The Mental Health of Elite Athletes: A Narrative Systematic Review

Abstract

BackgroundThe physical impacts of elite sport participation have been well documented; however, there is comparatively less research on the mental health and psychological wellbeing of elite athletes.ObjectiveThis review appraises the evidence base regarding the mental health and wellbeing of elite-level athletes, including the incidence and/or nature of mental ill-health and substance use.MethodsA systematic search of the PubMed, EMBASE, SPORTDiscus, PsycINFO, Cochrane and Google Scholar databases, up to and including May 2015, was conducted.ResultsThe search yielded a total of 2279 records. Following double screening, 60 studies were included. The findings suggested that elite athletes experience a broadly comparable risk of high-prevalence mental disorders (i.e. anxiety, depression) relative to the general population. Evidence regarding other mental health domains (i.e. eating disorders, substance use, stress and coping) is less consistent. These results are prefaced, however, by the outcome of the quality assessment of the included studies, which demonstrated that relatively few studies (25 %) were well reported or methodologically rigorous. Furthermore, there is a lack of intervention-based research on this topic.ConclusionThe evidence base regarding the mental health and wellbeing of elite athletes is limited by a paucity of high-quality, systematic studies. Nonetheless, the research demonstrates that this population is vulnerable to a range of mental health problems (including substance misuse), which may be related to both sporting factors (e.g. injury, overtraining and burnout) and non-sporting factors. More high-quality epidemiological and intervention studies are needed to inform optimal strategies to identify and respond to player mental health needs.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-016-0492-2) contains supplementary material, which is available to authorized users.

Balancing performance-based expectations with a holistic perspective on coaching: a qualitative study of Swedish women’s national football team coaches’ practice experiences

“…It is feasible to assume, for instance, that the relatively fixed demands placed on national team coaches to satisfy organizations and stakeholders influence them to adopt coaching methods that result in athletes pushing themselves beyond their physical and mental limits (Barker-Ruchti, Barker, Rynne, & Lee, 2016). Research does indeed show that elite athletes’ experiences of high expectations and competitive pressure increase their vulnerability to burnout, poor mental health, and risk-taking behaviours (Gustafsson, Hassmén, Kenttä, & Johansson, 2008; Hughes & Leavey, 2012; Rice et al, 2016; Safai, Baker, & Fraser-Thomas, 2014). Other “workplace” stressors, including public scrutiny through mainstream and social media, group dynamics, especially in team sports, and injuries, increase this athlete vulnerability (Hanton, Fletcher, & Coughlan, 2005; Johnson, 1997).…”

Perfectionism, Burnout, and Depression in Youth Soccer Players: A Longitudinal Study

“…In this regard, this particular model can help to explain how heavy investment in sport may make athletes vulnerable to depression if they are unable to successfully navigate the academy system. Three recent reviews of research have identified risk factors of depression in athletes (Frank, Nixdorf, & Beckmann, 2015;Rice et al, 2016;Wolanin, Gross, & Hong, 2015 …”

Are mental toughness and mental health contradictory concepts in elite sport? A narrative review of theory and evidence

“…Narrative Review of Theory and Evidence 24 25 The psychological aspects of athlete health and performance have gained increased attention 26 over the past two decades, with much of this research concerned with the mental health of 27 athletes and the concept of mental toughness. It was recently proposed that mental health and 28 mental toughness are contradictory concepts in the world of elite sport 1 .…”