Mental Health Literacy
Sebbens, J., Hassmen, P., Crisp, D., & Wensley, K. (2016). Mental Health In Sport (MHS): Improving the early intervention knowledge and confidence of elite sport staff. Frontiers in Psychology, 7(JUN), 1–9. http://doi.org/10.3389/fpsyg.2016.00911
Mental health problems are common in elite sporting populations. Among the barriers to accessing appropriate help are a lack of recognition and an unsupportive sports culture – not found in all sports but certainly in some.
Improving ‘mental health literacy’ is one way to address this. Literacy in this context means improving knowledge, understanding beliefs abut mental health problems and improving recognition, management and prevention.
Several programmes have been developed to improve this kind of literacy. Here the authors report a programme in sport designed to be brief (and therefore accessible) as well as specific to the culture of sport.
A 4-hour workshop was developed making use of case studies and role-play. The ‘four Rs’ of ‘recognise’, ‘reach out’, ‘refer’ and ‘remain supportive’ were emphasised. Participants were drawn from coaches and other support staff working in high-level sport.
Knowledge of signs and symptoms and confidence to provide support were all significantly enhanced by the programme and especially for anxiety disorders (which are particularly common in sport).
Petito, A., Altamura, M., Iuso, S., Padalino, F. A., Sessa, F., D’Andrea, G., … Bellomo, A. (2016). The relationship between personality traits, the 5HTT polymorphisms, and the occurrence of anxiety and depressive symptoms in elite athletes. PLoS ONE, 11(6), 1–13. http://doi.org/10.1371/journal.pone.0156601
Many different factors contribute to the presence of anxiety and stress in athletes. This study describes a fascinating interaction between biology, psychology and environment. The researchers recruited 133 athletes and examined not only serotonin transporter gene (5HTT) polymorphisms but also measures of emotional arousal, personality traits (including neuroticism), and mood states. Their conclusion is that ‘a significant interaction’ exists between polymorphism, neuroticism and sporting stresses and that this predicts mental health problems in athletes.
The ‘dark side’ – depressive experiences in elite sport
Newman, H. J. H., Howells, K. L., & Fletcher, D. (2016). Frontiers in Psychology, 7(JUN).
Therapists of all disciplines who work with elite athletes will recognise the themes that emerge from this interesting review of 12 sporting autobiographies. Themes such as how sport initially provides a relief from mental distress before itself becoming a contributory factor as sporting demands increase.
The mental health of college athletes
Rao, A. L., & Hong, E. S. (2016). British Journal of Sports Medicine, 50(3).
This review includes a comprehensive review of risk factors for mental ill-health within college athletics. It also provides another welcome call for mental health to be accorded parity with physical health in providing appropriate health care for college athletes.
The emotional impact of being dropped
Two established ‘hot-spots’ for athletes are injuries and transitions and both have been associated with psychiatric morbidity and psychological symptoms. A large study of elite German school athletes (aged 12-15) adds to our knowledge of these difficulties by comparing the mental health of athletes deselected from performance programmes with those maintained on such programmes (and a control group of non-athletes).
Deselected athletes perhaps unsurprisingly had higher levels of psychological symptoms and less positive mood scores.
Whilst it is tempting to see cause/effect relationships in these associations – deselection is bad for your psychological well-being – what if it were the other way round? Are athletes more likely to be deselected if their psychological health is poor?
In either case this is an important reminder of the need to provide psychological support for athletes at all stages in their development.
Click the image to find out more.
Psychological Symptoms and Chronic Mood in Representative Samples of Elite Student-Athletes, Deselected Student-Athletes and Comparison Students. Brand R, Wolff W, Hoyer J. School Mental Health, vol. 5, issue 3 (2013) pp. 166-174
Cannabis Use in Sport
When we think of drugs in sport our first thought is usually a doping issue or use illegal performance drugs (PEDs). This intriguing study is a timely reminder that substance misuse is not uncommon in sports and in some subgroups there may be particular problems for the sports psychiatrist to address in helping athletes to better health and improved performances. Click the image for more.
Brisola-Santos, M. B., Gallinaro, J. G. de M. e, Gil, F., Sampaio-Junior, B., Marin, M. C. D., de Andrade, A. G., … Castaldelli-Maia, J. M. (2016). Prevalence and correlates of cannabis use among athletes-A systematic review. The American Journal on Addictions, 25(7), 518–528. http://doi.org/10.1111/ajad.12425
Dan Begel is one of the founding fathers of sports psychiatry. His work since the 1980s has encouraged many to pursue a career in that field and his 1992 publication was especially influential (An Overview of Sport Psychiatry in the American Journal of Psychiatry). His reflections 24 years later are definitely worth a read and he offers many useful insights into the current status of sports psychiatry and his hopes for the future. Click each image for more.
Many contact and collision sports are working hard to develop guidelines on the management of concussion. The focus is usually on the prevention of longer-term neurological sequelae. It seems that concussed athletes are also at risk of depression and this study describes some of the associations between concussion and subsequent depressive symptoms.
Gray Vargas, Amanda Rabinowitz, Jessica Meyer, and Peter A. Arnett (2015) Predictors and Prevalence of Postconcussion Depression Symptoms in Collegiate Athletes. Journal of Athletic Training: March 2015, Vol. 50, No. 3, pp. 250-255.