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Lundqvist C, Schary DP, Jacobsson J, Korhonen L, Timpka T. Aligning categories of mental health conditions with intervention types in high-performance sports: A narrative cornerstone review and classification framework. J Sci Med Sport 2024:S1440-2440(24)00150-6. [PMID: 38796375 DOI: 10.1016/j.jsams.2024.05.001] [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: 02/29/2024] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024]
Abstract
Epidemiological studies suggest that psychiatric disorders are as prevalent amongst high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sport organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sport performance ethos with a discourse on mental health. This narrative cornerstone review examines challenges related to definitions and classifications of athlete mental health in high-performance sports and how these influence assessments and the implementation of interventions. We discuss challenges with concept creep and psychiatrisation and outline their consequences for sport healthcare professionals. Based on this, we present a framework that aligns different categories of athlete mental health conditions (from the reduction of wellbeing to psychiatric disorders) with intervention types (from the provision of supporting environments to pharmacotherapy). We conclude that researchers and sport practitioners need to carefully consider conceptual creep and the risk of pathologising normal and healthy, albeit emotionally aversive, reactions to athlete lifeworld events when assessing athlete mental health. A clear separation of terminology denoting the athlete's resources to handle the lifeworld (including salutogenic factors) and terms describing psychiatric conditions and their management is necessary to avoid misguidance in intervention planning.
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Affiliation(s)
- Carolina Lundqvist
- Department of Behavioural Sciences and Learning, Linköping University, Sweden; Athletics Research Center, Linköping University, Sweden.
| | - David P Schary
- Department of Physical Education, Sport and Human Performance, Winthrop University, USA. https://twitter.com/DrDavidSchary
| | - Jenny Jacobsson
- Athletics Research Center, Linköping University, Sweden; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Sweden
| | - Laura Korhonen
- Barnafrid and Department of Biomedical and Clinical Sciences, Linköping University, Sweden
| | - Toomas Timpka
- Athletics Research Center, Linköping University, Sweden; Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Sweden; Regional Executive Office, Region Östergötland, Sweden
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2
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Cosh SM, McNeil DG, Jeffreys A, Clark L, Tully PJ. Athlete mental health help-seeking: A systematic review and meta-analysis of rates, barriers and facilitators. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 71:102586. [PMID: 38128709 DOI: 10.1016/j.psychsport.2023.102586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
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.
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Affiliation(s)
- S M Cosh
- School of Psychology, University of New England, Armidale, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia.
| | - D G McNeil
- Institute of Health and Wellbeing, Federation University, Ballarat, Australia
| | - A Jeffreys
- School of Psychology, University of New England, Armidale, Australia
| | - L Clark
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - P J Tully
- School of Psychology, University of New England, Armidale, Australia; Discipline of Medicine, The University of Adelaide, Adelaide, Australia
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3
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Frost J, Walton CC, Purcell R, Fisher K, Gwyther K, Kocherginsky M, Rice SM. The Mental Health of Elite-Level Coaches: A Systematic Scoping Review. SPORTS MEDICINE - OPEN 2024; 10:16. [PMID: 38341831 PMCID: PMC10859359 DOI: 10.1186/s40798-023-00655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/01/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Elite-level coaches are exposed to multiple performance, organisational and personal stressors which may contribute to reduced mental health and wellbeing. This systematic scoping review examined the current body of evidence to explore what is known about the mental health of elite-level coaches (i.e. wellbeing and mental ill-health), the risk and protective factors that influence coach mental health, and the relationship between mental health and coaching effectiveness. METHODS The review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was undertaken and updated in September 2022 using six electronic databases. RESULTS 12,376 studies were identified and screened, with 42 studies satisfying the inclusion criteria. Despite the paucity of high-quality research, findings indicated that 40% of the included studies examined themes connected to wellbeing, with 76% assessing the nature or prevalence of mental ill-health in elite-level coaches. Among studies exploring mental ill-health, coach burnout was the primary focus, while scant research examined symptoms associated with clinical disorders (e.g. anxiety and depression). Overall, psychological outcomes for elite-level coaches were shaped by risk and protective factors operating at the individual, interpersonal, organisational and societal level. Preliminary evidence was also found to suggest that poor mental health may contribute to reduced coaching effectiveness. It is proposed that coaching effectiveness could therefore be employed as a 'hook' to engage elite-level coaches in greater consideration of their mental health needs. CONCLUSION Alongside the development of methodologically robust research, there is a need to examine dynamic individual (e.g. psychological skills), interpersonal (e.g. strong social supports) and organisational (e.g. workload) factors that aim to preserve the mental health and optimise the efficacy of elite-level coaches.
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Affiliation(s)
- Joshua Frost
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
- Elite Sports and Mental Health, Orygen, Melbourne, Australia.
| | - Courtney C Walton
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Rosemary Purcell
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Krista Fisher
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Kate Gwyther
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Michael Kocherginsky
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Simon M Rice
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
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Kegelaers J, Trotter MG, Watson M, Pedraza-Ramirez I, Bonilla I, Wylleman P, Mairesse O, Van Heel M. Promoting mental health in esports. Front Psychol 2024; 15:1342220. [PMID: 38312393 PMCID: PMC10836213 DOI: 10.3389/fpsyg.2024.1342220] [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: 11/21/2023] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
There is growing recognition of the demands and health challenges experienced by esports athletes. The purpose of this perspective paper is to draw specific attention to the mental health of competitive gamers and spur on both future research and applied initiatives focussing on this important but under-addressed topic. We will briefly discuss the prevalence of mental health concerns, domain-specific stressors, and the need for comprehensive mental health support systems tailored to the esports context. It is our hope that, with this perspective paper, we can help set a new research agenda addressing mental health in esports.
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Affiliation(s)
| | | | | | | | - Iván Bonilla
- Universitat Autònoma de Barcelona, Barcelona, Spain
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Thuany M, Viljoen C, Gomes TN, Knechtle B, Scheer V. Mental Health in Ultra-Endurance Runners: A Systematic Review. Sports Med 2023; 53:1891-1904. [PMID: 37535248 DOI: 10.1007/s40279-023-01890-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Among ultra-endurance runners (UER), the mental, behavioral, and physical demands of training/competition can result in maladaptive outcomes. Mental health issues are common in athletes and can impact psychology, physical health, and performance. OBJECTIVE To synthesize information regarding the incidence/prevalence and factors associated with mental health issues among UER. METHODS Systematic searches were performed in PubMed, SPORTDiscus, Scopus, Cochrane databases, CINAHL, Web of Science, and Medline Ovid using key terms related to UER (e.g., trail running, road running) and psychological issues (e.g., exercise addiction, depression). Inclusion criteria included original articles published in peer-reviewed journals in English, using qualitative or quantitative approaches. We considered papers reporting incidence/prevalence and associated factors with mental health outcomes in UER of both sexes, all ages, and levels of competition (e.g., elite, nonprofessional runners). The Joanna Briggs Institute Analytical Cross-Sectional Studies critical appraisal tool was used for quality assessment. RESULTS A total of 282 studies were identified, and 11 studies were included in the final selection. A total of 3670 UER were included in the studies. The prevalence of mental health issues among UER ranged between 32.0% and 62.5% for eating disorders, from 11.5% to 18.2% for exercise addiction, 18.6% for depressive symptoms, and 24.5% for sleep disturbance. Exercise addiction was not related to weekly volume, but a strong relationship with exercise in an unstructured space, age, and body mass index was shown. CONCLUSION Mental health issues among UER are common, especially eating disorders, exercise addiction, sleep disturbances, and depressive symptoms. Further high-quality studies are needed to examine underlying factors and find preventative strategies to protect UER. REGISTRATION The protocol of this systematic review was registered at the PROSPERO-CRD42022338743.
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Affiliation(s)
- Mabliny Thuany
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal.
| | - Carel Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Thayse Natacha Gomes
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Physical Education, Federal University of Sergipe, São Cristóvão, Brazil
| | - Beat Knechtle
- Medbase St. Gallen am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Volker Scheer
- Ultra Sports Science Foundation, Pierre-Bénite, France
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Frost J, Walton CC, Purcell R, Rice SM. Supporting The Mental Health Of Elite-Level Coaches Through Early Intervention. Arthrosc Sports Med Rehabil 2023; 5:100734. [PMID: 37645386 PMCID: PMC10461153 DOI: 10.1016/j.asmr.2023.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/03/2023] [Indexed: 08/31/2023] Open
Abstract
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.
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Affiliation(s)
- Joshua Frost
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Courtney C. Walton
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Rosemary Purcell
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Simon M. Rice
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
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Oevreboe TH, Ivarsson A, Sundgot-Borgen J, Knudsen AKS, Reneflot A, Pensgaard AM. Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes. BMJ Open Sport Exerc Med 2023; 9:e001538. [PMID: 37485002 PMCID: PMC10357714 DOI: 10.1136/bmjsem-2023-001538] [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] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives To, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with 'at-risk scores' on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between 'at-risk scores' and diagnosed mental disorders. Methods A two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with 'at-risk scores' using the fifth version of the Composite International Diagnostic Interview. Results Two hundred and eighty athletes (74.1%) had an 'at-risk score,' and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews. Conclusions Using self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further.
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Affiliation(s)
- Tom Henning Oevreboe
- Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | | | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Marte Pensgaard
- Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway
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Rose S, Burton D, Kercher V, Grindley E, Richardson C. Enduring stress: A quantitative analysis on coping profiles and sport well-being in amateur endurance athletes. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 65:102365. [PMID: 37665837 DOI: 10.1016/j.psychsport.2022.102365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/08/2022] [Accepted: 12/09/2022] [Indexed: 09/06/2023]
Abstract
Endurance athletes experience physical and psychological stress during training and competition that can inhibit performance and promote negative health implications (i.e., lower well-being) without proper coping mechanisms (McCormick et al., 2018; Sakar & Fletcher, 2014). Additionally, these athletes that train at an amateur level have received limited attention regarding coping with stress and how it impacts well-being (McCormick et al., 2018). The purpose of this study was threefold: to (a) determine common coping profiles of trained amateur endurance athletes, (b) explore the relationship between sport well-being and these coping profiles, and (c) examine the potential roles that appraisals might play in the coping-well-being relationship. The results yielded five distinct coping profiles: Mixed Adaptive Copers (MAC), Mixed Maladaptive Copers (MMC), Engaged Copers (EC), Avoidant Copers (AC), and Social Copers (SC). Coping profiles differed across various variables including sport well-being, appraisals, and demographic factors. Overall, MAC and EC had higher levels of sport well-being. MAC viewed stressors as a challenge (i.e., opportunity) compared to EC and AC. These findings suggest the complex nature of coping in sport and that athletes should develop an assortment of coping strategies that provide different strategies for various stressful situations.
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Affiliation(s)
- Seth Rose
- Department of Movement Sciences, University of Idaho, United States.
| | - Damon Burton
- Department of Movement Sciences, University of Idaho, United States
| | - Vanessa Kercher
- Department of Kinesiology, Indiana University, Bloomington, United States
| | - Emma Grindley
- Department of Movement Sciences, University of Idaho, United States
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Koh ZH, Skues J, Murray G. Digital self-report instruments for repeated measurement of mental health in the general adult population: a protocol for a systematic review. BMJ Open 2023; 13:e065162. [PMID: 36693693 PMCID: PMC9884895 DOI: 10.1136/bmjopen-2022-065162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Digital technologies present tremendous opportunities for enabling long-term measurement of mental health in the general population. Emerging studies have established preliminary efficacy of collecting self-report data digitally. However, a key challenge when developing a new self-report instrument is navigating the abundance of existing instruments to select relevant constructs for measurements. This review is a precursor to developing a novel future integrated digital instrument for repeated measurements. We interrogate the literature as the first step towards optimal measurement of the multifaceted mental health concept, in the context of digital repeated measurement. This review aims to identify (1) digital self-report instruments administered repeatedly to measure the mental health of the general adult population; (2) their structure and format; (3) their psychometric properties; (4) their usage in empirical studies; and (5) the constructs these instruments were designed to measure (as characterised in the original publication), and the constructs the instruments have been used to measure in the identified empirical studies. METHODS AND ANALYSIS Five major electronic databases will be searched. Studies administering mental health instruments (in English) repeatedly to community dwellers in the general adult population are eligible. A reviewer will preliminarily screen for eligible studies. Then, two reviewers will independently screen the full text of the eligible articles and extract data. Both reviewers will resolve any disagreement through discussion or with a third reviewer. After the data extraction, a reviewer will manually search for the structure, format, psychometric properties and the original constructs these instruments were developed to measure. This review will synthesise the results in a narrative approach. The reporting in this review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. ETHICS AND DISSEMINATION Ethical approval is not required as no data will be collected. Findings of the systematic review will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42022306547.
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Affiliation(s)
- Zhao Hui Koh
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jason Skues
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
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10
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Jederström M, Agnafors S, Ekegren CL, Fagher K, Gauffin H, Korhonen L, Park J, Spreco A, Timpka T. A cross-sectional study of anxiety and depression caseness in female competitive figure skaters in Sweden. BMJ Open Sport Exerc Med 2023; 9:e001491. [PMID: 36919120 PMCID: PMC10008236 DOI: 10.1136/bmjsem-2022-001491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 03/10/2023] Open
Abstract
Objectives Little is known about figure skaters' mental health. This study aimed to describe anxiety and depression caseness (defined as a screening condition qualifying for psychiatric examination) in competitive figure skaters and analyse factors associated with such caseness. Methods A cross-sectional study was performed in April 2019 among all competitive figure skaters in the south-eastern region of Sweden (N=400). The primary outcomes were anxiety caseness, measured using the short-form Spielberger State-Trait Anxiety Inventory and depression caseness, measured using the WHO-5 index. Multivariable logistic regression models were employed to determine the association between anxiety caseness and explanatory factors. Results In total, 36% (n=142) of the invited skaters participated. Only females (n=137), mean age 12.9 (SD 3.0) years) were selected for analysis. Of the participating skaters, 47% displayed anxiety caseness and 10% depression caseness. Overweight body image perception (OR 5.9; 95% CI 2.0 to 17.6; p=0.001) and older age (OR 1.2; 95% CI 1.1 to 1.4; p=0.005) were associated with anxiety caseness. Skaters reporting no caseness were younger than those reporting only anxiety caseness (mean age difference -1.9 years; 95% CI -3.1 to -0.7; p=0.001) or anxiety and depression caseness (OR -3.5 years; 95% CI -5.6 to -1.5 years; p<0.001). Conclusion Anxiety caseness was associated with overweight body image perception and older age in female competitive figure skaters. Older skaters reported generally worse mental health. More research on the mental health of figure skaters is warranted, considering comorbidity and focusing on those needing further assessment and support.
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Affiliation(s)
- Moa Jederström
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden
| | - Sara Agnafors
- Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health, Linköping University, Linköping, Sweden.,Department of Research, Södra Älvsborgs Hospital, Borås, Sweden
| | - Christina L Ekegren
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Håkan Gauffin
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden.,Department of Orthopaedics and Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden
| | - Laura Korhonen
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linkoping, Sweden
| | - Jennifer Park
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Armin Spreco
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden.,Center for Health Services Development, Region Östergötland, Linköping, Sweden.,Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden
| | - Toomas Timpka
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden.,Center for Health Services Development, Region Östergötland, Linköping, Sweden.,Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden
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11
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Lundqvist C, Kristiansen E. Lockdown and No Lockdown: How Norwegian and Swedish Elite Athletes Managed Preparations for Tokyo 2020 and Mental Health Challenges in the Shadow of COVID-19. Front Sports Act Living 2022; 4:918825. [PMID: 35982760 PMCID: PMC9378964 DOI: 10.3389/fspor.2022.918825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
The present study explored Norwegian and Swedish Olympic aspirants' perceived challenges for the preparations of Tokyo 2020 Olympic Games (OG) and risk and protective factors for mental health. The focus for this study was the timespan between the declaration of the postponement of Tokyo 2020 and the final months before the Games. A secondary purpose was to explore experiences of both elite athletes affected by lockdown (i.e., Norwegian athletes) and elite athletes not affected by lockdown in their home country (i.e., Swedish athletes). Twelve elite athletes (Norwegian: n = 6; Swedish: n = 6; Women: n = 6; Men: n = 6) with a mean age of 28.25 (SD = 3.60) participated. Semi-structured interviews were conducted between April and June 2021. Seven athletes had qualified and five were still trying to qualify. Eight of the interviewed athletes had previous experiences with OG participation. Template analysis revealed two main themes: (a) challenges and risk-factors for mental health and (b) protective factors. The pandemic exposed athletes to several psychological strains like uncertainty and difficulties with planning and preparations for the OG and personal and social challenges (i.e., worry about physical health and risk of overtraining, social contacts, identity, and life issues). Protective factors included perceived benefits of increased recovery and time for quality training. The athletes used several coping strategies and self-care behaviors (e.g., focus on the controllable, playfulness, putting sports in perspective, daily routines, short-term goals, working or studying for personal development) and they tapped into various internal and external psychosocial resources perceived as protective for mental health, personal growth, resiliency, and adjustment to the pandemic. The holistic perspectives used contribute to an increased understanding of elite sport athletes' mental health needs in stressful and unforeseen situations such as a pandemic.
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Affiliation(s)
- Carolina Lundqvist
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Athletics Research Center, Linköping University, Linköping, Sweden
- *Correspondence: Carolina Lundqvist
| | - Elsa Kristiansen
- Department of Business, Strategy and Political Science, USN School of Business, University of South-Eastern, Drammen, Norway
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12
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Lundqvist C, Jederström M, Korhonen L, Timpka T. Nuances in key constructs need attention in research on mental health and psychiatric disorders in sports medicine. BMJ Open Sport Exerc Med 2022; 8:e001414. [PMID: 36111128 PMCID: PMC9438056 DOI: 10.1136/bmjsem-2022-001414] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Carolina Lundqvist
- Department of Behavioral Sciences and Learning, Linköping University, Linkoping, Sweden
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Moa Jederström
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Laura Korhonen
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linkoping, Sweden
| | - Toomas Timpka
- Athletics Research Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linkoping, Sweden
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13
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Ekelund R, Holmström S, Stenling A. Mental Health in Athletes: Where Are the Treatment Studies? Front Psychol 2022; 13:781177. [PMID: 35859831 PMCID: PMC9289539 DOI: 10.3389/fpsyg.2022.781177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
In recent years, athletes’ mental health has gained interest among researchers, sport practitioners, and the media. However, the field of sport psychology lacks empirical evidence on the effectiveness of psychotherapeutic interventions for mental health problems and disorders in athletes. Thus far, intervention research in sport psychology has mainly focused on performance enhancement using between-subject designs and healthy athlete samples. In the current paper, we highlight three interrelated key issues in relation to treating mental health problems and disorders in athletes. (i) How are mental health and mental health problems and disorders defined in the sport psychology literature? (ii) How are prevalence rates of mental health problems and disorders in athletes determined? (iii) What is known about psychotherapeutic interventions for mental health problems and disorders in athletes? We conclude that the reliance on different definitions and assessments of mental health problems and disorders contributes to heterogeneous prevalence rates. In turn, this limits our understanding of the extent of mental health problems and disorders in athletes. Furthermore, knowledge of the effectiveness of psychotherapeutic interventions for athletes with mental health problems and disorders is scarce. Future research should include athletes with established mental health problems and disorders in intervention studies. We also propose an increased use of N-of-1 trials to enhance the knowledge of effective psychotherapeutic interventions in this population.
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Affiliation(s)
- Rebecka Ekelund
- Department of Psychology, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
- *Correspondence: Rebecka Ekelund,
| | - Stefan Holmström
- Department of Psychology, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Andreas Stenling
- Department of Psychology, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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14
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Hoare E, Couston N, Hall K. Case Report: An Application of Wellbeing Science for the Development of Adolescent High-Performance Athletes in the Australian Football League. Front Psychol 2022; 13:856241. [PMID: 35756279 PMCID: PMC9231612 DOI: 10.3389/fpsyg.2022.856241] [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: 01/16/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Elite athletes experience both universal and sport-related mental health risks. Young high-performance athletes on pathways to professional sport also face the additional challenges associated with the developmental period of adolescence and early adulthood, making prevention and mental health promotion critical in this population group. This community case study considers the wider youth mental wellbeing evidence base, alongside primary prevention in elite sport, and proposes a model of wellbeing for the specific implementation in youth high performance athletes in the Australian setting. The Mental Fitness Model is based on the PERMA theory of wellbeing, which comprises positive emotion, engagement, relationships, meaning, and accomplishment, and is tailored specifically to the unique needs of young high-performance athletes in Australia. The Model sits within a host of evidence-based, appropriately resourced, wellbeing science activities, coordinated by an overall strategy that allows monitoring and continuous improvement. As such, we propose this application of wellbeing science is highly novel for the youth high performance setting. Future work is needed to test the feasibility of this model in an applied context. Further work is also needed to integrate specifically cultural considerations for wellbeing, and to integrate the lived experiences of young people through participatory research. This model is proposed to hold unique promise to meet the mental wellbeing needs of young high-performance athletes, whilst promoting positive mental health that can track into adulthood.
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Affiliation(s)
- Erin Hoare
- Australian Football League, Melbourne, VIC, Australia.,IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Nicky Couston
- Australian Football League, Melbourne, VIC, Australia
| | - Kate Hall
- Australian Football League, Melbourne, VIC, Australia.,School of Psychology, Deakin University, Geelong, VIC, Australia
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15
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Purcell R, Pilkington V, Carberry S, Reid D, Gwyther K, Hall K, Deacon A, Manon R, Walton CC, Rice S. An Evidence-Informed Framework to Promote Mental Wellbeing in Elite Sport. Front Psychol 2022; 13:780359. [PMID: 35250720 PMCID: PMC8890033 DOI: 10.3389/fpsyg.2022.780359] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Elite athletes, coaches and high-performance staff are exposed to a range of stressors that have been shown to increase their susceptibility to experiencing mental ill-health. Despite this, athletes may be less inclined than the general population to seek support for their mental health due to stigma, perceptions of limited psychological safety within sport to disclose mental health difficulties (e.g., selection concerns) and/or fears of help-seeking signifying weakness in the context of high performance sport. Guidance on the best ways to promote mental health within sporting environments is increasing, though current frameworks and position statements require greater focus on a whole of system approach, in which the needs of athlete, coaches and high-performance staff are considered within the context of the broader ecological system in which they operate and perform. This paper synthesizes existing research, reviewed for translatability by mental health professionals working in elite sport, to provide an evidence-informed framework with real world utility to promote mentally healthy environments for all stakeholders in elite sporting organizations, from athletes through to administrators. Recommendations are provided to positively impact the mental wellbeing of athletes and support staff, which may in turn influence athletic performance. This framework is intended to provide sporting organizations with evidence-informed or best practice principles on which they can develop or progress their policies to support mental health promotion and prevent the onset of mental health difficulties. It is intended that the framework can be adapted or tailored by elite sporting organizations based upon their unique cultural, contextual and resourcing circumstances.
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Affiliation(s)
- Rosemary Purcell
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Vita Pilkington
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Serena Carberry
- School of Psychology, University College Dublin, Dublin, Ireland
| | - David Reid
- Focus Coaching, Melbourne, VIC, Australia
| | - Kate Gwyther
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Kate Hall
- Australian Football League, Docklands, VIC, Australia
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Adam Deacon
- Consultant Psychiatrist, Melbourne, VIC, Australia
| | - Ranjit Manon
- Australian Football League, Docklands, VIC, Australia
- Department of Psychiatry, Monash University, Clayton, VIC, Australia
| | - Courtney C. Walton
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Simon Rice
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Youth Mood Clinic, Orygen Youth Health, Melbourne, VIC, Australia
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