Predicting Athlete Mental Health Stigma Using the Theory of Reasoned Action Framework

in Journal of Clinical Sport Psychology
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  • 1 Ulster University
  • 2 Dublin Business School
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Recent evidence suggests that attempts to tackle mental health stigma in athletes should include psychological theory to understand the competitive sport environment. Using the Theory of Reasoned Action (TRA), the aim was to determine what demographic and psychological factors predicted mental health stigma among athletes. Athletes (n = 471) completed a questionnaire, and a multiple linear regression analyses was conducted, specifying demographic (e.g., gender), psychological (e.g., norms) and moderating variables (e.g., sport type) as predictors of stigma-related intentions to socialise with individuals who are living with a mental health condition. TRA models explained a significant amount of variance for intentions, in which knowledge about and exposure to individuals with mental health conditions significantly predicted better intentions. Further, athletes competing in team sports, particularly females, had stronger intentions. This was the first study to explore mental health stigma using the TRA. Findings can inform the development of mental health awareness programs for athletes.

Breslin, Shannon, Ferguson, Devlin, and Haughey are with the Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, Northern Ireland. Breslin is also with the Bamford Centre for Mental Health and Wellbeing, Ulster University, Derry, Northern Ireland. Prentice is with the Dublin Business School, Dublin, Ireland.

Address author correspondence to Gavin Breslin at g.breslin1@ulster.ac.uk.
  • Ahmedani, B.K. (2011). Mental health stigma: Society, individuals, and the profession. Journal of Social Work Values and Ethics, 8(2), 41.

    • Search Google Scholar
    • Export Citation
  • Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179211. doi:10.1016/0749-5978(91)90020-T

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ajzen, I., & Fishbein, M. (1977). Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychological Bulletin, 84(5), 888918. doi:10.1037/0033-2909.84.5.888

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.

  • Bauman N.J. (2016). The stigma of mental health in athletes: Are mental toughness and mental health seen as contradictory in elite sport? BMJ, 50(3).

    • Search Google Scholar
    • Export Citation
  • Beach, B., & Bamford, S.M. (2014). Isolation: The emerging crisis for older men. A report exploring experiences of social isolation and loneliness among older men in England. London,UK: Independent Age, and the International Longevity Center-UK (ILC-UK). Retrieved from https://independent-age-assets.s3.eu-west-1.amazonaws.com/s3fs-public/2016-05/isolation-the-emerging-crisis-for-older-men-report.pdf

    • Search Google Scholar
    • Export Citation
  • Biddle S.J., Gorely T., & Stensel D.J. (2004). Health-enhancing physical activity and sedentary behaviour in children and adolescents. Journal of Sports Sciences, 22(8), 679701. PubMed ID: 15370482 doi:10.1080/02640410410001712412

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Breslin, G., Donnelly, P., Kearney, C., Haughey, T., & Prentice, G. (2017). Mental health and well-being in sport: A pilot educational programme for clubs. Journal of Public Mental Health, 6, 177 . doi:10.1186/s13643-017-0568-6

    • Search Google Scholar
    • Export Citation
  • Breslin, G., Shannon, S., Haughey, T.J., Donnelly, P., & Leavey, G. (2017). A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches and officials. Systematic Reviews, 6(1), 177. PubMed ID: 28859666 doi:10.1186/s13643-017-0568-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carless, D., & Douglas, K. (2008). The role of sport and exercise in recovery from mental illness: Two case studies. International Journal of Men’s Health, 7, 139158.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 1127. PubMed ID: 24569086 doi:10.1017/S0033291714000129

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cooper, P., Stringer, W., Howes, J., & Norton, J. (2015). The state of mind boot room: Reducing social isolation and promoting mental fitness. British Journal of Mental Health Nursing, 4(3), 136139. doi:10.12968/bjmh.2015.4.3.136

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Demyan, A.L., & Anderson, T. (2012). Effects of a brief media intervention on expectations, attitudes, and intentions of mental health help seeking. Journal of Counselling Psychology, 59(2), 222229. doi:10.1037/a0026541

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ekkekakis, P. (2015). Honey, I shrunk the pooled SMD! Guide to critical appraisal of systematic reviews and meta-analyses using the Cochrane review on exercise for depression as example. Mental Health and Physical Activity, 8, 2136. doi:10.1016/j.mhpa.2014.12.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Evans-Lacko S., Little K., Meltzer H., Rose D., Rhydderch D., Henderson C., & Thornicroft G. (2010). Development and psychometric properties of the mental health knowledge schedule. The Canadian Journal of Psychiatry, 55(7), 440448. PubMed ID: 20704771 doi:10.1177/070674371005500707

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Evans-Lacko S., Rose D., Little K., Flach C., Rhydderch D., Henderson C., & Thornicroft G. (2011). Development and psychometric properties of the reported and intended behaviour scale (RIBS): A stigma-related behaviour measure. Epidemiology and Psychiatric Sciences, 20(3), 263271. PubMed ID: 21922969 doi:10.1017/S2045796011000308

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Goodheart, C.D., Kazdin, A.E., & Sternberg, R.J. (2006). Evidence-based psychotherapy: Where practice and research meet. Washington DC, WAAmerican Psychological Association.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Griffiths, K.M., Christensen, H., & Jorm, A.F. (2008). Predictors of depression stigma. BMC Psychiatry, 8(1), 25. doi:10.1186/1471-244X-8-25

  • Gulliver, A., Griffiths, K.M., & Christensen, H. (2012). Barriers and facilitators to mental health help-seeking for young elite athletes: A qualitative study. BMC Psychiatry, 12(1), 157. doi:10.1186/1471-244X-12-157

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hughes, L., & Leavey, G. (2012). Setting the bar: Athletes and vulnerability to mental illness. The British Journal of Psychiatry, 200(2), 9596. PubMed ID: 22297587 doi:10.1192/bjp.bp.111.095976

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Huppert, F.A. (2009). Psychological well-being: Evidence regarding its causes and consequences. Applied Psychology: Health and Well-Being, 1(2), 137164. doi:10.1111/j.1758-0854.2009.01008.x

    • Search Google Scholar
    • Export Citation
  • Jorm, A.F. (2000). Mental health literacy: Public knowledge and beliefs about. British Journal of Psychiatry, 177(396), 317327.

  • Kaier, E., Cromer, L.D., Johnson, M.D., Strunk, K., & Davis, J.L. (2015). Perceptions of mental illness stigma: Comparisons of athletes to nonathlete peers. Journal of College Student Development, 56(7), 735739. doi:10.1353/csd.2015.0079

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kinderman, P. (2017). A manifesto for psychological health and wellbeing. In J. Davies (Ed.,) The Sedated Society (pp. 271301). London, UK: Springer International Publishing.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Liddle, S.K., Deane, F.P., & Vella, S.A. (2017). Addressing mental health through sport: A review of sporting organizations’ websites. Early Intervention in Psychiatry, 11(2), 93103. PubMed ID: 27027595 doi:10.1111/eip.12337

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lopez, R.L., & Levy, J.J. (2013). Student athletes’ perceived barriers to and preferences for seeking counseling. Journal of College Counselling, 16(1), 1931. doi:10.1002/j.2161-1882.2013.00024.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lubans, D., Richards, J., Hillman, C., Faulkner, G., Beauchamp, M., Nilsson, M., … Biddle, S. (2016). Physical activity for cognitive and mental health in youth: A systematic review of mechanisms. Pediatrics, 138(3), 20161642. PubMed ID: 27542849 doi:10.1542/peds.2016-1642

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mason, O.J., & Holt, R. (2012). A role for football in mental health: The coping through football project. The Psychiatrist, 36(8), 290293. doi:10.1192/pb.bp.111.036269

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McManus, S., Meltzer, H., Brugha, T.S., Bebbington, P.E., & Jenkins, R. (2009). Adult psychiatric morbidity in England, 2007: Results of a household survey. The NHS Information Centre for health and social care. Retrieved from

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mental Health First Aid (2006). Accessed from https://healthmattersni.com/services/first-aid-training/mental-health-first-aid/

    • Export Citation
  • Papadopoulos, P., Vlouhou, O., & Terzoglou, M. (2008). The theory of reasoned action: Implications for promoting recreational sport programs. Studies in Physical Culture & Tourism, 15(2), 133139.

    • Search Google Scholar
    • Export Citation
  • Putukian, M. (2016). The psychological response to injury in student athletes: A narrative review with a focus on mental health. British Journal of Sports Medicine, 50(3), 145148. PubMed ID: 26719498 doi:10.1136/bjsports-2015-095586

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Richardson, D., Littlewood, M., Nesti, M., & Benstead, L. (2012). An examination of the migratory transition of elite young European soccer players to the English Premier League. Journal of Sports Sciences, 30(15), 16051618. PubMed ID: 23098129 doi:10.1080/02640414.2012.733017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Rüsch, N., Evans-Lacko, S.E., Henderson, C., Flach, C., & Thornicroft, G. (2011). Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatric Services, 62, 675678. doi:10.1176/ps.62.6.pss6206_0675

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ryan, R.M., & Deci, E.L. (2017). Self-determination theory: Basic psychological needs in motivation, development, and wellness. New York, NY: Guilford Publishing.

    • Search Google Scholar
    • Export Citation
  • Schwenk, T.L. (2000). The stigmatisation and denial of mental illness in athletes. British Journal of Sports Medicine, 34(1), 45. PubMed ID: 10690441 doi:10.1136/bjsm.34.1.4

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., & Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 11231132. doi:10.1016/S0140-6736(15)00298-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thornicroft, G., Rose, D., Kassam, A., & Sartorius, N. (2007). Stigma: Ignorance, prejudice or discrimination?. The British Journal of Psychiatry, 190(3), 192193. doi:10.1192/bjp.bp.106.025791

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Trojian, T. (2016). Depression is under-recognised in the sport setting: Time for primary care sports medicine to be proactive and screen widely for depression symptoms. British Journal of Sports Medicine, 50(3), 137139. PubMed ID: 26614764 doi:10.1136/bjsports-2015-095582

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Uphill, M., Sly, D., & Swain, J. (2016). From mental health to mental wealth in athletes: Looking back and moving forward. Frontiers in Psychology, 4, 715.

    • Search Google Scholar
    • Export Citation
  • Van Brakel W.H. (2006). Measuring health-related stigma—a literature review. Psychology, Health & Medicine, 11(3), 307334. PubMed ID: 17130068 doi:10.1080/1354850060059516

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Williams B., & Pow J. (2007). Gender differences and mental health: An exploratory study of knowledge and attitudes to mental health among Scottish teenagers. Child and Adolescent Mental Health, 12(1), 812. doi:10.1111/j.1475-3588.2006.00413.x

    • 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(1), 5660. PubMed ID: 25574886 doi:10.1249/JSR.0000000000000123

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2014). Mental health: A state of well-being. Retrieved from http://www.who.int/mediacentre/factsheets/fs220/en/

    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Retrieved from http://apps.who.int/iris/bitstream/10665/254610/1/WHO-MSD-MER-2017.2-eng.pdf

    • Search Google Scholar
    • Export Citation
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