Psychopathology in sport
Although there is evidence that in sport success is negatively related with psychopathology (Morgan 1985), athletes are not protected against mental and behavioral disorders. A tendency to idealize athletes leads to a general assumption that athletes rarely suffer from mental illness. Similarly, athletes tend to conceal their potential signs of weakness.
The following various possible relationships between athletics and psychiatric disorders have been described:’
- athletes may obtain high levels of success in spite of a coexistent primary psychiatric disorder;
- athletes may have chosen the athletic arena as a means of coping with a disorder (e.g. eating disorders);
- athletes may have psychiatric illness precipitated or worsened by sport itself.
Mood Disorders
Psychiatric illnesses, including mood disorders, in athletes have been relatively understudied. Most existing data suggest that depression is equally common in athletes and non-athletes. However, depression in athletes needs significantly further study. One important question is the relationship between MDD and OT, given the prevalence of OT in athletes and its potential implications for performance and quality of life. Prevention of OT should also be more rigorously studied. Morgan et al. suggested that monitoring of mood states throughout the season could provide a potential method of preventing OT, but acceptability and feasibility of this for athletes needs further attention. Mood monitoring and appropriate adjustment of training might indeed prove more acceptable to athletes than taking psychotropic medication would be.
Times of transition (e.g. post-injury and retirement) present increased risk for psychological distress, particularly symptoms of depression, in athletes. Accordingly, diagnosis of psychiatric symptoms during these times should be studied in a rigorous fashion. Suicide and bipolar disorder in athletes should be more rigorously studied as well as the former has not been systematically researched and the latter has not been studied at all.
Apart from one small study on social anxiety disorder in athletes, this group of disorders have not been scientifically studied in athletes and warrants further research attention. Anxiety could be a substantial deterrent to athletic participation. On the other hand, it well could be a reason to avidly encourage athletic participation as sport might prove a helpful treatment for anxiety disorders. This is an example in which
knowledge about the prevalence of, and effects of, psychiatric diagnoses in athletes is an important issue for individual athletes but is a public health issue as well, further justifying the need for more and higher quality research in this area. For example, if people with anxiety disorders such as social phobia tend to avoid athletic involvement because of fear of negative evaluation, their physical and mental health could suffer,
thereby contributing to a greater healthcare burden. Longitudinal studies of different mental illnesses, including anxiety and how they affect choices about whether to become involved in sport and exercise, could further the understanding of these issues. Ultimately, addressing psychological issues such as these, as well as diagnosing and treating mental disorders, might allow more people to become athletically active.
Eating disorders are especially prevalent in ‘leanness sports’ and are surprisingly common in men athletes in addition to being very common in women athletes. While all psychiatric conditions in athletes need more rigorous study, this is an area in which further research could be particularly high-yield for many athletes given that this might be one of the few areas in which the disorders are actually perpetuated by sports participation itself.
Attention-Deficit Hyperactivify Disorder (ADHD)
In contrast to athletes with eating disorders, athletes with ADHD might choose to participate in sports as a coping strategy. However, this relationship between sports participation and coping with psychopathology is merely an anecdotal assertion and further research on ADHD in athletes is needed, especially given the implications that treatment involves using potentially performance-enhancing stimulants
Overall, athletes appear to use substances of abuse more than the general population, but it is not clear if the reason for this has more to do with issues of abuse/dependence or performance enhancement.
Historically, it had been thought that stimulants and anabolic steroids had low physical dependence potential, suggesting that these substances might be predominantly used for performance enhancement, but there is now evidence that people can become physically dependent on these substances as well. The potential role of preexisting or emergent psychiatric symptoms in the development of drug and alcohol abuse in athletes merits further study.
In considering prevention strategies, at least at the college level, more stringent drug testing has been associated with lower rates of substance use, and thus more rigorous urine and blood testing at all levels of athletics might prove helpful not only in diagnosis but also in leading to appropriate treatment. If coaches or healthcare providers have concerns about heavy alcohol use they also might consider testing alcohol levels in athletes in the early afternoon following suspected drinking. as the presence of alcohol at that late point in the day suggests heavy drinking the night before. Additionally, healthcare providers could ask all their athletes, including recreational ones and including both boys and girls starting at a young age, about their use of anabolic steroids.
Pathological Gambling
The essential feature of pathological gambling is persistent and recurrent maladaptive gambling behavior that disrupts personal, family or vocational pursuits. In a survey of 636 college athletes at three universities, Kerber (…) found that almost 15% had problem or pathological gambling. They reported no control group. An American Psychiatric Association Task Force on Disorders of Impulse Control not Elsewhere Classified (…) reported that slot and poker machines were the favorite gambling activities of athletes. In a literature review. Miller et al. (…) reported that the largest sex difference among addictive behaviors by athletes involved gambling, with many more men than women athletes engaging in gambling.
Concussion
Concussion is defined as a head injury with a transient loss of brain function, and it is the most frequent type of head injury that occurs in athletes(…). Complicated concussions can result in numerous psychological symptoms, including irritability, depression, anxiety and impulsivity(…). (vt uuesti!!!) had 2340 men and women high school and collegiate athletes complete pre-season neurocognitive testing. They retested the 155 athletes who sustained sports-related concussions during their seasons. Women athletes showed greater declines in simple and complex reaction times and more post-concussion symptoms than men.
Delirium
Delirium is a fairly rapidly developing disturbance of consciousness that is accompanied by a change in cognition and is due to medical/physical Stressors on the body. Acute delirium can occur in endurance athletes, including cyclists, triathletes and mountaineers(…). Causes include hyponatraemia (???), hyperthermia and heat stroke.
References
Morgen, W. P. (1985). Selected psychological factors limiting performance
Morgan WP. 1985. Selected psychological factors limiting performance-A mental health model. Limits of Human Performance.