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Raphael Frank, Insa Nixdorf, and Jürgen Beckmann

Findings on burnout and depression in athletes highlight their potential severity. Although both constructs are discussed in similar, stress-based concepts, it is unclear how they relate to each other. To address this issue, we conducted a crosssectional multiple linear regression analysis (MLR; N = 194) and a longitudinal analysis of a three-wave cross-lagged panel (CLP; n = 92) in German junior elite athletes. MLR showed that depression and burnout were both associated with chronic stress. Stress was a significant better predictor for both burnout and depression than each was for the other. CLP analysis on the constructs of burnout and depression revealed support for cross-paths in both directions. Thus, burnout and depression might cause each other to some degree, with no distinct direction of this link. However, as both syndromes do not fully explain each other, interchanging both terms and syndromes should be avoided. Preferably, future research might consider the transfer of knowledge between both syndromes to draw founded conclusions.

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Insa Nixdorf, Raphael Frank, Martin Hautzinger, and Juergen Beckmann

Depression among elite athletes is a topic of increasing interest, but empirical data are rare. The present study aimed to provide insight into the prevalence of depressive symptoms among German elite athletes and possible associated factors. In an online survey of 162 athletes, we explored depressive symptoms, chronic stress, coping strategies and stress-recovery states. Results indicated an overall prevalence of 15% for depression among elite athletes (n = 99), and revealed higher levels of depressive symptoms among the individual athletes than the team athletes. Furthermore, correlation analyses showed a significant connection between high levels of depressive symptoms and high levels of chronic stress, negative coping strategies and negative stress-recovery states. Results indicate that the prevalence for depressive symptoms in elite athletes is comparable to that in the general German population. Moreover, exploratory analyses provide first indications of factors associated with depressive symptoms.

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Katharina Diehl, Manfred Mayer, Frank Mayer, Tatiana Görig, Christina Bock, Raphael M. Herr, and Sven Schneider


In physical activity (PA) counseling, primary care physicians (PCPs) play a key role because they are in regular contact with large sections of the population and are important contact people in all health-related issues. However, little is known about their attitudes, knowledge, and perceived success, as well as about factors associated with the implementation of PA counseling.


We collected data from 4074 PCPs including information on physician and practice characteristics, attitudes toward cardiovascular disease (CVD) prevention, and measures used during routine practice to prevent CVD. Here, we followed widely the established 5 A’s strategy (Assess, Advise, Agree, Assist, Arrange).


The majority (87.2%) of PCPs rated their own level of competence in PA counseling as ‘high,’ while 52.3% rated their own capability to motivate patients to increase PA as ‘not good.’ Nine of ten PCPs routinely provided at least 1 measure of the modified 5 A’s strategy, while 9.5% routinely used all 5 intervention strategies.


The positive attitude toward PA counseling among PCPs should be supported by other stakeholders in the field of prevention and health promotion. An example would be the reimbursement of health counseling services by compulsory health insurance, which would enable PCPs to invest more time in individualized health promotion.