Mortality from mental disorders and suicide in male professional American football and soccer players: A meta-analysis.

OBJECTIVE: To determine the risk of mortality from mental disorders and suicide in professional sports associated with repeated head impacts. METHODS: A systematic search was performed in PubMed, Web of Science, Scopus, and SPORTDiscus (since inception to June 8, 2021) to find studies comparing the incidence of mortality from mental disorders or suicide in former or active professional athletes of sports characterized by repeated head impacts vs athletes with no such exposure or the general non-athletic population. RESULTS: Seven retrospective studies of moderate-to-high quality that included data from boxers and from basketball, ice hockey, soccer, and National Football League (NFL) players, respectively (total = 27 477 athletes, 100% male) met all inclusion criteria. Former male NFL players (n = 13 217) had a lower risk of mortality from mental disorders (standard mortality rate [SMR] = 0.30; 0.12-0.77; p = 0.012) and suicide (SMR = 0.54; 0.37-0.78; p < 0.001) than the general population. This finding was also corroborated in male soccer players (n = 13,065; SMR = 0.55; 0.46-0.67; p < 0.001). Male athletes participating in sports associated with repeated head impacts (n = 18,606) had also a lower risk of all-cause, cardiovascular disease (CVD), and cancer mortality (all p < 0.01) than the general population. CONCLUSIONS: Participation of male athletes in American football or soccer at the professional level might confer a certain protective effect against mortality from mental disorders or suicide, besides its association with a lower risk of all-cause, CVD, or cancer-related mortality.

History of Sport-Related Concussion and Long-Term Clinical Cognitive Health Outcomes in Retired Athletes: A Systematic Review.

BACKGROUND: Sport-related concussions (SRCs) are known to have short-term effects on cognitive processes, which can result in diverse clinical presentations. The long-term effects of SRC and repeated exposure to head impacts that do not result in SRC on specific cognitive health outcomes remain unclear. OBJECTIVES: To synthesize and appraise the evidence base regarding cognitive health in living retired athletes with a history of head-impact exposure or SRC. DATA SOURCES: A systematic search of the EMBASE, PsycINFO, MEDLINE/PubMed, CINAHL, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted from inception to April 2018 using common key words and medical subject headings related to 3 components: (1) the participant (eg, retired athlete), (2) the primary outcome measure (eg, cognitive test used), and (3) the secondary outcome measure (eg, history of sport concussion). STUDY SELECTION: Cross-sectional studies of living retired male or female athletes in which at least 1 cognitive test was used as an outcome measure were included. Two reviewers independently screened studies. DATA EXTRACTION: Data extraction was performed using Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Methodologic quality was assessed independently by 2 reviewers using the Downs and Black tool. DATA SYNTHESIS: The search yielded 46 cross-sectional observational studies that were included in a qualitative synthesis. Most included studies (80%, n = 37) were published in the 5 years before our review. A large proportion of these studies (n = 20) included retired American National Football League players. The other research investigated professional, university, high school, and amateur retired athletes participating in sports such as American and Australian football, boxing, field and ice hockey, rugby, and soccer. The total sample consisted of 13 975 participants: 7387 collision-sport athletes, 662 contact-sport athletes, 3346 noncontact-sport athletes, and 2580 participants classified as controls. Compared with control participants or normative data, retired athletes displayed worse performance in 17 of 31 studies (55%) of memory, 6 of 11 studies (55%) of executive function, and 4 of 6 studies (67%) of psychomotor function and increased subjective concerns about cognitive function in 11 of 14 studies (79%). The authors of 13 of 46 investigations (28%) reported a frequency-response relationship, with poorer cognitive outcomes in athletes who had greater levels of exposure to head impacts or concussions. However, these results must be interpreted in light of the lack of methodologic rigor and moderate quality assessment of the included studies. CONCLUSIONS: Evidence of poorer cognitive health among retired athletes with a history of concussion and head-impact exposure is evolving. Our results suggest that a history of SRC may more greatly affect the cognitive domains of memory, executive function, and psychomotor function. Retired athletes appeared to have increased self-reported cognitive difficulties, but the paucity of high-quality, prospective studies limited the conclusions that could be drawn regarding a cause-and-effect relationship between concussion and long-term health outcomes. Future researchers should consider a range of cognitive health outcomes, as well as premorbid ability, in diverse samples of athletes with or without a history of concussion or head-impact exposure to delineate the long-term effects of sport participation on cognitive functioning.

The Relations Among Depression, Cognition, and Brain Volume in Professional Boxers: A Preliminary Examination Using Brief Clinical Measures.

OBJECTIVE: Depression, neuropathology, and cognitive decline are commonly observed with repetitive head injuries (RHIs). We examined whether in boxers (a) clinically significant depression is associated with structural brain changes and cognition; (b) minimal symptoms of depression moderate the relations among RHI and brain volumes and cognition; and (c) baseline depression is associated with longitudinal cognitive changes. SETTING: Clinical Research Center. PARTICIPANTS: A total of 205 male professional boxers. DESIGN: Cross-sectional and longitudinal (subsample: n = 45; first visit to follow-up range = 1-6 years; mean = 2.61 years). MAIN MEASURES: Patient Health Questionnaire-9 depression; CNS Vital Signs cognitive battery; brain imaging. RESULTS: Clinically significant depression was associated with smaller regional volumes in insula, cingulate, orbitofrontal cortex, thalami, and middle corpus-callosum subregions; and with poorer verbal memory and psychomotor speed performance. Depression symptoms moderated the relations between RHI and bilateral thalami, left hippocampus, left medial orbitofrontal cortex, and bilateral insula volumes; but not cognition. Baseline depression was associated with poorer psychomotor speed and reaction time longitudinally and improved verbal memory performance longitudinally. CONCLUSION: Clinical depression is associated with volumetric and cognitive changes occasioning RHI exposure, and even minimal depressive symptoms may moderate the relations between exposure and brain volumes in key regions. Longitudinally, there is preliminary evidence that depression precedes cognitive changes.

False-performance feedback does not affect punching forces and pacing of elite boxers.

Prior research indicates that providing participants with positive augmented feedback tends to enhance motor learning and performance, whereas the opposite occurs with negative feedback. However, the majority of studies were conducted with untrained participants performing unfamiliar motor tasks and so it remains unclear if elite athletes completing familiar tasks respond in a similar fashion. Thus, this study investigated the effects of three different versions of false-performance feedback on punching force (N), pacing (force over time) and ratings of perceived exertion (RPE) in 15 elite amateur male boxers. Athletes completed a simulated boxing bout consisting of three rounds with 84 maximal effort punches delivered to a punching integrator on four separate days. Day one was a familiarisation session in which no feedback was provided. In the following three days athletes randomly received false-positive, false-negative and false-neutral feedback on their punching performance between each round. No statistical or meaningful differences were observed in punching forces, pacing or RPE between conditions (P > 0.05; ≤ 2%). These null results could stem from the elite status of the athletes involved, the focus on performance rather than learning, or they may indicate that false feedback has a less potent effect on performance than previously thought.

Early onset dementia in New Zealand Pacific boxers: a case series.

AIM: To describe the biopsychosocial characteristics of a series of Pacific men living in South Auckland with a history of boxing presenting with early onset dementia. We discuss the history of boxing in Pacific people and the possibility of increased risk of early onset dementia in New Zealand Pacific men compared to their European counterparts. METHOD: We reviewed the files of Pacific men with a history of amateur or professional boxing who presented to our memory and older adult mental health services with early onset dementia over a 45-month period. We gathered relevant information to construct a biopsychosocial paradigm as possible explanation of this phenomenon. RESULTS: We identified a series of eight New Zealand Pacific men with early onset dementia and with a history of boxing. Alcohol was a contributing factor in seven of the eight cases, and vascular risk factors in five. CONCLUSION: Historical, cultural and socio-economic factors underpin the attraction of some Pacific men to boxing as a sport. Given that New Zealand Pacific peoples may have an earlier onset of dementia than their European counterparts, further research is required to establish whether boxing is a contributory factor. Sports physicians should advise young New Zealand Pacific boxers about the long-term risks associated with their sport.

Functional work breaks in a high-demanding work environment: an experimental field study.

Work breaks are known to have positive effects on employees' health, performance and safety. Using a sample of twelve employees working in a stressful and cognitively demanding working environment, this experimental field study examined how different types of work breaks (boxing, deep relaxation and usual breaks) affect participants' mood, cognitive performance and neurophysiological state compared to a control condition without any break. In a repeated measures experimental design, cognitive performance was assessed using an auditory oddball test and a Movement Detection Test. Brain cortical activity was recorded using electroencephalography. Individual's mood was analysed using a profile of mood state. Although neurophysiological data showed improved relaxation of cortical state after boxing (vs. 'no break' and 'deep relaxation'), neither performance nor mood assessment showed similar results. It remains questionable whether there is a universal work break type that has beneficial effects for all individuals. Practitioner Summary: Research on work breaks and their positive effects on employees' health and performance often disregards break activities. This experimental field study in a stressful working environment investigated the effect of different work break activities. A universal work break type that is beneficial for this workplace could not be identified.

Lack of Influence of Apolipoprotein E Status on Cognition or Brain Structure in Professional Fighters.

The role of the apolipoprotein e4 allele in moderating cognitive and neuroanatomical degeneration following repeated traumatic brain injury is controversial. Here we sought to establish the presence or absence of such a moderating relationship in a prospective study of active and retired boxers and mixed martial arts fighters. Fighters (n = 193) underwent cognitive evaluations, interviews regarding fight history, MRI of the brain, and genetic testing. We used a series of moderator analyses to test for any relationship of apolipoprotein genotype on structural volumes of brain regions previously established to be smaller in those with the most fight exposure, and on cognitive abilities also established to be sensitive to fight exposure. No moderating relationship was detected in any of the analyses. The results of this study suggest that there is no impact of apolipoprotein genotype on the apparent negative association between exposure to professional fighting and brain structure volume or aspects of cognition.

Choices enhance punching performance of competitive kickboxers.

While self-controlled practice has been shown to enhance motor learning with various populations and novel tasks, it remains unclear if such effects would be found with athletes completing familiar tasks. Study 1 used a single case-study design with a world-champion kickboxer. We investigated whether giving the athlete a choice over the order of punches would affect punching velocity and impact force. Separated by 1 min of rest, the athlete completed 2 rounds of 12 single, maximal effort punches (lead straight, rear straight, lead hook and rear hook) delivered to a punching integrator in a counterbalanced order over six testing days. In one round the punches were delivered in a predetermined order while in the second round the order was self-selected by the athlete. In the choice condition, the world champion punched with greater velocities (6-11 %) and impact forces (5-10 %). In Study 2, the same testing procedures were repeated with 13 amateur male kickboxers over 2 testing days. Similar to Study 1, the athletes punched with significantly greater velocities (6 %, p < 0.05) and normalised impact forces (2 %, p < 0.05) in the choice condition. These findings complement research on autonomy support in motor learning by demonstrating immediate advantages in force production and velocity with experienced athletes.

Effects of mental training on muscular force, hormonal and physiological changes in kickboxers.

BACKGROUND: The aim of the present study was to examine the effects of mental training on muscular force generation, hormonal alterations, and physiological adaptations in male trained kickboxers. METHODS: Fifty-three male trained kickboxers (24.2±4.4 years, 1.75±0.08 m and 70.4±10.2 kg) were randomly assigned to a physical-training group (PG; N.=20), physical and mental training group (PMG: N.=18, mental-training package [MTP] plus physical training] or control group (CG: N.=15). Physical fitness tests: countermovement jump (CMJ), medicine ball throw (MBT), bench press, and half-squat tests; hormones: resting cortisol (C) blood sample, plasma testosterone (T) concentration, and T/C ratio; and physiological variables: resting heart rate (HR), and blood pressure (BP) were assessed before training commenced (baseline) and at week 6 and 12 of training. RESULTS: PMG and PG improved performance in CMJ height (16.2%, 8.4%), MBT (27.9%, 14.2%), bench press (26.5%, 15.7%), half-squat (27.2%, 16.3%), T concentration (35.2%, 22.4%), and T/C ratio (60%, 0%, for PMG only), respectively. In contrast, the C concentration decreased for the PMG (16.3%) and increased for the PG (22%) after 12 weeks. The PMG and PG had significant decrease from pre- to post-training for the resting HR (9.1%, 3%, respectively) and BP (8.5%, 5.3%, respectively). Furthermore, there was a significant increase in MBT (9.3%) after 6 weeks in PMG. Outlined improvements (PMG and PG) were favorable compared to CG (P<0.05) in all instances. CONCLUSIONS: The greater muscular force generation in PMG than PG seem to be explained by the reduction of hormonal and physiological stress after 12 weeks.

The effects of attentional focus instructions on punching velocity and impact forces among trained combat athletes.

Research indicates that instructing athlete's to focus on bodily movements (internal focus of attention [IFA]) may hinder performance, whereas instructing them to focus on the movement outcome (external focus of attention [EFA]) often enhances performance. Despite the importance of instructions in striking combat sports, limited research has examined the influence of IFA and EFA on performance in well-trained combat athletes. This study investigated the effects of different instructional cues on punching velocity (m · s-1) and normalised impact forces (N · kg-1) among intermediate (n = 8) and expert (n = 7) competitive boxers and kickboxers. Athletes completed three rounds of 12 maximal effort punches delivered to a punching integrator on three separate days. Day one was a familiarisation session with only control instructions provided. In the following two days athletes randomly received IFA, EFA or control instructions prior to each of the three rounds. Athletes punching with EFA were 4% faster and 5% more forceful than IFA (P < 0.05), and 2% faster and 3% more forceful than control (P < 0.05). Furthermore, experts punched 11% faster and with 13% greater force compared with intermediate athletes (P < 0.05). EFA led to a positive effect on punching performance and should be favoured over IFA and control instructions.

SPORTS PREFERENCE AND DIGIT RATIO (2D:4D) AMONG FEMALE STUDENTS IN WROCLAW, POLAND.

Humans exhibit sex differences in competitiveness, sensation seeking and risk-taking attitude, which are required in sports. These attributes are often linked to prenatal testosterone (PT) exposure. The second-to-fourth digit length ratio (2D:4D) is an indicator of PT exposure. A lower 2D:4D indicates higher PT exposure and vice versa. Males generally have a lower 2D:4D than females. Sensation- and/or thrill-seeking behaviours have also been found to be negatively associated with 2D:4D. Boxing and judo are considered to be high-risk sports. Voluntary participation in judo/boxing in contrast to aerobics can be guided by such behaviours and thus have an association with lower 2D:4D. This cross-sectional study included 167 female students from a military academy in Wroclaw, Poland. Of them, 119 had voluntarily chosen aerobic exercise, and 48 opted for judo/boxing. Height, weight and second and fourth digit lengths were measured. Physical fitness was assessed using Eurofit tests. The two groups showed similar physical fitness and body size. However, the judo/boxing group had significantly lower mean 2D:4D values than the aerobics group. It is proposed that voluntary choice of participation in a sport discipline by women could be linked to the 'organizational' effect of intrauterine testosterone exposure during prenatal growth.

Different proactive and reactive action control in fencers' and boxers' brain.

Practicing sport at top level requires excellent physical and cognitive skills. The goal of the present study was to investigate whether specific sport practice may affect the preparation-perception-action stages of processing during a visuo-motor task requiring perceptual discrimination and fast response. We recruited 39 participants (two groups of professional fencers and boxers, and a control group; N=13 for each group) and measured behavioral performance and event-related potentials (ERPs) while performing a go/no-go task. Results revealed that athletes were faster than controls, while fencers were more accurate than boxers. ERP analysis revealed that motor preparation, indexed by the Bereitschaftspotential (BP), was increased in athletes than controls, whereas the top-down attentional control, reflected by the prefrontal negativity (pN) component, was enhanced only in fencers when compared to controls. Most of the post-stimulus ERPs i.e. the N1, the N2, the P3, and the pP2, were enhanced in fencers. Combat sports require fast action execution, but the preparatory brain activity might differ according to the specific practice required by each discipline. Boxers might afford to commit more errors (as reflected by high commission error (CE) rate and by a small pN amplitude), while fencers have to be as much fast and accurate as possible (thanks to an enhanced pN amplitude). Although the possible influence of repetitive head blows on cerebral activity cannot be excluded in boxers, our results suggest that cognitive benefits of high-level sport practice might also be transferred to the daily (i.e., no sport-related) activities.

Executive (Dys)Functioning and Impulsivity as Possible Vulnerability Factors for Aggression in Forensic Patients.

This study investigated whether executive dysfunction and impulsivity are both predictors of reactive aggression and is the first to use behavioral assessment of aggression in response to provocation by means of a personalized boxing body opponent bag giving harassing feedback. Aggressive behavior, self-reported aggression, executive functioning (ie, working memory, flexibility, and divided attention), and impulsivity dimensions (i.e., Sensation Seeking, Impulsive Decision Making, and [inadequate] Response Inhibition) were measured in 44 incarcerated psychiatric patients. Results show that both executive functioning (working memory) and impulsivity (Impulsive Decision Making) predicted self-reported reactive aggression, whereas Response Inhibition was the only predictor for reactive aggressive behavioral responses. The study suggests that Response Inhibition is a stronger predictor of reactive aggressive behavior than executive capacities of working memory, flexibility, and divided attention. Therefore, future research should investigate whether (inadequate) Response Inhibition could also be a valuable predictor for violent recidivism.

Chronic Effects of Boxing: Diffusion Tensor Imaging and Cognitive Findings.

We used magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) to evaluate the effects of boxing on brain structure and cognition in 10 boxers (8 retired, 2 active; mean age = 45.7 years; standard deviation [SD] = 9.71) and 9 participants (mean age = 43.44; SD = 9.11) in noncombative sports. Evans Index (maximum width of the anterior horns of the lateral ventricles/maximal width of the internal diameter of the skull) was significantly larger in the boxers (F = 4.52; p = 0.050; Cohen's f = 0.531). Word list recall was impaired in the boxers (F(1,14) = 10.70; p = 0.006; f = 0.84), whereas implicit memory measured by faster reaction time (RT) to a repeating sequence of numbers than to a random sequence was preserved (t = 2.52; p < 0.04). Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) measured by tractography did not significantly differ between groups. However, DTI metrics were significantly correlated with declarative memory (e.g., left ventral striatum ADC with delayed recall, r = -0.74; p = 0.02) and with RT to the repeating number sequence (r = 0.70; p = 0.04) in the boxers. Years of boxing had the most consistent, negative correlations with FA, ranging from -0.65 for the right ventral striatum to -0.92 for the right cerebral peduncle. Years of boxing was negatively related to the number of words consistently recalled over trials (r = -0.74; p = 0.02), delayed recall (r = -0.83; p = 0.003), and serial RT (r = 0.66; p = 0.05). We conclude that microstructural integrity of white matter tracts is related to declarative memory and response speed in boxers and to the extent of boxing exposure. Implications for chronic traumatic encephalopathy are discussed.

Heart Rate and Liking During "Kinect Boxing" Versus "Wii Boxing": The Potential for Enjoyable Vigorous Physical Activity Videogames.

OBJECTIVE: Nintendo(®) (Kyoto, Japan) "Wii™ Sports Boxing" ("Wii Boxing") and Xbox(®) (Microsoft, Redmond, WA) "Kinect(®) Sports Boxing" ("Kinect Boxing") are both boxing simulation videogames that are available for two different active videogame (AVG) systems. Although these AVGs are similar, the style of gameplay required is different (i.e., upper body only versus total body movements) and may alter physical activity intensity and one's preference for playing one game over the other. AVGs that elicit the greatest physiologic challenge and are preferred by users should be identified in an effort to enhance the efficacy of physical activity interventions and programs that include AVGs. MATERIALS AND METHODS: The mean heart rate (HRmean) and peak heart rate (HRpeak) for 27 adults (22.7±4.2 years old) were recorded during four 10-minute conditions: seated rest, treadmill walking at 3 miles/hour, "Wii Boxing," and "Kinect Boxing." Upon completion of all four conditions, participants indicated which condition they preferred, and HRmean and HRpeak were calculated as a percentage of age-predicted maximum heart rate to classify physical activity intensity for the three activity conditions (treadmill, "Wii Boxing," and "Kinect Boxing"). RESULTS: "Kinect Boxing" significantly (P<0.001) increased percentage HRmean (64.1±1.6 percent of age-predicted maximum) and percentage HRpeak (76.5±1.9 percent) above all other conditions: Wii HRmean, 53.0±1.2 percent; Wii HRpeak, 61.8±1.5 percent; treadmill HRmean, 52.4±1.2 percent; treadmill HRpeak, 55.2±2.2 percent. Percentage HRpeak for "Kinect Boxing" was great enough to be considered a vigorous-intensity physical activity. There was no difference (P=0.55) in percentage HRmean between "Wii Boxing" and treadmill walking. Participants also preferred "Kinect Boxing" (P<0.001; n=26) to all other conditions ("Wii Boxing," n=1; treadmill n=0). CONCLUSIONS: "Kinect Boxing" was the most preferred and the only condition that was physiologically challenging enough to be classified as a vigorous-intensity physical activity.

What boxing-related stimuli reveal about response behaviour.

When two athletes meet inside the ropes of the boxing ring to fight, their cognitive systems have to respond as quickly as possible to a manifold of stimuli to assure victory. In the present work, we studied the pre-attentive mechanisms, which form the basis of an athlete's ability in reacting to an opponent's punches. Expert boxers, beginner boxers and people with no experience of boxing performed a Simon-like task where they judged the colour of the boxing gloves worn by athletes in attack postures by pressing two lateralised keys. Although participants were not instructed to pay attention to the direction of the punches, beginner boxers' responses resembled a defence-related pattern, expert boxers' resembled counterattacks, whereas non-athletes' responses were not influenced by the unrelated task information. Results are discussed in the light of an expertise-related action simulation account.

Prediction of winning amateur boxers using pretournament reaction times.

AIM: Boxing requires agility and manual dexterity, which is associated with fast reflexes and reaction time. This study evaluated the relation between reaction times on cognitive tasks and competition outcomes in boxers. METHODS: The design was a prospective cohort study. Participants were collegiate amateur boxers who won at least one bout in a single elimination tournament. Optimal pre-participation performance using a computerized cognitive assessment tool (CCAT, Axon Sports) and no significant deterioration in cognitive performance within 24 hours post-bout was required to compete in future bouts. Winners were assumed to be motivated to perform optimally on testing. Performance on speed and accuracy measures were compared in winning and non-winning boxers. Pre-competition minutes of sparring and tournament seedings were recorded. RESULTS: There were 96 eligible boxers who won at least one of 160 bouts. The mean age was 21.3 (SD 1.9) years (range 18.5-29.7). A significant improvement in mean reaction times as a function of advancement in the boxing tournament was observed. The 18 winning boxers who advanced to the finals had significantly faster mean reaction times at the baseline assessment before the competition began (speed composite z-score F(1,94)=4.14, P<0.05, effect size 0.54). Winners also had more sparring experience (Mann-Whitney U=302.5, P<0.001) and higher pre-competition rankings (Mann-Whitney U=288.5, P<0.001). CONCLUSION: In highly motivated amateur boxers, finalists performed significantly faster than those who failed to reach the finals on measures of pre-competition reaction time. These findings suggest that winners of boxing tournaments might be predicted using pre-competition measures of processing speed.

Mediating factors in martial arts and combat sports: an analysis of the type of martial art, characteristics, and social background of young participants.

To date, most studies regarding the social-psychological effects of martial arts and combat sports (MA&CS) on young people focus on measuring effects without considering mediating factors. The aim of the present study was to analyze three mediating factors that might be influential when examining outcomes of MA&CS for youth (i.e., the type of MA&CS, participants' characteristics, and social background). Young MA&CS participants (N = 477, M age = 14.0 yr., SD = 2.13) practicing judo, aikido, kick-/Thai boxing or karate, as well as their parents (N = 307), were assessed in terms of their goal orientations, aggressiveness, psychosocial behavior, and social background. It was concluded that differences exist in the characteristics and social background of participants depending on the type of MA&CS being practiced. The fact that differences in these mediating factors can be identified indicates that in future research these and possible other mediating factors should be considered when trying to determine social-psychological outcomes of MA&CS.

Long term effects of recreational SCUBA diving on higher cognitive function.

We investigated long-term effects of SCUBA diving on cognitive function using a battery of neuropsychometric tests: the Simple Reaction Time (REA), Symbol Digit Substitution (SDS), Digit Span Backwards (DSB), and Hand-Eye Coordination tests (EYE). A group (n = 44) of experienced SCUBA divers with no history of decompression sickness was compared to non-diving control subjects (n = 37), as well as to professional boxers (n = 24), who are considered at higher risk of long term neurological damage. The REA was significantly shorter in SCUBA divers compared to the control subjects, and also more stable over the time course of the test. In contrast, the number of digits correctly memorized and reordered (DSB) was significantly lower for SCUBA divers compared to the control group. The results also showed that boxers performed significantly worse than the control group in three out of four tests (REA, DSB, EYE). While it may be concluded that accident-free SCUBA diving may have some long-term adverse effects on short-term memory, there is however, no evidence of general higher cognitive function deficiency.

Sport specificity of mental disorders: the issue of sport psychiatry.

The prevalence of psychiatric conditions among elite athletes is still under debate. More and more evidence has accumulated that high-performance athletes are not protected from mental disorders as previously thought. The authors discuss the issue of the sport specificity of selected mental diseases in elite athletes. Specific aspects of eating disorders, exercise addiction, chronic traumatic encephalopathy and mood disorders in the context of overtraining syndrome are examined. In particular, the interrelationship between life and work characteristics unique to elite athletes and the development of mental disorders are reviewed. Differences of clinical presentation and some therapeutic consequences are discussed. The authors suggest that the physical and mental strains endured by elite athletes might influence the onset and severity of their psychiatric disorder. Beside the existing research strategies dealing with the amount of exercise, its intensity and lack of recreation experienced by athletes, further research on psycho-social factors is needed to better understand the sport-specific aetiology of mental disorders in high-performance athletes.