A conceptual model for mental health and performance of North American athletes: A mixed methods study

ObjectiveThe demands of sport create psychological and physical challenges for athletes, making it essential to understand what factors contribute to mental health and performance optimization in sport. The purpose of this mixed-methods investigation was to develop a conceptual model for mental health and performance of North American athletes.MethodForty-three experienced athletes, coaches, and sport professionals identified, sorted, and rated 113 behaviors, thoughts, and feelings that contribute to optimal mental health and performance for athletes. Using Multidimensional Scaling, the research team created a two-dimensional point map of participant responses. Hierarchical Cluster Analysis was then used to reveal underlying clusters in the data.FindingsSeven clusters emerged from the data: Stress Management, Mental Skills, Self-Awareness, Managing Setbacks, Intentional Practice, Team Relationships, and Social Support. Though all clusters were rated as important to mental health and/or performance, the Managing Setbacks cluster displayed high importance ratings for both mental health and performance.ConclusionOur preliminary findings suggest a comprehensive approach to athlete thoughts, feelings, and behaviors contributes to optimal mental health and performance for North American athletes.     

Pregnancy and motherhood in elite sport: The longitudinal experiences of two elite athletes

Since the end of the 20th century, the elite athlete mother has been a growing social phenomenon, with increasing numbers of female athletes returning to elite level sport postpartum. Allyson Felix and Serena Williams are two recent elite athletes who successfully transitioned into their new identity of elite athlete mother. However, there is no guarantee that all transitional journeys will be as successful. The purpose of the present study was to enhance current knowledge of the experiences during pregnancy and motherhood in elite sport by exploring how becoming a mother impacted on the perceived personal and physical identity of elite athletes. Two elite athletes who had recently given birth to their first child were interviewed at two-months, six-months, and 15–16 months post-birth. Interviews were analyzed using a reflexive thematic analysis to explore how identity may have changed over the initial 15–16 months of motherhood. Three themes were developed, comprising: athlete identity; mother identity; and athlete mother identity. The sub-themes of identity, physical identity, shifting of goals, juggling athlete and mother identity, dual identity, priorities, and lifestyle were generated and demonstrated both similarities and nuances in the experiences of the two athletes. This study is the first to provide longitudinal insights into the experiences of both para and non-para elite athlete mothers during the initial stages of motherhood. Findings highlight the individual nature of such an experience and illuminate some of the negotiations of the personal, athlete, and mother identity that an athlete mother may experience.     

Gaining perspectives: A scoping review of research assessing depressive symptoms in athletes

The aim of this review was to 1) describe methodological characteristics of the research that has assessed depressive symptoms in athletes, and 2) to map the variables that have been tested in relation to these symptoms. A review framework proposed by Arksey and O’Malley (2005) was utilized, and of 6983 records screened, 157 studies were included. Most studies were cross-sectional, with samples including current male and female athletes from multiple sports and levels. Non-athlete comparison groups frequently consisted of student samples. Twenty-eight different depression scales were utilized, of which CES-D, BDI, BDI-II, and the PHQ-9 were most common. The most commonly tested variables in relation to depressive symptoms were identified as proximal (micro- and meso-level) sport-specific (e.g. type of sport) (36.4%) and generic (e.g. sex) (31.5%) factors. Within-individual vulnerabilities (e.g. neurocognitive performance) accounted for 17.2%, while comorbid disorders accounted for 9.3%, and macro-level variables (e.g. ethnicity) for 5% of all observations. Longitudinal studies within specific sports are needed to understand the relative influence of sport-specific and generic factors on depressive symptoms in athletes. Few studies explored sociocultural or macro-level factors, and research concerning within-individual vulnerability is fragmented and needs to be further explored to inform individual-level support and prevention initiatives.     

Effects of psychological interventions on competitive anxiety in sport: A meta-analysis

ObjectivesThis study reviewed the effects of psychological interventions on competitive anxiety in sport.DesignMeta-analysis and systematic review.MethodPsycINFO, PsycARTICLES, SPORTDiscus, Web of Science, ProQuest, and Sage databases were searched for experimental studies that fulfilled the inclusion criteria. Risk of bias was assessed using the 12 criteria Cochrane Review Book Group tool. Hedge's g and 95% confidence intervals (CIs) were calculated and pooled using a random effects model employing the Hartung-Knapp-Sidik-Jonkman (HKSJ) method.ResultsThe search strategy identified 37 studies which fulfilled the inclusion criteria. The meta-analysis was conducted on 34 studies after removal of outliers. The results showed an overall small to medium-sized effect for psychological interventions on competitive anxiety in athletes (g = −0.42; 95% CI, −0.58 to −0.25). Subsequent subgroup analyses showed that this finding was robust regardless of experimental design, anxiety measure, anxiety type, gender, country, sport, intervention component, intervention delivery method, and intervention duration. The results indicated that the effects might be greater for athletes of higher levels of competition as compared to those from lower levels of competition. Separate meta-analyses also suggested that there were medium to large-sized effects for cognitive anxiety (g = −0.54) and self-confidence (g = 0.55) intensity, and a small to medium-sized effect for somatic anxiety (g = −0.36) intensity.ConclusionThe findings from this review study provide a robust evidence base for the use of psychological interventions to help reduce competitive anxiety in athletes. Future studies need to investigate how psychological interventions might affect the directional interpretation of anxiety symptoms.     

Narrative, identity and mental health: How men with serious mental illness re-story their lives through sport and exercise

ObjectivesIt has been suggested that mental illness threatens identity and sense of self when one's personal story is displaced by dominant illness narratives focussing on deficit and dysfunction. One role of therapy, therefore, is to allow individuals to re-story their life in a more positive way which facilitates the reconstruction of a meaningful identity and sense of self. This research explores the ways in which involvement in sport and exercise may play a part in this process.DesignQualitative analysis of narrative.MethodWe used an interpretive approach which included semi-structured interviews and participant observation with 11 men with serious mental illness to gather stories of participants’ sport and exercise experiences. We conducted an analysis of narrative to explore the more general narrative types which were evident in participants’ accounts.FindingsWe identified three narrative types underlying participants’ talk about sport and exercise: (a) an action narrative about “going places and doing stuff”; (b) an achievement narrative about accomplishment through effort, skill or courage; (c) a relationship narrative of shared experiences to talk about combined with opportunities to talk about those experiences. We note that these narrative types differ significantly from—and may be considered alternatives to—dominant illness narratives.ConclusionThis study provides an alternative perspective on how sport and exercise can help men with serious mental illness by providing the narrative resources which enabled participants to re-story aspects of their lives through creating and sharing personal stories through which they rebuilt or maintained a positive sense of self and identity.     

When the final whistle blows: Social identity pathways support mental health and life satisfaction after retirement from competitive sport

For many athletes, retirement from higher levels of competitive sport poses significant challenges. Research has shown that athletic identity is a key predictor of adjustment trajectories, but the mechanisms through which this affects outcomes are less clear. Added to this, there has been limited research on the role that wider social identities, and the resources they enable, play in adjustment. Addressing both these issues, we examined theoretically derived social identity pathways to retirement adjustment in athletes who had played sport at higher competitive levels and two potential mechanisms, or psychological resources, through which adjustment might be enabled. This was examined in two samples: retired athletes from countries in Western (n = 215) and Eastern (n = 183) regions. Loss of athletic identity, social group memberships (multiple, maintained and new), psychological resources (perceived meaning in life and control), and adjustment (life satisfaction, depression, and perceived physical health) were assessed. In both samples, the loss of athletic identity undermined adjustment by reducing meaning in life and perceived control. Path analysis showed that both maintained and gained social group memberships counteracted the negative effects of athletic identity loss on adjustment. Evidence that these pathways enabled access to psychological resources was found primarily in Chinese athletes, with maintained groups influencing personal control and new groups influencing meaning in life. These findings highlight the importance of social identity processes to retirement from higher levels of competitive sport and the mechanisms through which they can either support or undermine adjustment.     

Media presentation of the mental health bill and representations of mental health problems

This paper discusses the findings of a study that examined the way in which the Mental Health Bill of June 2002 was presented in the British national and local media over a 3‐year period. A Lexis Nexis search yielded 256 articles, which were then analysed qualitatively and quantitatively. Overall, and perhaps contrary to what might have been expected given previous studies' conclusions regarding the media's negative portrayal of mental ill health, most articles tended to present a negative view of the Bill as unnecessarily repressive, and consequently were more sympathetic towards mental heath service clients, although this was not the case for tabloid articles. However, this paper then considers the more implicit representations found within the articles. It focuses particularly on the continued linking of mental ill health and violence, and also on the way in which the mental health service user might be portrayed as passive and rather pitiful as an alternative to violent and dangerous. It is suggested that the continued use of such images may stem from the fact that mental health problems have long been constructed as ‘Other’, and are therefore deeply engrained in our society. The implications of this for anti‐stigma campaigns are briefly discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Self-compassion and women athletes' responses to emotionally difficult sport situations: An evaluation of a brief induction

ObjectivesTo examine self-compassion as a way to promote healthy responses in women athletes when faced with emotionally difficult sport-specific situations.DesignPhase I, cross-sectional; Phase II, experimental.MethodsIn Phase I, participants (N = 101; M_age = 20.0, SD = 2.8 years) completed measures of self-compassion, self-esteem, and narcissism, as well as reactions, thoughts, and emotions in response to hypothetical (i.e., responsible for a team loss) and recalled scenarios. Participants returning for Phase II were randomly assigned to a brief self-compassion induction (n = 21), self-esteem induction (n = 20), or writing control (n = 18) group. Following the induction, they responded to the same hypothetical scenario as in Phase I.Phase I resultsAfter partialling out self-esteem and narcissism, self-compassion was related (p < .01) to negative affect (r = −.40), catastrophizing thoughts (r = −.30), personalizing thoughts (r = −.32), and behavioral equanimity (r = .28) for the hypothetical scenario. A similar pattern was found for the recalled scenario.Phase II resultsA MANOVA with Phase I self-compassion, self-esteem, and narcissism as covariates resulted in a non-significant group by time interaction, Wilks' Lambda = .75, F(12,96) = 1.27, p = .25. Follow-up hierarchical regression analysis showed Phase I levels of self-compassion as the only significant predictor for negative affect, personalizing thoughts, and behavioral equanimity.ConclusionsWomen athletes with higher self-compassion levels generally responded in healthier ways to emotionally difficult hypothetical and recalled situations in sport than their less self-compassionate counterparts. However, future research needs continued focus on evaluating self-compassion inductions and interventions for use in sport.     

“双37”高射炮兵自我概念与心理健康相关研究

目的:探讨"双37"高射炮兵自我概念与心理健康之间的关系。方法:采用田纳西自我概念量表(TSCS)和临床症状自评量表(SCL-90),对143名"双37"高射炮兵的自我概念与心理健康进行了测量、统计与分析。结果:不同自我概念水平的"双37"高射炮兵在SCL-90上的得分有显著差异,且"双37"高射炮兵自我概念及各因子(自我批评因子除外)均与心理健康状况呈显著的正相关。对"双37"高射炮兵心理健康影响最大的是心理自我,其次是生理自我。结论:引导"双37"高射炮兵正确评价自己、悦纳自己是促进其心理健康的有效途径。     

Exploring athletes' perceptions of the relationship between mental toughness and dispositional flow in sport

ObjectivesDespite considerable scholarly attention over the last two decades, little is known about the influence of dispositional attributes on flow in sport. In achievement settings, mental toughness (MT) is a personal capacity supporting the process of high performance. Based on common overlaps with peak performance, confidence, control, concentration, and thriving in demanding situations, the present research aimed to explore the relationship between MT and dispositional flow and elucidate the psychological variables underlying dispositional flow.DesignA mixed method explanatory participant-selection design was adopted, whereby a quantitative approach was used to identify individuals for a qualitative follow-up phase to explore the relationship between MT and dispositional flow.MethodAn intensity sampling strategy was used to identify individuals with higher/lower MT and dispositional flow. Semi-structured interviews were conducted with 16 athletes (M age = 25, SD = 3.24; female n = 10; male n = 6). An inductive content analysis was undertaken to interpret data.ResultsSeven general dimensions describing the psychological attributes related to dispositional flow in athletes with higher and lower MT emerged. Specifically, differences in confidence, perfectionism, goal orientation, coping mechanism selection, locus of control, optimism and concentration were apparent and could account for differences in dispositional flow.ConclusionWhile all athletes experienced flow, there were differences in dispositional flow and the processes involved in entering, maintaining and restoring flow between higher and lower MT subgroups. Findings are discussed in relation to the existing literature, and recommendations for future research into the MT-flow relationship are outlined.     

The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.     

The link between involuntary non-regular employment and poor mental health: A cross-sectional study of Japanese workers

Involuntary non-regular employment is a severe inequity problem worldwide, and it may significantly affect the mental health of employees. The present study aimed to examine the relationship between employment type and mental health. Additionally, the characteristics of involuntary non-regularly employed workers were explored. An online-based cross-sectional study was conducted in Japan, and 1566 participants were included in the data analysis. The eligible participants were divided into four categories: regularly employed (n = 1092), voluntary (n = 134), average (n = 233) and involuntary (n = 107) non-regularly employed individuals, respectively. Involuntary non-regular employment was associated with greater lack of vigour, anger-irritability, fatigue, anxiety, and depression. It was higher among women, those who were single or had no childcare, and those who had lower personal income or shorter working hours, or who tended not to practice relaxation activities. Lower personal income was associated with a risk of anxiety and depressive symptoms. Those individuals experiencing involuntary non-regular employment had a higher risk of poor mental health; subgroup analysis showed that this was particularly true among men. Both encouragement of employment stability via policy reform and workplace mental health support for involuntary non-regularly employed individuals are urgent health concerns.     

National attitudes towards mental health treatment: the importance of research evidence

Most conceptualizations of evidence-based practice view it as a “three legged stool” consisting of: the use of best available research evidence, clinical expertise, and client preferences. Although empirical evidence and clinical expertise have received greater empirical attention, relatively little research has systematically explored client preferences. The present study analyzed self-reported treatment preferences for various clinical and non-clinical presentations. Adult participants (n = 1262) residing in the United States were presented with diagnostic vignettes and rated their relative preferences among 5 treatment variables, including: use of an empirically supported treatment (EST), quality of the client–therapist relationship, therapist empathy, therapist experience, and client speaking for the majority of therapy sessions. Results indicated that participants endorsed significant preference for receiving an EST over other treatment variables for all clinical disorders, with effect sizes ranging from small to large depending on the diagnosis. There was slightly greater variability in treatment preferences for non-clinical issues, though participants generally reported greater preference for receiving an EST. Follow-up questions provided further evidence for EST preferences. The implications of these results are discussed.     

Organizational justice and mental health: A multi‐level test of justice interactions

We examine main and interaction effects of organizational justice at the individual and the organizational levels on general health in a Kenyan sample. We theoretically differentiate between two different interaction patterns of justice effects: buffering mechanisms based on trust versus intensifying explanations of justice interactions that involve psychological contract violations. Using a two‐level hierarchical linear model with responses from 427 employees in 29 organizations, only interpersonal justice at level 1 demonstrated a significant main effect. Interactions between distributive and interpersonal justice at both the individual and the collective levels were found. The intensifying hypothesis was supported: the relationship between distributive justice and mental health problems was strongest when interpersonal justice was high. This contrasts with buffering patterns described in Western samples. We argue that justice interaction patterns shift depending on the economic conditions and sociocultural characteristics of employees studied.     

Fitness- and appearance-related self-conscious emotions and sport experiences: A prospective longitudinal investigation among adolescent girls

Despite well-documented benefits of sport participation for adolescents, girls are less likely to initiate participation and more likely to disengage from sport, compared to boys. Due to the highly evaluative and social nature of the sport context, girls’ emotional experiences around their body’s abilities, function, and fitness are important – yet understudied – predictors of sport participation. The objectives of this longitudinal study were to describe changes in fitness-related and appearance-related self-conscious emotions (i.e., guilt, shame, authentic pride, hubristic pride) and sport experiences (i.e., sport commitment, enjoyment, anxiety) over time, and examine whether between- and within-person differences in these emotions predict sport experiences during adolescence. A sample of 518 girls involved in organized sport completed questionnaires once a year over a three-year period. Results from multilevel models reveal detrimental changes in emotions, sport commitment and enjoyment over time. Further, fitness-related emotions remain significant predictors of sport experiences above and beyond appearance-related emotions thus highlighting the importance of fitness-related emotions in predicting sport experiences. Examining both between and within-person effects is novel in elucidating the predictive capacity of fitness-related emotions as they explain differences between girls – as well as variations in girls’ sport experiences over time.     

Correlates of youth sport attrition: A review and future directions

ObjectivesThis review aims to (a) identify correlates of youth sport attrition, (b) frame correlates within a multilevel model of youth sport participation (i.e., biological, intra-personal, inter-personal, institutional, community, and policy levels), and (c) assess the level of evidence for each correlate.DesignReview paper.MethodsSystematic review method.ResultsEntering relevant search terms into PubMed, PsycINFO, SPORTDiscus and Web of Knowledge databases identified 23 articles with a total of 8345 participants. Satisfactory articles largely examined sport-specific attrition and sampled youth from western countries (e.g., Canada, France, Spain, United States). Of the 141 correlates examined, most were framed at the intrapersonal (90) and inter-personal levels (43). The level of evidence for each correlate (i.e., high, low, insufficient) was systematically assessed based on the quantity and quality of supporting articles. In total, 11 correlates were categorized as having a high quality level of evidence and 10 as having a low quality. High quality correlates included, among others, age, autonomy, perceived competence, relatedness, and task climate.ConclusionsOverall, established correlates of youth sport attrition are largely social in nature. Future directions surrounding (a) the need to examine correlates at lower (i.e., biological level) and higher (i.e., institutional, community, policy) analytic levels, (b) to sample participants from more culturally diverse societies and (c) to examine sport-general attrition are offered.     

Review of refugee mental health and wellbeing: Australian perspectives

This review covers refugee mental health and wellbeing within the Australian context to assist psychologists who provide services for, or who conduct research with, refugees. It provides a brief overview of the refugee movement, prior to examining evidence relating to the impacts of pre‐displacement, displacement and resettlement factors on psychological adjustment in the resettlement phase, and the systemic and sociopolitical factors that influence the process of adaptation during resettlement. Australian findings suggest that mental health and wellbeing outcomes are influenced by a complexity of pre‐displacement, displacement, resettlement and systemic factors; the detention or award of temporary residence to refugees who are already experiencing psychological distress on arrival are cases in point. Limitations of the findings are considered. More research into the combined, pathwise relations between the psychosocial pre‐determinants and psychological sequelae of the refugee experience is required. Finally, suggestions for the development of practice, training and ethical guidelines are offered.     

Gender-linked personality and mental health: The role of trait emotional intelligence

The present study examined the role of the emotion-related personality dimension, or trait emotional intelligence (EI), in the relationship between gender-linked personality (GLP) traits and internalizing mental health difficulties (IMHDs). GLP traits were measured as Agency and Communion, due to conceptual advantages over other semantic representations (e.g., masculinity, femininity) in the literature. IMHDs as the outcome variable were conceptualized as a latent composite of anxiety, stress, and emotion-oriented coping. A moderate relationship between Agency and IMHDs was fully mediated by trait EI. Trait EI also divided an overall non-significant effect of Communion on IMHDs into an indirect, protective effect via trait EI and a direct, adverse effect. The results suggest that Agency and Communion subsume different sets of trait EI facets, which may account for much of the differential protective effects of these GLP traits on IMHDs. Discussion focuses on implications of the results for sex differences in mental health.     

Early identification of mental health problems in schools: The status of instrumentation

When embedded within a continuum of mental health services including both prevention and treatment, school-based mental health identification programs can promote improved academic and mental health functioning among students. This article describes the scientific status of assessment instrumentation that may be used for early mental health identification in schools. Currently available instruments are described in terms of their ability to accurately detect youth with mental health problems. Implications for selecting mental health screening and assessment instruments and integrating them into schools are discussed. Finally, a range of approaches to early identification in schools as well as some of the broader ethical and practical issues related to the integration of these strategies into a school-wide continuum of services are presented.