Prevalence of COVID-19 Anxiety in Division I Student-Athletes

in Journal of Clinical Sport Psychology
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Anxiety and depressive symptoms are prevalent in athletes. The pandemic of novel coronavirus (COVID-19) may increase risk for symptoms due to fear of exposure during competition or uncertainty regarding participation. The current study examined the prevalence of COVID-19 anxiety in 437 National Collegiate Athletic Association Division I student-athletes and its association with psychological symptoms. Only 0.2% of participants endorsed COVID-19 anxiety symptoms above cutoff. COVID-19 anxiety did not change after postponement of fall sports or differ between persons competing in different seasons. However, higher levels of COVID-19 anxiety were significantly associated with depression, anxiety, and stress. Though student-athletes generally reported low levels of psychological symptoms, females endorsed significantly higher levels than males. Low levels of COVID-19 anxiety in student-athletes may reflect protective factors (e.g., health knowledge, emotion regulation) or the tendency for this population to minimize psychological symptoms. Further investigations on the psychological impact of COVID-19 in athletes is needed.

Sanborn, Todd, Schmetzer, Manitkul-Davis, Updegraff, and Gunstad are with the Department of Psychological Sciences, Kent State University, Kent, OH, USA. Gunstad is also with the Brain Health Research Institute, Kent State University, Kent, OH, USA.

Sanborn (vsanborn@kent.edu) is corresponding author.
  • Asmundson, G.J., Abramowitz, J.S., Richter, A.A., & Whedon, M. (2010). Health anxiety: Current perspectives and future directions. Current Psychiatry Reports, 12(4), 306312. PubMed ID: 20549396 doi:10.1007/s11920-010-0123-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Asmundson, G.J., & Taylor, S. (2020). How health anxiety influences responses to viral outbreaks like COVID-19: What all decision-makers, health authorities, and health care professionals need to know. Journal of Anxiety Disorders, 71, 102211. PubMed ID: 32179380 doi:10.1016/j.janxdis.2020.102211

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Baggish, A., Drezner, J.A., Kim, J., Martinez, M., & Prutkin, J.M. (2020). Resurgence of sport in the wake of COVID-19: Cardiac considerations in competitive athletes. British Journal of Sports Medicine, 54(19), 11301131. doi:10.1136/bjsports-2020-102516

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bhullar, N., Hine, D.W., & Phillips, W.J. (2014). Profiles of psychological well‐being in a sample of Australian university students. International Journal of Psychology, 49(4), 288294. PubMed ID: 24990640 doi:10.1002/ijop.12022

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Carleton, R.N., Mulvogue, M.K., Thibodeau, M.A., McCabe, R.E., Antony, M.M., & Asmundson, G.J. (2012). Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression. Journal of Anxiety Disorders, 26(3), 468479. PubMed ID: 22366534 doi:10.1016/j.janxdis.2012.01.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chang, C., Putukian, M., Aerni, G., Diamond, A., Hong, G., Ingram, Y., … Wolanin, A. (2020). Mental health issues and psychological factors in athletes: Detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary. British Journal of Sports Medicine, 54(4), 216220. PubMed ID: 31810972 doi:10.1136/bjsports-2019-101583

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cohen, B.E., Edmondson, D., & Kronish, I.M. (2015). State of the art review: Depression, stress, anxiety, and cardiovascular disease. American Journal of Hypertension, 28(11), 12951302. PubMed ID: 25911639 doi:10.1093/ajh/hpv047

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Commodari, E., & La Rosa, V.L. (2020). Adolescents in quarantine during COVID-19 pandemic in Italy: Perceived health risk, beliefs, psychological experiences and expectations for the future. Frontiers in Psychology, 11, 2480. doi:10.3389/fpsyg.2020.559951

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Commodari, E., La Rosa, V.L., & Coniglio, M.A. (2020). Health risk perceptions in the era of the new coronavirus: Are the Italian people ready for a novel virus? A cross-sectional study on perceived personal and comparative susceptibility for infectious diseases. Public Health, 187, 814. PubMed ID: 32866818 doi:10.1016/j.puhe.2020.07.036

    • Crossref
    • Search Google Scholar
    • Export Citation
  • De Pero, R., Minganti, C., Pesce, C., Capranica, L., & Piacentini, M.F. (2013). The relationships between pre-competition anxiety, self-efficacy, and fear of injury in elite Teamgym athletes. Kinesiology, 45(1), 6372. http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=0&sid=c089f0cc-328a-4abe-ac0e-a73b8b64d7af%40sessionmgr4006

    • Search Google Scholar
    • Export Citation
  • Edwards, C.E., & Singh, M. (2020, April 27). Anxiety and insomnia in athletes during the COVID era: Part 1 – Foundation and Facts. British Journal of Sports Medicine: Blog. https://blogs.bmj.com/bjsm/2020/04/27/anxiety-and-insomnia-in-athletes-during-the-covid-era-part-1-foundation-and-facts/

    • Search Google Scholar
    • Export Citation
  • Edwards, C.E., & Thornton, J. (2020, March 25). Athlete mental health and mental illness in the era of COVID-19: Shifting focus with a new reality. British Journal of Sports Medicine: Blog. https://blogs.bmj.com/bjsm/2020/03/25/athlete-mental-health-and-mental-illness-in-the-era-of-covid-19-shifting-focus-a-new-reality/

    • Search Google Scholar
    • Export Citation
  • Egan, K.P. (2019). Supporting mental health and well-being among student-athletes. Clinics in Sports Medicine, 38(4), 537544. PubMed ID: 31472764 doi:10.1016/j.csm.2019.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Evers, A.G., Somogie, J.A., Wong, I.L., Allen, J.D., & Cuevas, A.G. (2020). The adaptation and evaluation of a pilot mindfulness intervention promoting mental health in student athletes. Journal of Clinical Sport Psychology, 1(aop), 121. doi:10.1123/jcsp.2019-0083

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Facer-Childs, E.R., Hoffman, D., Tran, J.N., Drummond, S., & Rajaratnam, S.M. (2021). Sleep and mental health in athletes during COVID-19 lockdown. Sleep, zsaa261. doi:10.1093/sleep/zsaa261

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fassett-Carman, A.N., DiDomenico, G.E., von Steiger, J., & Snyder, H.R. (2020). Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors. Journal of Affective Disorders, 260, 638645. PubMed ID: 31542557 doi:10.1016/j.jad.2019.09.053

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fogaca, J.L. (2021). Combining mental health and performance interventions: Coping and social support for student-athletes. Journal of Applied Sport Psychology, 33(1), 419. doi:10.1080/10413200.2019.1648326

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Foster, B.J., & Chow, G.M. (2020). The effects of psychological skills and mindfulness on well-being of student-athletes: A path analysis. Performance Enhancement & Health, 8(2–3), 100180. doi:10.1016/j.peh.2020.100180

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Giles, G.E., Eddy, M.D., Brunyé, T.T., Urry, H.L., Graber, H.L., Barbour, R.L., Kanarek, R.B. (2018). Endurance exercise enhances emotional valence and emotion regulation. Frontiers in Human Neuroscience, 12, 398. PubMed ID: 30459576 doi:10.3389/fnhum.2018.00398

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Glanz, K., Rimer, B.K., & Viswanath, K. (2008). Health behavior and health education (4th ed.). San Francisco, CA: John Wiley & Sons, Inc.

    • Search Google Scholar
    • Export Citation
  • Graupensperger, S., Benson, A.J., Kilmer, J.R., & Evans, M.B. (2020). Social (un) distancing: Teammate interactions, athletic identity, and mental health of student-athletes during the COVID-19 pandemic. Journal of Adolescent Health, 67(5), 662670. doi:10.1016/j.jadohealth.2020.08.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Grupe, D.W., & Nitschke, J.B. (2013). Uncertainty and anticipation in anxiety: An integrated neurobiological and psychological perspective. Nature Reviews Neuroscience, 14(7), 488501. PubMed ID: 23783199 doi:10.1038/nrn3524

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gupta, S., Hayek, S.S., Wang, W., Chan, L., Mathews, K.S., Melamed, M.L., … STOP-COVID Investigators. (2020). Factors associated with death in critically ill patients with coronavirus disease 2019 in the US. JAMA Internal Medicine, 180(11), 14361446. doi:10.1001/jamainternmed.2020.3596

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hull, J.H., Loosemore, M., & Schwellnus, M. (2020). Respiratory health in athletes: Facing the COVID-19 challenge. The Lancet Respiratory Medicine, 8(6), 557558. PubMed ID: 32277869 doi:10.1016/S2213-2600(20)30175-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ibuka, Y., Chapman, G.B., Meyers, L.A., Li, M., & Galvani, A.P. (2010). The dynamics of risk perceptions and precautionary behavior in response to 2009 (H1N1) pandemic influenza. BMC Infectious Diseases, 10(1), 296. doi:10.1186/1471-2334-10-296

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jungmann, S.M., & Witthöft, M. (2020). Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety? Journal of Anxiety Disorders, 73, 102239. PubMed ID: 32502806 doi:10.1016/j.janxdis.2020.102239

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kamara, S., Walder, A., Duncan, J., Kabbedijk, A., Hughes, P., & Muana, A. (2017). Mental health care during the Ebola virus disease outbreak in Sierra Leone. Bulletin of the World Health Organization, 95(12), 842. PubMed ID: 29200525 doi:10.2471/BLT.16.190470

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Keeley, R.D., Brody, D.S., Engel, M., Burke, B.L., Nordstrom, K., Moralez, E., … Emsermann, C. (2016). Motivational interviewing improves depression outcome in primary care: A cluster randomized trial. Journal of Consulting and Clinical Psychology, 84(11), 9931007. PubMed ID: 27599229 doi:10.1037/ccp0000124

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kim, Y., Park, I., Kang, S., Kim, Y., Park, I., & Kang, S. (2018). Age and gender differences in health risk perception. Central European Journal of Public Health, 26(1), 5459. PubMed ID: 29684299 doi:10.21101/cejph.a4920

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leddy, M.H., Lambert, M.J., & Ogles, B.M. (1994). Psychological consequences of athletic injury among high-level competitors. Research Quarterly for Exercise and Sport, 65(4), 347354. PubMed ID: 7886284 doi:10.1080/02701367.1994.10607639

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lee, S.A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Studies, 44(7), 393401. PubMed ID: 32299304 doi:10.1080/07481187.2020.1748481

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leguizamo, F., Olmedilla, A., Núñez, A., Verdaguer, F., Gómez-Espejo, V., Ruiz-Barquín, R., & Garcia-Mas, A. (2021). Personality, coping strategies, and mental health in high-performance athletes during confinement derived from the COVID-19 pandemic. Frontiers in Public Health, 8, 924. doi:10.3389/fpubh.2020.561198

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leonelli, B.R., Kuhn, T., Sanborn, V., & Gunstad, J. (2020). Feasibility of predicting in-Season mental health problems in college student-athletes from pre-season assessment. Clinical Journal of Sport Medicine. Advance online publication. doi:10.1097/JSM.0000000000000899

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Limbachia, C., Morrow, K., Khibovska, A., Meyer, C., Padmala, S., & Pessoa, L. (2021). Controllability over stressor decreases responses in key threat-related brain areas. Communications Biology, 4(1), 111. doi:10.1038/s42003-020-01537-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lovibond, P.F., & Lovibond, S.H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335343. PubMed ID: 7726811 doi:10.1016/0005-7967(94)00075-U

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mahase, E. (2020). Covid-19: Death rate is 0.66% and increases with age, study estimates. BMJ, 369, m1327. doi:10.1136/bmj.m1327

  • Maunder, R., Hunter, J., Vincent, L., Bennett, J., Peladeau, N., Leszcz, M., … Mazzulli, T. (2003). The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ, 168(10), 12451251. PubMed ID: 12743065

    • Search Google Scholar
    • Export Citation
  • McDonnell, W.M., Nelson, D.S., & Schunk, J.E. (2012). Should we fear “flu fear” itself? Effects of H1N1 influenza fear on ED use. The American Journal of Emergency Medicine, 30(2), 275282. PubMed ID: 21208765 doi:10.1016/j.ajem.2010.11.027

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mehrsafar, A.H., Gazerani, P., Moghadam Zadeh, A., & Jaenes Sánchez, J.C. (2020). Addressing potential impact of COVID-19 pandemic on physical and mental health of elite athletes. Brain, Behavior, and Immunity, 87, 147148. doi:10.1016/j.bbi.2020.05.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Milner, A., Krnjacki, L., & LaMontagne, A.D. (2016). Age and gender differences in the influence of social support on mental health: a longitudinal fixed-effects analysis using 13 annual waves of the HILDA cohort. Public Health, 140, 172178. PubMed ID: 27527844 doi:10.1016/j.puhe.2016.06.029

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Moreland, J.J., Coxe, K.A., & Yang, J. (2018). Collegiate athletes’ mental health services utilization: A systematic review of conceptualizations, operationalizations, facilitators, and barriers. Journal of Sport and Health Science, 7(1), 5869. PubMed ID: 30356496 doi:10.1016/j.jshs.2017.04.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mukhtar, S. (2020). Psychological health during the coronavirus disease 2019 pandemic outbreak. International Journal of Social Psychiatry, 66(5). 512516. doi:10.1177/0020764020925835

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Osman, A., Wong, J.L., Bagge, C.L., Freedenthal, S., Gutierrez, P.M., & Lozano, G. (2012). The depression anxiety stress Scales—21 (DASS‐21): Further examination of dimensions, scale reliability, and correlates. Journal of Clinical Psychology, 68(12), 13221338. PubMed ID: 22930477 doi:10.1002/jclp.21908

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V.G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901907. PubMed ID: 32437915 doi:10.1016/j.bbi.2020.05.026

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Patel, D.R., Omar, H., & Terry, M. (2010). Sport-related performance anxiety in young female athletes. Journal of Pediatric and Adolescent Gynecology, 23(6), 325335. PubMed ID: 20869282 doi:10.1016/j.jpag.2010.04.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pillay, L., van Rensburg, D.C.C.J., van Rensburg, A.J., Ramagole, D.A., Holtzhausen, L., Dijkstra, H.P., & Cronje, T. (2020). Nowhere to hide: The significant impact of coronavirus disease 2019 (COVID-19) measures on elite and semi-elite South African athletes. Journal of Science and Medicine in Sport, 23(7), 670679. PubMed ID: 32448749 doi:10.1016/j.jsams.2020.05.016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Proctor, S.L., & Boan-Lenzo, C. (2010). Prevalence of depressive symptoms in male intercollegiate student-athletes and nonathletes. Journal of Clinical Sport Psychology, 4(3), 204220. doi:10.1123/jcsp.4.3.204

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Psychology Foundation of Australia. (2011). Depression Anxiety Stress Scale—DASS. Retrieved from http://www2.psy.unsw.edu.au/groups/dass//

    • Search Google Scholar
    • Export Citation
  • Rice, S.M., Gwyther, K., Santesteban-Echarri, O., Baron, D., Gorczynski, P., Gouttebarge, V., … Purcell, R. (2019). Determinants of anxiety in elite athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(11), 722730. PubMed ID: 31097452 doi:10.1136/bjsports-2019-100620

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rocha, V.V.S., & Osório, F.D.L. (2018). Associations between competitive anxiety, athlete characteristics and sport context: Evidence from a systematic review and meta-analysis. Archives of Clinical Psychiatry, 45(3), 6774. doi:10.1590/0101-60830000000160

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Salmon, P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress: A unifying theory. Clinical Psychology Review, 21(1), 3361. PubMed ID: 11148895 doi:10.1016/S0272-7358(99)00032-X

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on college students’ mental health in the United States: Interview survey study. Journal of Medical Internet Research, 22(9), e21279. PubMed ID: 32805704 doi:10.2196/21279

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tesarz, J., Schuster, A.K., Hartmann, M., Gerhardt, A., & Eich, W. (2012). Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis. Pain, 153(6), 12531262. PubMed ID: 22607985 doi:10.1016/j.pain.2012.03.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Toresdahl, B.G., & Asif, I.M. (2020). Coronavirus disease 2019 (COVID-19): Considerations for the competitive athlete. Sports Health, 12(3), 221224. doi:10.1177/1941738120918876

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vindegaard, N., & Benros, M.E. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity, 89. 531542.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Wersebe, H., Lieb, R., Meyer, A.H., Hofer, P., & Gloster, A.T. (2018). The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention. International Journal of Clinical and Health Psychology, 18(1), 6068. PubMed ID: 30487911 doi:10.1016/j.ijchp.2017.09.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wetherill, R.R., & Fromme, K. (2007). Alcohol use, sexual activity, and perceived risk in high school athletes and non-athletes. Journal of Adolescent Health, 41(3), 294301. doi:10.1016/j.jadohealth.2007.04.019

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wilson, M.G., Hull, J.H., Rogers, J., Pollock, N., Dodd, M., Haines, J., … Shah, A. (2020). Cardiorespiratory considerations for return-to-play in elite athletes after COVID-19 infection: A practical guide for sport and exercise medicine physicians. British Journal of Sports Medicine, 54(19), 11571161. PubMed ID: 32878870 doi:10.1136/bjsports-2020-102710

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wippert, P.M., & Wippert, J. (2010). The effects of involuntary athletic career termination on psychological distress. Journal of Clinical Sport Psychology, 4(2), 133149. doi:10.1123/jcsp.4.2.133

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wollenberg, G., Shriver, L.H., & Gates, G.E. (2015). Comparison of disordered eating symptoms and emotion regulation difficulties between female college athletes and non-athletes. Eating Behaviors, 18, 16. PubMed ID: 25841217 doi:10.1016/j.eatbeh.2015.03.008

    • Crossref
    • Search Google Scholar
    • Export Citation
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