Multilayer Perceptron-Based Wearable Exercise-Related Heart Rate Variability Predicts Anxiety and Depression in College Students

(1) Background: This study aims to investigate the correlation between heart rate variability (HRV) during exercise and recovery periods and the levels of anxiety and depression among college students. Additionally, the study assesses the accuracy of a multilayer perceptron-based HRV analysis in predicting these emotional states. (2) Methods: A total of 845 healthy college students, aged between 18 and 22, participated in the study. Participants completed self-assessment scales for anxiety and depression (SAS and PHQ-9). HRV data were collected during exercise and for a 5-min period post-exercise. The multilayer perceptron neural network model, which included several branches with identical configurations, was employed for data processing. (3) Results: Through a 5-fold cross-validation approach, the average accuracy of HRV in predicting anxiety levels was 89.3% for no anxiety, 83.6% for mild anxiety, and 74.9% for moderate to severe anxiety. For depression levels, the average accuracy was 90.1% for no depression, 84.2% for mild depression, and 82.1% for moderate to severe depression. The predictive R-squared values for anxiety and depression scores were 0.62 and 0.41, respectively. (4) Conclusions: The study demonstrated that HRV during exercise and recovery in college students can effectively predict levels of anxiety and depression. However, the accuracy of score prediction requires further improvement. HRV related to exercise can serve as a non-invasive biomarker for assessing psychological health.

Athlete mental health help-seeking: A systematic review and meta-analysis of rates, barriers and facilitators

Athletes are vulnerable to a range of mental health symptoms, in part due to stressors within the sport environment. An early intervention framework suggests the benefits of routine screening and referral for mental health, however, greater understanding around athlete help-seeking is needed to support referral uptake. This review examined rates of formal help-seeking behaviour as well as barriers and facilitators to help-seeking in sport settings. Relevant studies were retrieved from SportDiscus, PubMed and PsycInfo, with unpublished studies identified through contacting authors. Help-seeking rates were meta-analysed and barriers and facilitators were meta-synthesised. Twenty-two studies were included. Help-seeking rates were reported in 11 studies (N = 3415) and the pooled proportion of help-seeking was 22.4 % (95 % CI 16.2-30.2, I2 = 95.7 %). Barriers were reported in 13 studies and facilitators in six, highlighting a range of sporting-specific factors, such as stigma in relation to athlete identity and sport culture, fear of deselection, and concerns around confidentiality in sport settings, in addition to lack of awareness, low mental health literacy, and negative attitudes to services. Normalising experiences of mental health in sport settings, including through role models, was a key facilitator to help-seeking. Results provide implications for sport organisations to promote help-seeking and athlete mental health, such as through the use of role models, ensuring clarity around confidentiality, stigma reduction interventions, and fostering team cultures that promote mental health. Findings also support the value of sport staff in facilitating help-seeking, and organisational culture changes to foster wellbeing.

Athletes' access to, attitudes towards and experiences of help-seeking for mental health: a scoping review protocol

INTRODUCTION

Athletes are not immune to mental health issues but are less likely to seek help than non-athletes and experience barriers including lack of access to services, lack of knowledge as to how to access services and negative past experiences for help-seeking. Formal (eg, university counsellors, general practitioners and psychologists) and semi-formal (eg, academic tutor, sports coach and physiotherapist) sources of support provided in healthcare, the sport context and higher education are key places for athletes to seek help for mental health, and there is a need to synthesise the evidence on athletes' access, attitudes to and experiences of these services, to understand how to improve these services specific to athletes' mental health needs. This protocol outlines a scoping review that will be used to map the evidence, identify gaps in the literature and summarise findings on athletes' access, attitudes to and experiences of help-seeking for their mental health.

METHODS AND ANALYSIS

The methodological frameworks of Arksey and O'Malley (2005), Levac et al (2010) and the Joanna Briggs Institute (2020 and 2021) were used to inform this scoping review protocol alongside the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols checklist and published scoping review protocols within sport and health. The six stages of Arksey and O'Malley's (2005) framework have been used for this scoping review. The searches were conducted between 30 March 2022 and 3 April 2022 in the following databases: APA PsycINFO (via OVID), Embase (via Ovid), MEDLINE (via Ovid), APA PsycArticles Full Text (via OVID), Web of Science Core Collection, SPORTDiscus (via EBSCO), CINAHL (via EBSCO), Scopus, ProQuest (Education Database), ProQuest (Education Collection), ProQuest (Health & Medical Collection), ProQuest (Nursing & Allied Health database), ProQuest (Psychology Database), ProQuest (Public Health Database) and ProQuest (Sports Medicine & Education). The main inclusion criteria of this review are: papers that focus on past help-seeking behaviour, attitudes towards help-seeking and future behavioural intentions, papers that refer to formal and semi-formal sources of support and peer-reviewed literature, primary research articles, systematic or scoping reviews and interventions. During title and abstract screening and full-text review, at least two reviewers will be involved. Data to be extracted from studies includes: details of the study population, whether the paper focuses on formal and/or semi-formal sources of support and whether the focus is on access, attitudes or experiences to help-seeking for mental health.

ETHICS AND DISSEMINATION

The evidence will be mapped numerically and through content analysis to describe studies and highlight key concepts, themes and gaps in the literature. The published scoping review will be disseminated to relevant stakeholders and policymakers including those in healthcare, the sporting context and the higher education system. The resulting outputs will be in the form of both peer-reviewed and non-peer reviewed publications (eg, multimedia in the form of a blog post and at conferences). The dissemination plan will be informed by patient and public involvement. Ethics approval was not required for this study.

Exploring the Relationship Between Sleep Quality, Sleep Hygiene, and Psychological Distress in a Sample of Canadian Varsity Athletes

Student athletes balance academic, social, and athletic demands, often leading to increased levels of stress and poor sleep. This study explores the relationship between sleep quality, sleep hygiene, and psychological distress in a sample of student athletes. Ninety-four student athletes completed the six-item Kessler Psychological Distress Scale (K6), Sleep Hygiene Practice Scale, and four components from the Pittsburgh Sleep Quality Index. Age, gender, and sport were also collected. The Pittsburgh Sleep Quality Index revealed that 44.7% of student athletes received ≥6.5 hr of sleep each night; 31% of athletes showed signs of severe mental illness according to the K6. Stepwise regression predicted K6 scores with the Pittsburgh Sleep Quality Index and the Sleep Hygiene Practice Scale scores as independent variables. A significant model accounting for 26% of the variation in K6 scores emerged; sleep schedule and sleep disturbances were significant predictors. Athletic staff should highlight the importance of sleep for mental health; suggestions on how to help athletes are provided.

Mental Health Literacy and Confidence in a Sample of Student Athletic Therapists

Intercollegiate student-athletes appear to be a high-risk population with respect to mental health. Student athletic therapists are one of the groups with whom these athletes may be comfortable disclosing concerns. The current study investigated the relationship between mental health literacy and mental health referral efficacy in a sample of intercollegiate student therapists. One hundred and eleven student athletic therapists (81 female, 29 male, 1 nondiscloure) competed a revised version of the multicomponent mental health literacy measure and a four-item measure of mental health referral efficacy. T tests revealed statistically significant differences in mental health literacy by gender and personal history, and a multiple linear regression revealed a significant model predicting referral efficacy from mental health literacy. There are several implications of these results, particularly when working with a high-risk population of student-athletes.