Social Support and Post-Injury Depressive and Anxiety Symptoms among College-Student Athletes

Sport anxiety and subjective happiness of college athletes: a self-determination theory perspective

Introduction

Sport anxiety not only impacts the performance of college athletes but also influences their psychological well-being. The psychological well-being of sports students is crucial for both academic performance and competition, as they need to balance their academic performance with professional athletic training.

Method

Based on self-determination theory, this study examines the relationship between various factors in sport anxiety (somatic anxiety, worry, and concentration disruption) and subjective happiness, as well as the mediating role of need satisfaction in this relationship. A total of 835 college athletic students participated in the study, completing the Sport Anxiety Scale-2, Basic Psychological Needs Satisfaction Scale-in General, and Subjective Happiness Scale.

Results

An analysis of gender differences revealed that female participants scored significantly higher on somatic anxiety (t = -2.21, df = 833, p = 0.028, Cohen's d = -0.155) and worry (t = -3.17, df = 833, p = 0.002, Cohen's d = -0.223) compared to males. In the analysis by sport type, participants engaged in team sports scored significantly higher on somatic anxiety (t = 2.70, df = 833, p = 0.007, Cohen's d = 0.187), Worry (t = 1.97, df = 833, p = 0.049, Cohen's d = 0.136), and concentration disruption (t = 2.73, df = 833, p = 0.007, Cohen's d = 0.189) than those in individual sports. Additionally, in the analysis by grade level, freshman college athletes exhibited significantly lower sport anxiety compared to sophomore athletes [F(4, 830) = 4.06, p = 0.003, η p 2 =0.019]. The mediation analysis revealed that concentration disruption in sport anxiety is significantly and negatively related to subjective happiness. Additionally, need satisfaction (competence, autonomy, and relatedness) mediates the relationship between worry, as well as concentration disruption in sport anxiety and subjective happiness.

Discussion

Future research should build on the current study by employing longitudinal designs and integrating multiple objective measures to further explore the relationship between sport anxiety and subjective happiness.

Subclinical, long-term psychological symptoms following sport-related concussion: are athletes more depressed than we think?

INTRODUCTION

In adolescent and collegiate athletes with sport-related concussion (SRC), we sought to evaluate the prevalence and predictors of long-term psychological symptoms.

METHODS

A cohort study was conducted of athletes 12-24-year-old diagnosed with SRC between November 2017 and April 2022. Athletes/proxies were interviewed on psychological symptoms (i.e. anger, anxiety, depression, and stress). Participants who scored ≥75th percentile on one or more PROMIS (Patient-Reported Outcomes Measurement System) measures were operationalized to have subclinical, long-term psychological symptoms. Uni/multivariable regressions were used.

RESULTS

Of 96 participants (60.4% male), the average age was 16.6 ± 2.6 years. The median time from concussion to interview was 286 days (IQR: 247-420). A total of 36.5% athletes demonstrated subclinical, long-term psychological symptoms. Univariate logistic regression revealed significant predictors of these symptoms: history of psychiatric disorder (OR = 7.42 95% CI 1.37,40.09), substance use (OR = 4.65 95% CI 1.15,18.81), new medical diagnosis since concussion (OR = 3.43 95% CI 1.27,9.26), amnesia (OR = 3.42 95% CI 1.02,11.41), other orthopedic injuries since concussion (OR = 3.11 95% CI 1.18,8.21), age (OR = 1.24 95% CI 1.03,1.48), days to return-to-play (OR = 1.02 95% CI 1.00,1.03), and psychiatric medication use (OR = 0.19 95% CI 0.05,0.74). Multivariable model revealed significant predictors: orthopedic injuries (OR = 5.17 95% CI 1.12,24.00) and return-to-play (OR = 1.02 95% CI 1.00,1.04).

CONCLUSIONS

Approximately one in three athletes endorsed long-term psychological symptoms. Predictors of these symptoms included orthopedic injuries and delayed RTP.

Multidimensional impact of sport types on the psychological well-being of student athletes: A multivariate investigation

The correlation between sports participation and psychological well-being is well-documented, revealing a complex interplay influenced by competition level and cultural context. This is particularly relevant in Korea, where the university sports culture significantly impacts student life. This study evaluates how competitive versus non-competitive sports affect Korean university students' psychological well-being using a quantitative approach with SmartPLS 4 for multi-group analysis. Findings reveal that competitive sports significantly enhance mental toughness and stress management through structured coping mechanisms and robust social support, improving coping strategy effectiveness by 34 % compared to non-competitive sports. Conversely, participants in non-competitive sports experience greater general well-being with a 40 % higher use of informal support. These insights suggest that university sports programs could benefit from targeted interventions incorporating specific coping strategies and social support frameworks tailored to the competitive context. This research underscores the need for precise stress management techniques and resilience-building exercises in sports curricula to optimize psychological well-being across different sports environments in Korean universities.

Personalizing Injury Management and Recovery: A Cross-Sectional Investigation of Musculoskeletal Injuries and Quality of Life in Athletes

Purpose

The study explores the impact of Musculoskeletal Injuries on the quality of life in youth athletes, aiming to understand the extent of these injuries' effects on their physical and mental wellbeing.

Patients and Methods

This cross-sectional study included 130 youth athletes, using questionnaires to collect data on demographics, training exposures (averaging 11±3.8 hours/week), overuse symptoms (using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire), acute injury history, and overall wellbeing (assessed by the RAND 36-item Short Form Health Survey).

Results

Findings indicated that 55.4% of participants had suffered an acute injury in the past 6 months, leading to an average of 4 weeks of time loss. The mean score for OSTRC-O Scores was 16.8±6.4, with knee overuse averaging 21.3± 8.8. In terms of wellbeing, physical and mental health scores were 82.4±15.3 and 81.7±14.1 respectively. There were significant correlations between higher overuse scores and poorer physical functioning (r=-0.42), bodily pain (r=-0.38), vitality (r=-0.32), and mental health (r=-0.31). Acute injuries were linked with worse physical functioning and role limitations. Regression analysis showed that both overuse and acute injuries predicted poorer physical health.

Conclusion

The study underscores the significant prevalence of musculoskeletal injuries among youth athletes and delineates their profound impact on the quality of life, encompassing both the physical and mental health realms. These findings advocate for the critical integration of preventive measures and personalized training protocols, spotlighting the pivotal role of comprehensive biopsychosocial strategies in nurturing athletes' overall wellbeing. By prioritizing the quality of life as a key outcome, this research advocates for a more nuanced approach to injury management and recovery.

Athletic Trainers' Observations of Social Determinants of Health in the Collegiate Setting: A Card Study

CONTEXT

Addressing social determinants of health (SDOH) in all populations improves patient outcomes, leading to better patient-centered care. Despite known influences of SDOH, little is known about the ability of athletic trainers (ATs) to observe SDOH in practice.

OBJECTIVE

To explore ATs' observations of SDOH and describe actions taken at the point of care in collegiate and university settings.

DESIGN

Descriptive via an observational card study.

SETTING

Athletic training facilities.

PATIENTS OR OTHER PARTICIPANTS

Collegiate and university ATs (23 participants across 20 institutions).

DATA COLLECTION AND ANALYSIS

The ATs used a modified observation card to document observations of SDOH during patient encounters in the collegiate or university setting. The cards contained instructions for completion and a table with 4 columns: (1) a list of 19 predetermined SDOH, (2) a checkbox for observed SDOH, (3) a checkbox for the perceived negative influence of observed SDOH on patient health, and (4) an open box to write in what actions, if any, were taken to address the observed SDOH.

RESULTS

Overall, 424 cards were collected. Of 725 observed SDOH, access to social media (153/725, 21.1%), academic stressors (131/725, 18.1%), and behavioral health issues (71/725, 9.8%) were the most commonly observed. Nearly 39% (281/725) had a perceived negative influence. Of those, academic stressors (49/281, 17.4%), behavioral health issues (46/281, 16.4%), and transportation issues (32/281, 11.4%) were most common. For the 23.0% (166/725) of SDOH acted upon, ATs used counseling and education (73/166), provided additional resources (60/166), referred to others (29/166), or communicated with others (4/166).

CONCLUSIONS

Because ATs are positioned to accurately assess SDOH, they can promote better patient-centered care and improve patient outcomes. Our results suggest that many SDOH observed by ATs in the collegiate or university setting have a negative influence on patient health. Better support for patients with academic stressors and behavioral health issues is important because of these SDOH.

Depression, anxiety and stress among female student-athletes: a systematic review and meta-analysis

OBJECTIVE

To identify, quantify and analyse determinants of depression, anxiety and stress symptoms among female student-athletes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Five online databases (PubMed, CINAHL, PsychInfo, SportDiscus and Web of Science) searched from inception through 14 September 2023. Hand-searches and contacting authors for eligible studies.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Articles were included if they were published in English, included female student-athletes competing at National Collegiate Athletic Association institutions, and measured symptom-level depression, anxiety and/or stress.

RESULTS AND SUMMARY

We screened 2415 articles; 52 studies (N=13 849) were included in the systematic review with 13 studies qualifying for meta-analysis. Seventeen determinants were identified including injury (eg, concussions), health (eg, sleep hygiene) and social factors (eg, social support). As data specific to female student-athletes was delineated from studies that included other populations, we observed 16 studies (30.7%) reported that identifying as female was a meaningful determinant of depression, anxiety and stress in athletes. Results of the meta-analysis (k=13, N=5004) suggested a small but significant association (r=0.15, 95% CI 0.05 to 0.24, p=0.004) between other determinants and depression, anxiety, and stress among female student-athletes.

CONCLUSION

Coaches, trainers and clinicians are key contributors in supporting female student-athlete mental health, with responsibilities for integrating mental skill training, sleep hygiene education and regular assessments. Comprehensive mental health and tailored education programmes considering determinants such as injury, health and social factors specific to female student-athletes are needed to enhance mental health equity in sport.

PROSPERO REGISTRATION NUMBER

CRD42022362163.

Anxiety Disorders in Athletes

Athletes and non-athletes experience many anxiety-related symptoms and disorders at comparable rates. Contributory factors may include pressure to perform, public scrutiny, sporting career dissatisfaction, injury, and harassment and abuse in sport. Anxiety may negatively impact sport performance. Specific types of anxiety may have unique presentations in athletes. It is important to rule out general medical and substance-related causes of anxiety symptoms. Psychotherapy and pharmacology treatment options should be considered, bearing in mind athletes' environmental circumstances and physiologies.

Multicentre evaluation of anxiety and mood among collegiate student athletes with concussion

Objectives

Mental health problems are a premorbid and postinjury concern among college student athletes. Clinical phenotypes of anxiety and mood disruption are prevalent following mild traumatic brain injury, including concussion, a common sports injury. This work examined whether concussed student athletes with a history of mental health problems and higher symptoms of anxiety and mood disruption at baseline were more likely to have higher postinjury reports of mood and anxiety as well as prolonged resolution of postconcussive symptoms to near-baseline measures.

Methods

This was a retrospective cohort study of a multi-institutional database of standardised baseline and postinjury assessments among college student athletes. Anxiety/mood evaluation data among varsity college athletes from four institutions over 1 year were measured and compared at baseline and postconcussion recovery using descriptive statistics and multilevel/mixed-effects analysis.

Results

Data from 2248 student athletes were analysed, with 40.6% reporting at least one symptom of anxiety and/or mood disruption at baseline. Of the 150 distinct concussions, 94.7% reported symptoms of anxiety/mood disruption during recovery (recovery time=0-96 days). Higher anxiety/mood scores at baseline were significantly associated with higher scores following concussion (p<0.001). Recovery trajectories of anxiety/mood scores showed different patterns by sex and prolonged recovery.

Conclusion

Symptoms of anxiety and mood disruption are common at baseline among college student athletes. These students are at higher risk for symptomatology following injury, representing a screening cohort that may benefit from early counselling. Almost all student athletes will experience symptoms of anxiety and/or mood disruption following concussion.