental health disorders. Proportionally, higher quality research designs were evident, as three of ten studies within the previous review did not demonstrate a high risk of bias, whereas thirteen of the eighteen additional studies did not display a high risk of bias. However, only one study included a behaviour change model in both the programme design and evaluation. CONCLUSIONS Our updated systematic review provides evidence of the benefits of mental health awareness interventions in sport; these benefits are mainly for athletes and show improvements in the methodological design of recent studies compared to the first review. There was also evidence of the extension of programme delivery to parents. In conclusion, researchers, practitioners and policy makers should consider methodological guidance and the application of theory when developing and evaluating complex interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016040178.
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Affiliation(s)
- Gavin Breslin
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Stephen Shannon
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland. .,Sport and Exercise Sciences Research Institute, Ulster University Jordanstown Campus, Newtownabbey, Northern Ireland.
| | - Michael Cummings
- Maastricht University, Minderbroedersberg 4-6, Maastricht, 6211 LK, The Netherlands
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
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Zhen Z, Wang R, Zhu W. A deep learning based method for intelligent detection of seafarers' mental health condition. Sci Rep 2022; 12:7890. [PMID: 35551204 PMCID: PMC9098153 DOI: 10.1038/s41598-022-11207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
Mental health monitoring of seafarers is an important part of achieving normal development of the ocean shipping industry. In this paper, a dual subjective-objective testing scheme is proposed to achieve a more effective and intelligent assessment of seafarers' mental health status. Firstly, a new seafarers' mental health test scale (SMHT) is revised based on fuzzy factor analysis and the test data of 283 marine practitioners are analyzed using SPSS v24 software; secondly, this paper proposes an intelligent framework module for immersive subjective emotion extraction based on natural language processing, namely semantic summary extraction (SSE), speech emotion extraction (SEE), using hybrid scoring mechanism to obtain semantic and emotion matching values and assist the seafarer mental health scale to obtain the final correction score. The results showed that the assessment results of the SMHT scale exhibited good reliability (Cronbach's alpha of 0.852 [Formula: see text] and retest reliability R of [Formula: see text]) and scale association validity (for SCL-90, ([Formula: see text]). In addition, the calibration rate of the subject-object dual test method was improved by approximately 12.05% compared to the traditional mental health scale. Finally, the advantages and disadvantages of this solution were compared with mental health testing techniques such as CAT, machine learning, SCL-90, and fMRI, and the method demonstrated more accurate psychological testing results, providing a simple and intelligent solution for standardized psychological testing of seafarers.
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Affiliation(s)
- Zhu Zhen
- Laboratory of Marine Simulation and Control, Dalian Maritime University, Dalian, Liaoning Province, China
| | - Renda Wang
- Laboratory of Marine Simulation and Control, Dalian Maritime University, Dalian, Liaoning Province, China.
| | - Wei Zhu
- Navigation College of Dalian Maritime University, Dalian, Liaoning Province, China
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Donohue B, Phrathep D, Stucki KB, Kowal I, Breslin G, Cohen M, White S, Jefferson L, White T, Irvin J, Reese G, Kessler FHP, Kieslich da Silva A, Gabriel Santos da Silva F, Fothergill M, Robinson G, Allen H, Light A, Allen DN. Adapting an evidence-supported optimization program for mental health and sport performance in collegiate athletes to fit youth from ethnic/racial minority and low-income neighborhoods: A National Institutes of Health stage model feasibility study. Int J Psychiatry Med 2022; 57:226-247. [PMID: 33910408 DOI: 10.1177/00912174211006547] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study addresses the need to empirically develop effective mental health interventions for youth from ethnic/racial minority and low-income neighborhoods. Using Stage Model evaluation methods supported by the National Institutes of Health in the US to address underutilization of mental healthcare among racial/ethnic minority youth, this feasibility study demonstrates empirical adaptation of an innovative sport-specific psychological intervention for use in youth from ethnic/racial minority and low-income neighborhoods. An international group of professionals familiar with sport performance and mental health intervention serving the target population experientially examined the adapted intervention protocols in workshops and provided feedback. Survey results indicated the professionals found the intervention components were easy to administer and likely to be safe, enjoyable, engaging and efficacious for youth mental health and sport performance. The protocols were revised based on feedback from these professionals and the intervention was examined in a case trial involving an Asian American youth who evidenced Social Anxiety Disorder. Case study results indicated the intervention could be implemented with integrity, and severity of psychiatric symptoms and factors interfering with sport performance decreased after intervention implementation. The participant's relationships with family, coaches and teammates were also improved.
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Affiliation(s)
- Brad Donohue
- Psychology Department, University of Nevada, Las Vegas, Nevada, USA
| | - Davy Phrathep
- Psychology Department, University of Nevada, Las Vegas, Nevada, USA
| | | | - Igor Kowal
- Psychology Department, University of Nevada, Las Vegas, Nevada, USA
| | - Gavin Breslin
- Bamford Centre for Mental Health and Well Being, Ulster University, Coleraine, UK
| | - Maya Cohen
- Psychology Department, University of Nevada, Las Vegas, Nevada, USA
| | - Semaj White
- HEROS Advocacy Group, Las Vegas, Nevada, USA
| | | | - Troy White
- HEROS Advocacy Group, Las Vegas, Nevada, USA
| | | | | | | | | | | | | | | | | | - Al Light
- Cirque du Soleil, Las Vegas, Nevada, USA
| | - Daniel N Allen
- Psychology Department, University of Nevada, Las Vegas, Nevada, USA
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Montero A, Stevens D, Adams R, Drummond M. Sleep and Mental Health Issues in Current and Former Athletes: A Mini Review. Front Psychol 2022; 13:868614. [PMID: 35465516 PMCID: PMC9023010 DOI: 10.3389/fpsyg.2022.868614] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep and mental health are important aspects of human health that work concurrently. However, sleep and mental health disorders are often overlooked and undiagnosed in sport due to the negative stigma associated with them. Evidence suggests that athletes are disproportionately affected by mental health issues and sleep problems. Internal and external pressures contribute to psychological distress. Variable competition times, travel and stress are detrimental to sleep quality. Retirement from sport can deteriorate sleep and psychological wellbeing, particularly for those who retired involuntarily and identify strongly with their athletic role. When untreated, these issues can manifest into a range of clinical disorders. This is concerning, not only for compromised athletic performance, but for general health and wellbeing beyond sport. Previous research has focussed on sleep and health independently among currently competing, or former, athletes. To date, no research has comprehensively assessed and compared sleep complaints and mental health issues between these two cohorts. Moreover, research has failed to obtain data across a variety of different competition levels, sports, and genders, leaving the current scope of the literature narrow. Comorbid conditions (e.g., concussion history, obesity), ex-college athletes, and mental health has been the focus of existing literature post-retirement. Future research would benefit from employing both quantitative and qualitative methodologies to comprehensively assess the prevalence and severity of sleep and mental health disorders across current and retired athletes. Research outcomes would inform education strategies, safeguarding athletes from these issues by reducing negative stigmas associated with help-seeking in sport and ultimately increase self-guided treatment.
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Affiliation(s)
- Ashley Montero
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
- Sport, Health, Activity, Performance and Exercise (SHAPE) Research Centre, Flinders University, Bedford Park, SA, Australia
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - David Stevens
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Robert Adams
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Murray Drummond
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
- Sport, Health, Activity, Performance and Exercise (SHAPE) Research Centre, Flinders University, Bedford Park, SA, Australia
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Mental health care for athletes in the Philippines. Lancet Psychiatry 2021; 8:1034. [PMID: 34801122 DOI: 10.1016/s2215-0366(21)00432-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 11/23/2022]
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Phrathep D, Donohue B, Kraus S, Paul M, Mercer J. A Controlled Evaluation of a Sport-Specific Performance Optimization Program in an Athlete Diagnosed With Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Within the Context of COVID-19. Clin Case Stud 2021; 21:209-234. [PMID: 35664370 PMCID: PMC9081019 DOI: 10.1177/15346501211048508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescent athletes with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) experience unique challenges that impact their sport performance, such as making errors due to poor concentration. The current multiple-baseline across behaviors case trial (i.e., positive assertion and negative assertion) is an evaluation of The Optimum Performance Program in Sports in an adolescent athlete diagnosed with ADHD and ODD. Intervention skill sets were targeted sequentially in a virtual format to safeguard against COVID-19 contraction. A battery of psychological measures was administered at baseline, post-intervention, and 1-month follow-up. Results indicated negative and positive assertion skills improved, but only when targeted, and severity of ADHD and ODD symptom severity, general mental health symptoms, and factors interfering with sport performance decreased from pre- to post-intervention and these improvements were maintained at 1-month follow-up. Similar improvements occurred in relationships with coaches, teammates, and family. Treatment integrity and consumer satisfaction were high.
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Affiliation(s)
- Davy Phrathep
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Brad Donohue
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Shane Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Michelle Paul
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - John Mercer
- Department of Kinesiology and Nutrition Sciences at the University of Nevada, Las Vegas
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16
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Rice SM, Treeby MS, Olive L, Saw AE, Kountouris A, Lloyd M, Macleod G, Orchard JW, Clarke P, Gwyther K, Purcell R. Athlete Experiences of Shame and Guilt: Initial Psychometric Properties of the Athletic Perceptions of Performance Scale Within Junior Elite Cricketers. Front Psychol 2021; 12:581914. [PMID: 33995169 PMCID: PMC8116891 DOI: 10.3389/fpsyg.2021.581914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/22/2021] [Indexed: 11/23/2022] Open
Abstract
Guilt and shame are self-conscious emotions with implications for mental health, social and occupational functioning, and the effectiveness of sports practice. To date, the assessment and role of athlete-specific guilt and shame has been under-researched. Reporting data from 174 junior elite cricketers (M = 17.34 years; females n = 85), the present study utilized exploratory factor analysis in validating the Athletic Perceptions of Performance Scale (APPS), assessing three distinct and statistically reliable factors: athletic shame-proneness, guilt-proneness, and no-concern. Conditional process analysis indicated that APPS shame-proneness mediated the relationship between general and athlete-specific distress (p < 0.01), with this pathway non-contingent on sex or past 12-month help-seeking for mental health concerns (p's > 0.05). While APPS domains of guilt-proneness and no-concern were not significant mediators, they exhibited correlations in the expected direction with indices of psychological distress and well-being. The APPS may assist coaches and support staff identify players who may benefit from targeted interventions to reduce the likelihood of experiencing shame-prone states.
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Affiliation(s)
- Simon M. Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Matt S. Treeby
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Lisa Olive
- Orygen, Parkville, VIC, Australia
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Anna E. Saw
- Cricket Australia, Melbourne, VIC, Australia
| | - Alex Kountouris
- Cricket Australia, Melbourne, VIC, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | - Greg Macleod
- Specialist Sports Medicine Centre, Canberra, ACT, Australia
| | - John W. Orchard
- Cricket Australia, Melbourne, VIC, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | | | - Kate Gwyther
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Rosemary Purcell
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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17
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González-Hernández J, López-Mora C, Yüce A, Nogueira-López A, Tovar-Gálvez MI. "Oh, My God! My Season Is Over!" COVID-19 and Regulation of the Psychological Response in Spanish High-Performance Athletes. Front Psychol 2021; 12:622529. [PMID: 33841254 PMCID: PMC8024472 DOI: 10.3389/fpsyg.2021.622529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background: In an unprecedented situation of interruption of the sporting dynamics, the world of sport is going through a series of adaptations necessary to continue functioning despite coronavirus disease 2019 (COVID-19). More than ever, athletes are facing a different challenge, a source of discomfort and uncertainty, and one that absolutely alters not only sports calendars, but also trajectories, progressions, and approaches to sports life. Therefore, it is necessary to identify the levels of psychological vulnerability that may have been generated in the athletes, because of the coexistence with dysfunctional responses during the COVID-19 experience, and which directly influence the decrease of their mental health. Methods: With a descriptive and transversal design, the study aims to identify the state of the dysfunctional psychological response of a sample of Spanish athletes (N = 284). The DASS-21 (Depression, Anxiety, and Stress Scale), Toronto-20 (alexithymia), and Distress Tolerance Scale questionnaires were administered to a sample of high-level Spanish athletes in Olympic programs. Results: The results suggest that the analyzed athletes indicate high levels of dysfunctional response (e.g., anxiety, stress, depression, and alexithymia) when their tolerance is low. In addition, the variables show less relational strength, when the capacity of tolerance to distress is worse and age is lower. At the same time, the greater the anxiety and uncertainty are, leading to more catastrophic and negative thoughts, the younger the athletes are. Conclusions: It is clear that both age and tolerance to distress are considered adequate protective factors for psychological vulnerability in general and for associated dysfunctional responses in particular. Moreover, the psychological resources offered by more experienced athletes are also a guarantee of protection against negativity and catastrophism.
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Affiliation(s)
- Juan González-Hernández
- Health Psychology/Behavioural Medicine, Research Group (CTS−0267), University of Granada, Granada, Spain
| | - Clara López-Mora
- Human Development and Family Science, University of Missouri-Columbia, Columbia, MO, United States
| | - Arif Yüce
- Department of Sports Management, Faculty of Sports Science, Eskisehir Technical University, Eskisehir, Turkey
| | - Abel Nogueira-López
- Department of Health and Sport, European University of the Atlantic, Santander, Spain
- Department of Health and Sport, International Ibero-American University, Campeche, Mexico
- Department of Health and Sport, International University of Cuanza, Cuito, Angola
| | - Maria Isabel Tovar-Gálvez
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
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18
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Donohue B, Gavrilova E, Danlag A, Perry J, Kuhn C, Allen D, Benning SD. A Comprehensive Examination of Factors Impacting Collegiate Athletes' Utilization of Psychological Assessment and Intervention Services. PSYCHOLOGY IN THE SCHOOLS 2021; 58:458-474. [PMID: 33678909 DOI: 10.1002/pits.22458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although collegiate athletes underutilize mental health programming, investigators have rarely examined factors that may influence their participation in such programs. The current study examined how structured interviews and demographic factors influence collegiate athletes to use psychological programming. Two-hundred and eighty-nine collegiate athletes were referred to the study. They were screened for mental health and randomly assigned to one of two semi-structured interviews based on experimental phase. Participants in Phase I received standard engagement (SE; N = 35) or SE+discussion of mental health (DMH; N = 44). Phase II participants received SE+DMH (N = 82) or SE+DMH + discussion of personal ambitions (DPA; N = 66). Phase III participants received SE+DMH+discussion about their culture of choice (DCC) (N = 25) or SE+DMH+discussion of sport culture (DSC) (N = 37). After receiving the respective interview participants were offered psychological assessment and intervention. Chi squared analyses revealed class standing, mental health symptom severity, referral type, and type of engagement interview influenced program commitment/utilization. Logistic regression analyses indicated SE+DMH+DPA and SE+DMH+DSC uniquely improved assessment attendance whereas referrals from the athletic department and coaches/teammates, participation in sport performance workshops, and senior status uniquely improved assessment and intervention attendance.
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Affiliation(s)
- Brad Donohue
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Elena Gavrilova
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Alexandra Danlag
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Joanne Perry
- Orthopedic Service Line, Novant Health, Charlotte, NC USA
| | - Corey Kuhn
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Daniel Allen
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
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19
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What Lies Beneath: Exploring Different Depressive Symptoms Across Selected Risk Factors in Icelandic Team Sport Athletes. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2021. [DOI: 10.1123/jcsp.2020-0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study was to explore the prevalence of specific symptoms of depression in athletes and to test differences in the likelihood of athletes exhibiting these symptoms across age, sex, type of team sport, and level of competition. A sample of Icelandic male and female team sport athletes (N = 894, 18–42 years) was included in the study. Of the athletes exhibiting clinically significant depressive symptoms on the Patient Health Questionnaire-9, 37.5% did not exhibit core symptoms of depression. Compared with males, females were significantly more likely to exhibit depressed mood, feelings of worthlessness/guilt, and problems with sleep, fatigue, appetite, and concentration. Within males, differences were mostly related to neurovegetative aspects of depression (sleep and appetite), whereas in females, differences were related to cognitive/emotional aspects (e.g., depressed mood, guilt/worthlessness). The findings underline the importance of exploring specific symptoms of depression to provide a richer understanding of depressive symptomology in athletes.
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20
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Factor structure and measurement invariance across gender, age and sport psychology experience of the SPA-R in Spanish athletes. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01447-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Plant CP, Donohue B, Freeman AJ, Allen DN. Examination of the Influence of Cognitive Behavior Therapy Components, Consumer Satisfaction and Engagement in Mothers Referred for Drug Abuse and Child Neglect on Treatment Outcomes. Behav Modif 2020; 45:1011-1040. [PMID: 32578438 DOI: 10.1177/0145445520935394] [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: 11/16/2022]
Abstract
Psychological interventions for child maltreatment have predominately been limited to family-supported, multi-component behavioral therapies. Although these comprehensive programs have resulted in positive outcomes, they are relatively costly and there is limited information available as to how the components of these programs influence treatment outcomes. In this study, the CBT components of an evidence-based treatment for child neglect and drug abuse (Family Behavior Therapy) were examined in regards to consumer preferences, consumer engagement and treatment outcomes. Thirty-five mothers identified for child neglect and drug abuse were administered various CBT components successively and cumulatively based on their preferences. Repeated measure ANOVAs indicated that participants chose to receive components that were specific to managing antecedents to drug abuse and child neglect most frequently, followed by parenting skills training, communication skills training, and job/financial skills training. No differences were found in treatment providers' ratings of the participants' engagement across intervention components throughout treatment. Participants rated the intervention components as similarly helpful. Partial correlations revealed that participants' ratings of helpfulness and provider ratings of participants' engagement were not associated with improved drug use outcomes at 6- and 10-months post baseline. Participants' ratings of helpfulness were associated with child maltreatment outcomes at 10-month post baseline, and provider ratings of participants' engagement were associated with child maltreatment outcomes at both 6- and 10-month post baseline. Participants identified for neglect not related to drug exposure in utero improved at a higher percentage than did participants identified for in utero drug exposure, and receiving behavioral intervention components more frequently led to greater percentages of participants improving in both drug use and child maltreatment outcomes.
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22
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Walton CC, Purcell R, Rice S. Addressing mental health in elite athletes as a vehicle for early detection and intervention in the general community. Early Interv Psychiatry 2019; 13:1530-1532. [PMID: 31264781 DOI: 10.1111/eip.12857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/28/2019] [Accepted: 06/09/2019] [Indexed: 12/22/2022]
Abstract
Recent scientific literature in addition to increased media attention has highlighted the important role of mental health in elite athletes. Often defined by terms such as "mental toughness", athletes are now becoming more open to discussing the role of anxiety, depression and other psychologically distressing processes that are intertwined with their time both during and after elite sport. In line with this, recent international position statements regarding the mental health of athletes have been released. The current New Hypothesis article follows on from these statements and proposes that further work must be performed to better understand this aspect of elite sport in addition to developing sport-specific interventions for athletes, their families, and support staff. Furthermore, we propose that by better understanding and treating the mental health of elite athletes a follow-on effect may occur, whereby help-seeking in the general community will increase. In particular, young adults who were previously hesitant to seek help may take strength from this shift, maximizing the success of early intervention occurring.
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Affiliation(s)
- Courtney C Walton
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Rosemary Purcell
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen Youth Health Clinical Program, Melbourne, Victoria, Australia
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Orygen Youth Health Clinical Program, Melbourne, Victoria, Australia
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23
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Empirical Development of a Screening Method to Assist Mental Health Referrals in Collegiate Athletes. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2019. [DOI: 10.1123/jcsp.2018-0070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The conspicuous absence of validated screening measures specific to mental health symptomology in collegiate athletes has negatively affected clinical practice in this population. Therefore, this study was performed to develop a sport specific measure to optimally identify collegiate athletes who are particularly likely to benefit from mental health programming. Participants were 289 collegiate-athletes who were assessed for mental health symptomology using the Global Severity Index of Symptom Checklist-90-Revised (GSI), factors that interfere with sport performance using the Problems in Sport Competition Scale (PSCS) and Problems in Sport Training Scale (PSTS), and motivation to pursue professional counseling using the Desire to Pursue Sport Psychology Scale (DSPS). As hypothesized, a hierarchical multiple regression analysis indicated that PSCS, PSTS and DSPS scores significantly predicted GSI scores, controlling gender and sport status (NCAA, club, intramural). Receiver operating characteristic (ROC) analysis indicated that high-risk athletes (GSI T-scores ≥ 60) could be correctly classified by PSTS and PSCS scores. Results suggest the PSCS and PSTS may assist identification of collegiate athletes who are especially appropriate for mental health programs. These scales additionally identify factors directly relevant to athletes’ sport performance.
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24
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Purcell R, Gwyther K, Rice SM. Mental Health In Elite Athletes: Increased Awareness Requires An Early Intervention Framework to Respond to Athlete Needs. SPORTS MEDICINE - OPEN 2019; 5:46. [PMID: 31781988 PMCID: PMC6883009 DOI: 10.1186/s40798-019-0220-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 10/09/2019] [Indexed: 12/02/2022]
Abstract
The current 'state of play' in supporting elite athlete mental health and wellbeing has centred mostly on building mental health literacy or awareness of the signs of mental ill-health amongst athletes. Such awareness is necessary, but not sufficient to address the varied mental health needs of elite athletes. We call for a new model of intervention and outline the backbone of a comprehensive mental health framework to promote athlete mental health and wellbeing, and respond to the needs of athletes who are at-risk of developing, or already experiencing mental health symptoms or disorders. Early detection of, and intervention for, mental health symptoms is essential in the elite sporting context. Such approaches help build cultures that acknowledge that an athlete's mental health needs are as important as their physical health needs, and that both are likely to contribute to optimising the athlete's overall wellbeing in conjunction with performance excellence. The proposed framework aims at (i) helping athletes develop a range of self-management skills that they can utilise to manage psychological distress, (ii) equipping key stakeholders in the elite sporting environment (such as coaches, sports medicine and high-performance support staff) to better recognise and respond to concerns regarding an athlete's mental health and (iii) highlighting the need for specialist multi-disciplinary teams or skilled mental health professionals to manage athletes with severe or complex mental disorders. Combined, these components ensure that elite athletes receive the intervention and support that they need at the right time, in the right place, with the right person.
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Affiliation(s)
- Rosemary Purcell
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Melbourne, Victoria, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Gwyther
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Melbourne, Victoria, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Simon M Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Melbourne, Victoria, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
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25
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Rice SM, Gwyther K, Santesteban-Echarri O, Baron D, Gorczynski P, Gouttebarge V, Reardon CL, Hitchcock ME, Hainline B, Purcell R. Determinants of anxiety in elite athletes: a systematic review and meta-analysis. Br J Sports Med 2019; 53:722-730. [PMID: 31097452 PMCID: PMC6579501 DOI: 10.1136/bjsports-2019-100620] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes. Design Systematic review and meta-analysis. Data sources Five online databases (PubMed, SportDiscus, PsycINFO, Scopus and Cochrane) were searched up to November 2018 to identify eligible citations. Eligibility criteria for selecting studies Articles were included if they were published in English, were quantitative studies and measured a symptom-level anxiety outcome in competing or retired athletes at the professional (including professional youth), Olympic or collegiate/university levels. Results and summary We screened 1163 articles; 61 studies were included in the systematic review and 27 of them were suitable for meta-analysis. Overall risk of bias for included studies was low. Athletes and non-athletes had no differences in anxiety profiles (d=−0.11, p=0.28). Pooled effect sizes, demonstrating moderate effects, were identified for (1) career dissatisfaction (d=0.45; higher anxiety in dissatisfied athletes), (2) gender (d=0.38; higher anxiety in female athletes), (3) age (d=−0.34; higher anxiety for younger athletes) and (4) musculoskeletal injury (d=0.31; higher anxiety for injured athletes). A small pooled effect was found for recent adverse life events (d=0.26)—higher anxiety in athletes who had experienced one or more recent adverse life events. Conclusion Determinants of anxiety in elite populations broadly reflect those experienced by the general population. Clinicians should be aware of these general and athlete-specific determinants of anxiety among elite athletes.
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Affiliation(s)
- Simon M Rice
- Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia .,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Gwyther
- Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Olga Santesteban-Echarri
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - David Baron
- Center for Health and Sport, Western University of Health Sciences, Pomona, California, USA
| | - Paul Gorczynski
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Vincent Gouttebarge
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef, The Netherlands.,AMC/VUmc IOC Research Center of Excellence, Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,University Health Services, University of Wisconsin, Madison, Wisconsin, USA
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Rosemary Purcell
- Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
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26
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Shannon S, Hanna D, Haughey T, Leavey G, McGeown C, Breslin G. Effects of a Mental Health Intervention in Athletes: Applying Self-Determination Theory. Front Psychol 2019; 10:1875. [PMID: 31456725 PMCID: PMC6700360 DOI: 10.3389/fpsyg.2019.01875] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/30/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Many sport associations have responded to mental health issues in sport through the inclusion of self-management programs, such as mindfulness training, which may improve well-being through increasing one's competence in self-regulating stressors. Yet, the mechanisms accounting such changes lack a theoretical basis, particularly in athletes. Aim: To determine the effect of a mental health intervention comprising a mindfulness program for promoting well-being, reducing stress, and increasing competence in mental health self-management. This is the first study among athletes to test the mechanisms of change in a mindfulness program using Self-Determination Theory (SDT). Methods: A 2 (groups) × 2 (time-point) non-randomized controlled trial was conducted, and between-groups baseline differences were firstly assessed. Two competing regression models assessing singular and serial indirect mediating mechanisms were conducted, in which mindfulness (Model 1) and competence satisfaction (Model 2) were both tested as primary and secondary mediators predicting change scores in stress and well-being. Demographic variables (i.e., gender, age) were controlled for in the analyses. Results: Two hundred and thirty-eight student athletes (mean age = 20.47 years, SD = 3.30, 57.6% = males) participated, with 108 in the intervention group who received an instructional workshop, and a home-directed mindfulness program comprising daily meditation sessions. No baseline differences were found between intervention and control groups. In Model 1, mindfulness was not directly enhanced by the intervention, subsequently resulting in no indirect effects on competence, stress and well-being. In Model 2, the intervention was directly related to positive changes in competence (β = 0.39, p < 0.05), subsequently resulting in indirect effects on mindfulness awareness (β = 0.07, p < 0.05), stress (β = -0.06, p < 0.05), and well-being (β = 0.05, p < 0.05). In addition, serial indirect effects for the intervention on stress were present through competence and mindfulness awareness in sequence (β = -0.02, p < 0.05), and; on well-being through competence, mindfulness awareness, and stress in sequence (β = 0.01, p < 0.05; R 2 = 0.54). Conclusion: Mindfulness-based mental health interventions may be effective at reducing stress and promoting well-being in athletes, with the caveat that attention is given to the inclusion of mental health competence promotion in program design. However, it remains unclear whether increasing mindfulness itself can exert additional salutary effects. Our findings have an important bearing on how mindfulness programs are developed within athlete mental health interventions.
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Affiliation(s)
- Stephen Shannon
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
- Institute of Mental Health Sciences, Ulster University, Derry, United Kingdom
| | - Donncha Hanna
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom
| | - Tandy Haughey
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Conor McGeown
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
| | - Gavin Breslin
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
- Institute of Mental Health Sciences, Ulster University, Derry, United Kingdom
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27
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Currie A, McDuff D, Johnston A, Hopley P, Hitchcock ME, Reardon CL, Hainline B. Management of mental health emergencies in elite athletes: a narrative review. Br J Sports Med 2019; 53:772-778. [PMID: 31097462 DOI: 10.1136/bjsports-2019-100691] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2019] [Indexed: 01/19/2023]
Abstract
Mental health emergencies require a rapid, effective response. We searched the literature on mental health emergencies in athletes and found five papers. None of these addressed elite athletes. Nonetheless, common mental health emergencies may present in the sports environment and may place the athlete and others at risk. Sports teams and organisations should anticipate which emergencies are likely and how medical and support staff can best respond. Responses should be based on general non-sporting guidelines. We stress the importance of clinicians following standard procedures.
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Affiliation(s)
- Alan Currie
- Regional Affective Disorders Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK
| | - David McDuff
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Allan Johnston
- Mental Health Expert Panel, English Institute of Sport, Sheffield, UK
| | | | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
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28
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Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med 2019; 53:667-699. [DOI: 10.1136/bjsports-2019-100715] [Citation(s) in RCA: 349] [Impact Index Per Article: 69.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
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Castaldelli-Maia JM, Gallinaro JGDME, Falcão RS, Gouttebarge V, Hitchcock ME, Hainline B, Reardon CL, Stull T. Mental health symptoms and disorders in elite athletes: a systematic review on cultural influencers and barriers to athletes seeking treatment. Br J Sports Med 2019; 53:707-721. [PMID: 31092400 DOI: 10.1136/bjsports-2019-100710] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To summarise the literature on the barriers to athletes seeking mental health treatment and cultural influencers of mental health in elite athletes. DESIGN Systematic review DATA SOURCES: PubMed, Cochrane, Scopus, SportDiscus (Ebsco), and PsycINFO (ProQuest) up to November 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative and quantitative original studies of elite athletes (those who competed at the professional, Olympic, or collegiate/university levels), published in any language. RESULTS Stigma, low mental health literacy, negative past experiences with mental health treatment-seeking, busy schedules, and hypermasculinity are barriers to elite athletes seeking mental health treatment. Cultural influencers of mental health in elite athletes include: (1) the lack of acceptance of women as athletes; (2) lower acceptability of mental health symptoms and disorders among non-white athletes; (3) non-disclosure of religious beliefs; and (4) higher dependence on economic benefits. Coaches have an important role in supporting elite athletes in obtaining treatment for mental illness. Brief anti-stigma interventions in elite athletes decrease stigma and improve literary about mental health. CONCLUSION There is a need for various actors to provide more effective strategies to overcome the stigma that surrounds mental illness, increase mental health literacy in the athlete/coach community, and address athlete-specific barriers to seeking treatment for mental illness. In this systematic review, we identified strategies that, if implemented, can overcome the cultural factors that may otherwise limit athletes seeking treatment. Coaches are critical for promoting a culture within elite athletes' environments that encourages athletes to seek treatment.
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Affiliation(s)
- João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo Andre, SP, Brazil .,Department of Psychiatry, Medical School, University of São Paulo, Sao Paulo, SP, Brazil.,ABC Center for Mental Health Studies, Santo André, SP, Brazil
| | | | | | - Vincent Gouttebarge
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Todd Stull
- Athletic Department, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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Hussey JE, Donohue B, Barchard KA, Allen DN. Family contributions to sport performance and their utility in predicting appropriate referrals to mental health optimization programmes. Eur J Sport Sci 2019; 19:972-982. [PMID: 30732531 DOI: 10.1080/17461391.2019.1574906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Limited research has examined the contributions of sport-specific family relationship problems to athlete mental health. In the current study we examined the extent to which collegiate athletes' family problems (as measured by the Student Athlete Relationship Instrument factors, SARI) predict athletes' general mental health distress and specific mental health symptoms that are relatively common in athletes (i.e. depression, anxiety, and drug and alcohol use). The study included 85 collegiate athletes (intramural, n = 26; club sport, n = 12; NCAA Division I, n = 47). We hypothesized that both general mental health distress and commonly evidenced mental health symptoms would be predicted by athletes' responses to the SARI factors (Poor Relationship and Lack of Support, General Pressure, Pressure to Quit or Continue Unsafely, Embarrassing Comments, and Negative Attitude). Results indicated that all of the aforementioned SARI factors predicted athletes' ratings of depression and general mental health distress levels. Only the General Pressure SARI factor predicted athletes' anxiety and drug use. Alcohol use was not predicted by any of the SARI factors. Receiver operating characteristic (ROC) analyses indicated that sport-specific problems in family relationships provided a good classification of athletes at risk for general mental health distress, depression, and anxiety. Practice implications are discussed in light of the results.
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Affiliation(s)
- Julia E Hussey
- a Department of Psychology , University of Nevada, Las Vegas , Las Vegas , NV , USA
| | - Brad Donohue
- a Department of Psychology , University of Nevada, Las Vegas , Las Vegas , NV , USA
| | - Kimberly A Barchard
- a Department of Psychology , University of Nevada, Las Vegas , Las Vegas , NV , USA
| | - Daniel N Allen
- a Department of Psychology , University of Nevada, Las Vegas , Las Vegas , NV , USA
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