Depression, Anxiety, and Help-Seeking Among NCAA Division III Athletes at a Historically Women’s College

in Journal of Clinical Sport Psychology

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Aidan D. KrausWheelock College of Education & Human Development, Department of Counseling Psychology & Applied Human Development, Boston University, Boston, MA, USA

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Erica TibbettsExercise and Sport Studies, Smith College, Northampton, MA, USA

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This study explored depression, anxiety, and help-seeking at a National Collegiate Athletic Association Division III historically women’s college in the United States, while taking into account gender identities outside of male and female. An online survey including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and help-seeking measures were completed by 109 student-athletes. Participants’ ages ranged from 18 to 22. Within the sample, 59.7% of participants identified as LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, among other identities) and 8.3% identified as genderqueer/gender-nonconforming. A total of 33.0% of the participants reported symptoms of depression, while 28.5% reported symptoms of anxiety. Genderqueer/gender-nonconforming athletes reported higher rates of anxiety than athletes who identified as women. Higher rates of depression and anxiety were related to higher levels of formal help-seeking. The results indicate that student-athletes at a historically women’s college may be experiencing higher levels of depression and anxiety than student-athletes in other contexts and have more positive views toward help-seeking. Student-athletes who identify outside of the gender binary may be at higher risk for anxiety.

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  • Bandre, M.A. (2011). The impact of financial aid on the enrollment and retention of student athletes at National Collegiate Athletic Association (NCAA) Division III colleges and universities: A review of the literature. Journal of Student Financial Aid, 41(1), 4. https://doi.org/10.55504/0884-9153.1018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Barlow, K.A., & Hickey, A. (2014). Academic achievement of NCAA Division III athletes. Journal of Research in Education, 24(2), 116123. https://www.files.eric.ed.gov/fulltext/EJ1098178.pdf

    • Search Google Scholar
    • Export Citation
  • Bauman, N.J. (2016). The stigma of mental health in athletes: Are mental toughness and mental health seen as contradictory in elite sport? British Journal of Sports Medicine, 50(3), 135136. https://doi.org/10.1136/bjsports-2015-095570

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beable, S., Fulcher, M., Lee, A.C., & Hamilton, B. (2017). SHARP sports mental health awareness research project: Prevalence and risk factors of depressive symptoms and life stress in elite athletes. Journal of Science and Medicine in Sport, 20(12), 10471052. https://doi.org/10.1016/j.jsams.2017.04.018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bird, M.D., Chow, G.M., & Cooper, B.T. (2020). Student-athletes’ mental health help-seeking experiences: A mixed methodological approach. Journal of College Student Psychotherapy, 34(1), 5977. https://doi.org/10.1080/87568225.2018.1523699

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bissett, J.E., Kroshus, E., & Hebard, S. (2020). Determining the role of sport coaches in promoting athlete mental health: A narrative review and Delphi approach. BMJ Open Sport & Exercise Medicine, 6(1), e000676. https://doi.org/10.1136/bmjsem-2019-000676

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bissett, J.E., & Tamminen, K.A. (2020). Student-athlete disclosures of psychological distress: Exploring the experiences of university coaches and athletes. Journal of Applied Sport Psychology, 34(2), 363383. https://doi.org/10.1080/10413200.2020.1753263

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bostwick, W.B., Boyd, C.J., Hughes, T.L., & McCabe, S.E. (2010). Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. American Journal of Public Health, 100(3), 468475. https://doi.org/10.2105/AJPH.2008.152942

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bostwick, W.B., Boyd, C.J., Hughes, T.L., West, B.T., & McCabe, S.E. (2014). Discrimination and mental health among lesbian, gay, and bisexual adults in the United States. The American Journal of Orthopsychiatry, 84(1), 3545. https://doi.org/10.1037/h0098851

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Braziller, Z. (2020). Tennessee QB Brian Maurer reveals planned suicide attempt, mental health struggle. New York Post. https://www.nypost.com/2020/05/02/tennessees-brian-maurer-reveals-mental-health-struggle/

    • Search Google Scholar
    • Export Citation
  • Bu, D., Chung, P.-K., Zhang, C.-Q., Liu, J., & Wang, X. (2020). Mental health literacy intervention on help-seeking in athletes: A systematic review. International Journal of Environmental Research and Public Health, 17(19), Article 7263. https://doi.org/10.3390/ijerph17197263

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Coakley, J. (2017). Sports in society: Issues and controversies (12th ed.). McGraw-Hill Education.

  • Cox, C.E., Ross-Stewart, L., & Foltz, B.D. (2017). Investigating the prevalence and risk factors of depression symptoms among NCAA Division I Collegiate Athletes. Journal of Sports Science, 5(1), 1428. https://doi.org/10.17265/2332-7839/2017.01.002

    • Search Google Scholar
    • Export Citation
  • Crenshaw, K. (1990). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43, 1241. https://doi.org/10.2307/1229039

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Davoren, A.K., & Hwang, S. (2014). Depression and anxiety prevalence in student-athletes. Nation collegiate athletics association, mind, body and sport: Understanding and supporting student-athlete mental wellness. https://www.ncaa.org/sport-science-institute/mind-body-and-sport-depression-and-anxiety-prevalence-student-athletes

    • Search Google Scholar
    • Export Citation
  • DeFoor, M.T., Stepleman, L.M., & Mann, P.C. (2018). Improving wellness for LGB collegiate student-athletes through sports medicine: A narrative review. Sports Medicine-Open, 4(1), 110. https://doi.org/10.1186/s40798-018-0163-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Drew, B., & Matthews, J. (2019). The prevalence of depressive and anxiety symptoms in student-athletes and the relationship with resilience and help-seeking behavior. Journal of Clinical Sport Psychology, 13(3), 421439. https://doi.org/10.1123/jcsp.2017-0043

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fagan, K. (2017). What made maddy run: The secret struggles and tragic death of an all-American teen. Little, Brown and Company.

  • Farmer, L.B., Robbins, C.K., Keith, J.L., & Mabry, C.J. (2020). Transgender and gender-expansive students’ experiences of genderism at women’s colleges and universities. Journal of Diversity in Higher Education, 13(2), 146157. https://doi.org/10.1037/dhe0000129

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fink, J.S. (2016). Hiding in plain sight: The embedded nature of sexism in sport. Journal of Sport Management, 30(1), 17. https://doi.org/10.1123/jsm.2015-0278

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Freitas, A. (2017). Beyond acceptance: Serving the needs of transgender students at women’s colleges. Humboldt Journal of Social Relations, 39(1), 294314.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Golberstein, E., Eisenberg, D., & Gollust, S.E. (2008). Perceived stigma and mental health care seeking. Psychiatric Services, 59(4), 392399. https://doi.org/10.1176/ps.2008.59.4.392

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gonzales, G., & Henning Smith, C. (2017). Barriers to care among transgender and gender nonconforming adults. The Milbank Quarterly, 95(4), 726748. https://doi.org/10.1111/1468-s0009.12297

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 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), 157171. https://doi.org/10.1186/1471-244X-12-157

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Heron, M. (2019). Deaths: Leading causes for 2017. National vital statistics reports. The Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_06-508.pdf

    • Search Google Scholar
    • Export Citation
  • Holt, M.K., Greif Green, J., Reid, G., DiMeo, A., Espelage, D.L., Felix, E.D., Furlong, M.J., Poteat, V.P., & Sharkey, J.D. (2014). Associations between past bullying experiences and psychosocial and academic functioning among college students. Journal of American College Health, 62(8), 552560. https://doi.org/10.1080/07448481.2014.947990

    • 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. https://doi.org/10.1192/bjp.bp.111.095976

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hughes, R., & Coakley, J. (1991). Positive deviance among athletes: The implications of overconformity to the Sport ethic. Sociology of Sport Journal, 8(4), 307325. https://doi.org/10.1123/ssj.8.4.307

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 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. https://doi.org/10.1353/csd.2015.0079

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kearns, M., Muldoon, O.T., Msetfi, R.M., & Surgenor, P.W. G. (2015). Understanding help-seeking amongst university students: The role of group identity, stigma, and exposure to suicide and help-seeking. Frontiers in Psychology, 6, Article 1462. https://doi.org/10.3389/fpsyg.2015.01462

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kisch, J., Leino, E.V., & Silverman, M.M. (2005). Aspects of suicidal behavior, depression, and treatment in college students: Results from the Spring 2000 national college health assessment survey. Suicide and Life-Threatening Behavior, 35(1), 313. https://doi.org/10.1521/suli.35.1.3.59263

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kroenke, K., Spitzer, R.L., & Williams, J.B.W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Li, H., Moreland, J.J., Peek-Asa, C., & Yang, J. (2017). Preseason anxiety and depressive symptoms and prospective injury risk in collegiate athletes. The American Journal of Sports Medicine, 45(9), 21482155. https://doi.org/10.1177/0363546517702847

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

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mackenzie, S., Wiegel, J.R., Mundt, M., Brown, D., Saewyc, E., Heiligenstein, E., Harahan, B., & Fleming, M. (2011). Depression and suicide ideation among students accessing campus healthcare. The American Journal of Orthopsychiatry, 81(1), 101107. https://doi.org/10.1111/j.1939-0025.2010.01077.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McNair, R.P., & Bush, R. (2016). Mental health help seeking patterns and associations among Australian same sex attracted women, trans and gender diverse people: A survey-based study. BMC Psychiatry, 16(1), 209235. https://doi.org/10.1186/s12888-016-0916-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mignano, A.C., Brewer, B.W., Winter, C.R., & Van Raalte, J.L. (2006). Athletic identity and student involvement of female athletes at NCAA division III women’s and coeducational colleges. Journal of College Student Development, 47(4), 457464. https://doi.org/10.1353/csd.2006.0050

    • 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. https://doi.org/10.1016/j.jshs.2017.04.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Munson, E.E., & Ensign, K.A. (2021). Transgender athletes’ experiences with health care in the athletic training setting. Journal of Athletic Training, 56(1), 101111. https://doi.org/10.4085%2F1062-6050-0562.19

    • Crossref
    • Search Google Scholar
    • Export Citation
  • NCAA. (2021). NCAA our division III story. https://www.ncaa.org/sports/2021/2/16/our-division-iii-story.aspx

  • Nepon, J., Belik, S.-L., Bolton, J., & Sareen, J. (2010). The relationship between anxiety disorders and suicide attempts: Findings from the national epidemiologic survey on alcohol and related conditions. Depression and Anxiety, 27(9), 791798. https://doi.org/10.1002/da.20674

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nichols, B.A., Smith, M.A., & Stellino, M.B. (2020). Factors influencing college selection by NCAA division III men’s basketball players. Journal of Amateur Sport, 6(1), 3251. https://doi.org/10.17161/jas.v6i1.8297

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nye, E.A., Crossway, A., Rogers, S.M., Games, K.E., & Eberman, L.E. (2019). Lesbian, gay, bisexual, transgender, and queer patients: Collegiate athletic trainers’ perceptions. Journal of Athletic Training, 54(3), 334344. https://doi.org/10.4085/1062-6050-260-17

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pattyn, E., Verhaeghe, M., Sercu, C., & Bracke, P. (2014). Public stigma and self-stigma: Differential association with attitudes toward formal and informal help seeking. Psychiatric Services, 65(2), 232238. https://doi.org/10.1176/appi.ps.201200561

    • 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. https://doi.org/10.1123/jcsp.4.3.204

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rice, S.M., Parker, A.G., Rosenbaum, S., Bailey, A., Mawren, D., & Purcell, R. (2018). Sport-related concussion and mental health outcomes in elite athletes: A systematic review. Sports Medicine, 48(2), 447465. https://doi.org/10.1007/s40279-017-0810-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Robinson, C. (2010). Marketing intercollegiate athletics at the NCAA division III level. Journal of Applied Sport Management, 2(1), 25. https://trace.tennessee.edu/jasm/vol2/iss1/25

    • Search Google Scholar
    • Export Citation
  • Rodgers, S., Vandeleur, C.L., Strippoli, M.-P.F., Castelao, E., Tesic, A., Glaus, J., Lasserre, A.M., Müller, M., Rössler, W., Ajdacic-Gross, V., & Preisig, M. (2017). Low emotion-oriented coping and informal help-seeking behaviour as major predictive factors for improvement in major depression at 5-year follow-up in the adult community. Social Psychiatry and Psychiatric Epidemiology, 52(9), 11691182. https://doi.org/10.1007/s00127-017-1421-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ryan, H., Gayles, J.G., & Bell, L. (2018). Student-athletes and mental health experiences. New Directions for Student Services, 2018(163), 6779. https://doi.org/10.1002/ss.20271

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Semerjian, T.Z., & Cohen, J.H. (2006). “FTM means female to me”: Transgender athletes performing gender. Women in Sport & Physical Activity Journal, 15(2), 2843. https://doi.org/10.1123/wspaj.15.2.28

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Spitzer, R.L., Kroenke, K., Williams, J.B.W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 10921097. https://doi.org/10.1001/archinte.166.10.1092

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Steinfeldt, J.A., & Steinfeldt, M.C. (2012). Profile of masculine norms and help-seeking stigma in college football. Sport, Exercise, and Performance Psychology, 1(1), 5871. https://doi.org/10.1037/a0024919

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sudano, L.E., Collins, G., & Miles, C.M. (2017). Reducing barriers to mental health care for student-athletes: An integrated care model. Families, Systems & Health, 35(1), 7784. https://doi.org/10.1037/fsh0000242

    • Crossref
    • Search Google Scholar
    • Export Citation
  • The Trevor Project. (2020). 2020 national survey on LGBTQ youth mental health. The Trevor Project. https://www.thetrevorproject.org/survey-2020/?section=Introduction

    • Search Google Scholar
    • Export Citation
  • Travers, A. (2008). The sport nexus and gender injustice. Studies in Social Justice, 2(1), 79101. https://doi.org/10.26522/ssj.v2i1.969

  • Ullman, J. (2014). Ladylike/butch, sporty/dapper: Exploring “gender climate” with Australian LGBTQ students using stage-environment fit theory. Sex Education, 14(4), 430443. https://doi.org/10.1080/14681811.2014.919912

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Veliz, P., Epstein-Ngo, Q., Zdroik, J., Boyd, C.J., & McCabe, S.E. (2016). Substance use among sexual minority collegiate athletes: A national study. Substance Use & Misuse, 51(4), 517532. https://doi.org/10.3109/10826084.2015.1126741

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vogel, D.L., Wester, S.R., Hammer, J.H., & Downing-Matibag, T.M. (2014). Referring men to seek help: The influence of gender role conflict and stigma. Psychology of Men & Masculinity, 15(1), 6067. https://doi.org/10.1037/a0031761

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Watson, J.C. (2006). Student-athletes and counseling: Factors influencing the decision to seek counseling services. College Student Journal, 40(1), 3542.

    • Search Google Scholar
    • Export Citation
  • Weber, S. (2016). “Womanhood does not reside in documentation”: Queer and feminist student activism for transgender women’s inclusion at women’s colleges. Journal of Lesbian Studies, 20(1), 2945. https://doi.org/10.1080/10894160.2015.1076238

    • 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. https://doi.org/10.1136/bjsports-2015-095756

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wood, S., Harrison, L.K., & Kucharska, J. (2017). Male professional footballers’ experiences of mental health difficulties and help-seeking. The Physician and Sports Medicine, 45(2), 120128. https://doi.org/10.1080/00913847.2017.1283209

    • Search Google Scholar
    • Export Citation
  • Xanthopoulos, M.S., Benton, T., Lewis, J., Case, J.A., & Master, C.L. (2020). Mental health in the young athlete. Current Psychiatry Reports, 22(11), 115. https://doi.org/10.1007/s11920-020-01185-w

    • Search Google Scholar
    • Export Citation
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