Breaking a taboo: why the International Olympic Committee convened experts to develop a consensus statement on mental health in elite athletes

Mental health symptoms among Dutch elite athletes and their coaches: a cross-sectional study

A bstract

Objective

To establish the prevalence of mental health symptoms (MHSs ) among Dutch elite athletes and their coaches, to examine the association between potential contributing factors and MHS among Dutch elite athletes and their coaches and to explore the view and needs of Dutch elite athletes and their coaches regarding mental health resources and support.

Methods

A cross-sectional study was conducted by distributing an electronic questionnaire based on validated screening questionnaires for the assessment of MHS.

Results

In total, 156 athletes (55 % female) and 95 coaches (79 % male) across various sports participated in this study. The most prevalent MHS among athletes and coaches were distress (73 % and 41 %) and alcohol misuse (52 % and 53 %). Adverse life events showed an association with anxiety, depression, sleep disturbance, alcohol misuse and disordered eating while severe injuries showed an association with distress and sleep disturbance in elite athletes. Among coaches, no significant associations were found between potential contributing factors and MHS. 60 % of the athletes and 60 % of the coaches (totally) agreed that they could openly address their mental health issues within their sport while 53 % of the athletes and 41 % of the coaches (totally) agreed a need for increased attention regarding mental health/guidance in their sport.

Conclusions

MHSs are prevalent among Dutch elite athletes and coaches. Recent adverse life events and severe injuries have a potential intersection with MHS in elite athletes. There is a need for increased attention regarding mental health/guidance among Dutch elite athletes and coaches within their sport so that subsequent treatment/support can be provided.

Coping with the COVID-19 pandemic by Paralympic athletes preparing for elite sport events: A longitudinal study

INTRODUCTION

This study investigates the impact of the COVID-19 pandemic on mental health, coping styles and their relationship, and training opportunities in elite athletes with disabilities (AwD) preparing for national and international sport events during a ten-month observation period.

METHODS

The study covered four time points in 3-month intervals, one retrospective, and three times during the 10 months of the pandemic period with diversified numbers of average new infections per day: A-pre-pandemic, B-third wave of the pandemic (mean = 15 681), C-decrease of the pandemic (mean = 102), and D-fourth wave of the pandemic (mean = 22 591). Main outcome measures included the Coping Inventory for Stressful Situations and the Hospital Anxiety and Depression Scale.

RESULTS

The models regarding changes in anxiety (F_(3,72)  = 22.43; p < 0.001; partial η2 = 0.48) and depression (F_(3,72)  = 23.82; p < 0.001; partial η²  = 0.50) over the four time points of examination were significant. The pattern of relationship between coping styles and mood changes during COVID-19 pandemic periods, that is, a sudden increase in anxiety during dynamic growth of infections (waves of a pandemic) and a steady increase in depression over the course of the pandemic was not found. The difference in planned and actual training decreased significantly over time (p < 0.001).

CONCLUSIONS

During the transitionary times of the COVID-19 pandemic, both mental health and training opportunities of AwD were at increased risk. Individual coping styles used by AwD were insufficient resources to cope with the extreme stress caused by the COVID-19 pandemic. Their mental health should be monitored in pandemics and similar situations to ensure appropriate and timely organizational and psychological intervention.

Depressive symptoms among Olympic athletes during the Covid-19 pandemic

Objectives

The aim of this study was to analyze athlete-specific psychological strain among Olympic athletes following the postponement of the Tokyo 2020 Olympic games due to the COVID-19 pandemic.

Methods

A survey that comprised three sub-sections (Psychological Strain Questionnaire (APSQ), Patient Health Questionnaire—Depression Module (PHQ-8) and Participant characteristic) concerning mental health, performance issues and concerns about the postponement of the Tokyo Olympics, was distributed online and sent to 102 Olympic athletes.

Results

A total of 85 participants from 11 Olympic sports were enrolled. Results indicated that most athletes showed psychological strain related to concerns regarding the postponement of the Tokyo Olympics. Depression severity was positively associated with maladaptive avoidance coping patterns, negative effects in training, worries and fear. Depression severity was also negatively associated with motivation and adaptive factors such as chances and opportunities that can be drawn from the pandemic.

Conclusion

The present sample of Olympic athletes reported suffering from psychological uncertainty associated with the postponement of the Olympic games. Sports federations should therefore, provide ongoing wellbeing support to athletes and offer them, for example, sports psychological support in order to be able to better deal with pandemic-related uncertainties and changes.

[Violence and Abuse in Competitive Sports]

Violence and Abuse in Competitive Sports Abstract. Violence and abuse in competitive sports, such as physical and emotional abuse, physical and emotional neglect and sexual abuse, affect children, adolescents and adults alike and lead to severe physical, psychological and social consequences. In current medical and educational care concepts of athletes, there is a lack of consistent integration of sports/psychiatric, clinical psychological and psychotherapeutic, developmental pediatric and developmental psychological expertise. Problem areas arise from fine lines between harassment, non-physical and physical violence. The present position paper includes recommendations for the development of a concept for the protection of mental health in competitive sports and for coping with mental stress and psychological disorders by qualified medical experts in mental health, i.e., child, adolescent and adult psychiatrists with specific expertise in competitive sports: sports psychiatrists. According to the recommendations, experts should also have and further develop competence in other fields, especially in ethics, child protection, protection against violence and abuse in competitive sports, awareness of and dealing with transgression of boundaries, knowledge about child development, and transparency in training structures and relationships.

What Predicts the Mood of Athletes Involved in Preparations for Tokyo 2020/2021 Olympic Games During the Covid - 19 Pandemic? The Role of Sense of Coherence, Hope for Success and Coping Strategies

The aim of the study was to identify coherence, hope for success and coping strategies as predictors of mood among this year's Olympians in the context of coronavirus events. The relationships between the above variables and the mood of athletes were analysed. The study group consisted of 57 athletes - women (29) and men (28) between 18 and 39 years of age - representing various sports disciplines who were preparing for the Tokyo Olympics. The research was conducted in the period of April 7-28, 2020 during the first threat of COVID-19 pandemic, following the decision to move the Summer Olympics to the year 2021. It was time of the greatest national restrictions and information about the postponement of the games had been received. As a result of the step regression analysis, three predictors of vigour were established: sense of meaningfulness, coping with stress through positive reframing, and not using the self-blaming strategy. A positive predictor of anger was the use of substances. Confusion was predicted based on the frequency of behavioral disengagement. Behavioral disengagement predicted the severity of depression. Predictors of fatigue were the sense of meaningfulness, and the strategies of positive reframing and self-blaming. The results obtained emphasize the importance of positive reframing as a factor contributing to maintaining a positive mood state. In contrast, behavioral disengagement and self-blaming were strategies that lowered the mood of elite athletes. The results confirm the importance of factors included in the salutogenic model (sense of coherence, coping strategies) as predictors of athletes' mood during a pandemic.

Prevalence of mental health symptoms among male and female Australian professional footballers

Objective

Determining the prevalence of mental health symptoms (MHS) among Australian professional footballers compared with former players. A secondary aim was to assess whether MHS were associated with recent injury and psychological resilience.

Methods

This cross-sectional study included 149 male (mean age: 24 years) and 132 female (mean age: 23 years) Australian A-League and W-League professional footballers (study group) and 81 former male footballers (control group, mean age: 39 years) for analysis. MHS and psychological resilience were assessed through validated questionnaires. Severe injuries were assessed through a single question. The adjusted Wald method was used to assess the primary aim. Logistic regression analyses was used to assess the secondary aim.

Results

The most prevalent MHS among active footballers and former footballers was sport-related psychological distress (63%) and alcohol misuse (69%), respectively. Global psychological distress, sleep disturbance, alcohol misuse and substance misuse were significantly lower among active male footballers than among former players. Increased psychological resilience among active male footballers was associated with a decrease in symptoms of sport-related and global psychological distress, anxiety and depression of 9%, 14%, 23% and 20%, respectively. Increased psychological resilience among female players was associated with 10% decrease in symptoms of depression. Problem gambling and sleep disturbance was associated with injury in the previous 6 months among active male and female footballers, respectively.

Conclusions

MHS are prevalent among active and former professional footballers. Higher level of psychological resilience is associated with decreased reporting of MHS. Severe injury is associated with problem gambling and sleep disturbance.

Presence and Perceptions of Menstrual Dysfunction and Associated Quality of Life Measures Among High School Female Athletes

CONTEXT

Adolescent female athletes are at risk for menstrual dysfunction in the setting of exercise and low energy availability. Education regarding menstrual dysfunction and its associated consequences is important to promote athlete well-being.

OBJECTIVES

The primary aim was to determine the prevalence and characteristics of female athletes who believe that losing their period is a normal response to high training demands. The secondary aim was to explore the relationship between menstrual dysfunction and patient-reported quality of life measures.

DESIGN

Cross-sectional study.

SETTING

Pre-participation evaluations for a local high school district.

PARTICIPANTS

Female athletes,13-18 years old.

INDEPENDENT VARIABLES

Presence of menstrual dysfunction, and response (yes/no) to the question, "Do you think it is normal to lose your period during high levels of athletic training?"

MAIN OUTCOME MEASURES

Health history, family affluence, and patient-reported quality of life measures.

RESULTS

Forty four percent (n=40) of 90 adolescent athletes answered that losing their period was a normal response to a high level of training, and this group had lower BMI, were less likely to report being worried about current weight, and had a higher family affluence level than those who answered losing their period was not a normal response to training. The overall prevalence of menstrual dysfunction was 28%. After adjusting for age and BMI, menstrual dysfunction was significantly associated with higher levels of anxiety, fatigue, and pain interference.

CONCLUSION

Nearly half of our sample of adolescent female athletes perceive losing their period as a normal response to high training demands. Females with menstrual dysfunction reported higher levels of anxiety, fatigue, and pain interference than those without. Understanding adolescent perceptions of menstrual dysfunction and the characteristics of those with menstrual dysfunction can guide future educational interventions aimed at athletes at risk for the female athlete triad.

Impact of concussion and severe musculoskeletal injuries on the onset of mental health symptoms in male professional rugby players: a 12-month study

Objective

This study explored the association between concussion or musculoskeletal injuries, and the onset of mental health symptoms (MHS) in male professional rugby players over a 12-month period.

Methods

Observational prospective cohort study with three measurements over a follow-up period of 12 months. At baseline, 573 participants provided informed consent. A total of 327 male professional rugby players (62% forwards, 38% backs) completed all follow-up assessments at baseline, 6 months and 12 months. The mean (±SD) age, height and weight of the participants at baseline was 25.9 (±4.4) years, 184.9 (±8.7) cm and 101.5 (±14.6) kg, respectively. Number of musculoskeletal injuries and number of confirmed concussions were assessed through single questions. Symptoms of distress, anxiety/depression, sleep disturbance, adverse alcohol use and eating disorders were assessed using validated questionnaires.

Results

Professional rugby players who sustained a concussion within 12 months of baseline were more likely to develop MHS with ORs ranging from 1.5 (95% CI 1.0 to 2.1) for distress to 2.0 (1.2 to 3.6) for adverse alcohol use. Players who sustained a severe injury within 12 months of baseline were more likely to develop symptoms anxiety/depression with an OR of 1.5 (1.1 to 2.0). There was no significant association in both groups for other MHS.

Conclusions

Rugby players who sustained concussion or severe injuries are up to two times more likely to develop symptoms of distress, adverse alcohol use or anxiety/depression.