Prevalence of clinically elevated depressive symptoms in college athletes and differences by gender and sport

ArticleinBritish Journal of Sports Medicine 50(3):167-171 · February 2016with 695 Reads 
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Abstract
Background There are approximately 400 000 National Collegiate Athletic Association (NCAA) student athletes and 5–7 million high school student athletes competing each year. According to the US Department of Health and Human Services, the depression prevalence rate for young adults, which ranges from 10% to 85% across studies, is higher than that of other age groups. Given the relatively high prevalence of depression in individuals of collegiate age in the general population, the prevalence of depression among athletes in this age group warrants further study. This multiyear study examined the prevalence of depressive symptoms in college athletes, as well as demographic factors related to increased or decreased rates of depressive symptoms by gender and sport. Objective To describe the prevalence of depression symptoms among NCAA division I student athletes at a single institution over 3 consecutive years. Method Participants (n=465) completed a battery of measures during their yearly spring sports medicine physical across 3 consecutive years. The battery included the Center for Epidemiological Studies Depression Scale (CES-D) and a demographic questionnaire, administered during the course of routine sports medicine physical examinations. Differences in depressive symptoms prevalence and relative risk ratios were calculated by gender and sport. Results The prevalence rate for a clinically relevant level of depressive symptoms, as measured on the CES-D (CES-D ≥16), was 23.7%. A moderate to severe level of depressive symptoms was reported by 6.3%. There was a significant gender difference in prevalence of depressive symptoms, χ2 (1)=7.459, p=0.006, with female athletes exhibiting 1.844 times the risk of male athletes for endorsing clinically relevant symptoms. Conclusions The CES-D identified clinically relevant levels of depressive symptoms in nearly one-quarter of college student athletes in this large cross-sectional sample. Female college athletes reported significantly more depressive symptoms than males. Findings suggest that depression prevalence among college athletes is comparable to that found in the general college population. In light of these findings, sports medicine personnel may wish to implement depression screening and assessment of depressive symptoms across sports to identify at-risk athletes. Risk factors related to depression in college athletes warrant additional study.

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  • ... Similar to broader mental health research, most studies on self-reported depression in athletes have been conducted with college-level athletes (Wolanin et al., 2015). The prevalence rates in this population have been shown to vary from 15.6% (Proctor & Boan-Lenzo, 2010) to considerably higher; for instance, Wolanin, Hong, Marks, Panchoo, and Gross (2016) reported that 21% of male and 28% of female collegiate athletes experienced clinically relevant depressive symptoms. Corresponding rates in college athletes were also reported for males (19.2%) and females (25.6%) by Yang et al. (2007). ...
    ... Approximately one in five athletes reported clinically relevant symptoms of depression, with female athletes reporting a 30.6% and male athletes a 13.1% prevalence. Our study adds to the rapidly growing evidence-base that demonstrates clinically relevant depressive symptoms in athletes and reports overall prevalence rates that are comparable with those found in other studies (e.g., Beable et al., 2017;Wolanin et al., 2016). Our findings also support previously reported gender difference in athlete depression Note. ...
    ... and reaffirm that female athletes show higher levels of depressive symptoms than their male counterparts (Gulliver et al., 2015;Yang et al., 2007;Wolanin et al., 2016). We also found that athletes between the ages of 18-34 had higher depressive symptom scores than athletes 35 years and older and that injured athletes had significantly higher levels of depression than uninjured athletes. ...
    Article
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    Individual differences in vulnerability to depression are still underexplored in athletes. We tested the influence of different brooding and reflective rumination profiles (i.e., repetitive thought processes in response to low/depressed mood) on the odds of experiencing clinically relevant depressive symptoms in competitive athletes ( N = 286). The Patient Health Questionnaire–9 and the Ruminative Responses Scale–short form were utilized to measure depression and rumination, respectively. Compared to athletes with a low brooding/reflection profile, athletes with a high brooding/reflection profile had significantly higher odds of experiencing clinical levels of depressive symptoms (OR = 13.40, 95% CI = 3.81–47.11). A high reflection/low brooding profile was not, however, related to increased odds of depressive symptoms. Future research could extend our findings by exploring determinants of ruminative tendencies, especially brooding, in athletes. Furthermore, psychological interventions targeting rumination could be examined as a potential prevention and treatment approach to tackling depressive symptoms in athletes.
  • ... Depression affects over 300 million people of all ages worldwide [1]. Between 6% and 15% of those who suffer from mood disorders commit suicide [2]; suicide is either the leading or second-leading cause of death among people aged [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] in Australia, the United Kingdom (UK), and the United States (US) [3][4][5]. Depression is a debilitating disorder that can be challenging to diagnose clinically [6]. ...
    ... The initial database search yielded a total of 3,803 records, of which 16 studies [9,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] fulfilled the inclusion criteria and were included in this review ( Figure 1). ...
    ... All of the studies were conducted in Western countries. Seven studies were from the US [21,[29][30][31][32][33][34], three were from Germany [26][27][28], three from Australia [22][23][24], one from New Zealand [35], one from Canada [9], and one from Switzerland [25]. Seven studies focused solely on collegiate-level athletes [21,[29][30][31][32][33][34], and three focused on national-level athletes only [25,27,35], while others included athletes competing at the state, national, international and Olympic levels [9,[22][23][24]28,35]. ...
    Article
    Objective: To provide an up-to-date overview of the prevalence of depressive symptoms in high-performance athletes and describe the tools used to assess for these in order to identify knowledge gaps and potential future research priorities. Data sources: PubMed, EMBASE, SPORTDiscus, PsychINFO, and Cochrane were systematically searched from December 1993 to December 2018. Peer-reviewed original research articles reporting the prevalence of depression among high-performance athletes aged ≥ 17 years were included. Study selection: Sixteen studies satisfied the inclusion criteria, and seven had a low risk of bias. Data extraction: The Center for Epidemiologic Studies Depression Scale (CES-D) was the most commonly used tool to assess for depressive symptoms. The prevalence of those with high depression symptom cutoff scores ranged from 6.7% to 34.0%. Data synthesis: Higher levels of competition, injuries, > 3 concussions, and female sex were identified as potential risk factors for depression. Female athletes and athletes playing individual sports had high risk of having elevated depression symptom scores. Conclusions: Prevention of mental illness in high-performance sports is a novel and emerging field of research interest. This review highlights the prevalence of high depression symptom scores among high-performance athletes. The data collection methods, sample size, sport and athlete population, and tools used to assess depression vary across studies; thus, findings cannot be generalized. This review establishes the need for data collection enhancements with robust longitudinal study designs and standardized depression assessment tools to guide the development of evidence-based mental wellbeing interventions.
  • ... A total of 23.7% of college athletes reported clinically significant depressive symptoms over a 5year period using a validated depression screening tool (the Center for Epidemiological Studies Depression scale) in the largest published study to date in the sports medicine literature. 198 Female athletes are at higher risk for reporting depression symptoms than male athletes in the general population and in the limited studies in athletes. In the available studies of depression in college athletes by gender, female athletes are twice as likely to report clinically significant depression symptoms compared with male athletes. ...
    ... The authors noted that in an individual-based sport such as track, there is only one winner in any given event, whereas in a team-based sport, half the participants are winners. 198 The signs and symptoms of depression may be atypical in athletes. For example, a report of "lack of focus" in the athlete may not be a "lack of interest" in the sport but rather a sign of cognitive functional impairment resulting from depression. ...
    ... For example, although exercise is an accepted form of treatment for depression, college athletes are likely to report depressive symptoms at similar rates as their nonathlete peers. 198 This may be because athletes have unique risk factors for depression as a result of their athletic pursuits. Depression increases the risk for suicide, but it is unclear whether there is a cause and effect relationship rather than an associative one. ...
    Article
    The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practice document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health (MH) issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and MH providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact MH, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific MH disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.
  • ... Student-athletes are a unique group of students, representing over 12,000 registered athletes (USports, 2017), and many others participating at regional levels (e.g., Ontario University Athletics or Atlantic University Sport). Because of their dual-role situation, student-athletes have a significantly different university experience than their nonathlete counterparts, including different stressors and resources that may affect rates of mental health disorders (Davoren & Hwang, 2014;Miller & Hoffman, 2009;Wolanin, Hong, Marks, Panchoo, & Gross, 2016). Noted stressors of student-athletes identified in an American study included academic anxiety, demanding or negative coaching behaviours, injury risk, and sleep quality (Davoren & Hwang, 2014). ...
    ... Further examination revealed that being female was associated with relatively higher levels of psychological distress. These findings agree with the majority of the literature, which has found that female athletes show higher scores of anxiety and depression when compared to male athletes (Ichraf, Ali, Khaled, Liwa, & Ali, 2013;Junge & Fedderman-Demont, 2016;Shaal et al., 2011;Wolanin et al., 2016;Wolf, Eys, & Kelinert, 2015). When comparing scores between genders in different forms of anxiety, Ichraf et al. (2013) reported that females scored higher on cognitive anxiety scales, while males scored higher on somatic anxiety scales. ...
    ... There was a significant effect of sport type on psychological distress, whereby track and field athletes reported significantly higher psychological distress than hockey players. This is consistent with the findings of Wolanin et al. (2016), who found that female track and field athletes had the highest prevalence of depressive symptoms of all the athletes in their study. These results suggest that there may be something specific to the context of collegiate track and field that requires further investigation. ...
  • ... Results provide support for the importance of the coach-athlete relationship for athletes' wellbeing, although more research with larger and more diverse samples is necessary to confirm this relationship. Wolanin, Hong, Marks, Panchoo, & Gross, 2016). In a major study of college students, 28% of the female and 21% of the male student athletes reported symptoms of depression in the last 12 months; 31% of male and 48% of female student athletes reported symptoms of anxiety (Davorean & Hwang, 2014). ...
    ... Mental health is related to personal, inter personal, and environmental factors, such as personality, social support, and life stressors (Hammen, 2005;Kotov, Gamez, Schimidt, & Watson, 2010;Oexle & Sheehan, 2020). Among personal factors, gender (Storch, Storch, Killiany, & Roberti, 2005;Wolanin et al., 2016) and personality (Kotov et al., 2010) have been linked to mental health in the past (Brewer, 1993). For example, a survey of 398 undergraduate students showed that female student athletes had higher social anxiety and depression than male athletes and nonathlete students (Storch et al., 2005). ...
    ... The authors noted that women may be exposed to a greater number of stressors during their collegiate careers, internalizing these stressors more than their male counterparts, and feeling less satisfied with their overall collegiate experience (Storch et al., 2005). Another survey of 465 NCAA Division I student athletes found that women showed a risk 1.84 times higher than men of reporting depressive symptoms (Wolanin et al., 2016). ...
  • ... Open access of depression among athletes have ranged from 15.6% to 23.7%. [13][14][15] Wolanin et al 14 found track and field athletes in particular to be at an even higher risk of depression, displaying clinically relevant symptoms of depression at a rate as high as 34%. Athletes experience unique pressures, some of which may put them at risk of developing mental health issues such as depression. ...
    ... Open access of depression among athletes have ranged from 15.6% to 23.7%. [13][14][15] Wolanin et al 14 found track and field athletes in particular to be at an even higher risk of depression, displaying clinically relevant symptoms of depression at a rate as high as 34%. Athletes experience unique pressures, some of which may put them at risk of developing mental health issues such as depression. ...
    ... Across all sports, studies have found rates between 15.6% and 23.7%. [13][14][15] Wolanin et al 14 reported the rate of depression among track and field to be as high as 34%, three times higher than the 11% rate reported by coaches in this study. A potential hypothesis for this discrepancy between participants' estimates and previous research is that coaches may not realise how much their athletes are struggling with depression symptoms. ...
    Article
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    Background The rate of depression among collegiate athletes ranges from 16% to 23%, with particularly high findings of prevalence in track and field athletes (34%). Collegiate athletes have also been found to underuse mental health resources. Given this high prevalence of depression and demonstrated reluctance to seek help, it is important to explore the awareness and understanding of depression among the individuals who work most closely with this population. Objective To assess coaches’ knowledge and awareness of depression among their athletes and describe their level of interest in receiving continuing education. Method All National Collegiate Athletic Association Division I cross-country and track and field coaches were invited to participate in an online survey. The sample consisted of 253 participants, of whom 56 (25%) identified themselves as female and 170 (75%) as male with 14 (±10.4) years of coaching experience. Respondents completed the Adolescent Depression Awareness Program (ADAP) questionnaire and related questions. Differences in depression knowledge and interest in continuing education were calculated by gender, event specialty, length of coaching experience and certification history using analysis of variance and χ² analysis. Results The mean score on the ADAP depression questionnaire was 83%. Significant differences were not observed by gender, length of coaching experience, coaching title or certification history. Distance coaches scored significantly higher on the test than sprints coaches. Coaches estimated that 11% of their former and current student-athletes have struggled with depression. 77% of coaches indicated a ‘strong interest’ in receiving continuing education. Conclusions The findings of this study indicate the participating coaches have a good knowledge of depression for individuals without formal education on the topic but may lack depression awareness. This hypothesis is supported by the finding that coaches in the sample found out an athlete was suffering from depression most often by the athlete self-reporting.
  • ... In sport, researchers have identified that elite female athletes are more likely to report symptoms of depression than their male counterparts (Junge & Feddermann-Demont, 2016;Wolanin, Hong, Marks, Panchoo, & Gross, 2016); however, few researchers have explored sex differences in the rates of other mental disorders among elite athletes (Gulliver et al., 2015). In one of the few studies that has explored sex differences in the mental health of elite athletes, researchers found that female athletes were more likely to experience at least one mental disorder; specifically, females were more likely to be 3 A COMMENTARY ON MENTAL HEALTH RESEARCH IN ELITE SPORT diagnosed with anxiety, eating disorders, and depression, and were more likely to report sleep problems and behaviors of self harm compared to males (Schaal et al., 2011). ...
    ... The fact that males are less likely to seek help (McRae et al., 2016) compounded by greater perceptions of stigma among males athletes who conform to traditional masculine norms (Steinfeldt & Steinfeldt, 2012), may mean that when sport psychology researchers do explore sex differences in disorder prevalence, the rates of certain disorders among elite male athletes will be even further underreported. Therefore, the finding that elite female athletes are more likely to experience depression than their male counterparts (Gulliver et al., 2015;Wolanin et al., 2016) could reflect actual differences in the rates of depression among elite male and female athletes, but it may also reflect the impact of beliefs about mental toughness and stigma among males, leading them to underreport their symptoms. ...
    Article
    Full-text available
    Elite athletes may be as likely as members of the general population to experience mental disorders (Gorczynski, Coyle, & Gibson, 2017; Moesch et al., 2018), and there has recently been a surge of research examining mental health among athletes (Rice et al., 2016). This paper provides an overview and commentary of the literature on the mental health of elite athletes and explores how trends within and beyond the field of sport psychology have impacted this literature. Reviewing the contextual influences on this field, namely disorder prevalence, barriers to support seeking, mental toughness, and psychiatric epidemiology, are important to understand the broader picture of mental health research and to further strengthen work undertaken in sport psychology. In addition, appreciating the influence of various contextual factors on athlete mental health research can help to highlight where sport psychology practitioners may focus their attention in order to advance research and applied practice with elite athletes experiencing poor mental health. It is important that researchers consider how they measure mental health, how studies on the mental health of elite athletes are designed, implemented, and evaluated, and how both researchers and practitioners may help to combat athletes’ perceptions of stigma surrounding mental health. Considering topics such as these may lead to a deeper understanding of athlete mental health, which may in turn help to inform sport specific policies, applied practice guidelines, and interventions designed to enhance athlete mental health. Lay Summary: Recently, there has been an expansion of research on the mental health of elite athletes. We discuss some factors that have influenced the study of elite athlete mental health and how these factors continue to shape the field. We propose ways that researchers and practitioners may advance the field.
  • ... [20][21][22][23] Among collegiate athletes, the prevalence of mental health disorders ranges from 10% to 25% for depression and eating disorders. [24][25][26][27][28][29][30] During an elite sport career, generic and sport specific factors may combine to increase the risk of mental health symptoms and disorders. 31 32 Elite athletes may experience a greater overall risk of mental health symptoms and disorders compared with their athletic counterparts if they suffer severe musculoskeletal injuries, undergo multiple surgeries, suffer from decreased sport performance or tend toward maladaptive perfectionism. ...
    ... 185 Among North American athletes, track and field athletes had the highest rates of MDD compared with those in other collegiate sports. 29 Depressive symptoms may be more prevalent in individual sport athletes compared with team sport athletes. 12 29 189 Risk factors associated with depressive symptoms and MDD in elite athletes include: genetic factors (eg, family history); environmental factors (eg, poor quality relationships, lack of social support); 61 190 injury; 39 competitive failure; 39 retirement from sport; 191 pain; 192 and concussion. ...
    Article
    Full-text available
    Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations. Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
  • ... These huge demands push the student athletes to be perfectionists (Garinger et al., 2018), and this puts them at potential risk of mental health issues (Moreland et al., 2018;van Slingerland et al., 2018). In exploring the prevalence of depressive symptoms in student athletes in the US National Collegiate Athletic Association, Wolanin et al. (2016) found that 23.7% of the respondents had depressive symptoms, with 6.3% reporting having moderate to severe levels of depressive symptoms. In their review, Moreland et al. (2018) found that student athletes in the US were susceptible not only to depression and anxiety, but also to sleep disturbances, eating disorders, substance abuse, and even suicide. ...
    ... due to the small sample size and low response rate, this result is consistent with US findings that 23.7% of student athletes had depressive symptoms (Wolanin et al., 2016). The third possible high-risk group is international students (Table 1). ...
    Article
    Full-text available
    Background Limited studies have been conducted to investigate the mental health status of subgroups of university students. This study hypothesized that there would be differences among student subgroups in the prevalence of depression, anxiety and stress; and association of age, gender, academic performance and mental health status. Methods This was a cross-sectional survey study. Since 2014, first-year university students in a university in Hong Kong were invited to complete the Depression Anxiety Stress Scale (DASS-21) before the commencement of their study. These DASS data were then merged with objectively measured data from university records. 9,479 students completed the DASS survey, this being 56.5% of the total student population in the records. Kruskal-Wallis Tests were applied to compare the differences among student subgroups. Results Community college transfer (CCT) students were the highest-risk group for depression, anxiety and stress, and their study load was the highest as well. Unexpectedly, mainstream students ranked after the CCT students in the prevalence and levels of depression, anxiety and stress. Student athletes had the highest prevalence of depression. Although there were declining trends for depression, anxiety and stress, it was only a slight drop. Overall, age, gender, study load and academic performance were associated with the mental health profile (p<0.05). Limitations After admission, students’ mental health conditions could have changed. Further studies are needed to measure mental health during their study. Conclusions Mental health problems were not distributed evenly across different student subgroups, psychological support should be designed according to the needs of each student subgroup.
  • ... [20][21][22][23] Among collegiate athletes, the prevalence of mental health disorders ranges from 10% to 25% for depression and eating disorders. [24][25][26][27][28][29][30] During an elite sport career, generic and sport specific factors may combine to increase the risk of mental health symptoms and disorders. 31 32 Elite athletes may experience a greater overall risk of mental health symptoms and disorders compared with their athletic counterparts if they suffer severe musculoskeletal injuries, undergo multiple surgeries, suffer from decreased sport performance or tend toward maladaptive perfectionism. ...
    ... 185 Among North American athletes, track and field athletes had the highest rates of MDD compared with those in other collegiate sports. 29 Depressive symptoms may be more prevalent in individual sport athletes compared with team sport athletes. 12 29 189 Risk factors associated with depressive symptoms and MDD in elite athletes include: genetic factors (eg, family history); environmental factors (eg, poor quality relationships, lack of social support); 61 190 injury; 39 competitive failure; 39 retirement from sport; 191 pain; 192 and concussion. ...
  • ... College student athletes face an array of challenges, ranging from the typical stressors of competing at a high level in a sport to finding healthy social support networks that encourage a balanced life (Kissinger & Watson, 2009). The range of these challenges can contribute to feelings of depression, a common result of the isolation and personal identity views that student-athletes encounter, as well as extreme personal identity anxiety (Wolanin, Hong, Marks, Panchoo, & Gross, 2016;Kissinger, Newman, Miller, & Nadler, 2011;Storch, Storch, Killany, & Robarti, 2005). Participation has also been linked to struggles in the classroom, retention, and even unhealthy physical behaviors (Hood, Craig, & Ferguson, 1992;Richards & Aries, 1999;Shulman & Bowen, 2001;Aries, McCarthy, Salovey, & Banaji, 2004). ...
    Article
    Full-text available
    This paper examined self-efficacy and self-regulatory skills and their influence on achievement in an online learning environment. This study utilized the Online Academic Success Indicators Scale (OASIS). The results of the scale were compared to previous tests measuring the predictive nature of self-efficacy and self-regulatory skills on academic success for the purpose of applying these skills to an online environment. Statistical analyses indicate strong correlations between self-efficacy and self-regulatory scores for both online learning environments and traditional learning environments. These findings suggest that high self-efficacy and positive self-regulatory behaviors are reliable predictors of academic success in online courses. Additionally, these findings validate the OASIS as an effective tool for measuring self-efficacy and self-regulation in online instruction.
  • ... Vor allem exzessives Sporttreiben kann auch mit psychischen Risiken verbunden sein. Psychische Störungsbilder wie Depression oder Burnout werden am häufigsten bei jungen Athletinnen beschrieben, die Prävalenz unterscheidet sich jedoch kaum zwischen Sportlern und Nichtsportlern [46]. Bezogen auf den Breitensport gibt es Ausübungsmotive, die ungesunde psychische Faktoren begünstigen können. ...
    Article
    Full-text available
    Sportliche Aktivität wird im Allgemeinen mit einer positiven Wirkung auf die Gesundheit in Verbindung gebracht. Unter verschiedenen Umständen kann Sportausübung aber riskant für die Gesundheit sein. Dies betrifft in erster Linie körperliche Beeinträchtigungen durch Verletzungen, die durch die Sportausübung entstehen können. Wenn Sport in einem exzessiven Umfang betrieben wird, erhöht sich zudem das Risiko für psychische Störungsbilder wie Essstörungen, Substanzmissbrauch sowie Sportabhängigkeit. Der vorliegende Beitrag hat zum Ziel, potenzielle Risiken und Nebenwirkungen, die mit Sportausübung verbunden sein können, zu beleuchten und in Relation zu den positiven Auswirkungen auf die Gesundheit zu setzen.
  • ... Elite athletes deserve greater attention, as they are an at-risk population that currently receives little care. Not only should greater care given to the mental health needs of elite athletes (Wolanin, Hong, Marks, Panchoo, & Gross, 2016), but also greater care should be given to their spiritual and moral development . ...
    Article
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    Previous research on virtue development through sports participation has produced mixed findings; some studies find participation increases symptoms of mental illness and antisocial behaviors (Fauth, Roth, & Brooks-Gunn, 2007; Kavussanu, Boardley, Sagar, & Ring, 2013), whereas other studies find that participation increases mental health and prosocial behaviors (Flanagan & Bundick, 2011; Flanagan & Levine, 2010). Few studies examine the processes that lead to virtue development through sports participation. We examine how positive and negative forms of religiousness are associated with the virtue of patience versus anxiety. Pathways by which the virtue of patience can be fostered or inhibited were examined in an elite athlete sample composed of emerging and young adults (N = 97). Path analysis showed intrinsic religiousness is indirectly related to higher patience through meaning and cognitive reappraisal. Conversely, view of the divine as perfectionistically critical is indirectly related to higher anxiety through self-worth contingent on performance and fear of failure.
  • ... In particular, 6 % of athletes have generalized anxiety disorder, 33 % -sleep disturbance, and 43 % -depressive symptoms (Rice, et. al., 2016;Wolanin, et al., 2016). ...
    Article
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    Emotions significantly influence physiological processes in the athlete’s body. The level of his/her mental stress during training, competitions and recreation is obviously not the same. Taking into account the athletes’ well-known predisposition to alexithymia, there is a need to search for objective ways of the level of psycho-emotional stress assessment. Using the calculated Stress Index (SI), based on electroencephalogram indicators and level of situational anxiety as per the standard Spielberger-Hanin test, our work assesses and compares the differences in the athletes’ psycho-emotional state in various phases of the annual macrocycle. The study involved 155 athletes doing various sports. 96 athletes were males, their average age being 24.34 ± 3.54 years; 59 athletes were females with the average age of 23.12 ± 2.3 years. The control group consisted of 101 individuals who did not experience systematic high physical exertion, 53 of them being males with the average age of 23.17 ± 2.54, 48 — females with the average age of 22.12 ± 3.01 years. The athletes’ SI values are significantly different from those in the control group, as well as among themselves at various stages of the annual macrocycle. In the preparatory and transitional periods, the SI is significantly lower than in the control group. However, during the competitive period this index increases considerably. This is characteristic of a significant increase in the athletes’ psycho-emotional stress. There is a high positive correlation (r = 0.81) between the SI value and the number of points scored in the Spielberger-Hanin situational anxiety test
  • ... 4,5,[27][28][29] Screening studies among US college students have found the proportion of students screening positive for ROD to be between 23.5 and 38.5%. [32][33][34] Among study participants under 25 years of age, 57% screened positive for ROD at T 1 . The difference may be because of unmeasured factors or quite possibly the deployment itself, particularly given the stress associated with a sudden change of status. ...
    Article
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    Background Depression is a leading cause of healthcare use and risk for suicide among US military personnel. Depression is not well characterised over the shipboard deployment cycle, and personnel undergo less screening than with land-based deployments, making early identification less likely. Aims To determine the demographic and behavioural risk factors associated with screening positive for risk of depression (ROD) across the shipboard deployment cycle. Method Active-duty ship assigned personnel completed an anonymous assessment using the Center for Epidemiologic Studies Depression Scale (CES-D) in the year prior to deployment, during deployment and in the months following deployment. Longitudinal models were used to determine risk factors. Results In total, 598 people were included in the analysis. Over 50% of the study population screened positive for ROD (CES-D score ≥16) and over 25% screened positive for risk of major depressive disorder (CES-D score ≥22) at all time points. Lower age, female gender, alcohol use, stress and prior mental health diagnoses were all associated with greater odds of screening positive for ROD in multivariable models. Conclusions Although the risk factors associated with screening positive for ROD are similar to those in other military and civilian populations, the proportion screening positive exceeds previously reported prevalence. This suggests that shipboard deployment or factors associated with shipboard deployment may present particular stressors or increase the likelihood of depressive symptoms. Declaration of interest The authors are military service members (or employees of the US Government). This work was prepared as part of the authors' official duties. Title 17, U.S.C. §105 provides the ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17, USC, §101 defines a US Government work as work prepared by a military service member or employee of the US Government as part of that person's official duties. The views expressed in this research are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of the Army, Department of the Air Force, Department of Veterans Affairs, Department of Defense, or the US Government. Approved for public release; distribution unlimited. Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense.
  • ... As this was the case, some studentathletes believed their issues to be more serious than others. Much of the existing research on student-athlete mental health focusses on the incidence rates that this population experience diagnosable mental health disorders (e.g., Wolanin, Hong, Marks, Panchoo, & Gross, 2016). The current study should serve as a reminder that mental health is to be viewed on a continuum of severity, and that those who do not meet the clinical threshold for diagnosis may also seek help for their issues. ...
    This study investigated six National Collegiate Athletic Association Division I student-athletes’ experiences of seeking help for a mental health concern using the Health Belief Model (HBM) as a conceptual framework. A convergent mixed methodological design was utilized. Qualitative data was collected to gain an in-depth understanding of help-seeking, while quantitative data was collected to identify the most salient factors of the HBM. Results from the qualitative data identified numerous themes related to each factor of the HBM. Quantitative data may suggest that perceived benefits of seeking help and self-efficacy to seek treatment are important factors of help-seeking.
  • ... 2 For example, many investigators had reported that undergraduate students suffered from depression and are vulnerable to suicide attempt and completed suicide. [3][4][5][6][7][8] In a meta-analysis, Ibrahim et al also concluded that undergraduate students were more prone to depression with high prevalence. 9 Therefore, robust identification of unhappy students is critical to develop and apply specific interventions to at-risk individuals. ...
    Article
    Full-text available
    Background Subjective well-being (SWB), also known as happiness, plays an important role in evaluating both mental and physical health. Adolescents deserve specific attention because they are under a great variety of stresses and are at risk for mental disorders during adulthood. Aim The present paper aims to predict undergraduate students’ SWB by machine learning method. Methods Gradient Boosting Classifier which was an innovative yet validated machine learning approach was used to analyse data from 10 518 Chinese adolescents. The online survey included 298 factors such as depression and personality. Quality control procedure was used to minimise biases due to online survey reports. We applied feature selection to achieve the balance between optimal prediction and result interpretation. Results The top 20 happiness risks and protective factors were finally brought into the predicting model. Approximately 90% individuals’ SWB can be predicted correctly, and the sensitivity and specificity were about 92% and 90%, respectively. Conclusions This result identifies at-risk individuals according to new characteristics and established the foundation for adolescent prevention strategies.
  • ... Poor sleep in athlete populations is well-documented (Mah, Kezirian, Marcello, & Dement, 2018;Swinbourne, Gill, Vaile, & Smart, 2016), and the sleep domains of the S3SE and S5SE demonstrated the strongest convergent validity (rho > 0.6). General mental health is increasingly under the spotlight given the high prevalence of mood disorders and related symptoms, often in the absence of formal diagnoses (Drew & Matthews, 2018;Wolanin, Hong, Marks, Panchoo, & Gross, 2016). Baseline screenings like the S5SE and BSI-18 could provide a wealth of data that more accurately identify those who would benefit from preventative health interventions. ...
    Article
    Objective: The Sport Concussion Assessment Tool (SCAT), fifth Edition, Symptom Evaluation (S5SE) differs from previous versions by having examinees report trait (i.e. "typical" feelings) as opposed to state (i.e., "how you feel right now") concussion-like symptoms at baseline. This study assessed differences among, and convergent validity of, scores on the S5SE, SCAT3 Symptom Evaluation (S3SE), and the Brief Symptom Inventory (BSI-18). Methods: A total of 113 University of Florida varsity athletes completed symptom questionnaires on the same day in a counterbalanced administration. The final sample consisted of 94 participants (mean age ± SD = 18.4 ± 0.8 years, 57% male, 65% white) from 17 sports. We assessed convergent validity using Spearman rank-order correlations. Within-participant differences were analyzed with Wilcoxon Signed-Rank tests. We qualitatively described free-response answers to the S5SE question that asks, "if not feeling 100%, why?". Results: S5SE total severity score demonstrated adequate convergent validity with both the S3SE (rho = .407, p < .001) and BSI-18 (rho = .432, p < .001). Domain-specific analyses indicated variable convergent validity (rho < 0.4 to rho > 0.6). Severity scores did not differ between the S3SE and S5SE (p = .500), but 24.5% of participants reported S3SE > S5SE and 34.0% S5SE > S3SE. Three themes emerged from qualitative examination of reasons for "not feeling 100%": (1) tiredness/sleep, (2) adjustment difficulties, and (3) academic/athletic stress. Conclusions: Adequate convergent validity exists between SCAT5 and SCAT3 symptom severity in collegiate athletes. However, most examinees report different baseline symptom severity when asked to describe their trait (S5SE) versus state symptoms (S3SE). Clinicians should consider using the new SCAT5 Symptom Evaluation as a screening tool for identifying otherwise healthy or "undiagnosed" individuals who would benefit from targeted interventions.
  • ... Female athletes typically present more clinically relevant symptoms of depression than their male counterparts [15]. ...
  • ... 29 The most commonly reported barrier to sleep among college students is perceived stress. 25 Among individuals with clinically relevant manifestations of depression and anxiety (25% of all collegiate athletes 30 ), sleep disturbances include difficulty with sleep initiation and maintenance, circadian rhythm dysregulation and insomnia or hypersomnia. 31 In the 2018 American College Health Association (ACHA)-NCHA dataset, collegiate athletes with self-identified sleep problems were more than twice as likely to report feeling Review overwhelming anxiety, being so depressed it was difficult to function and considering suicide in the last 30 days compared with athletes who did not indicate sleep disturbance. ...
    Article
    Sleep is an important determinant of collegiate athlete health, well-being and performance. However, collegiate athlete social and physical environments are often not conducive to obtaining restorative sleep. Traditionally, sleep has not been a primary focus of collegiate athletic training and is neglected due to competing academic, athletic and social demands. Collegiate athletics departments are well positioned to facilitate better sleep culture for their athletes. Recognising the lack of evidence-based or consensus-based guidelines for sleep management and restorative sleep for collegiate athletes, the National Collegiate Athletic Association hosted a sleep summit in 2017. Members of the Interassociation Task Force on Sleep and Wellness reviewed current data related to collegiate athlete sleep and aimed to develop consensus recommendations on sleep management and restorative sleep using the Delphi method. In this paper, we provide a narrative review of four topics central to collegiate athlete sleep: (1) sleep patterns and disorders among collegiate athletes; (2) sleep and optimal functioning among athletes; (3) screening, tracking and assessment of athlete sleep; and (4) interventions to improve sleep. We also present five consensus recommendations for colleges to improve their athletes’ sleep.
  • ... On the basis of the conceptual model for the effects of PA on mental health outcomes, individuals that prefer to engage in individual sports may equally derive mental health benefits, depending on individual preferences and character traits. In professional athletes, higher average depression scores were found in individual rather than in team sport athletes [30,31], while one study found no difference in levels of depression between individual and team athletes [32]. Social support and relationships in team sports may protect the athlete from developing depressive symptoms. ...
    Article
    Full-text available
    Purpose. Physical activity (PA) can protect from developing mental disorders. Knowledge regarding optimal PA intensity, type, context, and amount for mental health is sparse. this study aims to determine the relationship between leisure-time PA and prevalence of depression and anxiety, and whether associations vary by PA amount, context, intensity, and type. Methods. Overall, 682 recreational athletes (age: M = 33.0 years; SD = 12.4; 53% female) completed a questionnaire on personal characteristics related to their leisure-time PA behaviour, the centre of Epidemiologic Studies Depression Scale (cES-D), and the Generalized Anxiety Disorder (GAD-7) scale. Effect sizes (cohen's d, ² partial) and power analyses using G*Power were applied. Results. Individuals who met PA recommendations (n = 596) reported lower depression scores (M = 11.69; SD = 8.57) than those who did not meet the recommendations (n = 86; M = 12.88; SD = 8.73). Lowest depression and anxiety scores were observed for indoor team athletes (M = 10.75; SD = 7.66 and M = 2.94; SD = 3.03, respectively), followed by outdoor individual athletes (M = 11.17; SD = 9.41 and M = 3.39; SD = 3.50, respectively). Under specific conditions, high depression scores were noted for vigorous-intensity PA levels (M = 20.5; SD = 4.94). Conclusions. Meeting the WHO PA recommendations (moderate-intensity PA 150 min/week) reduces symptoms of depression and anxiety. However, no linear dose-response relation was observed. No differences were found between in- and outdoor or team and individual sports but between sport disciplines. Prospective research to evaluate the reasons is needed.
  • ... Furthermore, adolescent depression was a strong predictor of mental disorders during adulthood [2]. For example, many investigators had reported that undergraduate students suffered from depression and are vulnerable to suicide attempt and completed suicide [3][4][5][6][7][8]. In a metaanalysis, Ibrahim also concluded that undergraduate students were more prone to depression with high prevalence [9]. ...
  • ... This protocol was not successful in collecting any complaints of mental illness, which is a concern in elite athletes. [84][85][86][87] These findings suggest that monitoring illnesses may be more challenging, potentially due to athlete perception around illness confidentiality. ...
    Article
    Full-text available
    Objective: To develop and implement a prospective varsity athlete surveillance system to identify injury and illness trends in a multisport varsity-level university setting. Design: Longitudinal prospective surveillance study. Setting: Varsity-level sport program at the University of Guelph, Guelph, ON, Canada. Participants: Athletic therapists (ATs) (n = 35) from 17 varsity sports provided injury and illness information on 624 varsity-level athletes (381 men and 243 women) during the 2016/2017 competitive season. Interventions: Team ATs reported athlete health complaints weekly. Athletes reported additional details on the injury or illness that was reported. Main outcome measures: The outcome measurements included when the injury or illness occurred, anatomical location, diagnosis, cause, perceived severity, treatment, estimated athlete exposure (AE) to training and competition, and time loss from sport. Measures were recorded from the teams' first competition through to the end the season and/or playoffs. Results: Twenty-nine of 30 varsity sports teams participated in this injury and illness surveillance protocol. The compliance of team ATs and varsity athletes was 89% (men: 94%, women: 82%). The overall injury and illness rates were 5.5 injuries and 1.7 illnesses per 1000 AEs, respectively. Men's injury rates were greater than women's, and injury rates of contact sports were greater than noncontact sports. Conclusions: The utilization of a prospective injury and illness surveillance protocol in the Canadian University sport system is feasible with good athlete, AT, and coach acceptance. The surveillance data should inform future injury and illness prevention strategies.
  • ... From a mental health perspective, due to links between sleep and depression, female athletes may be more vulnerable to depression and anxiety symptoms (Stracciolini, McCracken, Milewski, & Meehan, 2019). In a study of 465 athletes who competed on NCAA-sponsored teams, nearly a third of the women in the study demonstrated signs of depression compared to 18% of men (Wolanin, Hong, Marks, Pancho, & Gross, 2016). Data from NCAA surveys from 2008 and 2012 showed that 48% of female collegiate athletes reported having depression or anxiety symptoms (Brown, Hainline, Kroshus, & Wilfert, 2014). ...
    Technical Report
    Full-text available
    Girls and Women shines a light on the current landscape for girls and women in sport reflected in the latest data from nearly 500 research reports and results from a new national survey of more than 2,300 women working in women's sport. Taking stock of where we are in achieving gender equity in sport requires study, transparency and candor. This groundbreaking report brings together the latest facts and milestones and elevates the voices of women offering fresh insight and perspective. Importantly the report includes calls to action to help propel momentum for change. Stakeholders in all areas of sport, from grassroots to high school, college and elite athletics, collegiate administrators, coaches, policymakers, leaders in the corporate and media sectors all have a critical role to play. The WSF is committed to keeping these conversations at the forefront and working collaboratively with others to accelerate the pace of change. Continued progress depends on comprehensive, up-to-date information in real time. Only when we operate from a shared understanding of the landscape can we ensure thoughtful conversation and sound decision-making necessary for progress. From playing fields to board rooms, girls and women continue to live out their passion for sport. As these accomplishments are celebrated, let's continue to examine the gaps and opportunities to ensure that all girls and all women can get in the game. Only then will we be able to realize the full potential unleashed by sport. All girls. All women. All sports.
  • ... The CES-D scale was developed by Radloff (1977) and is a self-reported depression scale that reflects various aspects of depression, including depressed mood, and feelings of worthlessness, helplessness and hopelessness, among others. The CES-D scale is considered a reliable measure of SWB and has been widely used in the literature (Arbona, Burridge, & Olvera, 2017;Stagl et al., 2015;Steptoe & Wardle, 2012;Wolanin, Hong, Marks, Panchoo, & Gross, 2016). The ELSA measure of depression adopted for use in our analysis provides a count of the number of CES-D questions to which respondents answered "yes". ...
    Chapter
    In this concluding chapter, the authors reflect on the chapters of the book, Measuring, Understanding and Improving Wellbeing Among Older People, and provide critical discussions on how policy aimed at improving the wellbeing of older people can be more effective. The authors examine the role of discourses of ageism in scientific and popular discourse and how these discourses can negatively influence and affect even well-intended policies and interventions. They further advocate for policies and interventions aimed at improving the wellbeing of older people to adopt an intersectionality lens to better capture disadvantages older people may have due to various vulnerable social identities.
  • ... Furthermore, the same study reported that 21% of male athletes and 28% of female athletes have suffered from depressive symptoms, which is just slightly lower than the non-athlete prevalence of 30% [23]. Other studies showed a prevalence of depression among 15% to a quarter of athletes [24,25]. Additionally, based upon a survey study in 2007, a large gap was identified between the amount of mental health issues presented and the number of available health-care providers who can refer the athletes to trained mental health specialists [26]. ...
    Article
    Full-text available
    INTRO: To determine clinical parameters that are related to abnormal cardiac symptoms in physically active youth. METHODS: We used the Simon’s Heart Heartbytes National Youth Cardiac Registry to collect data from adolescent athletes in southeastern Pennsylvania. We collected age, race/ethnicity, abnormal cardiac symptoms, medical history, medication use, caffeine intake, and family history. We obtained height, weight, blood pressure, cardiac murmur findings, and ECGs. Echocardiogram was obtained if necessary. Binary logistic regression analysis was performed to identify independent associations between abnormal cardiac symptoms and collected variables. The odds ratio (OR), 95% confidence interval (95% CI), and p-values were used as statistical values. RESULTS: Of the 887 athletes (543 males and 344 females, age=16.9±2.1 years, height=166.9±11.4 cm, weight=62.0±16.0 kg), 186 (21%) had abnormal cardiac symptoms including chest pain, passing out, difficulty breathing, extreme fatigue, and heart race. There was an independent association between abnormal symptoms and a past medical history (OR: 4.77, 95%CI: 3.18, 7.17, p=0.001) and medication use (OR: 1.74, 95%CI: 1.08, 2.79, p=0.022). In the medical history, young athletes with asthma showed greater propensity of abnormal cardiac symptoms (48.9%) compared to young athletes without (14.0%, p=0.001). Additionally, young athletes with anxiety or depression demonstrated higher proportion of abnormal cardiac symptoms (48.9%) than those without (19.5%, p=0.001). Although the association between the presence of abnormal symptoms and African-American race (OR:2.04, 95%CI: 0.96, 4.35, p=0.065) and average daily consumption of at least 2 caffeine drinks (OR:2.08, 95%CI: 0.86, 5.02, p=0.103) were not significant, there was a trend to reach the a priori significance level. CONCLUSIONS: This study identified several clinical parameters that are associated with symptoms suggestive of abnormal cardiac conditions. Larger studies need to be done to better sort out the clinical history that may contribute to false positives to further reduce false positives at heart screenings.
  • ... In sport, this psychological disorder is also a considerable challenge. Depending on the sample and the assessment method, prevalence rates appear to be at a concerning level, averaging around 20% Gulliver et al., 2015;Wolanin et al., 2016). However, there is little evidence pointing out underlying mechanisms and factors which would help preventing syndromes of depression in sports . ...
    Article
    Full-text available
    There exists a strong need for research in clinical sport psychology which does not merely gather information on prevalence rates for psychological disorders and case studies of affected athletes. Rather, research should also uncover the underlying psychological variables which increase the risk for depression and burnout in elite athletes. Many studies gather general factors (e.g., gender, injury, sport discipline) and stay on a more descriptive level. Both constructs (burnout and depression) are based on a temporal, stress-related process model assuming the development of either syndrome results from unfavorable personal (e.g., dysfunctional attitudes, perfectionism, negative coping strategies) or environmental (e.g., cohesion) factors coexisting with severe stressors (i.e., chronic stress). Integrating this knowledge, we propose a shared model for depression and burnout in athletes: a sport specific diathesis-stress model. The present longitudinal study assesses data throughout one sporting season to analyze predictors for both constructs in junior elite athletes. Hierarchical multiple linear regression analyses resulted in six predictors for best model fit. The following factors demonstrated a significant impact on predicting (a) burnout or (b) depression scores at the end of the season: dysfunctional attitudes (a and b), coping strategies (a and b), perfectionism (a), recovery (b), stress (a) and the level of depression at onset (b). Variables such as cohesion or attributional style did not significantly predict depression or burnout. The study supports the structure of a process model (diathesis-stress model) for burnout and depression with the assumption of temporal progression. With some vulnerabilities and their temporal, developmental link identified, prevention can become athlete-specific, effective and economical.
  • ... The CES-D scale was developed by Radloff (1977) and is a self-reported depression scale that reflects various aspects of depression, including depressed mood, and feelings of worthlessness, helplessness and hopelessness, among others. The CES-D scale is considered a reliable measure of SWB and has been widely used in the literature (Arbona, Burridge, & Olvera, 2017;Stagl et al., 2015;Steptoe & Wardle, 2012;Wolanin, Hong, Marks, Panchoo, & Gross, 2016). The ELSA measure of depression adopted for use in our analysis provides a count of the number of CES-D questions to which respondents answered "yes". ...
    Book
    “This book uses diverse methods in a range of different contexts to research a pressing problem of our time – how to support the wellbeing of the elderly. It is essential reading for anyone working in this field.” -- Paul Dalziel, Professor of Economics, Lincoln University, New Zealand. How can we be happier, healthier and more satisfied in life? This edited collection examines various dimensions of wellbeing among older people, including its measurement; social, environmental and economic determinants; and how research can be translated into policy to improve quality of life for older people. With an increasingly ageing population across countries and an increasing population of older adults, there is growing interest in improving older people’s ability to live healthily and happily. With a focus on retirement and aged care, this book is important reading for those interested in Welfare Economics, Health Economics and Development. Sefa Awaworyi Churchill is an Associate Professor and Principal Research Fellow with the School of Economics, Finance & Marketing at RMIT University, Australia. He holds a PhD in Economics from Monash University. His inter- disciplinary research focuses on development economics, addictive behavior, ethnic diversity, wellbeing, and other issues related to sociology, health and economics. He has experience working on consultancy projects for various policy agencies and international development organizations. Lisa Farrell is Professor and Deputy Dean (Research and Innovation) in the School of Economics, Finance and Marketing at RMIT University, Australia. Her research field is in the area of applied microeconomics, with a particular focus on important contemporary social issues such as subjective wellbeing, decision making under uncertainty and lifestyle choice behaviours. Samuelson Appau is Lecturer in Marketing in the School of Economics, Finance and Marketing at RMIT University, Australia. His research focuses on how factors such as poverty, religion and social processes and structures impact consumer wellbeing.
  • ... The CES-D scale was developed by Radloff (1977) and is a self-reported depression scale that reflects various aspects of depression, including depressed mood, and feelings of worthlessness, helplessness and hopelessness, among others. The CES-D scale is considered a reliable measure of SWB and has been widely used in the literature (Arbona, Burridge, & Olvera, 2017;Stagl et al., 2015;Steptoe & Wardle, 2012;Wolanin, Hong, Marks, Panchoo, & Gross, 2016). The ELSA measure of depression adopted for use in our analysis provides a count of the number of CES-D questions to which respondents answered "yes". ...
    Chapter
    Using seven waves of the English Longitudinal Survey of Ageing (ELSA), this chapter examines the impact of labour market attachments on subjective wellbeing (SWB) and quality of life (QoL), during employment and retirement. The authors show that that permanent employees (as opposed to temporary employees) and self-employed (as opposed to paid employees) report higher levels of SWB and QoL throughout their working lives. They argue that this is because permanent employees and the self-employed become more attached to their jobs due to a perceived stronger job-identity fit. However, in retirement, withdrawal from the labour market represents a loss of this identity. Thus, a significant drop in SWB and QoL is observed for permanent employees and self-employed during retirement.
  • ... The CES-D scale was developed by Radloff (1977) and is a self-reported depression scale that reflects various aspects of depression, including depressed mood, and feelings of worthlessness, helplessness and hopelessness, among others. The CES-D scale is considered a reliable measure of SWB and has been widely used in the literature (Arbona, Burridge, & Olvera, 2017;Stagl et al., 2015;Steptoe & Wardle, 2012;Wolanin, Hong, Marks, Panchoo, & Gross, 2016). The ELSA measure of depression adopted for use in our analysis provides a count of the number of CES-D questions to which respondents answered "yes". ...
    Chapter
    This chapter examines the discourse on the relationship between culture and wellbeing of elderly persons, based on ethnographic study of accused witches in northern Ghana. The authors find that elderly people are mostly accused of witchcraft and are violently banished from their communities to live in witch camps; this has serious negative impacts on their wellbeing. The chapter therefore problematizes and examines the aspects of cultural practices and discourses that legitimize such ill-treatment of elderly persons. The authors also discuss implications for policy, government and other agencies working with the elderly to improve their wellbeing.
  • ... The literature highlights the collectivity as an element that benefits individuals´ mental health (Nixdorf et al., 2016;Wolanin et al., 2016). When there are teammates, the individual can divide the conflicts and the results (Alloy et al., 2006;Hanrahan and Cerin, 2009), experiencing less stressful events alone. ...
  • ... Sleep restriction has been demonstrated to have a negative impact on attention and reaction times. [134][135][136][137] Furthermore, it has been demonstrated that reaction times are adversely impacted after only a 1-night, complete sleep deprivation. 74 Sleep extension, conversely, has been shown to improve reaction times by 15% and also improve objective daytime sleepiness, 138 in a study of student athletes. ...
    Article
    KEY POINTS - Insufficient sleep and poor sleep quality are prevalent among athletes, potentially due to time demands, physical demands, and developmental needs. -Sleep disturbances among athletes have adverse impacts on physical performance, mental performance, injury risk and recovery, medical health, and mental health. -Sleep interventions among athletes have been shown to improve physical strength and speed, cognitive performance and reaction time, mental health, and other domains. -Sport organizations should incorporate sleep health promotion programs at individual, team, and system levels.
  • Chapter
    Mental health screening has shown promise and value in the athletic population. Screening tests for eating disorders, depression, and general anxiety disorder should be performed for identifying those athletes that might need support. Ideally, screening would take place on intake and following injury, and testing should be considered for depression, anxiety, sexual abuse, and alcohol and drug use in the appropriate context, particularly for at-risk athletes or for those athletes not following predictable recovery courses following injury.
  • Chapter
    The stigma of mental health in the athletic setting is a principal barrier to help-seeking among athletes. While athletes may be seen as models for health and wellness within their communities, they may be in fact as vulnerable to some mental illnesses as the general population. The culture of sports can discourage athletes from disclosing of mental health concerns for fear of judgment and reprisal. Athletes, and the people around athletes such as coaches, may also be unaware of the signs and symptoms of mental illness. In recent years, a number of barriers and facilitators to mental health help-seeking have been identified. Governing organizations are beginning to take steps to improve the mental health care of their athletes, while fostering an environment more conducive to disclosure of mental health concerns.
  • Chapter
    Depression is a commonly occurring mental health issue in the general population and in athletic populations. Sports medicine professionals need to consider the unique risk factors of athletes when screening and managing depression in athletes. Sports medicine professionals should provide or refer athletes for evidence-based treatment by providers who are experienced with and can consider the unique stressors and environmental factors that athletes face.
  • Chapter
    There is a complex and interrelated relationship between injury, performance, and mental health (Putukian, Br J Sports Med 50:145–148, 2016; NCAA Interassociation Consensus Document: understanding and supporting student-athlete mental wellness. Mental health best practices. 2018. Available from http://www.ncaa.org/sites/default/files/SSI_MentalHealthBestPractices_Web_20170921.pdf. Accessed 18 Feb 2018; Putukian, How being injured affects mental health. In: Brown GT, Hainline B, Kroshus E et al, (eds) Mind, body and sport: understanding and supporting student-athlete mental wellness. NCAA Press, Indianapolis, p 72–75, 2014; Herring et al, Med Sci Sports Exerc 49:1043–1054, 2017; Neal et al, J Athl Train 48:716–720, 2013). Participating in sport at a competitive level entails specific stressors that may increase the likelihood of injury or illness, including mental health disorders (Ivarsson et al, J Sport Rehabil 22:19–26, 2013; Ivarsson and Johnson, J Sports Sci Med 9:347–352, 2010; Ivarsson et al, Sports Med 47:353–365, 2017; Ardern et al, Br J Sports Med 47:1120–1126, 2013; Wiese-Bjornstal, Scand J Med Sci Sports 20:103–111, 2010; Wiese-bjornstal et al, J Appl Sport Psychol 10:46–69, 1998; Nippert and Smith, Phys Med Rehabil Clin N Am 19:399–418, 2008). There are certain physical and mental health disorders that may be more common in athletes compared with their nonathlete peers, including performance anxiety, disordered eating, menstrual dysfunction, and binge drinking (Glazer, Curr Sports Med Rep;7:332–337, 2008; DeSouza et al, Clin J Sport Med 24:96–119, 2014; Nattiv et al, Clin J Sports Med 7:262–272, 1997). There are several psychological symptoms that are reported in athletes including burnout and substance abuse as well as depression and anxiety, with ranges from 5% to 45% respectively (Beable et al, J Sci Med Sport 20:1047–1052, 2017; Drew et al, Br J Sports Med 51:1209–1214, 2017; Gouttebarge et al, J Hum Kinet 49:277–286, 2015; Gouttebarge et al, J Sports Sci Med 14:811, 2015; Gouttebarge et al, Occup Med 65:190–196, 2015; Gouttebarge et al, J Sports Sci 35:2148–2156, 2017; Gouttebarge et al, Phys Sportsmed 45:426–432, 2017; Gouttebarge et al, Eur J Sport Sci 18:1004–1012, 2018; Gulliver et al, J Sci Med Sport 18:255–261, 2015; Kilic et al, Knee Surg Sports Traumatol Arthrosc 26:946–954, 2018; Kilic et al, Eur J Sport Sci 17:1328–1334, 2017; Nixdorf et al, J Clin Sport Psychol 7:313–326, 2013; Schuring et al, Phys Sportsmed 45:463–469, 2017). In addition, there are increasing demands on athletes at all levels of play, most importantly youth athletes that may be of particular risk for overuse and overtraining (DiFiori et al, Br J Sports Med 48:287–288, 2014). (DiFiore AAP Overuse).
  • Chapter
    Performance-enhancing drug (PED) use is a known and increasingly recognized maladaptive behavior among athletes of all ages and levels of competition. The underlying reasons for use are diverse and may include attempting to gain a selective advantage, to recover from injury, or to optimize cosmetic appearance. The veil of secrecy and stigma regarding PED use challenges the careful study of use behavior patterns, but there is an emerging body of evidence linking PED use to the presence and development of mental health disorders. In order to counteract PED use in the interest of athlete safety and fair play, most governing sports bodies have imposed escalating penalties, including performance bans, for multiple-time PED offenders. It is important for the treating provider to become familiar with PED use and use patterns in order to have an educated discussion with the at-risk athlete.
  • Chapter
    This chapter serves as the introductory chapter to the book. In this chapter, the reader is presented with the primary hypotheses supporting a model of servant leadership including antecedents, applications, and outcomes. Before describing the model, a brief overview of leadership is provided to offer some context as to how leadership theories have evolved from a trait, behavioral, to an other-centered approach. A brief overview of the construct of servant leadership is then offered before discussing its proposed antecedent. It is proposed that for one to be prepared to meet the needs of others, a primary tenet of servant leadership, they need to experience personal need satisfaction and well-being. Seligman’s 2011 well-being theory is used as a proxy for well-being and includes character strengths as supportive of the elements of well-being positive emotions, engagement, positive relationships, meaning, and accomplishment or his PERMA model. Through experiencing well-being, it is proposed that need satisfaction is experienced. Need satisfaction is described using self-determination theory (SDT; Deci & Ryan in Intrinsic Motivation and Self-determination in Human Behavior. Plenum, New York, NY, 1985) and includes the need for autonomy, belongingness or relatedness, and competency. It is proposed that need satisfaction for servant leaders better enables them to meet the needs of others and provides a number of positive outcomes.
  • Chapter
    Athletes, like all human beings, require timely and effective mental health treatment in order to attenuate the risk of chronic functional impairment. Unfortunately, social stigma and stereotypes regarding mental illness, along with competitive performance pressures, can foster denial and avoidance of one’s distress, especially for the athlete who feels a need to conform to the athletic ideal of self-sufficiency, imperturbability, and action over contemplation. The decision by an athlete to engage versus forgo the pursuit of treatment can be positively influenced through an understanding of human beings’ core psychological needs. Self-determination theory (SDT) is predicated on the assumption that the satisfaction of one’s needs for relatedness, competence, and autonomy ultimately determines goal-directed behavior. By attending to the threats to belonging, competence, and autonomy that arise as a function of social stigma and stereotypes, it is possible to reframe mental health treatment as socially acceptable, capable of fostering optimal performance, and facilitative of self-rule. In that vein, sports medicine professionals are uniquely positioned to assist athletes in embracing timely treatment engagement by offering a “prescription for excellence.”
  • Article
    Background: Athletes, like non-athletes, suffer from mental health symptoms and disorders that affect their lives and their performance. Psychotherapy, either as the sole treatment or combined with other nonpharmacological and pharmacological strategies, is a pivotal component of management of mental health symptoms and disorders in elite athletes. Psychotherapy takes the form of individual, couples/family or group therapy and should address athlete-specific issues while being embraced as normative by athletes and their core stakeholders. Main findings: This narrative review summaries controlled and non-controlled research on psychotherapy for elite athletes with mental health symptoms and disorders. In summary, treatment is similar to that of non-athletes—although with attention to issues that are athlete-specific. Challenges associated with psychotherapy with elite athletes are discussed, including diagnostic issues, deterrents to help-seeking and expectations about services. We describe certain personality characteristics sometimes associated with elite athletes, including narcissism and aggression, which could make psychotherapy with this population more challenging. The literature regarding psychotherapeutic interventions in elite athletes is sparse and largely anecdotal.
  • Article
    College athletes across north America are often known on their respective college campuses for their athleticism, and spend a considerable amount of hours weekly engaging in their respective sport through practices, meetings, travelling and meals, to name a few. It is no wonder it is difficult for these students to feel fully engaged and connected on university campuses as students. Female college athletes in particular, who often are not athletes in revenue-generating sports, often feel left behind as students and isolated as athletes. The purpose of the current study was to examine female collegiate athletes’ experience with belonging in a university setting. This qualitative inquiry utilised consensual qualitative research to explore 14 female student athletes’ experience of belonging on a university campus. The results of the data analysis yielded the following domains or themes: athletic team culture, athletic department culture, campus support and involvement, female athlete identity, and individual athlete experience. The most salient finding was that these female athletes suggested that their sense of belonging on campus was almost exclusively related to their experience as an athlete and their athletic team.
  • Article
    Researchers have examined burnout and depression in athletes, yet there are no investigations of the relationship of these two constructs in intercollegiate athletes. This study examined potential gender and sport-type differences (team versus individual) in the strength of the relationship between sport burnout and depression. Participants were 422 intercollegiate athletes from 19 sports. Participants completed burnout and depression surveys as well as a depressive symptom checklist. There were moderate to strong positive correlations between burnout symptoms and depression and there were significant regression models for both genders and sport types. Some gender and sport-type differences emerged. Additionally, 47% of participants who reported previously experiencing burnout also reported five or more concurrent depressive symptoms. Based on the results, sport burnout should be considered a serious mental health concern. Results are discussed in terms of screening and treatment for athlete subgroups and the conceptualization of burnout as a psychological construct.
  • Article
    College student-athletes often meet additional challenges and stressors compared to their nonathlete peers. Because of their training and skills in academic, personal, and career development, high school counselors can help facilitate a smoother transition to college athletics for their athletes. This article reviews current literature related to college athletes and school counselors. Recommendations are provided for high school counselors when working with their athletes transitioning to college sports.
  • Article
    Depression levels in collegiate athletes are consistent with or higher than those of the general population [Cox (2015 Cox, C. (2015). Investigating the prevalence and risk-factors of depression symptoms among NCAA Division I collegiate athletes [Doctoral dissertation, Southern Illinois University at Edwardsville]. [Google Scholar]). Investigating the prevalence and risk-factors of depression symptoms among NCAA Division I collegiate athletes (Doctoral dissertation, Southern Illinois University at Edwardsville); Prinz, Dvořák, & Junge (2016 Prinz, B., Dvořák, J., & Junge, A. (2016). Symptoms and risk factors of depression during and after the football career of elite female players. British Journal of Medicine and Sport Open Sport & Exercise Medicine, 2(1), e000124.https://doi.org/10.1136/bmjsem-2016-000124 [Google Scholar]). Symptoms and risk factors of depression during and after the football career of elite female players. British Journal of Medicine and Sport Open Sport & Exercise Medicine, 2(1), e000124; Wolanin, Hong, Marks, Panchoo, & Gross (2016 Wolanin, A., Hong, E., Marks, D., Panchoo, K., & Gross, M. (2016). Prevalence of clinically elevated depressive symptoms in college athletes and differences by gender and sport. British Journal of Sports Medicine, 50(3), 167–171. https://doi.org/10.1136/bjsports-2015-095756[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Prevalence of clinically elevated depressive symptoms in college athletes and differences by gender and sport. British Journal of Sports Medicine, 50(3), 167–171], warranting examination of probable causes and protective factors. This study examined depressive symptoms in collegiate athletes and how they relate to different types and sources of social support. The student athlete population at a Division I university (N = 238) completed a survey on depressive symptoms (i.e., Center for Epidemiological Studies Depression Scale) [CES-D; Radloff (1977 Radloff, L. S. (1977). The CES-D scale. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306[Crossref], [Web of Science ®] , [Google Scholar]). The CES-D scale. Applied Psychological Measurement, 1(3), 385–401] and social support (i.e., Berlin Social Support Scale; [BSSS; Schulz & Schwarzer (2003 Schulz, U., & Schwarzer, R. (2003). Soziale Unterstützung bei der Krankheitsbewältigung. Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica, 49(2), 73–82. https://doi.org/10.1026//0012-1924.49.2.73[Crossref], [Web of Science ®] , [Google Scholar]). Soziale Unterstützung bei der Krankheitsbewältigung. Die Berliner social support Skalen (BSSS) [Social support in coping with illness: The Berlin social support scales (BSSS)]. Diagnostica, 49(2), 73–82]four open-ended questions). Higher levels of social support were correlated with fewer depressive symptoms. Multiple regression revealed tangible support from athletic sources, need for support, and tangible support from personal sources were significant predictors of depressive symptoms, (F = 23.2, p <.001). Most beneficial soources of support were teammates (n=20) and non-athletic persons (n=19). Athletes wanted more support from coached (n=72). This study offers insight into how best to provide support, which impacts performance and overall mental health.
  • Article
    The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.
  • Article
    The overarching purpose of the current article is to examine the status of sport psychology as a profession in 4 ways. First, I characterize the profession of sport psychology as an illusion because there is so little demand for sport psychology services and because there are so few full-time practicing sport psychologists. Second, paradoxically it appears that many people assume that applied sport psychology is a healthy and viable profession so I comment on why this is the case. Sidestepping the lack of jobs issue does a disservice to graduate students who believe they can easily become practicing sport psychologists. Third, it is clear that few athletes or teams want to pay for SPP services so I present some reasons why this is the case. Fourth, I speculate about the future of SPP followed by some recommendations that would rectify my claim that the field’s relative silence on this issue does a disservice to students.
  • Article
    Full-text available
    Objectives To explore the association between depressive symptoms and recent head-related trauma (diagnosed concussion, subconcussive impacts) in semiprofessional male Australian Football (AF) players. Methods Sixty-nine semiprofessional male players from a West Australian Football League (WAFL) club participated in the study (M age =21.81, SD=2.91 years). Depressive symptoms were measured using the Centre for Epidemiological Studies Depression Scale. Injuries and potential confounding variables (eg, pre-existing mental health condition; alcohol or drug hangovers; experiencing a stressful event) were self-reported anonymously using the WAFL Injury Report Survey. Both tools were administered every 2-weeks over the first 22-weeks of the WAFL season. Controlling for potential confounding variables and other injuries, a repeated measures generalised estimating equations model assessed the risk of clinically relevant depressive symptoms occurring, when diagnosed concussion or subconcussive impacts were experienced. Results A total of 10 concussions and 183 subconcussive impacts were reported. Players who experienced a concussion were almost nine times more likely to experience clinically relevant depressive symptoms (OR 8.88, 95% CI 2.65 to 29.77, p<0.001). Although elevated, depressive symptoms following subconcussive impacts were not statistically significant (OR 1.13, 95% CI 0.67 to 1.92, p=0.641). Conclusion These findings indicate that semiprofessional AF athletes may be at risk of experiencing depressive symptoms after concussion. Severity (concussion vs subconcussive impacts) and dose (number of impacts) appear to have an important relationship with depressive symptom outcomes in this cohort and should be considered for further research and management of player welfare.
  • Article
    The overarching purpose of the current article was to examine the status of sport psychology as a profession in 4 ways. First, the author characterizes the profession of sport psychology as an illusion because there is so little demand for sport psychology services and because there are so few full-time practicing sport psychologists. Second, paradoxically, it appears that many people assume that applied sport psychology is a healthy and viable profession, so the author comments on why this is the case. Sidestepping the lack of jobs does a disservice to graduate students who believe they can easily become practicing sport psychologists. Third, it is clear that few athletes or teams want to pay for sport psychology services, so some reasons why this is the case are presented. Fourth, the author speculates about the future of the sport psychology profession, followed by some recommendations that would rectify his claim that the field’s relative silence on this issue does a disservice to students.
  • Article
    NCAA student-athletes are at risk for various physical (e.g. injury), psychosocial (e.g. depression), and spiritual (e.g. identity development) health concerns. Consequently, researchers and NCAA athletics’ personnel have prioritized conducting research and developing interventions designed to improve the overall health and well-being of student-athletes. This systematic review was guided by the biopsychosocial-spiritual (BPSS) framework to account for student-athletes’ overall health experience. We incorporated Cooper’s [2010. Research synthesis and meta-analysis: A step-by-step approach (4th ed.). Sage] seven-step protocol for research synthesis to examine the effectiveness of interventions targeting BPSS health outcomes among NCAA student-athletes. Of the 420 studies retrieved from five electronic databases, a total of 20 studies published between 1989 and 2017 were included for review. Results indicated that mindfulness- and cognitive-behavioral-based interventions may be effective at improving BPSS health outcomes among student-athletes. However, the majority of studies had poor methodological quality and demonstrated high risk of bias, raising concern for the generalizability and validity of findings. Implications are discussed.
  • International encyclopedia of statistical science
    • D C Howell
    Howell, DC. Chi-square test: analysis of contingency tables. In: Lovric M, ed. International encyclopedia of statistical science. Springer, 2011:250-2.
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    Full-text available
    This study examined the athletic status differences in reported depressive symptoms between male intercollegiate team sport athletes (n = 66) and male nonathletes (n = 51) enrolled at one of two public universities in the Southeastern United States, while controlling for preferred (task-oriented and emotion-oriented) coping strategies. Analysis of covariance (ANCOVA) revealed that the athletes reported significantly fewer depressive symptoms than nonathletes while controlling for coping strategy selection (p < .05). In terms of the actual prevalence rates of depressive symptoms, 29.4% of the nonathletes met the criterion for possible depression compared with only 15.6% of the athletes. Overall, athletic participation in an intercollegiate team sport appears related to lower levels of depression. The potentially distress-buffering aspects of athletic involvement and implications for future research are discussed.
  • Article
    • A two-stage assessment of newly admitted outpatients at community mental health centers and primary medical care centers found the Center for Epidemiological Studies Depression Scale to be highly sensitive but relatively nonspecific when compared with assessments of depression by the Diagnostic Interview Schedule. Considerably higher than usual screening scores are recommended with both patient populations to improve the efficiency of the Center for Epidemiological Studies Depression Scale. The reasons for our finding that primary care clinicians underdiagnose depressive disorder while psychiatric clinicians overdiagnose it relative to the Diagnostic Interview Schedule include varied presentations by each sector's patients, differing clinical acumen, and factors affecting third-party reimbursement.
  • Article
    Depression affects an estimated 6.7% of today's adult population in a 12-month period. The prevalence rates for certain age groups, such as young adults and older adults, are higher. There are approximately 400,000 National Collegiate Athletic Association student athletes competing each year and 5 to 7 million high school student athletes involved in competitive interscholastic sports. Given such a high prevalence rate in certain age groups and a large denominator pool of athletes, past notions that athletes are devoid of mental health issues have come under scrutiny by sports medicine providers. Initial data suggest that athletes are far from immune to depression. The purpose of this article was to review the current research on athletes and depression; particularly this article will provide an overview of studies, which have investigated the rate of depression among athletes, and discuss relevant risk factors, which may contribute to depression among athletes.
  • Article
    BACKGROUND:High school athletes are at risk for concussions. Although a previously published study showed an increase in concussion rates for a single school district, it remains unknown if the rate of concussions among high school athletes is increasing nationally. PURPOSE:To investigate national high school athlete concussion rates over time. STUDY DESIGN:Descriptive epidemiologic study. METHODS:The rate of concussions per 1000 athlete-exposures was calculated for academic years 2005-2006 through 2011-2012 using the High School Reporting Information Online sports injury surveillance system. RESULTS:During the 7-year period of this study, High School Reporting Information Online captured 4024 concussions with overall concussion diagnosis rates increasing significantly from 0.23 to 0.51 (P = .004). Concussion diagnosis rates increased for each of the 9 sports studied, with 5 sports having statistically significant increases over this 7-year period. CONCLUSION:The study analysis indicates that national concussion diagnosis rates for high school sports have increased significantly over time.
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    Physical activity may play an important role in the management of mild-to-moderate mental health diseases, especially depression and anxiety. Although people with depression tend to be less physically active than non-depressed individuals, increased aerobic exercise or strength training has been shown to reduce depressive symptoms significantly. However, habitual physical activity has not been shown to prevent the onset of depression. Anxiety symptoms and panic disorder also improve with regular exercise, and beneficial effects appear to equal meditation or relaxation. In general, acute anxiety responds better to exercise than chronic anxiety. Studies of older adults and adolescents with depression or anxiety have been limited, but physical activity appears beneficial to these populations as well. Excessive physical activity may lead to overtraining and generate psychological symptoms that mimic depression. Several differing psychological and physiological mechanisms have been proposed to explain the effect of physical activity on mental health disorders. Well controlled studies are needed to clarify the mental health benefits of exercise among various populations and to address directly processes underlying the benefits of exercise on mental health.
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    MacDonald and Gardner reported the results of a comparative study of two post hoc cellwise tests in 3 X 4 contingency tables under the independence and homogeneity models. Based on their results, they advised against the use of standardized residuals and in favor of adjusted residuals. Here the authors show that the comparison was biased in favor of adjusted residuals because of a failure to consider the nonunit variance of standardized residuals. The authors define a moment-corrected standardized residual that overcomes this bias and present the results of a thorough study including two-way tables of all dimensions between 2 X 2 and 8 X 12 that aimed at comparing moment-corrected standardized residuals with adjusted residuals. Across the entire set of table dimensions included in this study, the results reveal that both residuals yield essentially the same pat-tern of cell-by-cell and experimentwise Type I error rates when the data come from variables with uniform marginal distributions. When the data come from variables with peaked marginal distributions, adjusted residuals behave minimally better than moment-corrected residuals.
  • Article
    The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
  • Article
    OBJECTIVE:: To assess the prevalence of diagnosed failure-based depression and self-reported symptoms of depression within a sample of elite swimmers competing for positions on Canadian Olympic and World Championship teams. DESIGN:: A cross-sectional design. SETTING:: Assessments were conducted after the conclusion of the qualifying swimming trials. PARTICIPANTS:: The sample consisted of 50 varsity swimmers (28 men and 22 women) based at 2 Canadian universities who were competing to represent Canada internationally. MAIN OUTCOME MEASURES:: Diagnosed depression was assessed using a semistructured interview, and symptoms of depression were also assessed by the Beck Depression Inventory II. Performance was measured by changes in swimming time and athlete ranking. RESULTS:: Before competition, 68% of athletes met criteria for a major depressive episode. More female athletes experienced depression than their male peers (P = 0.01). After the competition, 34% of athletes met diagnostic criteria and 26% self-reported mild to moderate symptoms of depression. The prevalence of depression doubled among the elite top 25% of athletes assessed. Within this group, performance failure was significantly associated with depression. CONCLUSIONS:: The findings suggest that the prevalence of depression among elite athletes is higher than what has been previously reported in the literature. Being ranked among the very elite athletes is related to an increase in susceptibility to depression, particularly in relation to a failed performance. Given these findings, it is important to consider the mental health of athletes and have appropriate support services in place.
  • Article
    This study examined depression among a random sample of students (N = 618) enrolled in a medium size university in the Pacific Northwest who responded to the American College Health Association's National College Health Assessment. The results indicated that one in four students experienced depression in the past year and men were as likely as women to report feeling depressed. Depressed students were more likely than non-depressed students to report academic impairment due to various physical conditions including chronic pain (p = 0.010) and sinus infections (p = 0.010), as well as psycho-social conditions such as learning disabilities (p = 0.037), relationship difficulties (p less than 0.001) and stress (p less than 0.001). Depressed students were more likely to report their health as fair or poor (p = 0.041), smoke cigarettes (p = 0.001), and be gay/lesbian, bisexual, or transgendered (p = 0.001). There were notable findings: several correlates of depression identified in previous studies, including alcohol use, did not prove to be significant. Students who worked, and volunteered more hours, were more likely to be depressed. These results provide important information for student affairs professionals and faculty as they respond to the growing concern of depression and its affect on student learning and well-being. (Contains 3 tables.)
  • Article
    BACKGROUND: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings. PURPOSE: To explore the prevalence of depression in university students. METHOD: PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating. RESULTS: Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%. CONCLUSIONS: The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990.
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    The present study investigated the relationship between some personality traits and participation in high physical risk sports. Twenty-seven alpinists, 72 mountaineering-related sportsmen, 221 sportsmen and 54 subjects not engaged in any risky activity, were administered the Sensation Seeking Scale, the EPQ, the Impulsiveness Scale of the IVE, the Socialization Scale of the CPI, and the Susceptibility to Punishment and Reward Scales. The results seem to indicate that there exists a personality profile of subjects engaged in high physical risk normative activities who share the following characteristics: extraversion, emotional stability, conformity to social norms, and seeking thrill and experience by socialized means.
  • Article
    The Center for Epidemiologic Studies Depression Scale (CES-D) is one of the most widely used measures of depressive symptoms in research today. The original psychometric work in support of the CES-D (Radloff, 1977) described a 4-factor model underlying the 20 items on the scale. Despite a long history of evidence supporting this structure, researchers routinely report single-number summaries from the CES-D. The research described in this article examines the plausibility of 1-factor model using an initial sample of 595 subjects and a cross-validation sample of 661. After comparing a series of models found in the literature or suggested by analyses, we determined that the good fit of the 4-factor model is mostly due to its ability to model excess covariance associated with the 4 reverse-scored items. A 2-factor model that included a general depression factor and a positive wording method factor loading only on those 4 items had fit that was nearly as good as the original 4-factor model. We conclude that although a 1-factor model may not be the best model for the full 20-item CES-D, it is at least plausible. If a unidimensional set of items is required (e.g., for a unidimensional item response theory analysis), by dropping 5 items, we were able to find a 1-factor model that had very similar fit to the 4-factor model with the original 20 items.
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    Full-text available
    Depression is common among athletes following sport injury, yet few studies have explored the severity of postinjury depression. Among those studies, only one examined gender differences although women in the general population are more likely than men to experience depression. No research to date has used interviews to assess depression despite their standard use among mental health professionals. In a quasi-experimental design, we used a self-report checklist and a clinical interview to compare depression among male and female athletes at 1 week, 1 month, and 3 months postinjury. Results revealed significant effects of group (injured vs. control) and time (since injury), and these effects were different for the two depression measures. We also explored the sensitivity and specificity of the user-rated checklist in identifying severely depressed athletes compared with the interview. Findings underscore the importance of multimodal approaches and clinical judgment when evaluating athletes' postinjury depression symptoms.
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    The authors compared collegiate athletes and nonathletes to see whether there were significant differences in the perceived levels of social connectedness, self-esteem, and depression and if an interaction among the variables of athlete status, gender, GPA, BMI, and levels of weekly exercise and sleep were associated with depression symptomatology. Participants were 227 college students. The authors surveyed students using the Center for Epidemiologic Studies Depression Scale, the Rosenberg Self-Esteem Scale, and the Social Connectedness Scale-Revised. Athletes had significantly greater levels of self-esteem and social connectedness, as well as significantly lower levels of depression, than did nonathletes. However, the statistically strongest predictors of depression in this cohort were the variables of gender, self-esteem, social connectedness, and sleep. This study adds to the limited and inconsistent research in the empirical knowledge base regarding depression among collegiate athletes.
  • Article
    The purpose of this study was to develop a scale to measure the psychological impact of returning to sport after anterior cruciate ligament (ACL) reconstruction surgery. Three types of psychological responses believed to be associated with resumption of sport following athletic injury--emotions, confidence in performance, and risk appraisal--were incorporated into a 12-item ACL-Return to Sport after Injury (ACL-RSI) scale. Two hundred and twenty participants who had undergone ACL reconstruction completed the scale between 8 and 22 months following surgery. The scale was shown to have acceptable reliability (Cronbach's alpha=0.92). Participants who had given up sport scored significantly lower on the scale (reflecting a more negative psychological response) than those who had returned or were planning to return to sport (p<0.001). It was concluded that the decision to return to sport after ACL reconstruction is associated with a significant psychological response. Preliminary reliability and validity was found for the ACL-RSI scale. This scale may help to identify athletes who will find sport resumption difficult.
  • Article
    A two-stage assessment of newly admitted outpatients at community mental health centers and primary medical care centers found the Center for Epidemiological Studies Depression Scale to be highly sensitive but relatively nonspecific when compared with assessments of depression by the Diagnostic Interview Schedule. Considerably higher than usual screening scores are recommended with both patient populations to improve the efficiency of the Center for Epidemiological Studies Depression Scale. The reasons for our finding that primary care clinicians underdiagnose depressive disorder while psychiatric clinicians overdiagnose it relative to the Diagnostic Interview Schedule include varied presentations by each sector's patients, differing clinical acumen, and factors affecting third-party reimbursement.
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    Full-text available
    The effects of using two methods (item mean and person mean) for replacing missing data in Likert scales were studied. The results showed that both methods were good representations of the original data when both the number of respondents with missing data and the number of items missing were 20% or less. As the numbers of missing items and of respondents with missing data increased for the person mean substitution method, a spurious increase in the inter-item correlations (and, therefore, reliability) for the sale was produced. The item mean substitution reduced the reliability estimates of the scale. These results suggest caution in the use of the person mean substitution method as the numbers of missing items and respondents increase.
  • Article
    To describe the prevalence of symptoms of depression among competitive collegiate student athletes and examine the factors associated with symptoms of depression among this population. A baseline survey of a prospective cohort study. The survey was administered at the preseason team meetings. The sample included 257 collegiate student athletes (167 males and 90 females) who participated in Division I National Collegiate Athletic Association (NCAA)-sponsored sports during the 2005-2006 academic year. Symptoms of depression were measured by the Center for Epidemiological Studies Depression Scale (CESD). Anxiety was measured by the State-Trait Anxiety Inventory (STAI). The Generalized Estimating Equations (GEE) was used to assess the factors associated with symptoms of depression. Twenty-one percent of participants reported experiencing symptoms of depression. Athletes who were female, freshmen, or with self-reported pain were associated with significantly increased odds of experiencing symptoms of depression after adjusting for sports and other covariates. In particular, female athletes had 1.32 greater odds (95% CI, 1.01 to 1.73) of experiencing symptoms of depression compared to male student athletes. Freshmen had 3.27 greater odds (95% CI, 1.63 to 6.59) of experiencing symptoms of depression than their more senior counterparts. Student athletes who reported symptoms of depression were associated with higher scores of State-Anxiety and Trait-Anxiety, respectively (P<0.0001). Our findings provide empirical data for the future study on mental health among collegiate athletes. Further studies on why female and freshmen athletes are at increased risk of experiencing symptoms of depression are also warranted.
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    Full-text available
    The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the "knee over toe position" when cutting.