Risk and protective factors for mental health in elite athletes: a scoping review

Abstract

The purpose of this scoping review was to provide an overview of studies concerning the mental health (MH) of elite athletes and to provide a methodological, conceptual, and applied overview of factors affecting elite athletes' MH. A total of nine reviews and 43 empirical studies were evaluated and are reported in three sections: sample characteristics, research design, and factors affecting elite athletes' MH. These factors were grouped into risk and protective factors and divided into a personal and sport-environmental domain.The studies used quantitative (84%), qualitative (11%), and mixed-method (5%) designs and examined a wide range of sports in different countries. Our review shows that researchers have predominantly examined the prevalence of athletes' mental ill-health (e.g., depression) and the related factors compromising MH. Potential protective factors such as the feeling of autonomy, positive relations in sport and private life, and adequate recovery were highlighted in the qualitative studies. The discussion appraises the findings through a critical lens, focuses on the current state of the research area and the MH definition, limitations, suggested practical implications (e.g., to provide MH literacy to both athletes and coaches), and future research directions (e.g., examining environments that foster elite athletes' MH).

Mental health and psychological well-being among professional rugby league players from the UK

“…The prevalence of mild and moderate/severe symptoms of anxiety appears to be higher in the present study than in some reports 9 10. This could be because HADS6 is more sensitive at detecting anxiety symptoms than both the GAD4 and the GHQ-12 5. As such, previous studies9 10 may have underestimated the prevalence of anxiety symptoms among elite athletes.…”

“…These equivocal findings from meta-analyses, scoping reviews and systematic reviews regarding depressive and anxiety symptoms1–5 may be due to differences in the content of questionnaires used in these studies, which have not been validated for elite athletes. Some studies9 10 assessed anxiety using the General Anxiety Disorder (GAD) scale,11 whereas another study8 used the General Health Questionnaire (GHQ-12) 12.…”

“…Although elite athletes often epitomise the fit and healthy archetype, research over recent years suggests that they are still as likely, if not more likely, to be at risk of experiencing mental health symptoms. Several meta-analyses and/or reviews indicate that playing sport at the highest level is associated with significant mental health symptoms such as depressive and anxiety symptoms 1–5. It has been suggested that this may be due to the significant pressures of being an elite athlete, including high training loads, stress of competition and insufficient recovery 4.…”

“…Several meta-analyses and/or reviews indicate that playing sport at the highest level is associated with significant mental health symptoms such as depressive and anxiety symptoms 1–5. It has been suggested that this may be due to the significant pressures of being an elite athlete, including high training loads, stress of competition and insufficient recovery 4. Mental health symptoms are a particular concern for elite athletes because they are associated with poor performance,6 which could then ultimately heighten symptoms of anxiety 7.…”

“…Reporting the prevalence of mental health symptoms among Super League players will reveal whether this specific group of athletes is at risk of developing mental health symptoms. This could then provide a rationale for the management of players and optimising training environments across different clubs in order to maximise mental health among Super League players 1 4…”