Anxiety disorders
Apart from the single study on social anxiety disorder, anxiety disorders, including social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder and specific phobias, have been minimally studied in athletes. Many athletes have normal ‘state anxiety’, meaning they become appropriately anxious before competition but it does not permeate their entire life.(…).
Social Anxiety Disorder
Social anxiety disorder is characterized by clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behaviour. Northon et al. .(…) hypothesized that undergraduates with social anxiety would experience related anxiety symptoms in sports, as sports often involve performance demands and social evaluation. Thus, their hypothesis was that social anxiety might be an example of a psychiatric condition in which the symptoms are exacerbated by sport itself. Their study of 180 students showed that, especially in women, general levels of social anxiety were related to social-evaluative fears in sport, but they did not measure the effects of anxiety on performance. Additionally, social anxiety was positively correlated with avoidance of individual sports but not team sports. Social anxiety did not correlate with level of competition (e.g. no involvement vs intramural vs intercollegiate).
Compulsive Disorders
Many mental health professionals consider OCD and addictive disorders to be related in sharing ritualistic behaviours that serve to assuage anxiety. There have been several studies that addressed exercise as a compulsive behaviour (variably referred to as positive addiction (…) exercise addiction and obligatory running). These studies have described a process in which individuals experience withdrawal symptoms such as depression. anxiety and irritability when they are unable to exercise, and how exercise ‘addicts’ continue to exercise despite medical contraindications, with potential adverse impact on work, home and social life. No systematic studies of the prevalence of ‘exercise addiction’ have been published. Muscle dysmorphia is probably a subtype of body dysmorphic disorder, which is often felt to lie on the OCD spectrum. It is a disorder of distorted body image in which patients who are quite muscular nonetheless feel that they are too small.(…) Muscle dysmorphia could well be an example of a psychiatric condition that is perpetuated by sport itself. No large, systematic studies of the prevalence of muscle dysmorphia have been published, ut Pope et al.(…) have reported that bodybuilders seem to be at higher risk than other athletes and that women bodybuilders have a higher incidence than their men counterparts.
It is also important for healthcare providers to distinguish superstitious rituals that are common in athletics from full-blown OCD.’^’i OCD is characterized by at least an hour per day of obsessions or compulsive behavior, in a manner that significantly interferes with daily functioning. Superstitions, on the other hand, are circumscribed to the athletic arena and do not interfere with functioning.
Other Anxiety Disorders
We found no studies in athletes on generalized anxiety disorder, OCD, panic disorder, posttraumatic stress disorder or specific phobias.