Mental health correlates of athletic shame and guilt among elite-level youth athletes in Turkey.

OBJECTIVES: This study evaluated the mental health correlates of athletic shame and guilt among elite-level youth athletes and provided psychometric data on the Turkish version of the Athletic Perceptions of Performance Scale. DESIGN: Cross-sectional. METHODS: An online survey was sent to 645 Turkish elite-level youth athletes incorporating standardized scales assessing athletic shame, guilt, and symptoms of high prevalence mental disorders. A subset of participants (n = 45) provided test-retest data at 30 days. RESULTS: A total of 301 elite youth athletes participated (M = 16.42 ±â€¯0.49 years; 48.7 % response rate) equally representing team and individual sports. Confirmatory factor analysis validated the Turkish version of the Athletic Perceptions of Performance Scale and test-retest data supported temporal stability. Female athletes (compared to male athletes) and athletes participating in an individual sport (compared to participating in a team sport) reported higher athletic shame-proneness scores (p < 0.01 and p = 0.04; respectively). The Turkish version of the Athletic Perceptions of Performance Scale shame-proneness and no-concern scores were associated with athlete-specific stress, anxiety, and depression scores. The Turkish version of the Athletic Perceptions of Performance Scale guilt-proneness was associated with athlete-specific stress and anxiety scores. CONCLUSIONS: Findings provide cross-cultural validation of the Athletic Perceptions of Performance Scale assessing athletic shame and guilt, demonstrating that female athletes and athletes participating in an individual sport were more likely to experience athletic shame-proneness. Results suggest that athletes experiencing shame-proneness and performance concerns may benefit from supportive coaching and/or mental health supports.

Which athletes are more vulnerable to mental health symptoms during the COVID-19 crisis? A cross-sectional study.

The present study evaluated the mental health (MH) of athletes according to a range of variables, including SARS-CoV-2 infection status and sport-specific factors. An online survey was sent to 1636 Turkish professional athletes incorporating standardized scales assessing athlete-specific stress, depression, and anxiety. A total of 579 professional athletes (29% SARS-CoV-2 positive) participated in the study. While female athletes reported higher anxiety scores than males (p < 0.01), the depression scores of the athletes who had been infected with SARS-CoV-2 were significantly higher than athletes who were not infected (p = 0.03). Higher athlete-specific stress, depression, and anxiety scores were associated with participating in an individual sport, experiencing chronic pain, severe sports injury history, and performance concerns (all p < 0.01). MH symptoms in athletes were associated with being infected with SARS-CoV-2, female gender, participating in an individual sport, and performance concerns. MH assessments should be undertaken with athletes to detect vulnerabilities and enable appropriate and timely MH interventions.

Mental health problems and risk assessment in football players infected with SARS-CoV-2: a cross-sectional study.

BACKGROUND: Although the negative psychological impact of the pandemic on athletes is well known, there is currently insufficient evidence regarding mental health (MH) problems among athletes infected with SARS-CoV-2. The aim of the present study was to evaluate the association between MH problems, demographics, and SARS-CoV-2 related variables in football players infected with SARS-CoV-2. METHODS: An online survey included demographic questions, SARS-CoV-2 related questions, the Athlete Psychological Strain Questionnaire, and the Depression Anxiety Stress Scales-21 was distributed to male and female professional football players aged between 18-38 and infected with SARS-CoV-2. RESULTS: A total of 261 football players participated in the study. The odds of athlete-specific distress in lower-level football players were up to 5.9 times more than those competing at the highest level (OR=3.06-5.93, 95% CI: 1.27-14.43, P<0.01). The odds of depression and stress in lower-level football players were up to 6.7 times more than those competing at the highest level (both OR=3.70-6.77, 95% CI: 1.18-19.20, P<0.01). In players who reported sleep problems, there was increased risk of athlete-specific distress (OR=2.43, 95% CI: 1.31-4.52, P<0.01), depression (OR=3.71, 95% CI: 1.98-6.95, P<0.01), anxiety (OR=2.93, 95% CI: 1.62-5.28, P<0.01), and stress (OR=7.08 95% CI: 3.52-14.02, P<0.01). There was increased risk of depression and stress in female players (OR=5.78, 95% CI: 2.03-16.4, P<0.01; OR=4.91, 95% CI: 1.57-15.4, P<0.01; respectively). The odds of anxiety in players who reported severe SARS-C0V-2 symptoms were up to 2.2 times more than asymptomatic players (OR=2.28, 95% CI: 1.08-4.82, P=0.03). CONCLUSIONS: MH problems in football players infected with SARS-CoV-2 were associated with female gender, participation in football in the lower-level, performance concerns, and sleep problems. MH assessment is indicated in athletes infected with SARS-CoV-2 to support detection, and appropriate and timely intervention.

Competing against COVID-19: what about the mental health problems of athletes with disabilities?

OBJECTIVES: Although there is growing interest in athletes' mental health (MH), there is a paucity of research exploring MH in athletes with disabilities (AWD). The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the psychological state of AWD. MATERIALS AND METHODS: An online survey including demographic questions, SARS-CoV-2-related questions, and standardized scales assessing depression, anxiety, stress, coronavirus anxiety (CAS), and nonspecific psychological distress was distributed to AWD. RESULTS: A total of 362 athletes (183 AWD) participated in the study (response rate 31.2%). AWD infected with SARS-CoV-2 reported higher depression, anxiety, and CAS scores than AWD not infected with SARS-CoV-2 (Z = -2.10, ES = 0.15 Z = -3.45, ES = 0.25; Z = -2.43, ES = 0.18; respectively). Female AWD reported higher anxiety scores compared to males (Z = -2.25, ES = 0.16). Depression (Z = -2.80, ES = 0.20), stress (Z = -2.12, ES = 0.15) and K-10 (Z = -2.02, ES = 0.14 scores of individual sport AWD were higher than team sports AWD. CONCLUSION: MH problems in AWD were associated with a wide range of variables such as being infected with SARS-CoV-2, female gender, competing in an individual sport, and having performance concerns. In light of these results, MH assessment should be undertaken for AWD to ensure appropriate and timely intervention.

The effects of home confinement on physical activity level and mental status in professional football players during COVID-19 outbreak.

OBJECTIVES: The coronavirus outbreak caused significant changes in football around the world, such as the suspension of leagues and home isolation of players, etc. The main purpose of the present study was to assess the psychological impacts of lockdown and similar restrictions on professional football players during the coronavirus pandemic. MATERIALS AND METHODS: The players from 36 professional football teams (n = 977) among Turkish Super League and First League teams were invited to complete a questionnaire including the Center for Epidemiologic Studies Depression Scale (CES-D), Impact of Event Scale-Revised Scores (IES-R) and short form of International Physical Activity Questionnaire (IPAQ). RESULTS: The online survey was completed by 237 players (24.3%). The mean number of self-quarantine day of participants was 26.9 ± 6.2 days. The median CES-D Scale and IES-R scores were 6.0 (min:0, max:42) and 23.0 (min:0, max:59), respectively. IPAQ scores of the players showed that four-fifths of the players still maintain high physical activity levels. There were negative, very weak and significant correlations between CES-D score and being married (r = -0.146, p = 0.024), as well as between CES-D score and IPAQ-Walking (r = -0.189, p = 0.004). A significant positive very weak correlation was observed between CES-D score and self-quarantine days (r = 0.148, p = 0.024). IPAQ-Walking was an independent predictor of CES-D. CONCLUSION: These findings support that maintaining regular physical activity and routinely exercising in a safe home environment is one of the most important strategies to ensure healthy mental state.

Vitamin D levels on sports injuries in outdoor and indoor athletes: a cross-sectional study.

OBJECTIVE: Having vitamin D levels within normal limits is important for bone and muscle health and its deficiency may increase the risk of injury. The aim of this cross-sectional study was to investigate whether vitamin D levels are different in indoor and outdoor athletes and its levels increase the risk of injury. MATERIAL AND METHODS: Serum vitamin D levels were measured in Caucasian adolescent athletes, who admitted to the sports medicine polyclinic due to a routine health check or injury. The study was carried out at 38°26' north latitude in Izmir between June and September 2019. After the physical examination of the injured athletes, the diagnoses were made accompanied by the findings obtained by imaging methods in cases of necessity. RESULTS: A total of 256 athletes, including swimmers (n = 87), basketball players (n = 104), and football (n = 65) players aged 13.2 (± 2.2) years, were investigated. The average serum vitamin D (25(OH)D) level in athletes was 29.2 (±10.0) ng/mL (6.0-66.0 ng/mL). Forty-six of all athletes (18%) had vitamin D deficiency, with a mean value of 15.7 (±4.0) ng/mL, and 93 of them (36.3%) had vitamin D deficiency with a mean value of 25.2 (±2.4) ng/mL. While vitamin D levels were significantly higher in football players (32 ng/mL) than in other athletes (p < 0.05), it was similar in basketball players (27 ng/mL) and swimmers (26 ng/mL) (p > 0.05). Vitamin D levels (26 ng/mL) of the injured athletes were significantly lower than those of the non-injured athletes (30 ng/mL) (p = 0.001). Bone injuries were significantly related to Vitamin D levels (p < 0.001) but not with muscle injuries (p > 0.05). CONCLUSION: Frequency of vitamin D deficiency and insufficiency is higher in indoor athletes andis especially associated with risk of bone injuries . In order to examine the effect of vitamin D level on bone mineral density, comprehensive prospective studies are required.

Effects of Long-Duration Home Isolation Linked to the COVID-19 Pandemic on Mental Health of Adolescent Athletes.

PURPOSE: To assess whether adolescent athletes were affected or not in terms of mental health by the long duration at home linked to isolation enforced during the COVID-19 pandemic. METHOD: The study included 940 team athletes, 274 individual athletes, and 131 nonathlete controls aged 12-17 years. Demographic data were obtained with a form including questions about age, sex, sports type, and physical activity status (type, duration, and frequency) during the isolation period. Participants completed the Children's Revised Impact of Event Scale-13, Center for Epidemiological Studies Depression Scale for Children, and State-Trait Anxiety Inventory for Children. RESULTS: Among participants, 88% did not meet the physical activity recommendations for children and adolescents, while 42.8% felt depressed. Depressive symptoms were present in 38.1% of boys and 59.7% of girls, with girls (6.4%) having higher posttraumatic stress symptoms than boys (3.5%). Among athletes, depressive and anxiety symptoms were lower compared with nonathlete controls (P < .01). Posttraumatic stress symptoms were lower among athletes than nonathlete controls for girls (team vs control, P = .006; individual vs control, P = .002) but similar for boys (P > .05). The depression (P = .518), state (P = .866), and trait anxiety (P = .507) symptoms were similar between team athletes and individual athletes. CONCLUSION: Though adolescent athletes' depression, anxiety, and posttraumatic stress symptoms were significantly lower than nonathlete controls, athletes also had high depression levels. These findings show the need to take precautions to protect the psychological health of not only nonathletes, but also athletes in the pandemic period.

The psychological impact of COVID-19 infection on athletes: example of professional male football players.

Objective: The purpose of this study was to evaluate the psychological state of professional male football players who were infected by COVID-19.Method: The Depression Anxiety Stress Scale 21 and Kessler Psychological Distress Scale were sent to players' smartphones by sharing a link to the questionnaire. A total of 523 professional football players aged between 18-38 years from 93 different sports clubs participated in the study. The players were divided into 2 groups according to Sars-COV-2 PCR test results.Results: Depression, anxiety, stress, and psychological distress scores of football players who were infected by COVID-19 were higher compared to players who were not infected by COVID-19 (all p < 0.001). Depression, stress, and psychological distress scores were higher for football players with higher loss of income than players with lower loss of income (p = 0.017, p = 0.007, p = 0.005, respectively). There were significant differences in anxiety, depression, and psychological distress scores in favor of the 18-22-year age group (p = 0.002, p = 0.009, p = 0.004, respectively).Conclusion: COVID-19 infection negatively affects the psychological states of football players. The psychological states of professional football players who were infected by COVID-19 should be monitored closely and psychological support should be provided.

The effect of isolation on athletes' mental health during the COVID-19 pandemic.

OBJECTIVE: We aimed to explore whether the mental health status of professional athletes was affected by the isolation period in which organized sports were suspended due to the COVID-19 pandemic. METHODS: A total of 612 volunteers between the ages of 18-38 enrolled in the study, 418 of them were athletes engaged in team sports or individual sports and 194 of them were non-athletes. Participants completed the Depression - Anxiety - Stress Scale 21 (DASS-21), the Impact of Events Scale-Revised (IES-R) and International Physical Activity Questionnaires (IPAQ). Non-parametric methods were used for comparisons between groups. The presence of a linear relationship was tested with the Spearman Correlation Test. A value of p < 0.05 was accepted statistically significant. RESULTS: A total of 571 participants, 372 males and 199 females, completed the study. Depression and anxiety symptoms were lower in athletes compared to non-athletes (p < 0.05). Depression, anxiety and stress symptoms were similar in team athletes and individual athletes (p = 0.232, p = 0.444, p = 0.116; respectively). The post-traumatic stress symptoms were lower in male team athletes than female team athletes (p = 0.020) and non-athletes (p < 0.001). Depression, anxiety and stress symptoms were found to be similar in men and women (p > 0.05). There was a negative correlation between physical activity level and mental health symptoms (p < 0.05). CONCLUSION: The mental health status of athletes was better than non-athletes, and the positive effect of sport, which was done until the break due to the isolation period, on mental health continued. These findings show that physical activity may help to protect mental health.

Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome.

The main purpose of the study is to investigate the inversion/eversion muscle strength balance of the ankle in patients with medial tibial stress syndrome (MTSS). A dysbalance of these muscles may play a role in the pathophysiology of MTSS. Another aim is to measure the medial longitudinal arch and navicular drop in patients with MTSS. A total of 11 patients diagnosed with MTSS in the outpatient clinic of Ege University School of Medicine Sports Medicine Department were enrolled in this study. The control group consisted of 11 regularly exercising individuals. The mean age of the patient group and the control group was 21. 0 ± 1.9 years (18-23 years) and 23.2 ± 2.9 years (18-27 years), respectively. A detailed exercise questionnaire was administered to all subjects. Isokinetic muscle strength testing was performed at 30°/sec and 120°/sec to assess invertor and evertor muscle strength of the ankle. Photographs of the weight bearing and non-weight bearing foot were taken to measure the medial longitudinal arch deformation and the navicular drop. At 30°/sec, the average eversion concentric strength was significantly higher in the patient group, and the inversion/eversion strength ratio was significantly higher in the control group (p < 0.05). At 120°/sec velocity, average concentric eversion strength was significantly higher in the patient group (p < 0.05). The measurements of pronation indicators did not reveal any statistically significant differences between the two groups (p > 0.05). MTSS may occur without an increase of pronation indicators like medial longitudinal arch deformation or navicular drop. In such cases, one of the predisposing factors may be the strength dysbalance of the invertor/evertor muscles in favour of the evertor muscles. This observation may be of additional value in the prevention and therapy of MTSS. Key pointsAt 30°/sec, the average eversion concentric strength was significantly higher in the MTSS group, and the inversion/eversion strength ratio was significantly higher in the control group.At 120°/sec velocity, average concentric eversion strength was significantly higher in the MTSS group.MTSS may occur without an increase of pronation indicators like medial longitudinal arch deformation or navicular drop. In such cases, one of the predisposing factors may be the strength dysbalance of the invertor/evertor muscles in favour of the evertor muscles.

Tibial bone density in athletes with medial tibial stress syndrome: a controlled study.

Medial tibial stress syndrome (MTSS) is a common overuse injury of the lower extremity predominantly observed in weight bearing activities. Knowledge about the pathological lesions and their pathophysiology is still limited. Only a single study was found to have investigated tibial bone density in the pain region, revealing lower density in athletes with long standing (range, 5-120 month) MTSS. In a follow-up study, bone density was determined to return to normal levels after recovery. The purpose of the present study was to investigate tibial bone density in athletes with shorter MTSS history (range, 3-10 weeks). A total of 11 athletes (7 males, 4 females) diagnosed with medial tibial stress syndrome were included in the study. The control group consisted of 11 regularly exercising individuals (7 males, 4 females). Tibial, femoral and vertebral bone densities were measured by dual energy x-ray absorptiometry. Total calcium intake was calculated by evaluating detailed nutrition history. No statistically significant differences were found in the tibial, femoral and vertebral bone densities between the groups. No statistically significant difference was found among groups, considering for calcium intake. Tibial bone densities were not lower in athletes with MTSS of 5.0 weeks mean duration (range, 3-10 weeks) compared to the healthy control group. Longitudinal studies with regular tibial bone density measurements in heavily trained athletes are necessary to investigate tibial density alterations in MTSS developing athletes during the course of the symptoms. Key pointsTibial, femoral and vertebral bone densities were measured by dual energy x-ray absorptiometry.No differences were found between the MTSS group (MTSS history 3-10 weeks) and the healthy athletes group.