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Recreational athletes comprise the most prevalent population using illegal Anabolic Androgenic Steroids (AAS). Despite regulatory efforts, substances are widely accessible, and most users report the experience of harmful side effects. It remains unclear why few users seek professional medical help. The aim of this study was to determine AAS users’ experience of side effects and help-seeking beliefs using an Interpretative Phenomenological Analysis of six interviews. Participants were from the United Kingdom (n = 5) and United States (n = 1), had all experienced side effects, with some reporting prolonged use of AAS (>10 years) and self-manufacturing the drugs from raw ingredients. Results showed that AAS users discredit medical professionals’ competencies, and practice cognitive dissonance by avoiding challenging situations. A microculture for information-sharing has developed among AAS users who initially self-treat to counteract side effects, leaving them vulnerable to further harm. To conclude, there is an urgent need for educational interventions that outline the risky practice of unregulated AAS use and self-treatments, and the need to seek professional help. Such interventions could be developed through a co-production basis, and be implemented by current/former AAS users alongside the medical community.

Individual differences in vulnerability to depression are still underexplored in athletes. We tested the influence of different brooding and reflective rumination profiles (i.e., repetitive thought processes in response to low/depressed mood) on the odds of experiencing clinically relevant depressive symptoms in competitive athletes (N = 286). The Patient Health Questionnaire–9 and the Ruminative Responses Scale–short form were utilized to measure depression and rumination, respectively. Compared to athletes with a low brooding/reflection profile, athletes with a high brooding/reflection profile had significantly higher odds of experiencing clinical levels of depressive symptoms (OR = 13.40, 95% CI = 3.81–47.11). A high reflection/low brooding profile was not, however, related to increased odds of depressive symptoms. Future research could extend our findings by exploring determinants of ruminative tendencies, especially brooding, in athletes. Furthermore, psychological interventions targeting rumination could be examined as a potential prevention and treatment approach to tackling depressive symptoms in athletes.

The purpose of this study was to examine the types and perceived usefulness of questionnaires used by consultants in applied intervention work with athletes in 2003 and 2017, as well as to understand consultants’ perceptions of the advantages, limitations, and needs regarding the use of questionnaires in consulting. Sport psychology consultants in 2003 (n = 96) and 2017 (n = 106) completed a questionnaire that included Likert-scale questions as well as open-ended questions. The percentage of consultants who used questionnaires decreased from 83% in 2003 to 67% in 2017. Consultants in 2003 rated questionnaires as more useful than consultants in 2017, although the specific questionnaires used by consultants did not change extensively over the 14-year period. Advantages in using questionnaires included efficiency, structure of assessment, consensual validation, and credibility, while limitations included lack of relevance, undermining of athlete-consultant relationship, interpretive problems, and cost and lack of access.

Evidence for the mechanisms of change by which sport psychology interventions enhance performance is limited and treatment monitoring and outcomes measures would assist in establishing evidence-based practices. The present paper fills a gap in sport psychology literature by demonstrating the development and validation of a new measure (Sport Psychology Outcomes and Research Tool; SPORT). Study 1 described test construction and pilot item selection with 73 collegiate student-athletes. Twenty-three pilot items contributed unique variance while maintaining the original constructs and were selected from 80 initial items. In Study 2, exploratory and confirmatory factor analyses were conducted with collegiate student-athletes (n = 220), revealing a 17-item, four-factor model measuring Athlete Wellbeing, Self-Regulation, Performance Satisfaction, and Sport-Related Distress. Concurrent validity was supported through correlational analyses. Overall, results supported the SPORT as a new transtheoretical tool for monitoring effectiveness and outcomes of sport psychology interventions.

Well-being research conducted in competitive athletics has been marred by the lack of a context-specific measurement instrument. The purpose of this study was to adapt the Mental Health Continuum – Short Form (MHC-SF) to create a sport-specific well-being instrument, the Sport Mental Health Continuum—Short Form (Sport MHC-SF), and test its initial psychometric properties. Participants were 287 collegiate athletes from a variety of sports. Confirmatory factor analysis (CFA) determined a three-factor structure of sport well-being, consisting of subjective, psychological, and social factors, as the model of best fit. Internal consistency reliabilities of the subscales exceeded .88. Moderate positive correlations were found between Sport MHC-SF subscales and quality of life indices, notably physical and emotional quality of life, demonstrating convergent validity. The Sport MHC-SF will facilitate empirical research by providing a more accurate and comprehensive measurement of well-being for an athletic population.

The conspicuous absence of validated screening measures specific to mental health symptomology in collegiate athletes has negatively affected clinical practice in this population. Therefore, this study was performed to develop a sport specific measure to optimally identify collegiate athletes who are particularly likely to benefit from mental health programming. Participants were 289 collegiate-athletes who were assessed for mental health symptomology using the Global Severity Index of Symptom Checklist-90-Revised (GSI), factors that interfere with sport performance using the Problems in Sport Competition Scale (PSCS) and Problems in Sport Training Scale (PSTS), and motivation to pursue professional counseling using the Desire to Pursue Sport Psychology Scale (DSPS). As hypothesized, a hierarchical multiple regression analysis indicated that PSCS, PSTS and DSPS scores significantly predicted GSI scores, controlling gender and sport status (NCAA, club, intramural). Receiver operating characteristic (ROC) analysis indicated that high-risk athletes (GSI T-scores ≥ 60) could be correctly classified by PSTS and PSCS scores. Results suggest the PSCS and PSTS may assist identification of collegiate athletes who are especially appropriate for mental health programs. These scales additionally identify factors directly relevant to athletes’ sport performance.

This manuscript seeks to offer insight about how coaches can better address drinking among collegiate student-athletes. Using a mixed-methods design, 519 NCAA coaches reported their attitudes and behaviors toward student-athlete drinking, and responded to open-ended questions about their perceived role, strategies, and challenges to addressing problems in this population. Three dimensions of coaches’ attitudes and behaviors toward student-athlete drinking emerged that were consistent regardless of the players’ or coach’s gender or division: Concerned Communication, Conditional Leniency, and Enforcement. Effective strategies identified by coaches included enforcement of policy, education about consequences of drinking, establishment of quality coach-athlete relationships, and management of athletes’ schedules. Coaches indicated the need to play a role in managing, educating, influencing, and supporting the student-athletes to prevent alcohol misuse. Coaches reported challenges regarding the culture of drinking on college campuses, individual differences (e.g., age) among student-athletes, acceptance and enforcement of the alcohol policy, lack of awareness about student-athletes’ activities, and identification of alcohol misuse.

This study investigated triathletes’ metacognitions and mindfulness traits (N = 232) measured prior to competition, and flow (N = 63), post competition. The primary aim was to investigate whether metacognitions (measured by the Metacognitions Questionnaire) would associate with mindfulness facets (measured by the Five Facet Mindfulness Questionnaire – Short Form), and metacognitions would also predict flow scores (measured by the Short Flow State Scale), over and above mindfulness facets. Regression analyses showed that metacognitions individually predicted mindfulness facets. A hierarchical regression showed that positive beliefs about worry negatively predicted flow, while a lack of cognitive confidence, beliefs about the need for thought control and acting with awareness positively predicted flow. These findings indicate that a) metacognitive beliefs are influential to cognitive predispositions, b) typically dysfunctional metacognitions may play a different role in competitive environments, and c) metacognitions may play a more important role in the occurrence of flow, than mindfulness.

College is a stressful time for many students, including student-athletes, who may benefit from mindfulness interventions focusing on present-moment awareness and nonjudgmental acceptance. Mindful sport performance enhancement (MSPE) has shown promise in previous open trials for promoting both athlete well-being and psychological factors related to sport performance, and this first randomized controlled trial of MSPE was conducted with mixed-sport groups of 52 NCAA Division III student-athletes. Each of the six sessions included educational, discussion-based, experiential, and home practice components, with meditation exercises progressing from sedentary mindfulness to mindfulness in motion. Whereas wait-list controls showed significant increases in depressive symptoms, those who received MSPE evidenced non-significant reductions in depressive symptoms over the course of treatment. Furthermore, once controls had also received MSPE, treatment completers (the 41% who attended at least five of six MSPE sessions) demonstrated significant increases in flow, trait mindfulness, satisfaction with life, and self-rated sport performance, along with reductions in worry, with medium to large effect sizes. There were no significant changes for treatment completers from post-treatment to 6-month follow-up, suggesting that improvements were maintained over time.