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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes: The Role of Gender and Athlete Status

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This study explored the influence of current anxiety and depression symptoms on intentions to seek professional help from a psychologist. Furthermore, the aim was to explore if symptoms influenced intentions differently in male and female, and in athlete and non-athlete samples. A total of 375 non-athlete university students and 187 individual sport athletes, 18 years and older were included in the study. A significant main effect of symptoms on help-seeking intentions was observed among females and this was moderated by athlete status; female athletes with depression symptoms reported lower intentions than female non-athletes with depression symptoms. There was no main effect of symptoms among athletes, but a significant cross-over interaction effect of symptoms and gender on intentions was observed; non-symptomatic female athletes reported higher intentions than male athletes without symptoms, and female athletes with depression symptoms reported lower intentions than male athletes with depression symptoms. Results suggested that experiencing depression symptoms may decrease female athletes’ intentions to seek help from psychologist.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in
Individual Sport Athletes and Non-Athletes: The Role of Gender and Athlete Status
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DOI: 10.1123/jcsp.2017-0028
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Note. This article will be published in a forthcoming issue of the Journal
of Clinical Sport Psychology. The article appears here in its accepted,
peer-reviewed form, as it was provided by the submitting author. It has
not been copyedited, proofread, or formatted by the publisher.
Section: Original Research
Article Title: The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions
in Individual Sport Athletes and Non-Athletes: The Role of Gender and Athlete Status
Authors: Richard E. Tahtinen1 and Hafrun Kristjansdottir2
Affiliations: 1Department of Psychology, Reykjavik University, Reykjavik, Iceland. 2Sports
Science Department, Reykjavik University, Reykjavik, Iceland.
Journal: Journal of Clinical Sport Psychology
Acceptance Date: February 27, 2018
©2018 Human Kinetics, Inc.
DOI: https://doi.org/10.1123/jcsp.2017-0028
The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
The influence of Anxiety and Depression Symptoms on Help-
Seeking Intentions in Individual Sport Athletes and Non-
Athletes: The Role of Gender and Athlete Status
Richard E. Tahtinen1 and Hafrun Kristjansdottir2
1. Reykjavik University, Department of Psychology
2. Reykjavik University, Sports Science Department
Corresponding author:
Richard E. Tahtinen
School of Business/Department of Psychology
Email: richard10@ru.is
Mobile: 00 354 863 8597
Háskólinn í Reykjavík | Reykjavík University
Menntavegi 1, 101 Reykjavik, Iceland
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Abstract
This study explored the influence of current anxiety and depression symptoms on intentions to
seek professional help from a psychologist. Furthermore, the aim was to explore if symptoms
influenced intentions differently in male and female, and in athlete and non-athlete samples. A
total of 375 non-athlete University students and 187 individual sport athletes, 18 years and older
were included in the study. A significant main effect of symptoms on help-seeking intentions was
observed among females and this was moderated by athlete status; female athletes with depression
symptoms reported lower intentions than female non-athletes with depression symptoms. There
was no main effect of symptoms among athletes, but a significant cross-over interaction effect of
symptoms and gender on intentions was observed; non-symptomatic female athletes reported
higher intentions than male athletes without symptoms, and female athletes with depression
symptoms reported lower intentions than male athletes with depression symptoms. Results
suggested that experiencing depression symptoms may decrease female athletes’ intentions to seek
help from psychologist.
Keywords: anxiety, depression, help-seeking intentions, athletes, university students
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Organized youth sports are thought to prepare individuals for life through positive physical
and psychosocial development (Eime, Young, Harvey, Charity, & Payne, 2013). However, despite
the potential benefits acquired through youth sports, as athletes transition into elite sports, health
related risk factors may become more prominent (Rice et al., 2016). It is not until recently however
that the prevalence of mental health disorders, such as anxiety and depression, have been
systematically explored among athlete populations.
Previous studies have reported highly variable prevalence rates in athletes’ current anxiety
and/or depression symptoms, ranging from 6 % (Schaal et al., 2011) to 43% (Gouttebarge, Backx,
Aoki, & Kerkhoffs, 2015). These inconsistencies may be due to differences in measurement and
assessment methods, as well as due to differences in study populations. For example, while some
studies have assessed prevalence of a range of different mental health disorders among European
elite athletes through in-person interviews (Schaal et al., 2011), others have utilized self-report
measures to assess symptom prevalence of specific disorders such as depression (Nixdorf, Frank,
Hautzinger, & Beckmann, 2013). Furthermore, while some European and Australian studies have
compared elite or professional athletes’ to the general population, showing similar prevalence rates
between these groups in anxiety (Gulliver et al., 2015) and depression symptoms (Gouttebarge et
al., 2015; Nixdorf et al., 2013), other studies have assessed prevalence rates among North
American collegiate athletes and non-athletes, and reported lower depression prevalence rates in
athletes than non-athletes (Armstrong, Burcin, Bjerke, & Early, 2015; Armstrong & Oomen-Early,
2009). Despite the methodological differences, the results from previous studies suggests that there
may be high variability of mental disorders across the athlete population. Hence, to improve
support initiatives for athletes experiencing mental health issues, further studies within specific
athlete groups are warranted.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
The current literature indicates that prevalence of mental disorders among athletes may
vary depending on sport-specific factors and that some athlete groups may be more vulnerable to
mental health problems than others (Gulliver, Griffiths, Mackinnon, Batterham, & Stanimirovic,
2015; Rice et al., 2016; Roberts, Faull, & Tod, 2016; Weigand, Cohen, & Merenstein, 2013). For
example, there is some support for the notion that prevalence of depression symptoms may be
higher in individual sport athletes than in team sport athletes (Nixdorf, Frank, & Beckmann, 2016;
Nixdorf et al., 2013). However, there is a need to explore this athlete population in more detail as
most studies to date have assessed mental health issues in relatively small samples of individual
sport athletes and/or within a limited range of different individual sports. For example, a study by
Hammond, Gialloreto, Kubas, and Davis IV (2013) assessed depression symptoms in athletes from
only one sport (swimming). Gulliver et al. (2015) assessed multiple mental disorders and only 15
individual athletes were included, representing only two different sports (rowing and sailing).
Another study assessed depression symptoms in individual sport athletes from 10 different
individual sports, however, the sample size was relatively small (n = 59) (Nixdorf et al., 2013).
Finally, Wolanin et al. (2016) assessed depressive symptoms in 465 collegiate athletes, including
127 individual sport athletes from five different individual sports.
One question that is especially important from a treatment perspective concerns athletes’
tendency to seek help when they experience mental health symptoms. Hence, although it is
important to acquire more knowledge about the prevalence of mental health disorders within the
athlete population, it is also important to understand which athletes may be in an increased risk for
not seeking help when symptoms emerge.
Help-seeking can be defined as a behavior where an individual expresses a need for help
by approaching informal (e.g. friends and family) or formal (e.g. psychologist) sources for help
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
(Rickwood, Deane, Wilson, & Ciarrochi, 2005). The help-seeking process involves the
identification of a need for help, a deliberate decision process to seek help (intention), and the
actual behavior of seeking help (Rickwood et al., 2005). Hence, as described by Rickwood and
colleagues (2005), the help-seeking process may be influenced at each of these different levels.
For example, although a need for help may be identified, this does not necessarily translate into
intentions to seek help.
Studies have consistently reported that mood and anxiety disorders are more prevalent
among females than males (Nolen-Hoeksema & Girgus, 1994; Steel et al., 2014), and that males
are as less likely than females to seek help for mental health problems (Addis & Mahalik, 2003).
Similar gender differences have also been observed within the athlete population in prevalence
(Rice et al., 2016) and in help-seeking patterns (Martin et al., 2001; Martin, Lavallee, Kellmann,
& Page, 2004). Males’ overall lower tendency to seek help has often been understood in terms of
males’ socialization into masculine roles, and that these roles are discrepant with the act of seeking
help from others (Addis & Mahalik, 2003; Judd, Komiti, & Jackson, 2008). This socialization
process may be especially prevalent within the sport culture where masking vulnerability (Doherty,
Hannigan, & Campbell, 2016) and exhibiting toughness, and ignoring or downplaying injury may
be highly valued (Martin, 2005; Steinfeldt, Steinfeldt, England, & Speight, 2009). Subsequently,
a study by Watson (2005) suggested that athletes may have less positives attitudes towards help-
seeking than non-athletes. A more recent study however suggested that the difference between
athletes’ and non-athletes may be narrowing, as the study did not find any differences between
athletes and non-athletes willingness to seek help (Barnard, 2016). Nevertheless, Barnard did
report that female athletes were more willing to seek help than male athletes.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Although these studies have expanded our understanding about how socialization through
and in sports may give rise to attitudes and beliefs that may hinder help-seeking, there may be
significant variation in peoples’ intentions to seek help depending on the type of symptoms
experienced (Deane, Wilson, & Ciarrochi, 2001; Rickwood et al., 2005; Wilson & Deane, 2010).
For example, in a study by Wilson and Deane (2010) increasing levels of depression symptoms
were related to decreased help-seeking intentions, while anxiety symptoms did not significantly
relate to help-seeking intentions. Furthermore, while individuals with minimal symptoms may
initially report intentions to seek help in the future, as mental health symptoms emerge, intentions
to seek help may decrease (Deane et al., 2001). However, to the authors’ best knowledge, no
previous studies have taken into account the potential influence of current anxiety and depression
symptoms on help-seeking intentions when assessing differences in athletes and non-athletes
help-seeking intentions.
The first aim of the current study was to assess anxiety and depression symptoms, and
help-seeking intentions specifically in individual sport athletes in comparison to a non-athlete
sample. Based on the reviewed studies it was anticipated that males would report significantly
lower levels of anxiety and depression symptoms, and help-seeking intentions than females. It was
also expected that athletes would have lower help-seeking intentions than non-athletes.
The second aim of this study was explorative in nature and aimed to extend current
knowledge by exploring the relationship between type of symptoms (i.e. no symptoms, anxiety
only, depression only, and comorbid anxiety and depression) and help-seeking intentions, and if
this relationship would be moderated by gender and/or athlete status.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Method
Participants
The individual sport athlete sample consisted of male (n = 85) and female (n = 97) athletes,
competing at the national and/or international level in any of the individual sports that are members
of the National Olympic and Sports Association of Iceland (Íþrótta og Ólympíusamband Íslands,
ISI). Inclusion criteria for athletes was; being 18 years or older, fluency in the Icelandic language,
and competing nationally or internationally in any of the individual sports that are members of the
National Olympic and Sports Association of Iceland. Different from the North-American
collegiate sport system, Icelandic sports are organized by independent sport federations, which in
turn are coordinated by the National Olympic and Sports Association of Iceland. In the athlete
sample, 34.2 % were currently University students, 22.8 % were secondary school students, and
36.9 % were non-students.
The non-athlete comparison group consisted of male (n = 101) and female (n = 270)
university students currently enrolled in one of the seven Icelandic Universities. Inclusion criteria
for the comparison sample was being 18 years or older, being fluent in the Icelandic language, and
not currently competing in any sport. In the non-athlete student sample 33 participants reported
competing in team sports (3.7 % of the whole sample), and these participants were excluded from
the analyses.
Measures
Background variables. The online survey assessed demographic variables such as age,
gender, and previous help-seeking from a Psychologist. Age was assessed in categories (three age
groups per category e.g. 18-20) and previous help-seeking was assessed with a multi-response
scale where respondents were asked if they had ever sought help from a psychologist. Response
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
categories were “yes, within the past 30 days”, “yes, within the past 12 months”, “yes, more than
12 months ago”, or “no”. Previous help-seeking was then coded into a dichotomized variable “yes”
or “no”. Individual sport athletes also answered whether they were currently in the national team
or in an elite training group.
General Anxiety Disorder 7 (GAD-7). Is a brief, 7-item self-report measure for assessing
generalized anxiety disorder but is also suitable for assessing symptoms of anxiety in more general
(Spitzer, Kroenke, Williams, & Löwe, 2006). The GAD-7 assesses symptom frequency and the
severity of those symptoms during the past two-weeks. Each item on the scale is scored from 0 to
3, thus total score ranges from 0-21, with higher scores representing more severe symptoms of
anxiety and scores 10 or above are considered as clinically relevant. The psychometric properties
of GAD have shown to be good among the clinical (Spitzer et al., 2006) and the general population
abroad (Löwe et al., 2008) and in Iceland (Ingólfsdóttir, 2014). In the current sample, reliability
was shown to be very good = .90). Responses with more than 10 % of missing values on the
scale were not included.
Patient Health Questionnaire 9 (PHQ 9). Is a nine-item self-report scale, that assesses
depressive symptoms during the past two-weeks. Each item is scored from 0 to 3 ranging from
“not at all” to “nearly every day”, thus total scores range from 0 to 27, with higher scores
representing more severe symptoms. Identical to the GAD-7, scores 10 or above are considered as
clinically relevant. The psychometric properties of PHQ-9 have shown to be good among the
clinical (Kroenke & Spitzer, 2002) and the general population (Martin, Rief, Klaiberg, & Braehler,
2006) abroad, and in Iceland (Palsdottir, 2007). In the current sample, reliability was shown to be
very good = .87). Responses with more than 10 % of missing values on the scale were not
included.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Icelandic version of the Beliefs About Psychological Services (I-BAPS). Is an Icelandic
(cross-culturally validated) version of the 18-item self-report measure; Beliefs About
Psychological Services (BAPS, Aegisdottir & Gerstein, 2009). The I-BAPS is a 22-item
questionnaire containing three subscales; Intent, Stigma Tolerance, and Expertness with each sub-
scale score intended to be reported separately. The intent sub-scale was utilized in the current
study. The intent scale includes six positively worded statements such as “At some future time, I
might want to see a psychologist” or “I would see a psychologist if I were worried or upset for a
long period of time”. Each item range from 1 (strongly disagree) to 6 (strongly agree) and the total
scale score is calculated as the sum of each item response divided by the number of items, with
higher scores representing greater intentions or willingness to seek help from a psychologist in the
future. The I-BAPS was chosen for the current study as it is currently the only measure of help-
seeking intention that has been adapted in Iceland, and has shown good psychometric properties
among the Icelandic general population (Ægisdóttir & Einarsdóttir, 2012). Permission to utilize
the scale was granted by the developers of the I-BAPS. In the current study sample, reliability was
shown to be very good (α = .87). Responses with more than 10 % of missing values on the scale
were not included.
Procedures
A non-probability (convenience) sampling method was utilized to recruit participants
competing in individual sports. Firstly, the author advertised the study on Facebook with a short
description of the study purpose, inclusion criteria, and providing a direct link to the online
questionnaire. Individual athletes currently in elite or national team programs were contacted
directly through Facebook or indirectly through their coaches, and requested to answer the online
questionnaire. Furthermore, with help from The National Olympic and Sports Association, all
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
individual Sport Federations were contacted and requested to forward a link to the online
questionnaire to relevant athletes (i.e. 18 years and older, fluent in Icelandic, and actively
competing in an individual sport at national or international level).
A non-probability (convenience) sampling method was also utilized to recruit the non-
athlete university sample. Firstly, the authors advertised the study on Facebook with a short
description of the study purpose, inclusion criteria, and providing a direct link to the online
questionnaire. Furthermore, all Icelandic Universities were contacted and requested to cooperate.
Universities that agreed to cooperate (six out of seven), advertised the study on their respective
internal webs and/or sent out emails to all students with a short description of the study purpose
and a link to the survey.
Statistical Analyses
For anxiety and depression symptoms, participants were dichotomized into clinically
relevant or not clinically relevant symptom-groups. Clinical relevance for depression symptoms
was defined according to the standard cut of point, or scores 10 (Kroenke & Spitzer, 2002).
Although both lower and higher cut off points have been used (Manea, Gilbody, & McMillan,
2012), the cut off score of ≥ 10 is still considered as the gold standard (Manea, Gilbody, &
McMillan, 2015). To assess clinical relevance for anxiety symptoms, we utilized the standard
clinical cut of point ≥ 10 as reported by Spitzer, Kroenke, Williams, and Löwe (2006). According
to Plummer, Manea, Trepel, and McMillan (2016), clinical cut off scores between 7 and 10 are
considered acceptable for GAD-7. Column proportions were then compared between athletes and
students utilizing Pearson’s chi square to test for significant differences in prevalence between
groups.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
To test how athlete status and gender was related to the dependent variables anxiety and
depression symptoms, and help-seeking intentions, separate 2 (athlete status) x 2 (gender) Factorial
ANOVAs were conducted for each dependent variable. It has been suggested that age and previous
help-seeking experiences may influence help-seeking intentions (Rickwood, 2005). Hence, when
testing help-seeking intentions, age and previous help-seeking from psychologist were included as
covariates. When testing for anxiety and depression symptoms, only age was included as a
covariate. Since the homogeneity of variance assumption was violated for anxiety and depression
symptoms, a square root transformation was executed for these dependent variables. However,
analyses with transformed data did not influence the results, and hence the original analyzes are
reported.
To explore the moderation effect of gender and athlete status on the relationship between
symptoms and help-seeking intentions, participants were categorized based on their clinically
relevant symptoms; no clinically elevated symptoms, anxiety only, depression only, and comorbid
depression and anxiety. A 2 (athlete status) x 4 (symptom type) model was conducted separately
for females and males to test the moderating effect of athlete status on the relationship between
symptoms and help-seeking intentions.
A 2 (gender) x 4 (symptom type) model was conducted separately for non-athletes and
athletes to test the moderating effect of gender on the relationship between symptoms and help-
seeking intentions. In all moderation models, help-seeking intention scale score was the dependent
variable, and age and previous help-seeking from psychologist were included as covariates. The
assumption of homogeneity of variance was not violated. All analyses were conducted with IBM
statistics SPSS software version 24.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Ethical Considerations
Participants received information about the study purpose and its anonymity on the
introduction page of the online questionnaire. Participants were informed that participation was
voluntary, and that participation could be withdrawn at any point during the study. Data was
merely accessible to the primary investigator and the supervisor of the study, and was stored on a
private password-protected folder. Considering the small population in Iceland, the athlete
questionnaire was designed in such a way that identification of individual athletes was not possible.
This study was approved by the Icelandic Bioethics Committee (application number 16-148).
Results
Descriptive Analyses
As shown in Table 1, the athlete sample had a higher proportion of participants in the age
ranges 18-20 years of age (30.8 %) than the student sample (8.2 %). Students also reported more
experience of seeking help from a psychologist at some point in their lives (55.0 %) than athletes
(39.3 %), and this difference was statistically significant [χ2 (1) = 12.04, p < .001]. Among
athletes, 75.0 % were currently in the national team or in an elite training group. Athletes competed
in a range of different sports including racquet sports (tennis, badminton, and table tennis),
precision sports (golf, bowling, and shooting sports), aesthetic sports (gymnastics, figure skating,
and dance), speed and conditioning sports (track and field and swimming), combat sports (Judo,
karate, boxing, Taekwondo, and wrestling) and power sports (powerlifting and Olympic
weightlifting). Thirty-five athletes did not specify their sport or their sport did not fall specifically
under any of the categories (e.g. equestrian sports).
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Prevalence
There was a significant difference in prevalence of clinically relevant anxiety symptoms
between athletes and non-athletes [x2 (1) = 6.82, p = .009], with athletes reporting significantly
lower prevalence (20.2 %) than non-athletes (30.7 %). Athletes reported also significantly lower
prevalence of depression symptoms (20.9 %) than students (34.1%) [x2 (1) = 10.26, p = .009].
The Effect of Athlete Status and Gender on Anxiety and Depression Symptoms, and Help-
Seeking Intentions
Means scores for anxiety and depression symptoms, and help-seeking intentions by gender
and athlete status are displayed in table 2.
Anxiety symptoms. There was a significant main effect of athlete status [F (1, 538) =
14.20, p < .001, partial η2 = .03] and gender [F (1, 538) = 13.48, p < .001, partial η2 = .02], but no
significant interaction effect on symptoms of anxiety. Hence independent of athlete status, males
had on average lower levels of depression symptoms than females, and independent from gender,
athletes had on average lower levels of depression symptoms than students. The total model
explained 6.3 % of the variance in anxiety symptoms with age significantly contributing to the
overall model [F (1, 538) = 8.91, p = .003, partial η2 = .02].
Depression symptoms. There was a significant main effect of athlete status [F (1, 535) =
9.92, p = .002, partial η2 = .02] and gender [F (1, 538) = 9.12, p = .003, partial η2 = .02], but no
significant interaction effect on symptoms of depression. Hence independent of athlete status,
males had on average lower levels of depression symptoms than females, and athletes had on
average lower levels of depression symptoms than students, independent from gender. The total
model explained 4.0 % of the variance and the age covariate did not significantly contribute to the
overall model.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Help-seeking intentions. There was a significant main effect gender [F (1, 532) = 9.02, p
= .003, partial η2 = .02], but no significant main effect of athlete status or interaction effect on help-
seeking intentions. Hence independent of athlete status, males had on average lower help-seeking
intentions than females. The overall model explained 12.0 % of the variance in help-seeking and
was significantly influenced by previous help-seeking [F (1, 532) = 37.58, p < .001, partial η2 =
.07] and age [F (1, 532) = 12.89, p < .001, partial η2 = .02].
Moderating Effect of Athlete Status on the Relationship Between Type of Symptom(s) and
Help-Seeking Intentions
Comparing female students and female athletes, there was a significant main effect of
symptom type on help-seeking intentions, [F (3, 342) = 2.98, p = .032, partial η2 = .03], but no
significant main effect of athlete status. There was also a significant interaction effect between
type of symptoms and athlete status on help-seeking intentions [F (3, 342) = 2.91, p = .035, partial
η2 = .03] (figure 1). This suggested that the relationship between symptom type and help-seeking
intentions was moderated by athlete status among females. Simple effects analyses showed that
female athletes with only depression symptoms had significantly lower help-seeking intentions (M
= 3.60, SE = .32) than female students reporting only depression symptoms (M = 4.77, SE = .19),
[F (1, 342) = 9.69, p = .002]. The total model explained 9.1 % of the variance in females’ help-
seeking intentions with previous help-seeking [F (1, 342) = 16.73, p < .001, partial η2 = .05] and
age [F (1, 342) = 8.82, p = .003, partial η2 = .03] significantly contributing to the model.
No significant main or interaction effects were observed for differences between male
athletes and male students. However, previous help-seeking was a significant predictor of male
participants help-seeking intentions [F (1, 171) = 21.58, p < .001, partial η2 = .11].
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Moderating Effect of Gender on the Relationship Between Type of Symptom(s) and Help-
Seeking-Intentions
Comparing male and female students, there was a significant main effect of gender [F (1,
347) = 4.47, p = .035, partial η2 = .01] but no main effect of symptom type or interaction effect
between gender and type of symptoms, suggesting that help-seeking intentions were lower among
male than female students independent from symptom type. The total model explained 8.9 % of
the variance in students’ help-seeking intentions with previous help-seeking [F (1, 347) = 18.47, p
< .001, partial η2 = .05] and age [F (1, 347) = 9.37, p = .002, partial η2 = .03] significantly
contributing to the model.
Comparing male and female athletes, no significant main effect of symptom type or gender
was observed. However, there was a significant cross-over interaction effect between type of
symptoms and gender on help-seeking intentions [F (3, 166) = 2.84, p = .040, partial η2 = .05]
(figure 2). Simple effects analyses showed that female athletes with no clinically relevant
symptoms had higher intention scores (M =4.585, SE =.120) than male athletes with no symptoms
(M =4.205, SE =.114), [F (1, 166) = 5.29, p = .023]. A reverse effect was shown for athletes
reporting only depression symptoms, where male athletes had significantly higher intention scores
(M =4.41, SE =.32) than female athletes (M =3.47, SE =.29), [F (1, 166) = 4.76, p = .030]. The
total model explained 15,1% of athletes’ help-seeking intentions, with previous help-seeking from
a psychologist significantly contributing to the model [F (1, 166) = 19.34, p < .001, partial η2 =
.10]. The influence of age on help-seeking intentions did not reach statistical significance.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Discussion
This study aimed to assess differences in anxiety and depression symptoms, and help-
seeking intentions between individual sport athletes and non-athlete University students in Iceland.
Furthermore, the aim was to extend the current athlete help-seeking literature by exploring the
relationship between symptoms and help-seeking intentions, and if gender or athlete status
moderated this relationship.
The prevalence of clinically relevant symptoms of current anxiety was 20.2 % among
individual sport athletes, which was significantly lower than the 30.7 % prevalence observed
among non-athletes. Athletes reported also significantly lower prevalence of depression symptoms
(20.9 %) than students (34.1%). For mean symptom scores, it was found that independent of
athlete status (i.e. non-athlete or athlete), male participants reported on average lower anxiety and
depression symptom scores than females. Furthermore, both male and female athletes reported
lower symptom scores than their student counterparts. These results are in line with some previous
studies suggesting males have on average lower symptoms of anxiety and depression than females
(e.g. Steel et al., 2014), and that athletes may have lower prevalence of some mental health
disorders than university students (Armstrong & Oomen-Early, 2009) or other non-athlete
populations (Armstrong et al., 2015). Although not specifically addressed in this study, the
observed differences in prevalence of anxiety and depression symptoms could potentially reflect
athletes’ higher internal (e.g. self-esteem) and external (e.g. social support) protective resources
gained through the socialization in and through sports (Armstrong, Burcin, Bjerke, & Early, 2015).
On the other hand, a recent study also showed that 25 % of collegiate athletes engaged in socially
desirable responding when answering questions about depressive symptoms (Gross, Wolanin,
Pess, & Hong, 2017). In their study, Gross and colleagues (2017) also reported that athletes who
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
engaged in socially desirable responding had significantly lower depression symptom scores than
those who did not. As suggested by the authors, future studies may benefit from considering
socially desirable responding when assessing prevalence rates in athletes.
As expected, male participants in this study had lower intentions to seek help from
psychologist than females, and is in-line with findings from previous studies (Addis & Mahalik,
2003). Based on the notion that socialization through sports could promote identification with
norms that may hinder athletes inclination to seek help for mental health problems (Gulliver,
Griffiths, & Christensen, 2012; Steinfeldt et al., 2009; Watson, 2005), it was expected that athletes
would have lower help-seeking intentions than non-athletes. However, this expectation was not
supported, as we did not find statistically significant differences in help-seeking intentions between
athletes and non-athletes. These overall non-significant differences in athletes and non-athletes
help-seeking intentions support Barnard’s (2016) assumption, that help-seeking for mental health
issues among athletes may not be as stigmatized as it may have been before.
An important aspect of the current study was however the idea, that help-seeking intentions
may vary depending on the type of symptoms experienced by individuals (Rickwood et al., 2005).
The second aim of the study explored this argument and it was found that symptom type was
significantly related to help-seeking intentions among females, but not males. For females, the
relationship between symptoms and help-seeking intentions varied as a function of athlete status;
female athletes who experienced clinically relevant symptoms of depression expressed
significantly lower intentions to seek help than female students with these symptoms. Considering
that conformity to traditional masculine gender norms may be more prevalent among female
athletes than female non-athletes (Lantz & Schroeder, 1999; Steinfeldt, Zakrajsek, Carter, &
Steinfeldt, 2011), it is possible that that the lower intentions to seek help among female athletes
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
than female students with depressive symptoms reflected this difference. For example, female
military veterans showed no differences from men in relation to attitudes towards seeking
psychological help in college after service (DiRamio, Jarvis, Iverson, Seher, & Anderson, 2015).
Hence, it is possible that due to their socialization through and in sports, female athletes in this
study identified more with norms discrepant with the act of seeking help than female students.
There was no significant main effect of symptom type on help-seeking when tested within
the student and athlete samples separately. However, there was a significant cross-over interaction
effect of gender and symptom type on help-seeking intentions among the athlete sample. This
suggested that the relationship between symptoms and help-seeking intentions were different
depending on athletes’ gender. More specifically, female athletes with no clinically significant
symptoms reported higher intentions to seek help than their male counterparts. Furthermore, in
athletes reporting clinically relevant depression symptoms, help-seeking intentions were
significantly lower for female than male athletes. Although no specific hypotheses were set forth,
this latter finding was especially surprising considering that males, of different ages, ethnicities,
and social backgrounds, have shown to be less likely than females to seek help for different mental
and physical issues (Addis & Mahalik, 2003). In addition, this gendered help-seeking pattern has
also been consistently reported within the athlete population (Barnard, 2016; Martin et al., 2001,
2004). It is also noteworthy that we did not find any significant effect of anxiety or comorbid
symptoms on help-seeking intentions among the athlete sample.
As discussed by Deane and colleagues (2001), while individuals with minimal symptoms
may initially report intentions to seek help in the future, as mental health symptoms emerge,
intentions to seek help may decrease. Hence, for female athletes, the deliberate decision process
to seek help (i.e. intention) (Rickwood et al., 2005) may have been disrupted due to the type of
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
symptoms they experienced. Although the behavioral characteristics related to depression, such as
decreased levels of interest and energy, and increased hopelessness, may explain the negative
correlation between depression and help-seeking (Nam et al., 2013), it does not explain why
depression symptoms influenced female athletes intentions significantly more than those of
males. One previous study among female non-athletes has however reported similar findings.
Chang (2014) studied help-seeking intentions for depressive symptoms among Chinese University
students and found that help-seeking intentions decreased as symptom severity increased.
Interestingly, Chang also found that gender moderated the effects of symptom severity on help-
seeking, where females with increasing levels of depression were less likely than male students to
seek professional help. These findings are intriguing and underline the importance of assessing
individuals’ symptom type and severity when exploring patterns of help-seeking. Furthermore,
although several studies have supported the notion that males have lower help-seeking intentions
than females, this relationship may not be as straightforward as previously indicated. Hence, within
some population sub-groups such as athletes, females may be in an elevated risk for not seeking
help when levels of depressive symptoms reach clinical relevance.
The Icelandic version of the Beliefs About Psychological Services (I-BAPS), that was
utilized in the current study to measure help-seeking intentions is currently the only measure about
help-seeking intentions that has been adapted to the Icelandic context. In a study by Ægisdóttir &
Einarsdóttir (2012) the psychometric properties of the IBAPS was tested among 336 randomly
selected, 17 to 70 year old Icelandic participants. When comparing the mean scores from that study
with the means in the current study, athletes and non-athletes scored similarly or slightly higher
than the Icelandic general population. However, when considering current symptomology, female
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
athletes with depression symptoms had considerably lower intention scores than the Icelandic
female population.
Although male athletes have been identified as a risk group for not seeking help for mental
health problems, our findings suggested that female individual sport athletes may be less willing
than male athletes to seek help from a Psychologist when experiencing clinically elevated
symptoms of depression. Hence, local and national sport organizations, and other stakeholders
may benefit from taking this possibility into consideration when developing support and
prevention strategies for athletes.
It is also worth noting that previous help-seeking experiences explained a significant
proportion of the total variance in all models, suggesting that previous experiences with a
psychologist may be a robust predictor of help-seeking intentions among Icelandic athletes and
non-athletes. This is in line with previous studies (Aegisdottir & Gerstein, 2009; Rickwood et al.,
2005) and hence, preventive efforts among athletes may benefit from an increased focus on
introducing positive psychological experiences to athletes early in their careers in order to lower
potential barriers to help-seeking. Based on the current results, it seems that Icelandic individual
sport athletes have less experience with seeking help from a psychologist than non-athletes. Future
studies could assess whether this pattern is the rule, rather than the exception within the athlete
population, and hence develop future youth and junior development programs accordingly.
There are some limitations to this study that should be mentioned. Firstly, the study was
cross-sectional in nature and hence causal attributions cannot be made. Also, self-selection bias
due to the convenience sampling methodology could have influenced the current findings, and
hence, these results could be replicated in future studies with a more representative sample.
Furthermore, we did not assess whether athletes were also engaging in other more cooperative
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
forms of competition and/or training (e.g. doubles in tennis, or relays in swimming). Nixdorf et
al., (2016), also noted this aspect of individual sports and hence, future studies could benefit from
more specific inclusion criteria when assessing mental health and/or help-seeking in individual
sport athletes. We did not assess help-seeking from other sources, such as family and friends, and
we did not take into account potential differences in accessibility to psychological services. Thus,
it is possible that female athletes with depression symptoms in this study were more likely to seek
help from other sources than from psychologists, perhaps due to low accessibility to psychological
services. Finally, although 75% of the athletes reported being currently in an elite group or national
team, and that top athletes in Iceland were directly contacted through Facebook or through their
coaches, it is difficult to evaluate athletes’ competitive level in this sample. As discussed by Swann
et al. (2015) the competitive level may vary largely depending on type of sport and depending on
its size and popularity within the country.
Nevertheless, to the author´s knowledge, the current study is the first study to assess the
effect of anxiety and depression symptoms on help-seeking intentions among a sample of athletes
competing in a range of different individual sports. We also utilized standardized measures that
have been adapted to the Icelandic context. Furthermore, we recruited a University student, non-
athlete sample to benchmark the prevalence of individual sport athletes’ anxiety and depression
symptoms, and the influence of these symptoms on help-seeking intentions. Considering that
university students have been shown to be a risk group in terms of prevalence of mental health
disorders (Stallman, 2010) and for underutilizing mental health services (Hunt & Eisenberg, 2010),
this comparison may be informative for relevant stakeholders within Icelandic sports as well as
the educational systems.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Conclusions and future directions
This study provides preliminary findings among individual sport athletes in Iceland and
suggests that although athletes may have in general lower levels of anxiety and depression
symptoms than Icelandic non-athlete university students; female athletes competing in individual
sports that do experience depression symptoms may have lower intentions to seek help from a
psychologist than female non-athletes and male athletes. Considering that previous help-seeking
was the strongest predictor of willingness to seek help from a psychologist, it may be important
for local and national sport organizations, and other stakeholders to promote early contact with
the psychology professionals. By introducing the different aspects of psychological services and
concepts as a normal part of the athletic culture, it is perhaps possible to further promote help-
seeking intentions and behaviors in the future. Future research could benefit from longitudinal
studies to describe the developmental features of mental health disorders and help-seeking among
athletes, and to identify the relevant sport and non-sport specific determinants. Furthermore, more
studies are warranted to replicate the findings concerning the potential negative impact of
depression symptoms on female athleteshelp-seeking intentions.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Figure 1: Help-Seeking Intentions for Female Participants by Athlete Status and Type of
Symptoms.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Figure 2: Help-seeking intentions for athletes by gender and type of symptoms.
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Table 1: Descriptive Statistics for Athletes and Non-Athletes.
Note. University students were not assessed on sport specific factors, hence the dashed cells.
Athletes
Factor
n
%
n
%
Age
18-20
56
30.8
30
8.2
21-23
45
24.7
93
25.3
24-26
31
17.0
72
19.6
27-29
15
8.2
45
12.3
30-32
13
7.1
30
8.2
33-35
8
4.4
36
9.8
36 +
14
7.7
61
16.6
Previous experience with psychologist
No
111
60.7
165
45.0
Yes
72
39.3
202
55.0
National or elite group
Yes
138
75.0
-
-
No
46
25.0
-
-
Type of sport
Racquet
24
12.8
-
-
Precision
32
17.1
-
-
Aesthetic
13
7.0
-
-
Speed and conditioning
36
19.3
-
-
Combat
25
13.4
-
-
Power
22
11.8
-
-
Other
35
18.7
-
-
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The Influence of Anxiety and Depression Symptoms on Help-Seeking Intentions in Individual Sport Athletes and Non-Athletes:
The Role of Gender and Athlete Status by Tahtinen RE
Journal of Clinical Sport Psychology
© 2018 Human Kinetics, Inc.
Table 2: Means, Standard Deviations, and Sample sizes in Anxiety, Depression, and Help-Seeking
Intentions by Gender and Athlete Status.
Measure
Gender
Athlete status
N
M
SD
Anxiety symptoms
Male
Non-athletes
98
6.46
4.94
Individual sport athletes
85
4.94
3.93
Total
183
5.75
4.55
Female
Non-athletes
266
8.13
5.22
Individual sport athletes
94
6.79
4.43
Total
360
7.78
5.05
Total
Non-athletes
364
7.68
5.19
Individual sport athletes
179
5.91
4.29
Total
543
7.10
4.98
Depression
Male
Non-athletes
97
6.89
5.59
Individual sport athletes
85
5.48
4.22
Total
182
6.23
5.03
Female
Non-athletes
265
8.44
5.42
Individual sport athletes
93
7.05
5.13
Total
358
8.08
5.37
Total
Non-athletes
362
8.02
5.50
Individual sport athletes
178
6.30
4.77
Total
540
7.46
5.33
Help-seeking intentions
Male
Non-athletes
97
4.37
1.13
Individual sport athletes
85
4.21
0.97
Total
182
4.30
1.06
Female
Non-athletes
262
4.77
1.09
Individual sport athletes
94
4.49
0.98
Total
356
4.69
1.07
Total
Non-athletes
359
4.66
1.11
Individual sport athletes
179
4.36
0.98
Total
538
4.56
1.08
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... IBM Corp., Armonk, NY). Following cleaning and screening checks for missing data and outliers, four univariate and nine multivariate outliers were removed (Tabachnick & Fidell, 2019). Descriptive and frequency statistics were also produced, followed by 2 one-way between-groups multivariate analysis of variance test for investigating differences in reappraisal and suppression use by gender and competitive level. ...
... Surprisingly, there were nonsignificant gender differences in depression and mental well-being scores, despite male athletes using the ostensibly "maladaptive" strategy of suppression more so than females. The present finding contrasts to previous studies in athlete and nonathlete samples which more typically report that females experience greater levels of depressive symptomatology (Tahtinen & Kristjansdottir, 2018). Therefore, it may be argued that, despite males using more suppression, this does not increase their risk of experiencing higher depressive symptoms and the potential benefits of sport participation hold true, independent of gender. ...
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This study investigated the relationship between reappraisal and suppression with depression and mental well-being among university athletes. It was hypothesized reappraisal would associate with lower depression and greater mental well-being, whereas suppression would associate with greater depression and reduced mental well-being. Employing a cross-sectional design, 427 participants ( M age = 20.18, SD = 1.52; 188 males and 239 females) completed questionnaires assessing mental health and strategy use. Hierarchical multiple regressions revealed reappraisal was positively associated, and suppression negatively associated with mental well-being, Δ R ² = 4.8%, Δ F (2, 422) = 17.01, p ≤ .001; suppression, β = −0.08, p = .028; reappraisal, β = 0.21, p ≤ .001, but neither were associated with depression, Δ R ² = 0.4%, Δ F (2, 422) = 1.33, p = .267; suppression, β = 0.06, p = .114; reappraisal, β = 0.03, p = .525. Results highlight reappraisal as correlated with mental well-being in student-athletes, and therefore, reappraisal could be beneficial for managing stress in sport. Reappraisal may implicate how well-being is promoted through sport, but future experimental research is needed to confirm causal relationships.
... One of the aims of this study was, therefore, to explore sum scores from the perspective of DSM criteria. Several studies in athletes have utilized PHQ-9 scores ≥10 as a cutoff for identifying clinically relevant cases and reporting prevalence rates (Bell et al., 2016;Du Preez et al., 2017;McGuire, Ingram, Sachs, & Tierney, 2017;Silva-Rocha, de Sousa, & Osório, 2019;Tahtinen et al., 2020;Tahtinen & Kristjansdottir, 2019). We, however, speculated that when applying this cutoff, athletes could attain clinically significant scores without exhibiting the core symptoms of depression (i.e., lack of interest and depressed mood). ...
... In Iceland (as in many other countries; Moesch et al., 2018), there are currently no systematic protocols in place for the assessment or treatment of mental health issues in athletes. However, as the current and previous findings (e.g., Kristjánsdóttir, Sigurðardóttir, Jónsdóttir, Þorsteinsdóttir, & Saavedra, 2019;Tahtinen & Kristjansdottir, 2019) suggest, more systematic approaches to providing mental health support among the Icelandic athlete population may be warranted. ...
Article
The aim of the study was to explore the prevalence of specific symptoms of depression in athletes and to test differences in the likelihood of athletes exhibiting these symptoms across age, sex, type of team sport, and level of competition. A sample of Icelandic male and female team sport athletes (N = 894, 18-42 years) was included in the study. Of the athletes exhibiting clinically significant depressive symptoms on the Patient Health Questionnaire-9, 37.5% did not exhibit core symptoms of depression. Compared with males, females were significantly more likely to exhibit depressed mood, feelings of worthlessness/guilt, and problems with sleep, fatigue, appetite, and concentration. Within males, differences were mostly related to neurovegetative aspects of depression (sleep and appetite), whereas in females, differences were related to cognitive/ emotional aspects (e.g., depressed mood, guilt/worthlessness). The findings underline the importance of exploring specific symptoms of depression to provide a richer understanding of depressive symptomology in athletes. Within the past decade, depression-related research in athletes has aimed at establishing an improved understanding of athletes' susceptibility to depression and depressive symptoms (Golding,
... These findings suggest that higher levels of competition are more likely to trigger higher levels of state anxiety and lower self-confidence in athletes. A recent study showed that males were less likely than females to seek professional help from a psychologist within the healthy athlete population (Tahtinen & Kristjansdottir, 2019). The process of socializing male athletes into masculine roles may be especially prevalent within the sport culture where the masking of anxiety, vulnerability (Doherty, Hannigan, & Campbell, 2016) and demonstrating toughness, and ignoring or downplaying injury may be strongly emphasized (Steinfeldt, Steinfeldt, England, & Speight, 2009). ...
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This study compares the levels of felt arousal and cognitive anxiety between male and female archers across different competition stages. Fifty-seven professional recurve archers (28 men, 29 women) who participated in the Asian Archery Championships were recruited as participants. Their levels of felt arousal and cognitive anxiety were recorded during the stages of qualifying, individual elimination, and team competition using the Sport Grid-Revised. The results showed no sex-based differences in competitive anxiety when competition stages were considered. However, the female archers demonstrated higher levels of felt arousal and cognitive anxiety than the male archers across the different stages. Further, all archers regardless of sex showed higher cognitive anxiety in the individual elimination and team competition stages than the qualifying stage. The findings show sex-based differences in felt arousal and cognitive anxiety before competitions. In addition, increasing cognitive anxiety is likely associated with fundamental differences in levels of competition pressure at various stages of a match. It seems beneficial for athletes to focus on reducing gender stereotypes through preventive interventions and developing effective coping strategies toward competitive anxiety.
... Anxiety is a sensation of uneasiness and worry, typically generalized and unfocused as an overreaction to a condition that is only subjectively seen as intimidating (Brandt et al., 2018;Tahtinen and Kristjansdottir, 2018). This feeling has been an essential concept for sports psychology and has demanded intensive investigation in combat sports for its effects on championship performance in karate (Friesen et al., 2018), judo (Matsumoto et al., 2000;Interdonato et al., 2013), kendo (Usui et al., 2018), jiu-jitsu (Andreato et al., 2014), taekwondo (Maloney et al., 2018), and wrestling (Bawa, 2010). ...
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Depression among elite athletes is a topic of increasing interest and public awareness. Currently, empirical data on elite athletes’ depressive symptoms are rare. Recent results indicate sport related mechanisms and effects on depression prevalence in elite athlete samples; specific factors associated with depression include overtraining, injury and failure in competition. One such effect is that athletes competing in individual sports were found to be more prone to depressive symptoms than athletes competing in team sports. The present study examined this effect by testing three possible, psychological mediators based on theoretical and empirical assumptions: namely, cohesion in team or training groups; perception of perfectionistic expectations from others; and negative attribution after failure. In a cross-sectional study, 199 German junior elite athletes (Mage = 14.96; SD = 1.56) participated and completed questionnaires on perfectionism, cohesion, attribution after failure, and depressive symptoms. Mediation analysis using path analysis with bootstrapping was used for data analysis. As expected, athletes in individual sports showed higher scores in depression than athletes in team sports (t(197) = 2.05; p < .05; d = .30). Furthermore, negative attribution after failure was associated with individual sports (β = .27; p < .001), as well as with the dependent variable depression (β = .26; p < .01). Mediation hypothesis was supported by a significant indirect effect (β = .07; p < .05). Negative attribution after failure mediated the relationship between individual sports and depression scores. Neither cohesion nor perfectionism met essential criteria to serve as mediators: Cohesion was not elevated in either team or individual sports, and perfectionism was positively related to team sports. The results support the assumption of previous findings on sport specific mechanisms (here the effect between individual and team sports) contributing to depressive symptoms among elite athletes. Additionally, attribution after failure seems to play an important role in this regard and could be considered in further research and practitioners in the field of sport psychology.
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Evidence on the prevalence of symptoms related to distress, anxiety/depression or substance abuse/dependence, – typically referred to as symptoms of common mental disorders (CMD) – is lacking in European professional football (soccer). The aims of the present study were to investigate the prevalence of symptoms related to CMD (distress, anxiety/depression, sleeping disturbance, adverse alcohol behaviour, and adverse nutrition behaviour) in professional footballers from five European countries , and to explore associations of the outcome measures under study with life events and career dissatisfaction. A cross-sectional design was used. Questionnaires were distributed among professional footballers by the national players' unions in Finland, France, Norway, Spain and Sweden. The highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway). In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour. Results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team.
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Given that there is evidence that college student-athletes may be at risk for psychological disturbances (Pinkerton, Hintz, & Barrow, 1989), and possibly underutilizing college mental health services (Watson & Kissinger, 2007), the purpose of this study was to examine attitudes toward mental illness and help seeking among college student-athletes compared to college student nonathletes. The roles that athletic identity and gender play in treatment-seeking comfort were examined. Contrary to what was hypothesized, the results showed that student-athletes and nonathletes did not significantly differ in willingness to seek mental health treatment. Student-athletes perceived significantly less discrimination toward individuals based on mental illness status.