Risk for Depression and Psychological Well-Being in German National and State Team Athletes—Associations With Age, Gender, and Performance Level

in Journal of Clinical Sport Psychology

Click name to view affiliation

Johanna Belz German Sport University Cologne

Search for other papers by Johanna Belz in
Current site
Google Scholar
PubMed
Close
*
,
Jens Kleinert German Sport University Cologne

Search for other papers by Jens Kleinert in
Current site
Google Scholar
PubMed
Close
*
,
Jeannine Ohlert German Sport University Cologne
University Hospital Ulm

Search for other papers by Jeannine Ohlert in
Current site
Google Scholar
PubMed
Close
*
,
Thea Rau University Hospital Ulm

Search for other papers by Thea Rau in
Current site
Google Scholar
PubMed
Close
*
, and
Marc Allroggen University Hospital Ulm

Search for other papers by Marc Allroggen in
Current site
Google Scholar
PubMed
Close
*
Restricted access

Adolescence is a vulnerable period for the development of depression. Research on depression in athletes including adolescent athletes, however, is scarce. The purpose of the present study was to assess the risk for depression depending on the athletes’ age, gender, and performance level. Data were collected from 1,799 German national and state team athletes. The PHQ-2 and the WHO-5 were administered to assess the athletes’ risk for depression and current state of psychological well-being. Overall, 13% of the athletes were screened positive for depression and 10% for impaired well-being. Adolescents, females and athletes of junior national teams showed a higher risk for depression and/or lower well-being than other subgroups. The finding that adolescent athletes are more vulnerable to suffer from depressive symptoms than adult athletes mirrors finding in the general population. Screening tools for depression should be followed up by clinical expert interviews to provide an external criterion for the obtained results.

Belz, Kleinert, and Ohlert are with the Dept. of Health & Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany. Ohlert, Rau, and Allroggen are with the Dept. of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany. Kleinert and Ohlert are also with the German Research Centre of Elite Sport - momentum, German Sport University Cologne, Cologne, Germany.

Address author correspondence to Johanna Belz at j.belz@dshs-koeln.de
  • Collapse
  • Expand
  • Allgaier, A.-K., Pietsch, K., Frühe, B., Prast, E., Sigl-Glöckner, J., & Schulte-Körne, G. (2012). Depression in pediatric care: Is the WHO-Five Well-Being Index a valid screening instrument for children and adolescents? General Hospital Psychiatry, 34, 234241. PubMed doi:10.1016/j.genhosppsych.2012.01.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Andersen, S.L., & Teicher, M.H. (2008). Stress, sensitive periods and maturational events in adolescent depression. Trends in Neurosciences, 31(4), 183191. PubMed doi:10.1016/j.tins.2008.01.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Angst, J., Gamma, A., Gastpar, M., Lepine, J.P., Mendlewicz, J., & Tylee, A. (2002). Gender differences in depression: Epidemiological findings from the European DEPRES I and II studies. European Archives of Psychiatry and Clinical Neuroscience, 252, 201209. PubMed doi:10.1007/s00406-002-0381-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Armstrong, S., & Oomen-Early, J. (2009). Social connectedness, self-esteem, and depression symptomatology among collegiate athletes versus nonathletes. Journal of American College Health, 57(5), 521526. PubMed doi:10.3200/JACH.57.5.521-526

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aquilina, D. (2013). A study of the relationship between elite athletes’ educational development and sporting performance. The International Journal of the History of Sport, 30(4), 374392. doi:10.1080/09523367.2013.765723

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Biddle, S.J.H., & Asare, M. (2011). Physical activity and mental health in children and adolescents. A review of reviews. British Journal of Sports Medicine, 45, 886895. PubMed doi:10.1136/bjsports-2011-090185

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Blom, E.H., Bech, P., Högberg, G., Larsson, J.O., & Serlachius, E. (2012). Screening for depressed mood in an adolescent psychiatric context by brief self-assessment scales: Testing psychometric validity of WHO-5 and BDI-6 indices by latent trait analyses. Health and Quality of Life Outcomes, 10(12), 16. doi:10.1186/1477-7525-10-149

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bonsignore, M., Barkow, K., Jessen, F., & Heun, R. (2001). Validity of the five-item WHO Well-Being Index (WHO-5) in an elderly population. European Archives of Psychiatry and Clinical Neuroscience, 251(Suppl. 2), 2731.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brand, R., Wolff, W., & Hoyer, J. (2012). Psychological symptoms and chronic mood in representative samples of elite student-athletes, deselected student-athletes and comparison students. School Mental Health, 5, 166174. doi:10.1007/s12310-012-9095-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brewer, W.B., & Petrie, T.A. (1995). A comparison between injured and uninjured football players on selected psychosocial variables. Academic Athletic Journal, 10, 1118.

    • Search Google Scholar
    • Export Citation
  • Christensen, K.S., Haugen, W., Sirpal, M.K., & Haavet, O.R. (2015). Diagnosis of depressed young people - criterion validity of WHO-5 and HSCL-6 in Denmark and Norway. Family Practice, 32(3), 359363. PubMed doi:10.1093/fampra/cmv011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • De Wit, M., Pouwer, F., Gemke, R.J., Delemarre-van de Waal, H.A., & Snoek, F.J. (2007). Validation of the WHO-5 Well-Being Index in adolescents with type 1 diabetes. Diabetes Care, 30(8), 20032006. PubMed doi:10.2337/dc07-0447

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Doherty, S., Hannigan, B., & Campbell, M.J. (2016). The experience of depression during the careers of elite male athletes. Frontiers in Psychology, 7, 111. doi:10.3389/fpsyg.2016.01069

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ewert, O.M. (1993). Entwicklungspsychologie des Jugendalters [Developmental Psychology of adolescence]. Stuttgart, Germany: Kohlhammer.

  • Frank, R., Nixdorf, I., & Beckmann, J. (2015). Depression among elite athletes: Prevalence and psychological factors. Deutsche Zeitschrift für Sportmedizin, 64, 320329.

    • Search Google Scholar
    • Export Citation
  • Gorczynski, P.F., Coyle, M., & Gibson, K. (2017). Depressive symptoms in high-performance athletes and non-athletes: A comparative meta-analysis. British Journal of Sports Medicine, 51(18), 13481354. PubMed doi:10.1136/bjsports-2016-096455

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gouttebarge, V., Frings-Dresen, M.H.W., & Sluiter, J.K. (2015). Mental and psychosocial health among current and former professional footballers. Occupational Medicine, 65(3), 190196. PubMed doi:10.1093/occmed/kqu202

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gulliver, A., Griffiths, K.M., Mackinnon, A., Batterham, P.J., & Stanimirovic, R. (2015). The mental health of Australian elite athletes. Journal of Science and Medicine in Sport, 18(3), 255261. doi:10.1016/j.jsams.2014.04.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hammond, T., Gialloreto, C., Kubas, H., & Davis, H. (2013). The prevalence of failure-based depression among elite athletes. Clinical Journal of Sport Medicine, 23(4), 273277. PubMed doi:10.1097/JSM.0b013e318287b870

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hankin, B.L. (2006). Adolescent depression: Description, causes, and interventions. Epilepsy & Behavior, 8, 102114. PubMed doi:10.1016/j.yebeh.2005.10.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hankin, B.L., Abramson, L.Y., Moffitt, T.E., Silva, P.A., McGee, R., & Angell, K.E. (1998). Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107(1), 128140. PubMed doi:10.1037/0021-843X.107.1.128

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harris, M.B., Page, P., & Begay, C. (1988). Attitudes toward aging in a Southwestern sample: Effects of ethnicity, age and sex. Psychological Reports, 62, 735746. doi:10.2466/pr0.1988.62.3.735

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Havighurst, R.J. (1974). Developmental tasks and education (3rd ed.). New York, NY: McKay.

  • Hong, E., Wolanin, A., & Gross, M. (2015). Response to the letter of the editor. Current Sports Medicine Reports, 14(3), 245. doi:10.1249/JSR.0000000000000152

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Junge, A., & Feddermann-Demont, N. (2016). Prevalence of depression and anxiety in top-level male and female football players. BMJ Open Sport & Exercise Medicine, 2, 2042. doi:10.1136/bmjsem-2015-000087

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 593602. PubMed doi:10.1001/archpsyc.62.6.593

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., … Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51(1), 819. PubMed doi:10.1001/archpsyc.1994.03950010008002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kleinert, J., Sulprizio, M., & Anderten, M. (2016). Depression und Jugendleistungssport: Hintergründe, Prävention und Früherkennung [Depression and youth elite sports: Background, prevention and early detection]. In H. Deimel & T. Thimme (Eds.), Bewegungs- und Sporttherapie bei psychischen Erkrankungen des Kindes- und Jugendalters (1st ed., pp. 108126). Sankt Augustin, Germany: Academia Verlag.

    • Search Google Scholar
    • Export Citation
  • Kohlmann, C.W., & Eschenbeck, H. (2009). Stress und Stressbewältigung [Stress and experience of stress]. In W. Schlicht & B. Strauß (Hrsg.), Enzyklopädie der Psychologie, Serie Sportpsychologie, Bd. 1: Grundlagen der Sportpsychologie (S. 635680). Göttingen, Germany: Hogrefe.

    • Search Google Scholar
    • Export Citation
  • Kroenke, K., & Spitzer, R.L. (2003). The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 12841292. PubMed doi:10.1097/01.MLR.0000093487.78664.3C

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Linder, D.E., Brewer, B.W., van Raalte, J.L., & de Lange, N. (1991). A negative halo for athletes who consult sport psychologists: Replication and extension. Journal of Sport & Exercise Psychology, 13, 133148. doi:10.1123/jsep.13.2.133

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Löwe, B., Kroenke, K., & Gräfe, K. (2005). Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research, 58(2), 163171. doi:10.1016/j.jpsychores.2004.09.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Löwe, B., Spitzer, R.L., Gräfe, K., Kroenke, K., Quenter, A., Zipfel, S., … Herzog, W. (2004). Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. Journal of Affective Disorders, 78(2), 131140. doi:10.1016/S0165-0327(02)00237-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nixdorf, I., Frank, R., Hautzinger, M., & Beckmann, J. (2013). Prevalence of depressive symptoms and correlating variables among German elite athletes. Journal of Clinical Sport Psychology, 7, 313326. doi:10.1123/jcsp.7.4.313

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Oerter R., & Montada L. (Eds.). (1998). Entwicklungspsychologie [Developmental psychology] (4th ed.). Weinheim, Germany: Beltz Psychologie Verlags Union.

    • Search Google Scholar
    • Export Citation
  • Ohlert, J., & Kleinert, J. (2014). Entwicklungsaufgaben jugendlicher Elite-Handballerinnen und–Handballer [Developmental tasks of adolescent elite handball players]. Zeitschrift für Sportpsychologie, 21(4), 161172. PubMed doi:10.1026/1612-5010/a000129

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Paluska, S.A., & Schwenk, T. (2000). Physical activity and mental health: Current concepts. Sports Medicine, 29(3), 167180. PubMed doi:10.2165/00007256-200029030-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Prinz, B., Dvorak, J., & Junge, A. (2016). Symptoms and risk factors of depression during and after the football career of elite female players. BMJ Open Sport & Exercise Medicine, 2, 000124. PubMed doi:10.1136/bmjsem-2016-000124

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Proctor, S.L., & Boan-Lenzo, C. (2010). Prevalence of depressive symptoms in male intercollegiate student-athletes and non-athletes. Journal of Clinical Sport Psychology, 4, 204220. doi:10.1123/jcsp.4.3.204

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Radloff, L.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385401. doi:10.1177/014662167700100306

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reardon, C.L., & Factor, R.M. (2010). Sport Psychiatry: A systematic review of diagnosis and medical treatment of mental illness in athletes. Sports Medicine, 40(11), 961980. PubMed doi:10.2165/11536580-000000000-00000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rice, S.M., Purcell, R., de Silva, S., Mawren, D., McGorry, P.D., & Parker, A.G. (2016). The mental health of elite athletes: A narrative systematic review. Sports Medicine, 46(9), 13331353. PubMed doi:10.1007/s40279-016-0492-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Richardson, L.P., Rockhill, C., Russo, J.E., Grossman, D.C., Richards, J., McCarty, C., … Katon, W. (2010). Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents. Pediatrics, 125(5), e10971103. PubMed doi:10.1542/peds.2009-2712

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Roberts, R.E., Andrews, J.A., Lewinsohn, P.M., & Hops, H. (1990). Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 122128. doi:10.1037/1040-3590.2.2.122

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schaal, K., Tafflet, M., Nassif, H., Thibault, V., Pichard, C., Alcotte, M., … Uddin, M. (2011). Psychological balance in high level athletes: Gender-based differences and sport-specific patterns. PLoS ONE, 6(5), e19007e19009. doi:10.1371/journal.pone.0019007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schuch, F.B. (2015). Depression in athletes or increased depressive symptoms in athletes? Current Sports Medicine Reports, 14(3), 244. PubMed doi:10.1249/JSR.0000000000000151

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Seiffge-Krenke, I., & Gelhaar, T. (2008). Does successful attainment of developmental tasks lead to happiness and success in later developmental tasks? A test of Havighurst’s (1948) theses. Journal of Adolescence, 31, 3352. PubMed doi:10.1016/j.adolescence.2007.04.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Seiffge-Krenke, I., Kiuru, N., & Nurmi, J.-E. (2010). Adolescents as “producers of their own development”: Correlates and consequences of the importance and attainment of developmental tasks. European Journal of Developmental Psychology, 7, 479510. doi:10.1080/17405620902905249

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Spengler, A., Schneider, G., & Schröder, E. (2013). Depressivität - Screening und Vorkommen in der sportmedizinischen Praxis [Depressiveness– Screening and incidence in sports medicine practice]. Deutsche Zeitschrift für Sportmedizin, 2013(2), 6568. doi:10.5960/dzsm.2012.045

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Storch, E.A., Storch, J.B., Killiany, E.M., & Roberti, J.W. (2005). Self-reported psychopathology in athletes: A comparison of intercollegiate student-athletes and non-athletes. Journal of Sport Behavior, 28(1), 8698.

    • Search Google Scholar
    • Export Citation
  • Stordal, E, Bjartveit Krüger, M., Dahl, N.H., Krüger, Ø., Mykletun, A., Dahl, A.A. (2001). Depression in relation to age and gender in the general population: The Nord-Trøndelag Health Study (HUNT). Acta Psychiatrica Scandinavia, 104, 210216. doi:10.1034/j.1600-0447.2001.00130.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ströhle, A., Höfler, M., Pfister, H., Müller, A.G., Hoyer, J., & Wittchen, H.U. (2007). Physical activity and prevalence and incidence of mental disorders in adolescents and young adults. Psychological Medicine, 37, 16571666.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Swann, C, Moran, A., & Piggott, D. (2015). Defining elite athletes: Issues in the study of expert performance in sport psychology. Psychology of Sport and Exercise, 16, 314. doi:10.1016/j.psychsport.2014.07.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tabachnick, B.G., & Fidell, L.S. (2013). Using multivariate statistics (6th ed.). Boston, MA: Pearson Education.

  • Topp, C.W., Østergaard, S.D., Søndergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: A systematic review of the literature. Psychotherapy and Psychosomatics, 84(3), 167176. PubMed doi:10.1159/000376585

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vaeyens, R., Lenoir, M., Williams, A.M., & Philippaerts, R.M. (2008). Talent identification and development programmes in sport: Current models and future directions. Sports Medicine, 38(9), 703714. PubMed doi:10.2165/00007256-200838090-00001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wade, T.J., Cairney, J., & Pevalin, D.J. (2002). Emergence of gender differences in depression during adolescence: National panel results from three countries. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 190198. PubMed doi:10.1097/00004583-200202000-00013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Weber, E. (1987). Generationskonflikte und Jugendprobleme aus (erwachsenen-)pädagogischer Sicht [Generation conflicts and adolescent problems from an (adult-) pedagogical viewpoint]. München, Germany: Verlag Ernst Vögel.

    • Search Google Scholar
    • Export Citation
  • Weigand, S., Cohen, J., & Merenstein, D. (2013). Susceptibility for depression in current and retired student athletes. Sports Health: A Multidisciplinary Approach, 5(3), 263266. doi:10.1177/1941738113480464

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wolanin, A., Gross, M., & Hong, E. (2015). Depression in athletes: Prevalence and risk factors. Current Sports Medicine Reports, 14, 5660. PubMed doi:10.1249/JSR.0000000000000123

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wolanin, A., Hong, E., Marks, D., Panchoo, K., & Gross, M. (2016). Prevalence of clinically elevated depressive symptoms in college athletes and differences by gender and sport. British Journal of Sports Medicine, 50(3), 167171. PubMed doi:10.1136/bjsports-2015-095756

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization, Regional Office for Europe. (1998). Use of well-being measures in primary health care - the DepCare project health for all. Target 12. E60246. Geneva, Switzerland: WHO.

    • Search Google Scholar
    • Export Citation
  • Yang, J., Cheng, G., Zhang, Y., Covassin, T., Heiden, E.O., & Peek-Asa, C. (2014). Influence of symptoms of depression and anxiety on injury hazard among collegiate American football players. Research in Sports Medicine, 22(2), 147160. PubMed doi:10.1080/15438627.2014.881818

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yang, J., Peek-Asa, C., Corlette, J.D., Cheng, G., Foster, D.T., & Albright, J. (2007). Prevalence of and risk factors associated with symptoms of depression in competitive collegiate student athletes. Clinical Journal of Sport Medicine, 17(6), 481487. PubMed doi:10.1097/JSM.0b013e31815aed6b

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yu, X., Stewart, S.M., Wong, P.T.K., & Lam, T.H. (2011). Screening for depression with the Patient Health Questionnaire-2 (PHQ-2) among the general population in Hong Kong. Journal of Affective Disorders, 134(1–3), 444447. PubMed doi:10.1016/j.jad.2011.05.007

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 4142 1061 49
Full Text Views 93 25 0
PDF Downloads 87 31 0