Integrating technology in psychological skills training for performance optimization in elite athletes: A systematic review

ObjectivesThe aim of the current study was to systematically review the literature on the integration of technology in psychological skills training (PST) to optimize elite athletes’ performance.DesignSystematic review.MethodPublished English, Italian, and Russian language articles were identified using electronic databases. Eighteen articles (out of 3753 records) fulfilled the inclusion criteria, and their quality was assessed using the Mixed Method Appraisal Tool (MMAT). Six papers were judged to be excellent and four to be high quality. There were significant methodological inconsistencies across eight studies. An overall score of quality assessment ranged from 20% to 100%.ResultsThe included studies implemented various technologies, in combination with PST, to identify, monitor and/or have an intervention aimed at optimizing elite athletes' performance. The results suggested that the integration covered different meanings, i.e., functional integration, integration between technologies and measures, integration between technology, theoretical framework, and psychological skills training. There was no distinct consistency between the studies with regards to the theory or model used.ConclusionsTechnology and mental training should not be viewed as interchangeable facets of performance enhancement, but rather as complementary ones – where technology integrated in psychological skills training can lead to identify and monitor optimal performance and to implement more effective interventions.     

The influence of an esports-adapted coping effectiveness training (E-CET) on resilience,mental health,and subjective performance among elite league of Legends players: A pilot study

ObjectiveThis study aimed to develop, and pilot esports-adapted coping effectiveness training (E-CET) and measure its influence on coping effectiveness (global and specific), subjective performance, mental health (psychological distress and wellbeing), and resilience.DesignFive elite male League of Legends players competing in the League of Legends Circuit Oceania participated in a mixed methods research design. The effects of E-CET were measured using a within-subjects quasi-experimental design (i.e., pre-to-post, no control group). To measure the effects of E-CET on specific stressors, a longitudinal diary design was used.MethodPlayers participated in a 2-h session of E-CET and a 45-min follow-up workshop. The 2-h workshop delivered content on two conceptual areas: (1) developing awareness of the stress and coping process; and (2) how to cope with stress. Players completed pre-intervention, post-intervention, and follow-up measures and twice-weekly stress journals.ResultsE-CET led to increases in players' perceived coping effectiveness and subjective performance, but there were no changes in psychological distress, psychological wellbeing, and resilience. However, the results indicate some positive signs for future coping interventions with League of Legends players and iterations of E-CET.ConclusionThe E-CET program appears to provide an opportunity to improve performance and mental health for esports players.     

Canadian athletes' perspectives of mental health care and the importance of clinicians' sport knowledge: A multi-method investigation

The purpose of this inquiry was to explore Canadian competitive athletes' perspectives on their mental health care experiences using a sequential multi-method design. The overarching aims of the study were to explore athletes' self-reported reasons for seeking mental health care, their awareness of their clinician's knowledge of sport, and the importance they placed on their clinician having knowledge of the sport context. A sequential mixed methods design was employed in which two studies were conducted to address these aims. In study one, 70 current and former Canadian athletes completed a short survey assessing basic demographics, athletes' reasons for seeking treatment, and the importance they placed on their clinician having sport knowledge for effective care. In study two, ten athletes participated in individual semi-structured interviews in which similar topics were explored. Fifty-six percent of surveyed athletes reported that their clinicians' knowledge of sport did not impact their treatment experience, however only 29% reported being aware of their clinician having such knowledge. Thematic analysis of the interview data suggested that the connectedness of athletes' mental health issues and sport participation played a role in the importance they placed on their clinician having sport knowledge. Key components of a successful therapeutic alliance included the clinician validating the importance of sport, normalizing athlete mental health challenges, and understanding the demands of the competitive sport culture. Conclusions of this inquiry include that assessing how inter-related an athlete perceives their mental health challenges and sport participation to be, and demonstrating an understanding of the importance of sport in competitive athletes' lives, are likely helpful strategies in working clinically with this population even if a clinician does not have specific experience with the sport context.     

Sleep interventions for performance,mood and sleep outcomes in athletes: A systematic review and meta-analysis

Sleep is fundamental to sports performance and other health outcomes such as mental wellbeing. This systematic review explored the effects of sleep interventions implemented among athletes on performance, sleep, and mood outcomes. Five databases were searched, returning 5996 records for screening. Of these, 27 articles met the inclusion criteria (16 controlled deigns, 11 uncontrolled; athletes n = 617; male n = 432, female n = 93, non-binary/other n = 0 or not reported n = 92). Narrative synthesis of all studies based on intervention type suggested that sleep hygiene, assisted sleep, and sleep extension interventions may be associated with improved sleep, performance, and mood outcomes. Twelve controlled trials were eligible for quantitative meta-analysis, investigating the effect of sleep interventions on athlete sleep, performance, and negative affect, compared to controls post-intervention. Utilizing random-effects meta-analyses, sleep interventions improved subjective sleep quality (g = 0.62, 95% CI [0.21, 1.02]), reduced sleepiness (g = 0.81, 95% CI [0.32, 1.30]) and decreased negative affect (g = 0.63, 95% CI [0.27, 0.98]), but did not appear to influence subjective sleep duration. No effects were identified for objective sleep measures (e.g., actigraphy), or aerobic/anaerobic performance indices. While sleep interventions may offer some benefit to athletes, caution is warranted given limitations of the extant research relating to small, non-representative studies with methodological concerns.     

Cumulative lifetime stress exposure,depression, anxiety,and well-being in elite athletes: A mixed-method study

Research suggests that elite athletes are at increased risk of poor mental health, partly due to the intense demands associated with top-level sport. Despite growing interest in the topic, the factors that influence the mental health and well-being of elite athletes remain unclear. From a theoretical perspective, the accumulation of stress and adversity experienced over the life course may be an important factor. To investigate this possibility, we employed a mixed-method design to: (a) examine whether cumulative lifetime stress predicted depression, anxiety, and well-being in elite athletes; and (b) help explain why cumulative lifetime stress exposure might have resulted in poor mental health and well-being. Ninety-five elite athletes (M_age = 29.81, SD = 10.88) completed the Stress and Adversity Inventory, Patient Health Questionnaire, Generalized Anxiety Disorder 7-item scale, and the Scales of General Well-Being. Hierarchical regression analyses revealed that total count and severity of lifetime stressor exposure significantly predicted greater depression (β = .42, p < .001; β = .46, p < .001) and anxiety symptoms (β = .34, p = .003; β = .28, p = .018), and worse well-being (β = -.42, p < .001; β = -.30, p = .015). Semi-structured interviews were then conducted with six athletes. Thematic analysis revealed that cumulative lifetime stress exposure fostered poor mental health and well-being by promoting maladaptive long-term coping strategies, increasing susceptibility to future stress, and limiting interpersonal relationships. We believe these findings can help practitioners identify, and intervene accordingly with, elite athletes at risk of experiencing stress-related mental health problems.     

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.     

Enduring stress: A quantitative analysis on coping profiles and sport well-being in amateur endurance athletes

Endurance athletes experience physical and psychological stress during training and competition that can inhibit performance and promote negative health implications (i.e., lower well-being) without proper coping mechanisms (McCormick et al., 2018; Sakar & Fletcher, 2014). Additionally, these athletes that train at an amateur level have received limited attention regarding coping with stress and how it impacts well-being (McCormick et al., 2018). The purpose of this study was threefold: to (a) determine common coping profiles of trained amateur endurance athletes, (b) explore the relationship between sport well-being and these coping profiles, and (c) examine the potential roles that appraisals might play in the coping-well-being relationship. The results yielded five distinct coping profiles: Mixed Adaptive Copers (MAC), Mixed Maladaptive Copers (MMC), Engaged Copers (EC), Avoidant Copers (AC), and Social Copers (SC). Coping profiles differed across various variables including sport well-being, appraisals, and demographic factors. Overall, MAC and EC had higher levels of sport well-being. MAC viewed stressors as a challenge (i.e., opportunity) compared to EC and AC. These findings suggest the complex nature of coping in sport and that athletes should develop an assortment of coping strategies that provide different strategies for various stressful situations.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

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.     

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.     

Three-dimensional model of performance anxiety: Tests of the adaptive potential of the regulatory dimension of anxiety

ObjectivesTo predict the complex anxiety-performance dynamics, Cheng and associates (Cheng, Hardy, & Markland, 2009, 2011; Cheng, Hardy, & Woodman, 2011) proposed a three-dimensional model of anxiety that highlighted the adaptive potential of anxiety, and was supported with regard to cross-cultural factorial validity and predictive validity in the context of sports performance. In particular, this anxiety model included a regulatory dimension (reflected by perceived control) in addition to the conventional intensity-oriented dimensions of cognitive and physiological anxiety.DesignTo further examine the characteristics of the hypothesized adaptive potential of the regulatory dimension of anxiety, a series of three studies were conducted to investigate the relationship mainly between the regulatory dimension and three psychological variables proposed to be related to performance and stress, namely, perfectionism, self-talk and coping strategy.MethodChinese sports participants and dancers completed self-report measures. Hierarchical multiple regression was adopted for data analysis.ResultsThe findings showed that the regulatory dimension of anxiety was positively predicted by relatively adaptive dimensions of perfectionism (personal standards) and self-talk (motivational and instructional self-talk), and positively predicted approach coping.ConclusionsOverall, these data support the hypothesized characteristics of the adaptive potential underlying the regulatory dimension of anxiety. Future research and applied implications are suggested.     

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.     

Online mental health resources for adolescents: Overview of research and theory

Adolescents use the Internet at higher rates than any other age group. The Internet therefore offers an obvious opportunity for the provision of mental health information for them. Little is known, however, about adolescent behaviour online, especially access of age‐appropriate mental health resources. This review of the published literature examines theoretical and research studies to develop an understanding of adolescent mental health‐seeking behaviour on the Internet. It is clear that adolescents do seek health information online, but little is known about its content, nature or mode of delivery. There appears to be no research specific to mental health resources for adolescents online.     

Forgiveness and mental health variables: Interpreting the relationship using an adaptational-continuum model of personality and coping

The present paper uses an adaptational-continuum model of personality, based on Ferguson’s (2001) health psychology model integrating Eysenck personality factors and coping style, to provide a context for examining the relationship between forgiveness and mental health. Three hundred and twenty respondents completed measures of personality, coping style, forgiveness (forgiveness of self, others, likelihood, presence of positive forgiveness, absence of negative forgiveness), general health, stress, positive and negative affect and life satisfaction. Among respondents, all measures of forgiveness, bar one, load negatively on a neuroticism-coping factor. The remaining measure of forgiveness (presence of positive forgiveness) loaded on an extraversion-coping factor. The relationship of the neuroticism-coping-forgiveness factor was associated with poorer mental health, suggesting forgiveness is associated with better mental health within the context of this personality-coping factor. Significant positive relationships were found between the extraversion-coping-forgiveness factor and two measures of positive mental health outcomes (positive affect and life satisfaction) suggesting forgiveness is associated with some aspects of mental health within the context of this personality-coping factor. The present findings suggest that forgiveness, or failure to forgive, can be conceptualised within an adaptational-continuum model of personality.     

Community types and mental health: a multilevel study of local environmental stress and coping

Research has found that neighborhood structural characteristics can influence residents' mental health. Few studies, however, have explored the proximal reasons behind such influences. This study investigates how different types of communities, in terms of environmental stressors (social and physical disorder and fear of crime) and social resources (informal ties and formal organizational participation), affect well-being, depression, and anxiety in adult residents. Data are from a survey of 412 residents nested in 50 street blocks. Block stressors and resources were cluster analyzed to identify six block types. After controlling for several individual- and block-level characteristics, results from multilevel models suggest that in communities facing relatively few stressors, higher levels of formal participation are associated with better mental health. Because high levels of formal participation were not found in communities with higher levels of stressors, the impact of participation in such contexts could not be examined. However, results suggest that in communities where stressors are more common, isolation from neighbors may have a protective effect on mental health.     

Towards a literary account of mental health from James' Principles of Psychology

The field of mental health tends to treat its literary metaphors as literal realities with the concomitant loss of vague “feelings of tendency” in “unusual experiences”. I develop this argument through the prism of William James’ (1890) “The Principles of Psychology”. In the first part of the paper, I reflect upon the relevance of James' “The Psychologist's Fallacy” to a literary account of mental health. In the second part of the paper, I develop the argument that “connotations” and “feelings of tendency” are central to resolving some of the more difficult challenges of this fallacy. I proceed to do this in James' spirit of generating imaginative metaphors to understand experience. Curiously, however, mental health presents a strange paradox in William James’ (1890) Principles of Psychology. He constructs an elaborate conception of the “empirical self” and “stream of thought” but chooses not to use these to understand unusual experiences – largely relying instead on the concept of a “secondary self.” In this article, I attempt to make more use of James' central division between the “stream of thought” and the “empirical self” to understand unusual experiences. I suggest that they can be usefully understood using the loose metaphor of a “binary star” where the “secondary self” can be seen as an “accretion disk” around one of the stars. Understood as literary rather the literal, this metaphor is quite different to more unitary models of self-breakdown in mental health, particularly in its separation of “self” from “the stream of thought” and I suggest it has the potential to start a re-imagination of the academic discourse around mental health.     

The role of primary prevention in mental health services: A review and critique

Community psychology in the West has had a growing impact on mental health service provision. One facet of this development has been the advocacy of an increased focus on the primary prevention of mental illness. This paper reviews both theoretical and practical work in this area in order to assess the current role and relevance of primary preventive interventions. There is a discussion of primary prevention's historical and theoretical contexts, of its conceptualisations and definitions, of criticisms of its relevance and efficacy, and of examples of its practice. It is argued that primary prevention is inappropriately marginalised in current service provision and that there is a need to engage in the long-term planning and evaluation of primary preventive interventions in order to facilitate their fuller incorporation into national and local policies on mental health.