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Robert C. Hilliard, Lorenzo A. Redmond, and Jack C. Watson II

Although factors involved with help-seeking have been widely studied in the general college population, college student-athletes have received less attention. The purpose of this study was to examine the moderating role of self-compassion on the relationship between public and self-stigma, and how self-stigma was associated with attitudes toward seeking counseling. A sample of 243 student-athletes from NCAA Divisions I and III participated in the study. Using structural equation modeling, self-compassion was not found to moderate the relationship between public and self-stigma. However, public stigma was positively associated with self-stigma, and self-stigma was negatively associated with attitudes toward counseling. A multigroup analysis did not find differences between males and females for the model. The results of this study have implications for professionals who work with college student-athletes and suggest that efforts should aim to reduce stigma and examine alternative factors that might improve attitudes toward mental health help-seeking.

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Susanna Kola-Palmer, Samantha Buckley, Gabrielle Kingston, Jonathan Stephen, Alison Rodriguez, Nicole Sherretts, and Kiara Lewis

Player welfare is an important development in supporting elite athletes during their professional careers. Little is known about how player engagement with player welfare provision impact on mental health. Over two consecutive years, professional rugby football league (RFL) players were invited to complete an anonymous online survey assessing psychological stress, athletic identity, and attitudes to player welfare provision. Findings indicate that nearly half of respondents experienced symptoms of anxiety and depression. Multivariate analyses suggest that higher psychological stress and athletic identity and less knowledge and less positive attitudes to RFL mental health support is associated with worse mental health, whereas older age is associated with better mental health. The study has identified some key variables to focus on in developing player care and support management, and also suggest directions for future research guiding player welfare support, especially regarding increasing positive attitudes to mental health supports.

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Rachael E. Flatt and Craig Barr Taylor

Eating disorders (EDs) are common amongst athletes, yet few receive treatment. Given that athletes have a unique set of risk factors for eating disorders and are faced with additional barriers to treatment, new models outside of face-to-face treatment are necessary to reach the population and provide more affordable, tailored, evidence-based care. One solution is to use digital mental health programs to provide primary or supplemental therapy. Digital programs can provide accessibility and privacy, and recent advancements allow for more personalized online experiences. However, there have been no studies to date that integrate technology-based tools to address the especially high prevalence rates of EDs in athletes. This paper describes how an integrated model that includes online screening linked to guided self-help programs, all adapted specifically for athletes, can be used to provide prevention and intervention of EDs in athletes.

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Jenny H. Conviser, Amanda Schlitzer Tierney, and Riley Nickols

It is estimated that 1.6 million people in the United States are currently diagnosed with an eating disorder. Eating disorders (EDs) have high rates of morbidity and mortality and remain the most severe mental illness. Unfortunately, rates of EDs and disordered eating behaviors (DEBs) among athletes appear to be increasing. In this study, authors summarize ED-related risks that pose compromises in psychological and social functioning, medical health, and overall quality of life. The importance of early detection and formal evaluation in preserving the athlete’s health, well-being and sustaining successful sport participation, and performance are highlighted. Athlete-specific factors, which challenge the ease and accuracy of ED detection and assessment, are noted. The recommended components of effective ED assessment are identified, including use of self-report measures and clinical interviews conducted by ED certified and licensed professionals. The importance of being well informed in tenets of ED awareness, prevention and supporting early detection, and referral for formal ED assessment are noted. Conclusions reflect the vital roles that both the multidisciplinary sport personnel and the sport environment/culture play in reducing the serious health risks of DEBs and EDs. Each is needed to protect an athlete’s well-being while fostering safe and successful sport participation.

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Sasha Gorrell and Drew A. Anderson

Purpose: The current study evaluated associations between exercise identity (Exercise Identity Scale; EIS), compulsive exercise (Compulsive Exercise Test; CET), and their association with Eating Disorder Examination – Questionnaire (EDE-Q) scores among adult runners registered for mid- and long-distance races (N = 282, 48.2% male). Methods: Runners of half and full marathon races completed the EIS, CET, and EDE-Q. Results: Regression analyses indicated that increased EIS, b = −.21, and CET, b = −3.25, scores contribute to decreased eating pathology amongst half-marathon runners; a significant interaction effect emerged for EIS × CET scores, b = .08, such that relations between EIS and EDEQ scores were significant among runners reporting either lower or higher CET scores. These associations were not demonstrated in marathon runners. Conclusions: Results suggest that it is beneficial to consider running status when addressing the effect that exercise identity and compulsive exercise may have on eating pathology in competitive runners.

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A.P. (Karin) de Bruin and Raôul R.D. Oudejans

The aim of the study was to investigate if and how body image, taken from a contextual perspective, contributes to the eating disorder history. This qualitative study investigated the process of eating disorder development in eight elite women athletes in at-risk sports. The results showed that the relationship between eating disorder symptomatology and the sports environment was clearly recognized by the elite women athletes. Contextual body image, more specifically negative body-evaluations and upward body comparisons, appeared as an important factor in the development of eating disorders, particularly in the athletic context. It became clear that the two aesthetic and two endurance athletes as well as the two weight-class athletes in rowing described quite negative body evaluations in the context of sport, while some of them also recognized an impact of body image experiences in daily life. However, for both judokas, their eating disorder had nothing to do with their body image but was attributed to the weight-classes in their sport and accompanying weight making. Several unique trajectories and individual eating disorder histories were distinguished which confirms the value of taking a qualitative approach in investigating eating disorders in sport. We also discovered links between what the athletes had reported as contributors to their eating disorder history and how they told their stories by combining content analysis and narrative inquiry. Furthermore, the present study also highlights several critical aspects for prevention and treatment that should support sport federations and clinical sport psychologists in taking appropriate actions to deal more effectively with eating disorders in athletes.

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Hayley Perelman, Joanna Buscemi, Elizabeth Dougherty, and Alissa Haedt-Matt

Body dissatisfaction is associated with marked distress and often precipitates disordered eating symptomology. Literature on body dissatisfaction in athletes appears to be mixed, perhaps because athletes vary along several key characteristics related to how they experience their bodies. This study sought to investigate group differences in body dissatisfaction between sex (men vs. women), sport type (lean-promoting vs. non-lean-promoting), and division level (Division I vs. Division III). Collegiate athletes (N = 191) completed a self-report measure of body dissatisfaction, demographics, and sport characteristics. A factorial ANOVA revealed that women reported greater body dissatisfaction compared to men regardless of division level and sport type. There was an interaction between sex and sport type such that men in lean-promoting sports reported greater body dissatisfaction than men in non-lean-promoting sports. Findings suggest that some athletes participating in lean-promoting sports may be at risk of developing significant body dissatisfaction. Research on body dissatisfaction in collegiate athletes can be used to develop clinical interventions that aim to reduce body dissatisfaction and the potential of developing disordered eating and related psychopathology.

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Laura K. Fewell, Riley Nickols, Amanda Schlitzer Tierney, and Cheri A. Levinson

The current study tested if athlete patients differed from non-athlete patients in measures of eating disorder (ED) and related pathology. Athlete (n = 91 in Study 1; n = 39 in Study 2) and non-athlete (n = 76 in Study 1; n = 26 in Study 2) patients completed self-report measures, and body mass index (BMI) was calculated. Athlete patients had significantly lower ED symptomatology and depression than non-athlete patients (ps < .05). ED impairment, worry, psychosocial functioning, BMI, obsessive-compulsiveness, and compulsive exercise did not significantly differ between groups (ps > .08). Greater ED symptomatology was associated with higher psychosocial functioning among athlete patients and higher obsessive-compulsive symptoms and compulsive exercise among non-athlete patients. This is a novel study comparing ED symptomatology and related measures of mental health in athlete and non-athlete patients engaged in residential or partial hospitalization ED treatment. Future research should further investigate how participation in high-level sport impacts the presentation, treatment, and outcome of individuals with EDs.