Controlled Evaluation of an Optimization Approach to Mental Health and Sport Performance

Abstract

Athletes experience unique stressors that have been indicated to compromise their mental wellness and sport performance, yet they underutilize mental health services. Indeed, very few mental health interventions for athletes have been developed to fit sport culture, and well-controlled mental health outcome research in athlete populations is warranted. In this randomized controlled trial, a sport specific optimization approach to concurrent mental health and sport performance (The Optimum Performance Program in Sports; TOPPS) was examined. Seventy-four collegiate athletes (NCAA = 42; club = 11; intramural = 21) formally assessed for mental health diagnostic severity were randomly assigned to TOPPS or campus counseling/psychological services as usual (SAU) after baseline. Dependent measures assessed general mental health, mood, mental health factors affecting sport performance in training, competition and life outside of sports, days using substances, sexual risk behaviors, happiness in relationships, relationships affecting sport performance, and contributions of relationship to sport performance. Intent to treat repeated measures analyses indicated that participants in TOPPS consistently demonstrated better outcomes than SAU up to 8-months post-randomization and for mental health/substance use measures, particularly when diagnostic criteria were most severe. Recommendations are provided in light of the results to assist sport-specific mental health intervention development and implementation within athlete populations.

Determinants of anxiety in elite athletes: a systematic review and meta-analysis

“…The development of youth-specific models of mental healthcare for those under 25 years has resulted in decreased stigma and service barriers, improving access to evidence-based intervention 91. Athlete-specific models of care are emerging,92 and efforts to consolidate and expand such initiatives warrant the support of governing bodies, codes, and competitions.…”

“…The single included intervention study was a small RCT testing a mindfulness-acceptance–based approach 94. While other groups have developed athlete-specific mental health interventions (eg, the athlete optimisation approach for college athletes of Donohue et al ),92 anxiety outcomes of these interventions are yet to be explored. The present results highlight the urgent need for well-conducted intervention-based RCTs, and specific attention towards the acceptability and efficacy of psychotherapy approaches among elite athletes is needed.…”

Preliminary psychometric validation of a brief screening tool for athlete mental health among male elite athletes: the Athlete Psychological Strain Questionnaire

“…Though beyond the scope of the present study, use of the APSQ alongside athlete-specific wellbeing interventions (e.g. Donohue et al, 2015Donohue et al, , 2018 may assist in determining the influence of scale domains on psychosocial and athletic functioning. If problems related to Self-Regulation and External Coping are associated with higher levels of psychological strain in athletes, it stands to reason that currently injured athletes would report higher scores on these factors, in addition to the athlete-specific Performance factor.…”

Addressing mental health in elite athletes as a vehicle for early detection and intervention in the general community

“…In addressing the current research gap, a promising recent RCT of The Optimum Performance Program in Sports (TOPSS) intervention (Donohue et al, ) recruited 74 collegiate athletes in the United States, 59 of them reported a previous or current mental health disorder. Rather than focusing on the reduction of psychopathology, TOPSS employed an “optimisation” approach, emphasizing the role that increased general well‐being can have on sporting performance.…”

“…In addition, well-designed RCTs targeting common mental health disorders for athletes need to be conducted to better understand how to minimize athlete distress. It is likely that commonly used interventions seen in general clinical practice need to be adapted to be more sportspecific to achieve traction with athletes and coaches (Donohue et al, 2018;Moesch et al, 2018). Last, focusing on mental health in elite athlete populations may be an influential element of empowering those who may have previously been hesitant to seek help.…”