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The Prevalence of Mental Health Conditions Among High School and Collegiate Student-Athletes: A Systematic Review

James E. Kaishian and Regina M. Kaishian

The physical impacts of overtraining, sport specification, and burnout are well documented in the literature; however, the state of the student-athlete’s (SA’s) mental health is something that needs to be investigated more comprehensively. Literature on SA mental health has gained prevalence within the last 5 years. The combination of pressure from sport and academics, as well as the stigmatization of clinical mental health treatment, can have a significant effect on the SA’s psyche. This review explores the prevalence of mental health conditions (MHCs) in high school and collegiate SAs. This includes signs and symptoms of mental health diagnoses to include substance- and alcohol-related addictive disorders and risk factors of such. A systematic review of the CINAHL, ERIC, SPORTDiscus, APA PsycINFO, and Rehabilitation & Sports Medicine resource databases was conducted. The initial search yielded 855 results. Following double screening, 22 studies were included, all of which were deemed medium to high quality. The findings indicate an alarming presence of MHCs ranging from risk factors of alcohol use and major depressive disorders among SAs. There was a high prevalence of mental health issues among SAs who are Black, Indigenous, people of color (BIPOC), and Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ). In most cases, participation in competitive athletics (varsity) did not contribute to additional MHCs for SAs. Sport psychologists should play a role in mental health programming within athletic departments. Athletic departments should develop proactive, targeted strategies to address MHCs for SAs.

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Preliminary Evidence for a Relationship Between Anxiety, Anger, and Impulsivity in Collegiate Athletes With Sport-Related Concussion

Megan M. Byrd, Anthony P. Kontos, Shawn R. Eagle, and Samuel Zizzi

This study used an exploratory mixed-method sequential design to examine anger, impulsivity, and anxiety following sport-related concussions (SRC). Ten college athletes (M = 20.10 years, SD = 2.92) completed four measures 1–10 days postconcussion (Visit 1) and 11–20 days postconcussion (Visit 2). At return to play or 30 days postconcussion, the athletes completed a semistructured interview (follow-up) to assess their lived experiences of the emotional sequelae of concussions. All participants indicated experiencing some level of anxiety at Visit 1, with half the participants scoring above the measure’s threshold for probable clinical diagnosis of anxiety. The results found a significant decrease in symptoms and anxiety at Visit 2. Inductive coding revealed frustration, irritability, impulsive behavior, and fear of the unknown as themes pertaining to athletes’ experiences. The findings highlight the need for sports medicine and sport psychology professionals to provide athletes with information to normalize their emotional responses during recovery.

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Exploring Student-Athlete Grit as a Mediator in the Relationships Between Parenting, Academic Success, and Mental Health Outcomes

Jackson M. Howard, Bonnie C. Nicholson, Michael B. Madson, Richard S. Mohn, and Emily Bullock-Yowell

Due to demand for high performance inside and outside of the classroom, student-athletes are a unique subsection of college students. Researchers have focused on investigating protective factors, which may enhance student-athlete well-being and academic success in higher education and reduce athlete burnout. The current study examined grit as a mediator between parenting behaviors and academic success, mental health outcomes, and burnout in higher education among National Collegiate Athletic Association Division I and Division II student-athletes (N =202). Overparenting behaviors were negatively associated with psychological autonomy granting, mental health outcomes, and athlete burnout. Psychological autonomy granting behaviors were positively associated with grit and negatively associated with mental health outcomes and athlete burnout. Student-athlete grit mediated the relationship between overparenting behaviors and mental health outcomes. Clinical implications include improving student-athlete parent onboarding protocol; student-athlete psychoeducation; and preventative outreach and health promotion among athletes, athletic staff, and university practitioners. In summary, these findings suggest that parenting behaviors and grit are factors that require more attention in fostering student-athlete success.

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Mental Health in Times of the COVID-19 Pandemic: Exploring the Impact on Well-Being Across the Athlete-Collegiate Career

David P. Schary and Carolina Lundqvist

In reaction to the COVID-19 pandemic, restrictive policies altered student-athletes’ academic and athletic life. Sparse research has investigated the pandemic’s effect on student-athlete mental health in terms of both negative (e.g., depression, anxiety) and positive (e.g., well-being, quality of life) dimensions. This study explored the effect of the COVID-19 pandemic on well-being and quality of life among National Collegiate Athletic Association Division I student-athletes at different stages of their collegiate career. Ninety-nine student-athletes (M age = 19.7 years, SD = 1.5) completed assessments on their mental health. Regression analysis revealed experiences directly related to COVID-19 did not affect general well-being or quality of life, but anxiety, depression, and significant insomnia did. Social well-being was lower for student-athletes closer to graduation (e.g., juniors, seniors), independent of reported anxiety and depression levels. These findings highlight the importance of psychosocial support, particularly in times of crisis, and indicate that tailored support might be beneficial at later stages of the collegiate years.

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The Relationship Between the Perceived Motivational Climate in Elite Collegiate Sport and Athlete Psychological Coping Skills

Mary D. Fry, Candace M. Hogue, Susumu Iwasaki, and Gloria B. Solomon

Psychological coping skills in sport are believed to be central to athlete performance and well-being. This study examined the relationship between the perceived motivational climate in elite collegiate sport teams and player psychological coping skills use. Division I athletes (N = 467) completed a questionnaire examining their perceptions of how caring, task-, and ego-involving their teams were and their use of sport specific psychological coping skills (i.e., coping with adversity, peaking under pressure, goal setting/mental preparation, concentration, freedom from worry, confidence/achievement motivation, and coachability). Structural equation modeling revealed positive relationships between perceptions of a task-involving climate and confidence/achievement motivation (β = 0.42) and goal setting/mental preparation (β = 0.27). Caring climate perceptions were positively associated with coachability (β = 0.34). These findings illustrate how encouraging athletes and coaches to create a caring, task-involving climate may facilitate athletes’ use of psychological coping skills and set athletes up to perform their best and have a positive sporting experience.

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Eating Behaviors Among Male Bodybuilders and Runners: Application of the Trans-Contextual Model of Motivation

Lisa Chaba, Stéphanie Scoffier-Mériaux, Fabienne d’Arripe-Longueville, and Vanessa Lentillon-Kaestner

This article focuses on two popular sports that can put male athletes at risk of developing an eating disorder: bodybuilding and running. Bodybuilders concentrate on gaining muscle mass and runners on leaning body mass. Based on the trans-contextual model of motivation, this study aimed to better understand the psychological mechanisms underlying eating disorders in these athletes. In all, 272 male bodybuilders and 217 male runners completed measures of sport motivation, theory of planned behavior variables (i.e., attitude, subjective norm, perceived behavioral control, and intention to gain muscle mass/lean body mass), and eating disorders (dieting, control, and bulimia behaviors). The results revealed satisfactory fit indices for both samples. Autonomous and controlled motivations for sport were positively directly and indirectly related to eating disorders in these athletes. This motivational mechanism needs more in-depth investigation, and motivational profiles might help distinguish athletes with and without eating disorders.

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Exploring the Association Between Sport Participation and Symptoms of Anxiety and Depression in a Sample of Canadian High School Students

Jessica Murphy, Karen A. Patte, Philip Sullivan, and Scott T. Leatherdale

The mental health benefits of physical activity may relate more to the context of the behavior, rather than the behavior of being active itself. The association between varsity sport (VS) participation, depression, and anxiety symptoms was explored using data from 70,449 high school students from the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior study. The model adjusted for potential covariates; interactions by sex and participation in outside of school sport (OSS) were explored. Overall, 70% and 24% of respondents met or exceeded cutoff values for depression and anxiety, respectively. Students participating in VS had lower symptoms of anxiety and depression compared with nonparticipants. Results were consistent regardless of OSS participation; associations were strongest among students who participated in both VS and OSS and males. Participation in VS may prove beneficial for the prevention and/or management of depression or anxiety symptoms, particularly among males. An additive beneficial effect of OSS on depression and anxiety scores may exist.

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Volume 15 (2021): Issue 2 (Jun 2021)

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A Time for Clinical Transformation: Emerging Implications From COVID-19 for Athlete Transition Research and Clinical Practice

J.D. DeFreese, Samuel R. Walton, Avinash Chandran, and Zachary Y. Kerr

The COVID-19 pandemic has resulted in changes to the structure of sport and the experiences of athletes. In this commentary, we consider how these changes, including schedule disruptions and the early termination of careers, have contributed to a reconsideration of how athlete transition should be defined, examined, and intervened upon. We outline our rationale for this proposed reconfiguration, including implications for researchers and practitioners working with athletes during the COVID-19 pandemic and beyond. For researchers, we recommend updating the transition definition, reconsidering the measurement of salient transition-related variables, and utilizing study designs/methods that best facilitate this work. For practitioners, we recommend considering the dynamic nature of transition within holistic athlete care, building momentum on mental health destigmatization achieved during the pandemic, athlete transition education, and clinician advocacy for transition-related resources for athletes. Ultimately, we hope this work will spark continued innovations in athlete transition research and practice moving forward.

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

Victoria Sanborn, Lauren Todd, Hanna Schmetzer, Nasha Manitkul-Davis, John Updegraff, and John Gunstad

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.