Psychological safety in elite sport settings: a psychometric study of the Sport Psychological Safety Inventory

The team behind the team: prevalence and correlates of mental health problems among professional football team medical and allied staff?

This study aimed to evaluate depression, anxiety, and stress prevalence and correlates among professional football team medical and allied health staff (MAHS) in Turkey. An online survey was sent to all MAHS (n = 865) attending the professional development accreditation course organized at the end of the 2021-2022 football season in Turkey. Three standardized scales assessed depression, anxiety, and stress. A total of 573 staff participated (response rate = 66.2%). 36.7% of MAHS reported at least moderate severity depression, 25% anxiety, and 80.5% stress. Younger (26-33 years) and less experienced (6-10 years) MAHS reported higher stress scores than their older (50-57 years) and more experienced (>15 years) counterparts (p = 0.02 and p = 0.03, respectively). Masseurs (compared to team doctors) and staff without a second job (compared to those with a second job) reported higher depression and anxiety scores (p = 0.02, p = 0.03, p = 0.03, p = 0.02, respectively). Depression, anxiety, and stress scores of MAHS whose monthly income was less than $519 were higher than those whose income was more than $1036 (all p < 0.01). Findings demonstrated that professional football team MAHS suffer from symptoms of mental-ill-health at substantial rates. In light of these results, organizational policies should be implemented to proactively support the mental health of MAHS working in professional football.

Factors that influence mental health and well-being of high-performance athletes from Olympic or Paralympic sport who have transitioned out of national-level or international-level sport: a mixed methods approach

Transitioning out of elite sports can be a challenging time for athletes. To illuminate the gaps and opportunities in existing support systems and better understand which initiatives may have the greatest benefit in supporting athletes to transition out of elite sport, this study examined the lived experience of retired elite Australian athletes. Using a sequential mixed-methods approach, quantitative data were collected via a self-report online survey, while qualitative data were collected via semistructured interviews. In total 102 retired high-performance athletes (M=27.35, SD=7.25 years) who competed in an Olympic or Paralympic recognised sport at the national and/or international-level participated in the online survey, providing data across domains of well-being and athletic retirement. Eleven survey respondents opted in for the semistructured interview (M=28.9, SD=6.9 years) providing in-depth responses on their retirement experiences. Using partial least squares structural equation modelling (PLS-SEM), latent variables were identified from the survey data and associations between retirement support, retirement difficulties, retirement experiences, well-being and mental health were determined. Interview data were thematically analysed. The structural model had good predictive validity for all nine latent variables, describing positive and negative associations of retirement experiences, mental health and well-being. Building an identity outside of sport, planning for retirement, and having adaptive coping strategies positively impacted retirement experiences. Feeling behind in a life stage and an abrupt loss of athletic identity had a negative impact on retirement experiences. Implications for sports policymakers are discussed, including support strategies that could better assist athletes in successfully transitioning from elite sports.

Understanding and Improving Athlete Mental Health: A Social Identity Approach

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.

Athlete Mental Health and Wellbeing During the Transition into Elite Sport: Strategies to Prepare the System

The transition into elite-level sport can expose young athletes to risk factors for mental ill-health, including increased performance expectations, stressors associated with becoming increasingly public figures, and changes in lifestyle demands, such as diet, training loads and sleep. Successful integration into elite-level sport requires athletes to quickly adapt to these newfound challenges and the norms and culture of the new sport setting, while developing relationships with teammates, coaches, and support staff. Despite these demands, the mental health experiences of athletes transitioning into elite-level sport have been largely neglected in sport psychology literature. This is reflected in the dearth of programs for supporting mental health during this career phase, particularly relative to retirement transition programs. In this article, we offer a preliminary framework for supporting athletes' mental health during the transition into elite-level sport. This framework is based on holistic, developmental, and ecological perspectives. Our framework outlines a range of recommendations for promoting mental health and preventing mental ill-health, including individual-level, relational, sport-level, and sociocultural-level strategies. Key recommendations include preparing athletes for the challenges they are likely to face throughout their athletic careers, highlighting athletes' competence earlier in their careers, developing supportive relationships in the sport setting, and fostering psychologically safe sporting cultures. Supporting mental health from earlier in the athletic career is likely to promote athletes' overall wellbeing, support enjoyment and retention in sport, and encourage help-seeking.

Relative energy deficiency in dance (RED-D): a consensus method approach to REDs in dance

Relative energy deficiency in sport (REDs) is a potentially severe, challenging, broad-spectrum syndrome with potential negative health and performance outcomes. The numerous research publications and International Olympic Committee consensus statements relating to REDs testify to the challenges faced in early identification or screening, diagnosis and management. Like sport, dance, in its simplest form, can be identified as an activity resulting in physiological energy demands and, as such, requires appropriate energy availability concerning energy expenditures. However, the specificity of physiological and psychological demands in dance must be considered when considering REDs. An environment where physical activity can exceed 30 hours per week and where culture may instil a value that thinness is required puts dancers at increased risk for REDs. The purpose of this study was to provide dance-specific guidance dance on this complex condition. An RAND/UCLA Delphi Panel method with nominal group technique was used to review the literature from REDs to evaluate how it may relate to dance. In addition to the EP, which was assembled from a multidisciplinary background with expertise in REDs and multiple genres of dance, six focus groups were commissioned. Four of the focus groups were drawn from the EP members and two additional focus groups formed by dancers and artistic leaders. These panels were used to guide the development of a RED-D diagnosis pathway, management plan and risk stratification and return to dance pathway. The dance-specific pathways are designed to be a practical tool for guiding and supporting clinicians managing RED-D. Furthermore, this paper represents an important focus of this area in dance and serves to stimulate discussion and further research within the sector.

Mental Health Among Elite Youth Athletes: A Narrative Overview to Advance Research and Practice

CONTEXT

Participation in sports during youth is typically beneficial for mental health. However, it is unclear whether elite sport contexts contribute to greater risk of psychological distress or disorder. The aims of this paper are to highlight conceptual issues that require resolution in future research and practice, and to examine the key factors that may contribute to the mental health of elite youth athletes (EYAs).

EVIDENCE ACQUISITION

A narrative overview of the literature combined with the clinical and research expertise of the authors.

STUDY DESIGN

Narrative overview.

LEVEL OF EVIDENCE

Level 5.

RESULTS

EYAs experience a range of biopsychosocial developmental changes that interact with mental health in a multitude of ways. In addition, there are various sport-specific factors that contribute to the mental health of EYAs that may become more prominent in elite contexts. These include - but are not limited to - patterns relating to athlete coping and self-relating styles, the nature of peer, parental, and coach relationships, organizational culture and performance pressures, and mental health service provision and accessibility.

CONCLUSION

A range of critical factors across individual, interpersonal, organizational, and societal domains have been shown to contribute to mental health among EYAs. However, this evidence is limited by heterogeneous samples and varied or imprecise terminology regarding what constitutes "youth" and "elite" in sport. Nevertheless, it is clear that EYAs face a range of risks that warrant careful consideration to progress to best practice principles and recommendations for mental health promotion and intervention in elite youth sport.

SORT

Level C.

Psychological Safety for Mental Health in Elite Sport: A Theoretically Informed Model

Elite sports contexts are highly pressurised and frequently enforce a win-at-all-costs approach. This narrow focus on performance outcomes can potentially contribute in negative ways to the mental health of those within these environments. In this Current Opinion paper, we propose a model that outlines how key elements contributing to psychologically safe or unsafe environments may contribute to better or worse mental health outcomes, respectively. In an environment in which individuals feel safe to show their authentic selves rather than 'wear a mask', different experiences of mental health are likely to be normalised, help-seeking behaviour increased, and thus, mental health outcomes enhanced. We outline how sports teams and organisations can contribute to this through the creation of appropriate policies and procedures, in addition to leaders modelling and reinforcing positive cultural norms. It is intended that the theoretical model can inform stakeholders in elite sport as well as future research directions.

Mental Health of Elite Sport Coaches and Entourage

There is growing understanding of the extent of mental health problems, and related mental health needs, among elite athletes. However, far less attention has been paid to mental health among elite coaches and high-performance support staff, the latter including strength and conditioning coaches, physiotherapists, sport psychologists, and other allied health workers in the daily training environment (high-performance support staff are referred to collectively as "entourage" throughout this article). The scarcity of research examining mental health among elite coaches and entourage warrants urgent attention, particularly given these individuals share similar performance demands and role-related stressors as elite athletes. This article reviews the available literature on this topic, including (1) an empirical study conducted by the authors with a sample of coaches and entourage from Australia's national high-performance sport system and (2) a case example to illustrate sport-specific and general risk factors that are likely to impact mental health in elite sporting environments. Avenues for supporting mental health among coaches and entourage are discussed.

AI-Assisted Fatigue and Stamina Control for Performance Sports on IMU-Generated Multivariate Times Series Datasets

BACKGROUND

Optimal sports performance requires a balance between intensive training and adequate rest. IMUs provide objective, quantifiable data to analyze performance dynamics, despite the challenges in quantifying athlete training loads. The ability of AI to analyze complex datasets brings innovation to the monitoring and optimization of athlete training cycles. Traditional techniques rely on subjective assessments to prevent overtraining, which can lead to injury and underperformance. IMUs provide objective, quantitative data on athletes' physical status during action. AI and machine learning can turn these data into useful insights, enabling data-driven athlete performance management. With IMU-generated multivariate time series data, this paper uses AI to construct a robust model for predicting fatigue and stamina.

MATERIALS AND METHODS

IMUs linked to 19 athletes recorded triaxial acceleration, angular velocity, and magnetic orientation throughout repeated sessions. Standardized training included steady-pace runs and fatigue-inducing techniques. The raw time series data were used to train a supervised ML model based on frequency and time-domain characteristics. The performances of Random Forest, Gradient Boosting Machines, and LSTM networks were compared. A feedback loop adjusted the model in real time based on prediction error and bias estimation.

RESULTS

The AI model demonstrated high predictive accuracy for fatigue, showing significant correlations between predicted fatigue levels and observed declines in performance. Stamina predictions enabled individualized training adjustments that were in sync with athletes' physiological thresholds. Bias correction mechanisms proved effective in minimizing systematic prediction errors. Moreover, real-time adaptations of the model led to enhanced training periodization strategies, reducing the risk of overtraining and improving overall athletic performance.

CONCLUSIONS

In sports performance analytics, the AI-assisted model using IMU multivariate time series data is effective. Training can be tailored and constantly altered because the model accurately predicts fatigue and stamina. AI models can effectively forecast the beginning of weariness before any physical symptoms appear. This allows for timely interventions to prevent overtraining and potential accidents. The model shows an exceptional ability to customize training programs according to the physiological reactions of each athlete and enhance the overall training effectiveness. In addition, the study demonstrated the model's efficacy in real-time monitoring performance, improving the decision-making abilities of both coaches and athletes. The approach enables ongoing and thorough data analysis, supporting strategic planning for training and competition, resulting in optimized performance outcomes. These findings highlight the revolutionary capability of AI in sports science, offering a future where data-driven methods greatly enhance athlete training and performance management.

Surveillance of athlete mental health symptoms and disorders: a supplement to the International Olympic Committee's consensus statement on injury and illness surveillance

In 2019, the International Olympic Committee (IOC) published a consensus statement outlining the principles for recording and reporting injury and illness in elite sport. The authors encouraged sport federations to adapt the framework to their sport-specific context. Since this publication, several sports have published extensions to the IOC consensus statement.In response to a paucity of epidemiological data on athlete mental health, the IOC mental health working group adapted the IOC consensus statement on injury and illness surveillance to improve the capturing of athlete mental health data. In addition to the members of the working group, other experts and athlete representatives joined the project team to address gaps in expertise, and to add stakeholder perspective, respectively. Following an in-person meeting, the authors worked remotely, applying the scientific literature on athlete mental health to the IOC injury and illness surveillance framework. A virtual meeting was held to reach consensus on final recommendations.Practical outcomes based on the analysis of the scientific literature are provided with respect to surveillance design, data collection and storage, data analysis and reporting of athlete mental health data. Mental health-specific report forms for athlete and health professional utilisation are included for both longitudinal and event-specific surveillance.Ultimately, this publication should encourage the standardisation of surveillance methodology for mental health symptoms and disorders among athletes, which will improve consistency in study designs, thus facilitating the pooling of data and comparison across studies. The goal is to encourage systematic surveillance of athlete mental health.

Supporting The Mental Health Of Elite-Level Coaches Through Early Intervention

Current evidence indicates that elite-level coaches encounter a range of performance, organizational, and personal stressors that may influence or compromise mental health. With exposure to these stressors, supports need to be established to protect and preserve the mental health of elite-level coaches. Given the paucity of evidence available, this article proposes a number of considerations that should be taken into account when developing a mental health and rehabilitation framework for high-performance coaches. We argue that early intervention should be positioned at the core of this framework, to address the onset of symptoms prior to the emergence of a mental disorder or mental health crisis. Mental health screening and monitoring of coaches, the psychological safety of high-performance environments, the mental health literacy of coaches, and the tailored pathways to support are discussed. Beyond these strategies, it is proposed that rehabilitation and reintegration should be addressed to assist coaches who are currently experiencing mental ill health or have left their role due to mental health reasons. Although further research is needed to implement evidence-based strategies, it is recommended that a future mental health framework should incorporate the perspectives of coaches to ensure it is consistent with their needs and experiences.

Mental health help-seeking preferences and behaviour in elite male rugby players

Objectives

Mental health symptoms and mental illnesses are common in elite athletes. There is an urgent need to develop care systems to support the mental health of elite athletes. Understanding elite athletes' preferences in mental health help seeking can help explore strategies to develop such systems. Therefore, this study aims to investigate with whom/where elite athletes feel comfortable discussing mental health concerns and seeking help.

Methods

We analyse data from 219 Japanese male rugby players out of 612 players (565 Japanese, 47 foreigners) aged 18 and over who belong to the Japan Rugby Players Association using a cross-sectional design and an anonymous, web-based, self-administered questionnaire. In the questionnaire, the players are asked to rate on a 5-point Likert scale how comfortable they feel talking about their mental health concerns with affiliation/team staff, family/relatives, friends, mental health professionals, rugby-related seniors and teammates. Analysis of variance and Dunnett's test are performed to detect differences in their preferences for sources of help.

Results

Dunnett's test shows that the mean scores for preferring to consult affiliation/team staff are significantly lower than for all the other groups (p<0.001), indicating that players are reluctant to seek help for mental health concerns from affiliation/team staff. Fewer players sought help from affiliation/team staff or mental health professionals than from other groups.

Conclusion

Regarding mental health concerns, for elite male rugby players as elite athletes, it can be difficult to ask for help or talk to team staff.

Creating the conditions for psychological safety and its impact on quality coach-athlete relationships

In this study, we investigated the notion that giving voice to athletes is an important aspect to creating a psychologically safe environment which can then feed into maintaining good quality coach-athlete relationships where every athlete feels heard, valued, and connected. 379 athletes completed a multi-section questionnaire that assessed their (a) capacity to be open and manage conflict with their coaches, (b) perceptions of psychological safety within their team or group, and (c) perceptions of the coach-athlete relationship quality. Structural equation modelling revealed that openness and conflict management positively predicted psychological safety which, in turn, positively predicted coach-athlete relationship quality. Psychological safety was found to explain the association between athletes' communication (i.e., capacity to be open, honest and transparent as well as manage interpersonal conflict effectively) and coach-athlete relationship quality regardless of athletes' gender. These findings highlighted that if athletes have the capacity to have candid discussions and can navigate conflict with their coaches, then it is possible to feel psychologically safe and thus able to engage in risky interpersonal interactions (e.g., raise concerns, admit mistakes) within their group context without fear of intimidation and humiliation. Furthermore, it was revealed that such a psychologically safe group environment fostered athletes' trust and respect, as well as commitment and cooperation with their coach. The discussion provides links to theory, research and practice.

Identification of Perception Differences in Personality Factors and Autonomy by Sporting Age Category in Competitive Bodybuilders

Knowing the personality and autonomy factors of bodybuilders is a necessity in order to improve sports training, which would lead to the development of mental skills specific to competitive bodybuilding. The purpose of the study was to identify perception differences in personality and autonomy factors for three age categories of competitive bodybuilders in order to optimize the sports training process. The secondary purpose of the study was to identify perception differences in the characteristics of personality and autonomy in relation to the increase in the sporting age category of the competitive bodybuilders. The research sample included 30 competitive bodybuilders aged between 18 and 53 years, of which 21 were male and 9 were female, who were divided into three groups according to the sporting age category: G1-junior (18-23 years old), 10 athletes (33.3%); G2-senior (24-35 years old for female and 24-40 years old for male), 12 athletes (40%); G3-masters (over 35 years old for female and 40 years old for male), 8 athletes (26.7%). In the precompetitive stage, three standardized questionnaires were applied to the study participants, namely, two personality questionnaires (CP5F and ZKPQ) and a personal autonomy questionnaire (PAQ), which provided us with useful information for understanding the psychological profile of bodybuilding athletes. The results of the study were statistically significant, with Cronbach's Alpha coefficient indicating high internal consistency of the three questionnaires for all three sporting age groups, with higher values than the selected reference threshold of 0.700. According to the results of our study, the following personality and autonomy factors recorded higher and higher scores in direct relation with the increase in sporting age: extraversion, agreeableness, conscientiousness, emotional stability, autonomy, impulsive sensation seeking, value autonomy, behavioral autonomy, and cognitive autonomy. The personality and autonomy factors of which the scores did not increase directly proportionally to the sporting age category were sociability, activity, aggression-hostility, neuroticism-anxiety, and emotional autonomy. Competitive bodybuilders perceive the factors of personality and autonomy differently in relation to particularities of age and sports experience, and knowledge of these changes can contribute to the improvement of the sports training process.

The Role of Challenge in Talent Development: Understanding Impact in Response to Emotional Disturbance

(1) Background: The pursuit of excellence is central to most development environments, and this is particularly the case in high-performance sport. Accordingly, we examined some mechanisms for development, focusing on the nature and impact of challenge in the experiences of more or less successful high-level rugby players. (2) Methods: Retrospective interviews were conducted with two groups of players. All had been successful on the development pathway (i.e., recruited to high level academies and selected as age group internationals). Only some had progressed to senior contracts and international selection, offering a basis for contrast. (3) Results: Data suggest the importance of negative experiences in the development of performers and performance. Importantly, however, the impact is dependent on both the skills of the individual and the style, timing and context of the challenge. (4) Conclusions: Negative experiences seemed to offer developmental opportunities wider than just learning to cope, at least for those who eventually succeeded. In short, progress was dependent on an interaction between individual skill, interpretation, context and social setting. The need for coaches and others to develop the appropriate attitudes and approach to challenge is a clear implication.