retired athletes mental health

Elite athletes estimates of the prevalence of illicit drug use: evidence for the false consensus effect. Neal TL, Diamond AB, Goldman S, et al. Roberts C-M, Mullen R, Evans L, et al. Suck it up: opinions and attitudes about mental illness stigma and help-seeking behaviour of male varsity football players. Peluso M, Andrade L. Physical activity and mental health: the association between exercise and mood. Wughalter EH, Gondola JC. Filaire E, Rouveix M, Pannafieux C, et al. Athletes reported greater negative feelings about their physical appearance and their body weight satisfaction than controls (, Literature review; body image in athletes and non-athletes, 19 studies with elite athletes, sex not reported, Overall findings highlighted that athletes had a more positive body image than non-athletes. Emotional reactivity and stressful life events were associated with poor on-field performance and injury [66, 67, 75, 82]. Hatzigeorgiadis A, Chroni S. Pre-competition anxiety and in-competition coping in experienced male swimmers. Our aim is that in developing retirement algorithms, support programs, and educational resources for athletes who are retired from sport, we can intervene early thus reducing the potential long-term psychological burden they may experience. Transcript NPR's Audie Cornish speaks with Rod Benson, retired basketball player and columnist for SFGATE, about the mental health of athletes and the future of sports press conferences.. This has sobering implications if elite athletes within such organisations are not provided with access to timely or adequate mental health care, or do not feel that the culture of the sporting organisation is such that they can even raise their mental health concerns. Hazardous drinking in NewZealand sportspeople: level of sporting participation and drinking motives. This is the story of a former college soccer player, Sarah Brink, and her experience with post-college grief. Disordered eating assessment for college student-athletes. Hausenblas HA, Symons Downs D. Comparison of body image between athletes and nonathletes: a meta-analytic review. The included studies were required to meet the following inclusion criteria: (1)participants were currently competing at the elite level, as able-bodied athletes, where the elite level was defined apriori to be competitive at either the Olympic, international, national or professional level; (2)the study reported quantitative data on a mental health, wellbeing or coping outcome; and (3)the study was published in English. Male athletes also scored higher in anxiety management and confidence. Female competitors indicated higher motivation, Mixed method; cross-sectional, observational, Psychological characteristics and performance, Athletes in this study showed low tension, depression, anger, fatigue and confusion scores, and high vigour scores. student-athletes with psychological concerns at the secondary school level: a consensus statement. 2015; 65:190-196. doi: 10.1093/occmed/kqu202. Abrahamsen FE, Roberts GC, Pensgaard AM. Diagnosis and psychiatric treatment of athletes. Terry was 22 years old and 6 feet 2 inches, with the kind of wavy hair sweatbands were made for. Delenardo S, Terrion JL. The football-specific stressor that was predictive of both health and job satisfaction outcomes was post-football uncertainty, Stress was mainly experienced prior to competition. Sixty quantitative studies were included in the review. Systematic review of barriers and facilitators to accessing and engaging with mental health care among at-risk young people. The self-report general-prevalence studies reporting smaller sample sizes (N<100) were relatively heterogeneous in outcomes. The site is secure. Higher levels of athlete anxiety were also found to be related to negative patterns of perfectionism [34]. That said, there may be subgroups of athletes at elevated risk of mental ill-health, including those in the retirement phase of their careers [44] or those experiencing performance failure [45]. 1Orygen, The National Centre of Excellence in Youth Mental Health, 35Poplar Road, Parkville, Melbourne, VIC 3052 Australia, 2Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC Australia, 3Orygen Youth Health Clinical Program, Melbourne, VIC Australia. Didymus FF, Fletcher D. Swimmers experiences of organizational stress: exploring the role of cognitive appraisal and coping strategies. High-quality, systematic studies on the nature and impacts of physical injuries in elite athletesmost notably, head injuries/concussion and limb injurieshave led to advances in how these injuries are optimally managed or, ideally, prevented. Psychological balance in high level athletes: gender-based differences and sport-specific patterns. Begel D. An overview of sport psychiatry. Eating attitudes and body shape perceptions among elite rowers: effects of age, gender and weight. The search yielded a total of 2279 records. Psychoeducation should also extend to substance usein particular, alcoholgiven the tendency for hazardous use (bingeing) outside competition periods [100] and the stigma related to athlete help seeking in this domain [61]. Adaptive, active coping strategies (such as problem solving, use of imagery, seeking social support and planning ahead) were frequently reported [66, 71, 81]; however, there was a tendency for athletes to engage in less adaptive (i.e. 8%) [56], which may be due to rigorous drug-testing procedures [58]. No studies were found that evaluated off-field expressions of anger or aggression. Athlete Mental Health. Onset of EDs was associated with prolonged dieting, weight fluctuation, sudden increase in training and traumatic events (e.g. Of the ten studies examining eating disorders and body image (see Table3), six were conducted with mixed populations [21, 3537, 40, 43], two with rowers [41, 42] and the remaining studies with distance runners [38] and figure skaters [39]. Venting of emotions, humour and denial were rated least frequently, Players generally coped well with the demands of elite competition; however, relative poor sleep quality was observed. student-athletes with psychological concerns at the collegiate level: An executive summary of a consensus statement. Need dissatisfaction assessed independently from need satisfaction may act to influence the wellbeing/stress pattern. Mood states of professional female tennis players. Using a harm minimisation strategy can work effectively alongside relevant anti-doping codes, Hazardous drinking and level of sport participation, Elite sportspeople reported higher rates of hazardous drinking than non-sportspeople and non-elite sportspeople. The literature search yielded a total of 2279 records. Stress appraisals, coping, and coping effectiveness among international cross-country runners during training and competition. Career termination can have a behavioral and emotional impact on the lives of retired elite athletes, consequently impairing future occupational and social functioning in these individuals ( Ogilvie & Taylor, 1993; Stephan, 2003; Taylor & Ogilvie, 1994 ). Of the females, 30% considered themselves overweight and 77% were terrified about gaining weight. Through research, we know some things can help ease the transition: . This review was conducted using an initial systematic approach and subsequently broadened to ascertain the scope of the current literature on sleep and mental health in current and retired athletes. Lower ratings of depression and distress were reported in highly achieving athletes [47] and in older versus younger female athletes [52], with global mood and anxiety predicting athlete performance [49]. In June, Katey Stone announced her retirement . Perceived ability predicted less performance worry for females and males, Quantitative; longitudinal, observational, Facilitative perceptions of anxiety symptoms were related to more adaptive cognitive and behavioural outcomes. 8600 Rockville Pike The findings suggested that elite athletes experience a broadly comparable risk of high-prevalence mental disorders (i.e. All of the included general-prevalence studies were cross-sectional in nature. Performance enhancement and the sports psychiatrist. performance or team success) and non-competitive spheres (i.e. Findings regarding the prevalence of eating disorders and body image concerns relative to the general population were inconsistent. The aggressive environment within locker rooms often preys on any perception of weakness, says Dr. Sacco. Research Strategy. http://creativecommons.org/licenses/by-nc/4./ Anxiety was the most cited emotion during training days and anger was the most cited emotion during match days. Difficulties Finding Employment doping) as opposed to personal use. Emerging research suggests that retired elite athletes may be at particularly elevated risk of mental ill-health [24], corresponding to both low rates of formal athlete mental health screening processes [25] and player perceptions of inadequate availability of mental health support [26]. Coping strategies based on problem solving and behavioural change were found to be the most effective in managing stress [64, 70, 77] and developing resilience [74]. GHB and ketamine). In addition to physical and competition stress, elite athletes face a unique array of workplace stressors, including the pressures of increased public scrutiny through mainstream and social media, limited support networks due to relocation, group dynamics in team sports and the potential for injuries to end careers prematurely [1317]. Three researchers independently assessed the eligibility of each retrieved record on the basis of the title and abstract. The objective of this review was to synthesise the growing evidence base regarding the incidence and nature of mental ill-health (including substance use) and psychological wellbeing among elite-level athletes in order to identify gaps that future research should prioritise, and inform strategies or guidelines to advance the detection and management of mental ill-health in this population. A budding area of research focuses on the transition out of competitive sport and how this impacts the mental health of retired athletes. where athletic performance is evaluated as threatening and is associated with elevated levels of arousal or worry) as opposed to generalised clinical or subclinical experiences of non-competitive anxiety, which are summarised in the general-prevalence studies listed in Table4. Acute sport-related stressors, coping, and emotion among professional rugby union players during training and matches. Arecent national survey of elite athletes in Australia found that almost half acknowledged symptoms of at least one of the mental health problems that were assessed, with prevalence rates similar to those reported in the community [23]. The search strategy for each database, MeSH descriptors and corresponding number of hits per database are presented in Electronic Supplementary Material Tables S1 andS2. While there have been efforts to disseminate sport-related mental health findings in order to advance the prevention, identification and early treatment of psychopathology in elite athletes, there are suggestions that some sporting governing bodies continue to minimise the significance of mental ill-health in this population [19]. Results indicated that prevalence of depressive symptoms in elite athletes was comparable to that in the general German population, Quantitative; cross-sectional, observational, retrospective, Psychological problems encountered, variations between sex and sport type, 17% of athletes had at least one ongoing or recent mental health disorder; higher rates of psychopathology were observed in females. The evidence base regarding the mental health and wellbeing of elite athletes is limited by a paucity of high-quality, systematic studies, including intervention trials. Prevalence of eating disorders in elite athletes is higher than in the general population. Quantitative BiologyClass of 2022 Background Prior Research Psychological risks of athletic injury (athletic identity, anger, boredom, depression, frustration, etc.) Glick ID, Kamm R, Morse E. The evolution of sport psychiatry, circa 2009. Koivula N, Hassmen P, Fallby J. Self-esteem and perfectionism in elite athletes: effects on competitive anxiety and self-confidence. Noblet AJ, Gifford SM. A retired basketball player messaged me on Instagram to discuss what his retirement was like. approach coping, social support) for managing symptoms of mental ill-health. Johnson U. Coping strategies among long-term injured competitive athletes: a study of 81 men and women in team and individual sports. Injury, errors on the sporting field, fatigue and club/organisational climate were identified as common sources of stress among elite athletes [66, 68, 69, 71, 81, 86]. For many athletes, retirement is a concept that they do not wish to think about in great detail. Most athletes perceived a high mastery climate and a low performance climate. Anxiety was a significant predictor of anger, while self-confidence was a significant predictor of control of anger. Nicholls A, Holt N, Polman R. Stressors, coping, and coping effectiveness among professional rugby union players. She was fined $15,000 after skipping a press conference due to concerns over her mental health. Hulley AJ, Hill AJ. Pensgaard A, Ursin H. Stress, control, and coping in elite athletes. The ten general-prevalence studies on elite athlete mental health (see Table4) reported data from either mixed samples [23, 46, 50, 51] or specific codes, including football [44], swimming [45], weight lifting [47], equestrian [48], distance running [49] and tennis [52]. Almost all included studies (N=59) defined their participants well and either reported use of standardised, validated questionnaires or clearly described the outcomes measured. The mental health of Australian elite athletes. For the purposes of reporting and analysis, studies were grouped according to the following major mental health constructs: anger and aggression (N=2) [29, 30], anxiety (N=4) [3134], eating disorder and body image (N=10) [21, 3543], general-prevalence studies (N=10) [23, 4452], help seeking (N=1) [11], sleep (N=1) [53], stress and coping (N=22) [6486], substance use (N=9) [5462] and wellbeing (N=1) [63]. Devantier C. Psychological predictors of injury among professional soccer players. Such models should capitalise on an early-intervention framework [102104], ensuring early detection and prompt access to high-quality, evidence-based interventions. Mental health of young people: a global public-health challenge. Regarding athletes mental health, we are still behind in recognizing how harmful the stigma can be to athletes. This paper was, in part, made possible from funding from several sporting bodies, all of whom requested anonymity. THE RESEARCH SHOWS THAT ELITE ATHLETES SPEND MOST OF THEIR LIVES FOCUSED ON PERFECTING THEMSELVES SO THAT THEY CAN BE THE BEST OF THE BEST AT THEIR SPORT. Inter-association recommendations for developing a plan to recognize and refer Four studies focused on anxiety in elite athletes (see Table2): two on swimmers [32, 33] and two on athletes from mixed sporting populations [31, 34]. Kotnik B, Tuak M, Topi MD, et al. Harcourt PR, Unglik H, Cook JL. Athletes indicated a tendency to hold back from responding to unexpected stressors. Share Mental Health Awareness: Athlete Identity and Career Retirement on Facebook; Tweet Mental Health Awareness: Athlete Identity and Career Retirement There was a trend (, Psychological variables associated with performance, Less interpersonal sensitivity, depression, psychoticism and psychological distress were reported in highly successful athletes. Mind, body and sport: understanding and supporting student-athlete mental wellness. Inclusion in an NLM database does not imply endorsement of, or agreement with, We have . Nicholls AR, Jones CR, Polman RCJ, et al. Injured athletes had higher levels of both symptoms of depression and generalised anxiety disorder, Before competition, 68% of athletes met criteria for a major depressive episode within the previous 3years (34% current), with higher rates observed in female athletes. Such an understanding is required to provide guidance for sport practitionersincluding coaches, medical staff and sport psychologistsin developing the coping abilities of elite athletes and, in turn, improving their emotional wellbeing [20]. Gutmann MC, Pollock ML, Foster C, et al. These guidelines show a growing emphasis on the need to provide specific and targeted support for the mental health needs of athletes. Increasing effort and blocking were used more often during competition. swimming, tennis, wrestling) and team-based sports (e.g. Prevalence of depression doubled among the elite top 25% of athletes assessed, and, within this group, performance failure was significantly associated with depression, Quantitative; cross-sectional, observational, comparison study, Psychological traits and any sex differences, Female athletes reported greater anxiety, while male athletes reported higher self-confidence scores and masculinity. Glick ID, Horsfall JL. Medical examinations undertaken by Dutch professional football clubs. Clinical staging: a heuristic model for psychiatry and youth mental health. Low social support from trainer or coach was associated with burnout, and low social support from teammates was associated with anxiety/depression, Overall, 46.4% of athletes were experiencing symptoms of at least one of the mental health problems assessed, with rates consistent with findings in epidemiological studies of international athlete and community samples: depression (27.2%), eating disorder (22.8%), general psychological distress (16.5%), social anxiety (14.7%), generalised anxiety disorder (7.1%) and panic disorder (4.5%). Of the two included studies that focused on anger and aggression (see Table1), one was conducted with rugby players [29], while the other was a case study of an elite table tennis player [30]. Common athlete-specific stressors noted across studies included injury, poor performance, fatigue and organisational factors, such as the coaching environment and coaching expectations. Wippert P-M, Wippert J. Over one third of the remaining studies (N=21; 45%) were assessed to be of moderate quality (scoring 3 out of5), while 24 studies (40%) were assessed to be of low quality (scoring 2 out of5). Questions that retired athletes often ask range from identity and transition to career. This review appraises the evidence base regarding the mental health and wellbeing of elite-level athletes, including the incidence and/or nature of mental ill-health and substance use. Despite potential stigma relating to athletes seeking drug-related information (i.e. Hamer M, Stamatakis E, Steptoe A. Dose-response relationship between physical activity and mental health: the Scottish Health Survey. Before Wiley; 2013. Summary of anger and aggression studies in elite athletes, Summary of anxiety studies in elite athletes, Summary of eating disorder (ED) and body image studies in elite athletes, EDNOSeating disorder not otherwise specified, Summary of general-prevalence studies on mental health in elite athletes, Summary of substance use studies in elite athletes, Summary of stress and coping studies in elite athletes, Summary of other mental health and wellbeing studies in elite athletes. Only social support had a significant impact on both psychological health and job satisfaction outcomes. Torstveit M, Rosenvinge J, Sundgot-Borgen J. One third of players had not been tested for drugs within the preceding 2years, and 60% felt that they were unlikely to be tested in the next year, Responses to stressful events were highly correlated with the athletes coping style (either approach or avoidance). The measure of global mood and trait anxiety accounted for 45% of the variance in athlete performance, highlighting the link between positive mental health and performance, Prevalence of depressive symptoms and possible associated factors, 15% prevalence of depression among elite athletes; higher levels of depressive symptoms observed among individual athletes than among team athletes. Arlington, VA: American Psychiatric Pub; 2012. In current players, major life events in the previous 12months were positively associated with distress, burnout and anxiety/depression. 7% of the sample indicated use of at least one illicit drug in the previous year, and one fifth reported having ever used cannabis. Below is the link to the electronic supplementary material. Dunn M, Thomas JO. When untreated, these issues can manifest into a range of clinical disorders. Furthermore, there is a lack of intervention-based research on this topic. Psychologists warn athletes without a plan or alternative career path will likely suffer serious mental health issues in retirement. Furthermore, self-confidence was higher in the elite group. Bruner MW, Munroe-Chandler KJ, Spink KS. Such efforts will enable the field to prosper and develop. A focus on success can hinder an athlete's prospects of planning for life after retirement. This study did, however, report relatively frequent sleep problems (delayed onset, frequent waking and daytime drowsiness) in 21.5% of athletes. There is comparatively less research on, but growing interest in, the mental health and psychological wellbeing of elite-level athletes [13]. Coaches perceived players to be relatively good at maintaining concentration and self-confidence, though relatively poor at controlling emotions and tension, Stress reactivity and emotional lability likely to be detrimental to performance and characteristic of less experienced athletes. Knowledge about the occurrence and timing of musculoskeletal, mental health and neurocognitive conditions among retired professional footballers can be used by a wide range of stakeholders to proactively intervene during and after a player's career to mitigate risk. Reardon CL, Factor RM. Given the paucity of research in the field [19], the present review took a broad and inclusive approach to study both outcomes and designs. the contents by NLM or the National Institutes of Health. There were 22 studies examining stress and coping in elite athletes (see Table6), comprising nine longitudinal studies [6472] and 13 cross-sectional observational studies [7385]. Lundqvist C, Raglin JS. Kristiansen E, Halvari H, Roberts GC. Pickswise has analyzed tweets sent to athletes. The effect size for this difference was small. 'Neuilly-on-Seine'), also known simply as Neuilly, is an urban commune in the Hauts-de-Seine department just west of Paris in France.Immediately adjacent to the city, north of the Bois de Boulogne, the area is composed of mostly select residential neighbourhoods, as well as many corporate headquarters and a handful of foreign . These studies focused primarily on the performance aspect of symptoms of anxiety (i.e. Hazardous drinking in elite NewZealand sportspeople. Kristiansen E, Roberts GC, Abrahamsen FE. Finally, the study examining athlete wellbeing identified distinct profiles, with feeling unappreciated, greater perfectionism and lower self-esteem impacting on athlete general wellbeing [63]. The intense mental and physical demands placed on elite athletes are a unique aspect of a sporting career, and these may increase their susceptibility to certain mental health problems and risk-taking behaviours [9]. Mental and psychosocial health among current and former professional footballers. Female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviours. Improved coping may be enabled by coaching staff emphasising a supportive training culture whereby athletes can interpret performance-related anxiety as facilitative, developing approach (as opposed to avoidance) strategies [31, 32]. While some mental health domains were relatively well represented by the included studies, other domainsparticularly athlete anger and aggression, help seeking and sleephad very few studies. All finalists used imagery extensively, but the better athletes reported a higher frequency of internal rather than external images, and better gymnasts experienced greater self-confidence, Mixed method; longitudinal, observational, Frequently cited stressors were injury concerns, mental errors and physical errors, with a general decline in frequency as the season progressed. Subjective ratings of physical and psychological wellness were sensitive to changes to weekly training, Psychological strengths profile; athlete and coach comparison, Ranking by players (greatest perceived strength to weakness): control of anxiety, maintaining concentration, planning and analysis, emotional control, use of imagery, maintaining self-confidence. Gastin PB, Meyer D, Robinson D. Perceptions of wellness to monitor adaptive responses to training and competition in elite Australian football. The one study examining sleep reported on a small sample of Australian Rules footballers (N=19) and found that match-related interstate air travel exerted relatively minimal effects on athlete sleep quality [53]. Anshel MH, Si G. Coping styles following acute stress in sport among elite Chinese athletes: a test of trait and transactional coping theories. . Four studies emphasised the impact of the coach in setting the organisational climate [72, 8284], noting the negative implications of a performance culture over a mastery culture for athletes stress. Stressful appraisals were associated with varied coping strategies, Coping with expected and unexpected stressors, Unexpected stressors were perceived as more threatening than expected stressors. Emerging research suggests that retired elite athletes may be at particularly elevated risk of mental ill-health , corresponding to both low rates of formal athlete mental health screening processes . While some still shy away, a lot of athletes are now openly discussing mental health especially due to the toll Covid-19 has taken. Schaal K, Tafflet M, Nassif H, et al. Eating disorders and health in elite women distance runners. Sport psychiatry: a systematic review of diagnosis and medical treatment of mental illness in athletes. avoidance-coping) strategies when faced with unexpected stressors [73, 76]. Waddington I MD, Roderick M, Naik R. Drug use in English professional football. While it is well established that physical activity has a positive effect on mental health [6, 7], a review has found that intense physical activity performed at the elite athlete level might instead compromise mental wellbeing, increasing symptoms of anxiety and depression through overtraining, injury and burnout [8].

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