Athlete Mental Health Issues Quiz

Stress, Mental Health, and Wellbeing in Sport and Exercise Psychology

• Stress is a physical and mental response to a stressor.
• A stressor is a force that acts on a biological system.
• Distress is a psychological reaction to stressors. It can be emotional, cognitive, or behavioral.
• Stress is an imbalance in physiological systems, activating physiological and behavioral responses to restore balance.

Psychosocial Disorders in Athletes

• 1 in 3 athletes affected by a mental health issue.
• 16-34% of active and inactive athletes are affected by mental health disorders.
• Mental health issues in athletes are more prevalent than in the general population regarding anxiety and depression.
• Examples of mental disorders prevalent among athletes include:
  • Anxiety
  • Depression
  • Bipolar disorder
  • Self-harm/self-injury
  • Eating disorders
  • Substance use disorders
  • Suicidal thoughts
  • Sleep problems
  • Family issues

Defining Wellbeing

• Psychological well-being is about lives going well.
• This is a combination of feeling good and functioning effectively.
• It is not about feeling good all the time.
• Feeling good has to do with positive emotions like happiness, contentment, and interest, as well as engagement, confidence, and affection.
• Functioning effectively is about developing one's potential, having control over one's life, having a sense of purpose, and experiencing positive relationships.

Drivers of Well-being

• Personality is the strongest predictor of usual emotional style.
• Higher levels of Extraversion usually predict positive emotional traits.
• Higher levels of Neuroticism usually predict negative emotional traits.
• U-shaped relationship between age and mental well-being (a single item)
• Gender effect on ill-being, with little evidence for well-being.
• Marital status is associated with higher life satisfaction and lower rates of psychological ill-being. However causation is unclear.
• Socioeconomic factors generally only account for 10-20% of the variance in psychological well being when looking at individuals.
• Higher levels of income and socioeconomic status is a positive influence
• Higher educational qualifications usually have a protective function against poor mental health but this can decrease with more education.

Theories and Models of Stress and Coping

• Stimulus-oriented approaches:
  • Life-event theory (Holmes & Rahe, 1967)
  • Major life changes are stressful.
  • Accumulation of life changes affect health.
  • The Social Readjustment Rating Scale (SRRS) measures stress from life changes.
  • Negative correlations between life events and health are usually small.
• Reaction-oriented approaches:
  • General Adaptation Syndrome (Hans Selye, 1950)
  • Stress is a nonspecific response to any demand.
  • Stages include alarm reaction, resistance and exhaustion.
• Cognitive approaches:
  • Transactional Model of Stress (Lazarus & Folkman, 1984):
  • Stress is a relationship between person and the environment that's appraised as taxing or exceeding one's resources.
  • Conservation of Resources (Hobfoll, 1988):
  • Stress results from a reaction to the environment that involves the threat of loss or actual loss of resources.

Difficulties in Stress-Related Research

• Various definitions of stress.
• Different types of measures may include Perceived Stress Questionnaire, or Salivary free cortisol.

Coping Strategies of Athletes

• Gender Differences:
  • Female athletes show higher levels of anxiety and use emotion-focused coping strategies.
  • Female athletes experience more intense stress from coaches.
  • Female athletes are more likely to search for emotional/instrumental support.
• Performance Level Differences:
  • Elite male athletes more frequently use approach coping styles than avoidance.
  • Non-elite male athletes more frequently use avoidance coping styles.
  • Elite female athletes more frequently use avoidance coping styles.
  • Non-elite athletes use approach coping strategies more often.
• Coping Strategies and Mental Health
  • Problem-focused coping associated with lower anxiety.
  • Emotion-focused coping associated with higher neuroticism.
  • Proactive coping is positively correlated to moderate physical activity and self-efficacy.
• Functionality of coping strategies
  • Emotion-focused coping is associated with negative affect and neuroticism.
  • Problem-focused coping is associated with positive affect and low anxiety.
  • Emotion-focused and avoidance coping are associated with cognitive anxiety and neuroticism.

Coping during Competitive Suffering Episodes

• Negative feelings about goal attainment predict problem-focused coping use.
• Negative feelings about goal attainment strongly predict emotion-focused coping use.
• Avoidance coping use decreases over time.
• Endurance athletes who fall behind their goals during competition experience competitive suffering.
• Endurance athletes adapt their coping efforts to manage reactions to goal failure.
• Participants increase attempts to regulate and change the reality of the situation.

Physical Activity and Stress

• Physical activity has an effect on exercise
• Exercise has an effect on stress.
• Stress and exercise influence one another in a bidirectional relationship.
• Cross sectional studies demonstrate a negative relationship between exercise and perceived stress.
• Longitudinal studies show exercise can reduce perceived stress but also high stress may cause a decrease in exercise participation.
• Exercise buffers against health-damaging effects of stress. This occurs by increasing psychosocial resources and reducing stress responses.
• Exercise can have an effect on the stress-health relationship by moderating the effect.

Cross-stressor Adaptation Hypothesis

• Regular exercise leads to adaptations in stress response systems
• This decreases physiological responses to psychological stressors.
• Exercise helps the body regulate the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS).
• These systems have significant roles in the physiological stress reaction
• These adaptations to physical activity also translate into adaptations to psychosocial demands.

Physical Activity /Exercise and Affect/Depression/Anxiety

• Physical activity related to positive mood and effect.
• Aerobic exercise has positive effects on vigor and small-to-moderate negative effects on fatigue, confusion, depression, anger, and tension.
• Experimental trials support the effect of moderate exercise on psychological well-being.
• Exercise is related to positive changes in self-esteem and physical perceptions.
• Exercise may decrease depression by exerting a regulatory influence on the monoamine (neurotransmitter) system and the HPA axis.

Psychological Antecedents of Sport Injury

• Physical factors are the main cause of sport injuries.
• Psychological factors can contribute to incidents of sport injuries. The relationship between sport injuries and psychological factors is primarily stress related.
• Situations can be perceived as threatening provoking anxiety and muscle tension which increases the chance of injury.
• A framework for predicting and preventing stress-related injuries should consider many factors like attentional, behavioral, intrapersonal, social and stress history variables.
• Increases in general muscle tension and attention deficits happen often during stress.
• People with personality traits that worsen stress response and few coping resources will likely have a higher risk of injury when in a stressful situation.

Psychological States and Risk of Injury

• Perceived Physical energy is the biggest predictor of risk of injury
• Feeling socially unable contributes to higher risk of injury
• Feelings of sleepiness doubles the risk of injury.
• Light injuries occur more often in athletes who perceived their physical health as bad
• Medium injuries occur more often in athletes who perceived themselves as less trained and highly outgoing.
• Significant injuries occur more often in athletes who are in a bad mood prior to a match.

Psychological Response to Sport Injury and Rehabilitation

• Personality characteristics, history of stressors, coping resources, and interventions influence athletes' stress response and the subsequent likelihood of injury.
• The same factors that determine injury risk also influence athletes' psychological response to injury.
• Key premise: Each individual may respond differently to an injury due to how they perceive the meaning of the injury, consequences of the injury, and one's ability to cope.

Substance Use Disorders (SUDs)

• In DSM-5, Substance Abuse and Dependence are replaced by Substance Use Disorders.
• Diagnostic criteria, symptoms, and severity vary between substances.
• A problematic pattern of substance use, leading to clinically significant impairment or distress, may occur over a 12 month period.
• Common symptoms include tolerance, withdrawal, and use despite negative consequences.

Additional Considerations

• WHO 2001&2016 definitions of Mental Health
• General definition of Health as a continuum
• Mental health spectrum with different levels (e.g. mild, moderate, severe, etc.)
• Classifications systems for mental health problems from WHO (ICD-10) APA (DSM-5)