Mental Health and Sport Performance Programming in Athletes Who Present Without Pathology: A Case Examination Supporting Optimization

Abstract

Athletes are exposed to unique stressors that often negatively impact the way they think, behave, and feel in athletic, academic, and social domains. The Optimum Performance Program in Sports (TOPPS), an adaptation of Family Behavior Therapy, is an innovative approach to optimization science that has demonstrated positive outcomes in student-athletes evidencing substance use disorders. However, this approach has yet to be evaluated in athletes who are interested in optimizing their mental health and sport performance, but have no indication of pathology. We describe the administration of TOPPS in a female student-athlete who presented for intervention with no assessed mental health pathology. Although experimental methodology was uncontrolled, many of the methodological features in this examination were advanced. Treatment integrity was reliably assessed and the athlete demonstrated significant improvements in psychometrically validated measurements of mental health and sport performance from baseline to 5-months post-treatment, including psychiatric domains (somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism), relationships with teammates, family members, coaches, and peers, and measures of sport performance. Future directions are reported in light of the results.

Student‐Athletes and Mental Health Experiences

“…They are more likely to seek help from a sports psychologist for performance issues because they view that as performance enhancement and not mental health counseling (Gulliver et al., ). They are also more likely to seek help when the program is targeted toward a sports culture (Gavrilova, Donohue, & Galante, ). These findings are noteworthy because student‐athletes often fail to make the connection between poor mental health and athletic performance.…”

“…A lack of knowledge is the second largest reason student‐athletes do not seek help for mental health issues (Gavrilova et al., ; Gulliver et al., ). A lack of knowledge about signs of mental health issues, what to expect from attending counseling, and overall lack of mental health literacy may prohibit a student‐athlete from seeking help (Gulliver et al., ).…”

Stress of the Off-Season May Be Greater for the Student-Athlete than during Competition: A Pilot Study

“…Gavrilova, Donohue, and Galante [17] recommend that athletic programs ensure that student athletes receive mental health screening, work to reduce the stigma associated with mental illness, and hire licensed clinical and counseling psychologists to provide assessment and evidence-based intervention programs.…”

Teammate influences, psychological well‐being, and athletes’ eating and exercise psychopathology: A moderated mediation analysis

“…In athletic populations, extant literature provides evidence in support of Fairburn et al's () proposed mediation pathway. For example, supportive teammate friendships have been associated with higher self‐esteem, higher positive affect, lower anxiety and depression (Kipp & Weiss, ; Scott et al, ) whereas pressure from teammates to lose weight has been associated with increased negative affect (sadness, anger, guilt, Anderson, Petrie, & Neumann, ) and modelling of teammates disordered eating has been found to occur in the context of negative thoughts and negative affect (Gavrilova, Donohue, & Galante, ).…”

“…To address the gaps and limitations of existing literature, the first aim of the present study was to explore whether self‐esteem, anxiety and depression mediate longitudinal relationships between the teammate influences and disordered eating/exercise behaviors that have been consistently found in the literature: supportive teammate friendships (Kipp & Weiss, ; Shanmugam et al, , , Scott et al, ), modelling of teammates’ disordered eating (Arthur‐Cameselle et al, ; Engel et al, ; Gavrilova et al, ; Scott et al, ) and teammate pressure to lose weight/change shape (Petrie et al, , ; Stirling & Kerr, ; Scott et al, ; Voelker, Petrie, Reel, & Gould, ). A prospective design using three time‐points was employed to determine the true temporal precedence of these variables.…”