This case report described the use of behavioral activation when a former Olympic athlete developed depression after career termination. Four sessions were conducted, one session each week, followed by a boost session 1 month later. In Session 1, the former Olympic athlete displayed mild-to-moderate depression with anxiety and a low quality of life (Montgomery–Åsberg Depression Rating Scale = 21; Generalized Anxiety Disorder-7 Scale = 17; Brunnsviken Brief Quality of Life Scale = 44). By Session 3, the Olympic athlete no longer met the diagnostic criteria for clinical depression or anxiety (Montgomery–Åsberg Depression Rating Scale = 2; Generalized Anxiety Disorder-7 Scale = 7) and the quality of life was improved (Brunnsviken Brief Quality of Life Scale = 60). Follow-up assessments 1-year posttreatment confirmed that the former Olympic athlete continued to improve (Montgomery–Åsberg Depression Rating Scale = 0; Generalized Anxiety Disorder-7 Scale = 0; Brunnsviken Brief Quality of Life Scale = 96). This case report discusses the benefits of proactive support to elite athletes and the use of established clinical psychological treatments, for example, behavioral activation, when athletes develop health-related conditions.
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Ending an Elite Sports Career: Case Report of Behavioral Activation Applied as an Evidence-Based Intervention With a Former Olympic Athlete Developing Depression
Carolina Lundqvist
Well-Being in Elite Sport: Dimensions of Hedonic and Eudaimonic Well-Being Among Elite Orienteers
Carolina Lundqvist and Fredrik Sandin
This study examined subjective (SWB), psychological (PWB) and social well-being (Social WB) at a global and sport contextual level among ten elite orienteers (6 women and 4 men, median age = 20.4, range 18–30) by employing semistructured interviews. Athletes described SWB as an interplay of satisfaction with life, sport experiences and perceived health combined with experienced enjoyment and happiness in both ordinary life and sport. SWB and PWB interacted, and important psychological functioning among the elite athletes included, among other things, abilities to adopt value-driven behaviors, be part of functional relationships, and to self-regulate one’s autonomy. The ability to organize and combine ordinary life with elite sport, and the use of strategies to protect the self during setbacks was also emphasized. For a comprehensive theoretical understanding of well-being applicable to elite athletes, the need for a holistic view considering both global and sport-specific aspects of WB is discussed.
Positive Emotions Are Not Simply the Absence of the Negative Ones: Development and Validation of the Emotional Recovery Questionnaire (EmRecQ)
Carolina Lundqvist and Göran Kenttä
The purpose of this study was to psychometrically evaluate the Emotional Recovery Questionnaire (EmRecQ) and to describe athletes’ individual response patterns in five repeated assessments using the EmRecQ. Three samples were used. Samples 1 and 2 consisted of 192 and 379 (Mean age 16.4 years, SD = 0.7 and Mean age: 17.0 years, SD = 1.1) elite athletes from different sports. The third sample consisted of 20 (Mean age: 21.3, SD = 19.0) female elite basketball players. The EmRecQ is a 22-item questionnaire that assesses Happiness, Security, Harmony, Love, and Vitality. Results showed acceptable weighted omega reliability and construct reliability. Confirmatory factor analyses supported the a priori specified five-factor correlated model. Case profiles of repeated assessments revealed individual response patterns of the separate EmRecQ subscales that corresponded well with rated training load and total quality of recovery. The findings provide support for the EmRecQ’s psychometric properties and applied usefulness.
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.
Flotation REST as a Stress Reduction Method: The Effects on Anxiety, Muscle Tension, and Performance
Marcus Börjesson, Carolina Lundqvist, Henrik Gustafsson, and Paul Davis
The purpose of the study was to investigate the influence of flotation REST upon skilled and less skilled golfers’ anxiety in terms of physiological indicators of stress, self-rated anxiety scores, muscle tension, and the effect on golf putting. Prior to performing the putting task participants underwent a treatment of flotation REST or a period of resting in an armchair. Participants completed both treatments in a randomized order with a two-week interval. The results showed that both flotation REST and the armchair treatment reduced systolic blood pressure and heart rate, with no differences between treatments or athlete skill levels. No significant differences between treatments were revealed regarding self-ratings, level of muscle tension or putting precision. The results indicate that flotation REST may be useful for reducing negative symptoms related to stress and anxiety in general; however, no support for direct positive effects on golf performance were found.
Prevalence of Burnout in Competitive Adolescent Athletes
Henrik Gustafsson, Göran Kenttä, Peter Hassmén, and Carolina Lundqvist
This study examined the factorial validity of the Eades Burnout Inventory (EABI) and the prevalence of burnout in adolescent elite athletes and whether burnout is more common in individual sports than in team sports. The EABI was distributed to 980 athletes (402 females and 578 males) in 29 different sports. Confirmatory-factor analyses revealed an acceptable factorial validity for a theoretically supported four-factor model of the EABI. Between 1% and 9% of the athletes displayed elevated burnout scores on these four subscales. The hypothesis of higher prevalence of burnout in individual sports was, however, not supported. Furthermore, no correlation between training load and burnout scores was found. These findings suggest that factors other than training load must be considered when athletes at risk for burnout are investigated.
Sport Psychology Consultants’ Views on Working With Perfectionistic Elite Athletes
Ellinor Klockare, Luke F. Olsson, Henrik Gustafsson, Carolina Lundqvist, and Andrew P. Hill
The purpose of this study was to explore the views and experiences of sport psychology consultants who have worked with perfectionistic elite athletes and, particularly, their views on the use of cognitive behavioral therapy. Semistructured interviews were conducted with four professional sport psychology consultants who identified themselves as having experience of working with athletes they consider to be perfectionistic. Two themes were generated: manifestations of perfectionism and management of perfectionism. The consultants found perfectionistic athletes to have rigid attitudes and strong negative emotional experiences, to use safety behaviors, and to regularly underperform. Cognitive behavioral therapy techniques such as mindfulness, cognitive restructuring, and psychological skills training were most commonly used and were largely viewed as effective against a backdrop of sporting environment that could often encourage athletes to be perfectionistic. The findings highlight the complexity of perfectionism from a consultancy perspective and the potential challenges associated with working with perfectionistic athletes.