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The Prevalence and Impact of Debilitative Psychological and Behavioral Responses to Long-Term Injury in Athletes

Misia Gervis, Helen Pickford, Hanna Nygârd, and Aura Goldman

Injuries, and their psychological and maladaptive behavioral consequences, are an inevitable by-product of sport participation. This study sought to investigate the prevalence of maladaptive behaviors and psychological corollaries of long-term injury in order to understand if these are universal experiences of long-term injured athletes. Competitive athletes (n = 187; average time spent injured =43 weeks), across a range of sports completed an online questionnaire developed to investigate the psychological and behavioral consequences of long-term injury. Results indicated that negative symptoms after injury were a universal experience and are the “normal” response to injury, not the “exception.” The most prevalent psychological consequences were rumination (97.9%), boredom (94.7%), and fear of reinjury (93.6%). Furthermore, indicators of suicidal ideation were reported by more than 50% of participants. Factor analysis revealed a six-factor model: (a) self-sabotaging behavior, (b) daily functioning, (c) addictive behavior, (d) clinical issues, (e) fixation on injury, and (f) compromised athletic identity. All factors significantly correlated with debilitating impact. Thus, this study calls for a change to the support of long-term injured athletes to include routine psychological care.

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Collegiate Student-Athlete Psychological Distress and Counseling Utilization During COVID-19

Lindsey E. Slavin, Tess M. Palmateer, Trent A. Petrie, and E. Whitney G. Moore

The onset of COVID-19 and cancellation of collegiate sports may have exacerbated student-athletes’ psychological distress. Within a national sample of collegiate athletes (N = 5,755; 66.7% women), we determined how gender and race related to rates of depression, stress, and counseling use at the beginning of the pandemic (April/May 2020). Overall, 26.5% (n = 1,526) and 10.6% (n = 612) endorsed clinical levels of depression and stress, respectively; 25.1% (n = 1,443) and 69.7% (n = 4,014) reported subclinical levels. Few athletes (2.3%–17.1%) reported counseling use before or after the onset of COVID-19; those who did reported higher levels of depression and stress than those who never sought services. The female athletes reported higher rates of depression, stress, and counseling use than the male athletes. There were no race effects. Athletic departments must address their student-athletes’ psychological distress by facilitating a higher use of mental health services.

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Barriers and Facilitators to Help-Seeking for Mental Health Difficulties Among Professional Jockeys in Ireland

Lewis King, SarahJane Cullen, Jean McArdle, Adrian McGoldrick, Jennifer Pugh, Giles Warrington, and Ciara Losty

A large proportion of jockeys report symptoms associated with mental health difficulties (MHDs), yet most do not seek help from professional mental health support services. Due to the paucity of literature in this field, this study sought to explore jockeys’ barriers to, and facilitators of, help-seeking for MHDs. Twelve jockeys participated in semistructured interviews, subsequently analyzed via reflexive thematic analysis. Barriers to help-seeking included the negative perceptions of others (stigma and career implications), cultural norms (masculinity and self-reliance), and low mental health literacy (not knowing where to seek help, minimization of MHDs, negative perceptions of treatment, and recognizing symptoms). Facilitators to help-seeking included education (exposure to psychological support at a younger age), social support (from professionals, jockeys, family, and friends), and media campaigns (high-profile disclosures from jockeys). Findings are consistent with barrier and facilitator studies among general and athletic populations. Applied recommendations and future research considerations are presented throughout the manuscript.

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An Independent Examination of the Mindful Sport Performance Enhancement Protocol in National Collegiate Athletic Association Swimming and Diving

Jason Kostrna and Aaron D’Addario

The mindful sport performance enhancement (MSPE) protocol is designed to enhance mindfulness, emotional regulation, and attentional awareness and control. The MSPE consists of trainer led group sessions teaching the concepts of mindfulness through discussion and meditation practice. However, little research has tested the MSPE protocol’s adaptability and generalizability to National Collegiate Athletic Association (NCAA) Division-I teams and practitioners independent of the MSPE protocol’s creators. Therefore, the aim of the present study was to test the efficacy of an adapted MSPE protocol. The adapted MSPE protocol was delivered to a NCAA Division I team while a second team participated as a potentially equivalent control group. Both teams completed measures of attentional control, flow, rumination, and mindful attention as primary outcome variables. Results revealed significant decreases in rumination and trait anxiety, as well as improvements in concentration control and focusing ability compared with the control group. Findings support the external validity of the MSPE protocol to adapt to independent practitioners and a previously unstudied combination of sport and level of competition.

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An Introduction to the Journal of Clinical Sport Psychology Special Issue on Burnout in Sport and Performance

J.D. DeFreese, Daniel J. Madigan, and Henrik Gustafsson

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Erratum: Bird, Quinton, and Cumming (2021)

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Volume 15 (2021): Issue 4 (Dec 2021)

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Lack of Sleep Among Adolescent Athletes Is Associated With a Higher Prevalence of Self-Reported History of Anxiety and Depression

Andrea Stracciolini, Caitlin M. McCracken, William P. Meehan III, and Matthew D. Milewski

Purpose: To study mental health, sleep duration, and daytime sleepiness in young athletes. Methods: A cross-sectional questionnaire study was conducted. The main outcome measures included sleep duration and daytime sleepiness. Results: Study participants included 756 athletes with a mean age of 13.5 years. A total of 39% (n = 296/756) reported not meeting current sleep recommendations for age. Athletes >12 years and with a self-reported anxiety and/or depression history were less likely to meet sleep recommendations and showed higher daytime sleepiness (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] [1.2, 1.4], β [SE] = 3.06 [0.74], respectively). Athletes with goal-oriented reasons for playing versus enjoyment (52% vs. 35%, aOR = 1.70, 95% CI [1.12, 2.58]) were less likely to meet sleep recommendations. Night time internet access and weeknight homework hours were negatively associated with sleep recommendations (aOR = 1.68, 95% CI [1.68, 2.47] and aOR = 3.11, 95% CI [1.82, 5.3]) and positively associated with daytime sleepiness (β [SE] = 1.44 [0.45] and 2.28 [0.59]). Conclusions: Many young athletes are not meeting sleep recommendations. Associated factors include mental health, reasons for play, internet access, and homework demand.

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A Content Analysis of Mental Health Literacy Education for Sport Coaches

Stephen P. Hebard, James E. Bissett, Emily Kroshus, Emily R. Beamon, and Aviry Reich

Sport coaches can play an influential role in athletes’ mental health help seeking through purposeful communication, destigmatization of mental health concerns, and supportive relationships. To positively engage in these behaviors, coaches require mental health knowledge (or literacy), positive attitudes about that knowledge, and self-efficacy to use that knowledge. Guided by a multidimensional health literacy framework, we conducted a content analysis of web content and scholarly literature to identify health education programming for coaches that addressed athlete mental health. A purposive sample of Olympic National Governing Bodies, collegiate athletic associations, high school sport associations, youth sport governing bodies, and the scholarly literature were analyzed. We found inconsistent programming regarding a range of mental health disorders, behaviors critical to mental health promotion, and critical components of mental health literacy. Implications and next steps for mental health literacy support for coaches are discussed.

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Promoting Athlete Mental Health: The Role of Emotion Regulation

Georgia A. Bird, Mary L. Quinton, and Jennifer Cumming

This study investigated the relationship between reappraisal and suppression with depression and mental well-being among university athletes. It was hypothesized reappraisal would associate with lower depression and greater mental well-being, whereas suppression would associate with greater depression and reduced mental well-being. Employing a cross-sectional design, 427 participants (M age = 20.18, SD = 1.52; 188 males and 239 females) completed questionnaires assessing mental health and strategy use. Hierarchical multiple regressions revealed reappraisal was positively associated, and suppression negatively associated with mental well-being, ΔR 2 = 4.8%, ΔF(2, 422) = 17.01, p < .001; suppression, β = −0.08, p = .028; reappraisal, β = 0.21, p < .001, but neither were associated with depression, ΔR 2 = 0.4%, ΔF(2, 422) = 1.33, p = .267; suppression, β = 0.06, p = .114; reappraisal, β = 0.03, p = .525. Results highlight reappraisal as correlated with mental well-being in student-athletes, and therefore, reappraisal could be beneficial for managing stress in sport. Reappraisal may implicate how well-being is promoted through sport, but future experimental research is needed to confirm causal relationships.