Sleep disturbances and depression are bidirectionally associated among college student athletes across COVID-19 pandemic exposure classes.

College athletes may be vulnerable to sleep disturbances and depression during the COVID-19 pandemic as a result of large shifts in social and athletic obligations. In a national sample of college athletes, we examined the associations between sleep disturbances and depression across two timepoints, using COVID-19 exposure as a moderator. Data were collected from 2098 NCAA Division I, II, and III college athletes during two timepoints, from April 10 to May 23, and from August 4 to September 15, 2020. First, a latent class analysis was conducted with five indicators of levels of COVID-19 exposure to determine different exposure profiles. Second, to examine the directionality of associations between sleep disturbance and depression, a cross-lagged panel model was added to the latent class membership structural equation model; this allowed for testing of moderation by COVID exposure class membership. Four highly homogeneous, well-separated classes of COVID-19 exposure were enumerated: Low Exposure (57%); Quarantine Only (21%); High Other, Low Self Exposure (14%); and High Exposure (8%). COVID-19 exposure class membership did not significantly moderate associations between sleep disturbances and depression. However, student athletes significantly differed in T2 depression by their COVID-19 exposure class membership. Depression and sleep disturbances were positively correlated at both timepoints (r T1 = 0.39; r T2 = 0.30). Additionally, cross-lagged associations were found such that T2 depression was associated with T1 sleep disturbances (ß = 0.14) and vice versa (ß = 0.11). These cross-lagged associations were not significantly affected by athletes' level of COVID-19 exposure during the beginning of the pandemic.

The Relationship of Resilience, Self-Compassion, and Social Support to Psychological Distress in Women Collegiate Athletes During COVID-19.

Given how COVID-19 had caused significant increases in collegiate athletes' psychological distress, we examined the extent to which such distress may have been ameliorated by the athletes' psychosocial resources (e.g., resilience). We used structural equation modeling to examine the direct and indirect relationships of resilience, self-compassion, and social support to women collegiate athletes' (N = 3,924; 81.2% White) psychological distress; athletes completed measures of these constructs from mid-April to mid-May 2020. Analyses revealed significant direct effects: More supported (ß = -0.12 to -0.19), self-compassionate (ß = -0.48 to -0.53), and resilient (ß = -0.21 to -0.35) athletes experienced less psychological distress (R2 = .61-.65). Further, self-compassion and social support were related indirectly (and inversely) to psychological distress through higher levels of resilience. These psychosocial resources appear to have played a positive role in how athletes coped with the pandemic, being associated with less psychological distress. These findings have application beyond the pandemic, providing direction for how sport psychology professionals may assist athletes in maintaining their well-being.

Selective Optimization and Compensation, Skilled Golf Performance, and Age.

The present study tests predictions regarding skilled golf performance and age-based upon Selection, Optimization, and Compensation (SOC) theory. Participants were 1,324 adults (17-85 years old) who competed in a three-day major amateur golf tournament. Findings indicated that older golfers were most likely to identify difficulties in their games worthy of remediation, relied on performance-enhancing equipment to the greatest degree, and scored higher on SOC selection. For such players, SOC selection and remaining competitive predicted better tournament performance. Older players were also less likely to rate a variety of game improvement techniques as effective, less likely to engage in preround preparation, and were less likely than younger players to engage in SOC optimization and compensation strategies. This pattern of findings to a large extent also characterized middle-aged players. Despite a mixed picture of support for SOC theory, these findings provide valuable insights into its application to aging and the competitive sport domain.

Psychosocial predictors of eating classification in female athletes: From collegiate sport to retirement.

OBJECTIVE: Due to high prevalence, female athletes are considered a high-risk group for eating disorders (i.e., clinical ED = 2.0% to 19.9%; subclinical ED = 7.1% to 49.2%). Cross-sectional and longitudinal research have identified psychosocial factors that influence current and future disordered eating (e.g., appearance pressures, body satisfaction), but are limited in design (e.g., timeframe, active competitors). Quantitative evaluations of psychosocial predictors of female athletes' disordered eating in retirement are lacking. METHOD: The current study investigated the predictive ability of psychosocial risk factors (e.g., body dissatisfaction, negative affect) from Time1, when collegiate female athletes were actively competing, to Time2, 6 years later when the women were retired (N = 194; Mage = 25.75 years [SD = 1.19]). RESULTS: From Time1 to Time2, 23.5% of the women who were Healthy moved to the Disordered classification; 51% remained in Disordered. The full model for athletes who maintained their Disordered status correctly classified 76% of the athletes. Dietary intent, pressure to exercise and change appearance, body satisfaction, and internalization significantly predicted athletes' maintenance as Disordered. DISCUSSION: Early intervention efforts that address appearance pressures, body image, and healthful eating when athletes are actively competing are vital to help alleviate future distress, particularly in retirement.

Insomnia, Psychosocial Well-Being, and Weight Control Behaviors Among Healthy-Weight Adolescent Females: Brief Report.

BACKGROUND: Weight control behaviors (WCBs) typically involve appearance- or health-driven behaviors that may be influenced by physiological, psychological, or social factors. Sleep disturbances like insomnia are an important area of research for adolescent populations, as early intervention may result in improvements in other physical and mental health domains. The purpose of this study was to investigate the relationship of insomnia, psychosocial well-being, and current WCBs in healthy-weight female adolescents. METHOD: Female adolescents (N = 323; Mage = 12.33 ± .04) who had healthy body mass index (BMI) levels completed self-report items on insomnia, depression, self-esteem, and physical self-concept. Multivariate analysis of covariance (MANCOVA), controlling for age, was conducted to further examine differences in insomnia and psychosocial variables among the WCB groups. RESULTS: Compared to those who were trying to stay the same weight or not trying to do anything about their weight, the girls who were trying to lose weight had significantly greater insomnia and depression symptoms, and lower self-esteem, with small to medium effect sizes. CONCLUSIONS: Clinicians working with adolescent girls should include assessments of WCBs in addition to measures of insomnia symptoms, even for adolescent girls within a normal BMI range, as these are common and frequently co-occurring phenomena. Additional research is needed to further disentangle these complicated relationships.

Female Athletes in Retirement: A Test of a Psychosocial Model of Bulimic Symptomatology.

Although researchers have examined eating disorders in female athletes, few such studies have been done with athletes who are retired, and even fewer have been quantitative. Thus, the authors empirically tested an established eating disorder theoretical model with 218 former NCAA Division-I female collegiate athletes who had been retired for 2-6 years. In retirement, participants completed measures of general sociocultural pressures related to body and appearance, thin-ideal internalization, body dissatisfaction, dietary restraint, negative affect, and bulimic symptomatology. Through structural equation modeling, the authors examined the direct and indirect relationships among the latent variables while controlling for body mass index and years since retirement. The model fit the data well, supporting the hypothesized direct and indirect relationships among the variables and explaining 54% of the variance in bulimic symptomatology. Despite no longer being exposed to sport pressures that contribute to eating disorders, female athletes experience such symptoms long into retirement.

Bulimic Symptomatology Among Male Collegiate Athletes: A Test of an Etiological Model.

We tested Petrie and Greenleaf's psychosocial model in relation to male athletes' bulimic symptomatology. Through structural equation modeling, we cross-sectionally examined the direct and indirect effects of general and sport-specific appearance pressures, internalization, body satisfaction, drive for muscularity, negative affect, and dietary restraint on bulimic symptomatology. Participants were U.S. male collegiate athletes (N = 698; Mage = 19.87 years) representing 17 sports. With minor respecifications, the model had acceptable fit, and the psychosocial variables explained 48% of the bulimic symptomatology variance. Although all variable paths were significant, sport pressures, such as from coaches and teammates about weight, importance of appearance, and looking good in a uniform, were the most salient latent variable. Athletes' engagement in muscle-building behaviors added uniquely and substantively as well. Our analysis begins to clarify the complex interactions among these psychosocial variables in understanding male athletes' bulimic symptomatology and provides a base from which to develop prevention programming.

Learning to eat again: Intuitive eating practices among retired female collegiate athletes.

The present study used an open-ended survey to collect information about current eating practices and coping strategies among 218 retired female athletes. An inductive and deductive thematic analysis revealed three themes relevant to the intuitive eating framework-permission to eat; recognizing internal hunger and satiety cues; and eating to meet physical and nutritional needs. Athletes described feeling liberated with regards to their eating following retirement from sport, and for some this included an alleviation of disordered eating practices. These changes, however, required an effortful process of recalibration, during which athletes had to relearn and reinterpret their body's physiological signals of hunger and satiety. Additional research is needed to understand just how this process unfolds and how retired athletes can be supported in developing a healthier and more adaptive approach to eating.

To Weigh or Not to Weigh? Relation to Disordered Eating Attitudes and Behaviors Among Female Collegiate Athletes.

Female athletes have been identified as a subpopulation at heightened risk for disordered eating attitudes and behaviors, particularly due to weight pressures in their environment. Using a sample of 414 NCAA Division-I female collegiate athletes, we examined the relations of required team weigh-ins or self-weighing on disordered eating attitudes and behaviors. Through a series of multivariate analyses, we determined that team weighs were unrelated significantly to all outcome measures. Self-weighing, however, differentiated the athletes' scores on internalization, body satisfaction, dietary restraint, negative affect, and bulimic symptomatology; athletes who self-weighed three or more times a week (sometimes 1-2 times per week) reported significantly higher levels of pathology across all measures. Mandatory team-conducted weigh-ins appear to not be a salient pressure for female gymnasts and swimmer/divers, although the frequency of their self-weighing may represent a level of self-monitoring that is associated with greater endorsement of disordered eating attitudes and behaviors.

Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes.

The aim of this study was to determine the prevalence of disordered eating and pathogenic weight control behaviors in male collegiate athletes. Male collegiate athletes (N = 732) from the across the U.S. completed questionnaires online. Results suggested that (a) most eating disturbances occur at the subclinical level, (b) exercising and dieting were the most commonly used weight control practices, and (c) athletes who participate in weight class sports are more likely to be classified as symptomatic and engage in pathogenic eating and weight control behaviors compared to endurance sport or ball game athletes. Implications for professionals working with athletes and recommendations for future research are discussed.

Body satisfaction and disordered eating among male collegiate athletes: From point-prevalence to prediction.

Body satisfaction (BS) predicts lower levels of eating disorders and disordered eating behaviors (ED/DE) among female athletes, though recent research suggests similar effects for male athletes. However, research on male athletes' BS and ED/DE is limited, particularly in relation to times of transition, such as occurred in the months immediately following COVID-19 being recognized as a global pandemic. In this study, we surveyed 1975 male collegiate athletes in April/May 2020 to assess their body satisfaction and ED/DE symptomatology to determine prevalence and prediction between the two. First, we determined athletes' ED classification: 18.5 % (clinical) and 4.7 % (subclinical). Second, although 60 % to 70 % of the athletes reported satisfaction across five body dimensions, they were significantly more satisfied with their body muscularity and least with their leanness and thinness. Third, through hierarchical regression, athletes' body satisfaction significantly explained their ED/DE symptomatology, explaining 34 % of the variance. Of the five BS dimensions, satisfaction with body size/shape (ß = -0.19), current weight (ß = -0.22), and thinness (ß = -0.25) were associated significantly with lower DE. Our results add to the limited research that has demonstrated that during times of transition, such as when athletes retire from sport or experience a global health pandemic, female and male athletes' report more body image concerns and DE symptoms. Further, our results indicate that satisfaction is perceived as multidimensional by male athletes, and that specific dimensions (e.g., weight, thinness) are more strongly associated with disturbances in eating.

What facilitates collegiate athletes seeking mental health care? Athletic trainers' perceptions.

Objective: To assess athletic trainers' (ATs) perceptions regarding the importance of athletes' beliefs and athletic department stakeholders in facilitating help-seeking for mental health (MH) care.Participants: 534 ATs within collegiate athletic departments (Mage = 35.50 years; 64.2% women; 87.3% White).Methods: ATs were asked to indicate the extent to which they believed 10 student-athlete beliefs about MH (e.g. confidence MH treatments work) and 10 stakeholders (e.g. teammate) would facilitate student-athletes' help-seeking for MH care (1, Strongly Disagree, to 5, Strongly Agree).Results: We conducted separate two-way mixed design ANOVAs, one for each set of 10beliefs and 10 stakeholders; each was significant (p's < .002). The ATs perceived confidentiality as the most facilitative belief and viewed ATs as the most facilitative stakeholder.Conclusions: ATs differentiate among student-athletes' beliefs and stakeholders on how facilitative each might be in help-seeking, suggesting pathways for improving MH climate within athletic departments through education and policies.

Barriers to and Facilitators of Collegiate Athletes Seeking Mental Health Services.

CONTEXT: Approximately 1 in 5 student-athletes experience some type of mental health concern. However, fewer than half of student-athletes who report mental health concerns seek mental health treatment (ie, psychotherapy or medication). Data concerning barriers to student-athletes seeking mental health care are limited but suggest that stigma is the primary reason. Further, whether having shared identities with their sport psychologists (eg, race and gender) encourages student-athletes to seek help has been minimally explored. OBJECTIVES: To determine the frequency of internal and external barriers to athletes seeking mental health care and examine the importance of athletes and sport psychologists sharing identities as a facilitator of seeking help. DESIGN: Cross-sectional study. SETTING: Collegiate athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 266 student-athletes (53.8% women, 42.5% White) from a National Collegiate Athletic Association Division I university. MAIN OUTCOME MEASURES: Student-athletes responded to 9 binary (yes or no) prompts related to internal barriers (eg, beliefs and attitudes about mental health) and 7 reflecting external barriers (ie, different stakeholders, such as the head coach). Regarding facilitators of mental health help-seeking, student-athletes rated how important it was for them to share each of 10 identities with their sport psychologist from 1 (not at all important) to 5 (extremely important). All identified barriers and facilitators were derived from existing research. RESULTS: Differences were found in athletes' ratings of internal and external barriers. For example, a belief in one's own reliance and not having enough time were significant barriers, as was their head coach having a negative attitude about the importance of mental health. Female student-athletes rated sharing a gender identity with their sport psychologist as more important than did male student-athletes. CONCLUSIONS: Despite efforts by the National Collegiate Athletic Association to reduce the stigma surrounding mental health, persisting barriers within collegiate sports may keep athletes from seeking help.

Male body satisfaction: factorial and construct validity of the Body Parts Satisfaction Scale for Men.

Given the centrality of body dissatisfaction in the manifestation of eating, exercise, and affective disturbances in men, measurement of this construct becomes essential. Across 2 studies with male undergraduates (Ns = 189 and 188), the psychometric properties, including incremental validity and factor structure, of the 25-item Body Parts Satisfaction Scale for Men (BPSS-M) were examined. Three factors--Upper Body, Legs, and Face--that included items measuring both muscularity and leanness were established. The factors were internally consistent and temporally stable (over 6 months), and support was found for their convergent, discriminant, and concurrent validity. Further, we established that, after controlling for social desirability and drive for muscularity, body satisfaction contributes uniquely to men's experience of disordered eating, negative affect and mood, and psychological well-being. The BPSS-M yielded reliable and valid scores with undergraduate men, suggesting that it may be useful for understanding not only body satisfaction but disordered eating and affective disturbances as well.

Intuitive eating scale: an examination among early adolescents.

The Intuitive Eating Scale (IES; Tylka, 2006) initially was developed in a sample of college women to measure adaptive forms of eating, such as eating based on physiological rather than emotional cues. This study extends the work of Tylka (2006) and reports the psychometric evaluation of the IES in a sample of 515 middle-school boys and girls. Exploratory factor analysis identified 4 factors: Unconditional Permission to Eat, Eating for Physical Rather Than Emotional Reasons, Trust in Internal Hunger/Satiety Cues, and Awareness of Internal Hunger/Satiety Cues. These factors were confirmed in a separate sample and, with 4 items from the original scale dropped, the model fit the data well. Supporting its validity, IES scores were related inversely to body mass index, body dissatisfaction, negative affect, pressure for thinness, and internalization of the thin ideal, and positively to satisfaction with life and positive affect. The underlying structure of this measure appears valid for early adolescence, though it may be best defined by fewer items and one additional factor.

The body satisfaction and psychological well-being of retired women athletes: A long-term qualitative analysis of bodies in motion.

We conducted a qualitative evaluation of Bodies in Motion (BIM), a dissonance, mindful self-compassion-based program that addresses the unique experiences and needs of female athletes with respect to their bodies and their well-being. Using semi-structured interviews, 12 collegiate female athletes (retired 2 - 6 years) reflected and provided feedback on the enduring impact of BIM on their body image, relationship to food and exercise, and overall psychological well-being. Through thematic analysis, we found that these retired athletes, extending from their initial program learning, reported increased awareness of sport and societal messages and their impact on body image, shifted perspectives in their view of themselves and their bodies, and used learned skills to manage body image in their lives. Further, with the passage of time, athletes emphasized how what they had learned in BIM remained essential as they navigated challenging life transitions, such as their retirement from collegiate sports. Our findings indicate that the benefits female athletes report accruing in the immediate aftermath of BIM remain with them, even growing and becoming more salient as they continue to reflect on the program and its impact on their body awareness and how they navigate their lives as women and former athletes.

Drinking among college student athletes during the COVID-19 pandemic.

Objective: To investigate demographics, sport type, athletic identity, and COVID-19 sport season cancelation in relation to alcohol consumption among college student athletes shortly after the pandemic emerged. Participants: College student athletes recruited from U.S. athletic departments. Methods: Survey data were collected from 5,915 college student athletes in April/May 2020. Results: Being female, Latinx, and in a relationship were associated with lower alcohol consumption. Among males, team sport participation was related to greater alcohol consumption. Among females, athletic identity was inversely related to drinking, which was moderated by sport type, such that alcohol consumption was lower as athletic identity strengthened in individual (vs. team) sport athletes. However, we did not find a relationship of COVID-19 sport season cancelation with drinking. Conclusions: Our gender-specific findings are novel and generalizable based on a large, national sample of college student athletes, and may inform strategies for alcohol consumption education among college team sport athletes.

Self-compassion, body satisfaction, and disordered eating symptoms in male collegiate athletes: A longitudinal analysis.

Male athletes are a subpopulation at risk for developing eating disorders and disordered eating concerns, primarily due to the presence of socioculturally-based factors, including body dissatisfaction. Self-compassion may alleviate this risk by improving body satisfaction. To date, no study has examined longitudinally self-compassion's effect on body satisfaction and, ultimately, disordered eating in male athletes. Across two time points separated by four months, we assessed self-compassion, body satisfaction, and disordered eating in 454 male collegiate athletes. Through cross-lagged, panel analysis, after controlling for the Time 1 scores, we determined that: (a) Time 1 self-compassion was neither directly related to Time 2 body satisfaction (ß = 0.02, p = .755), nor indirectly to Time 2 disordered eating (ß = -0.002, 95% BCaCI [-0.028, 0.014]), and (b) Time 1 body satisfaction directly predicted Time 2 disordered eating (ß = -0.12, p < 0.05). Our findings extend past research, demonstrating that body satisfaction is a primary antecedent to disordered eating among male athletes. However, the proposed effects of self-compassion on the body satisfaction to disordered eating relationship were not supported and may be dependent on gender and athlete status.

College Student-athletes' COVID-19 Worry and Psychological Distress Differed by Gender, Race, and Exposure to COVID-19-related Events.

PURPOSE: The purpose of this study was to determine the prevalence of National Collegiate Athletic Association (NCAA) student-athletes' exposure to COVID-19-related events (e.g., canceled season, diagnosed with COVID) and their psychological distress in April/May 2020. METHODS: The link to the online survey was emailed to NCAA student-athletes by the NCAA Student Athlete Advisory Council and the athletic departments of 80 NCAA institutions. In April-May of 2020, student-athletes (N = 5915; women = 3924) completed the online survey once. The survey included measures of their psychological distress, COVID-19 worry, and their exposure to different COVID-19-related events. To examine differences in exposure to COVID-related events by racial, ethnicity, and gender identities, we conducted logistic regressions. A path analysis examined relationships between COVID-related events, COVID-19 worry, and psychological distress for men and women. RESULTS: Student-athletes' exposure to COVID-19 events differed significantly by gender, race, and ethnicity. In addition, 58.7% of women's and 54.5% of men's psychological distress variance was explained by the path model and mostly by their COVID-related worry. Student-athletes' stress was directly related to the changes that occurred in class delivery (i.e., online format) and indirectly by being quarantined. Men's psychological distress was also related through worry by their sport season being canceled. DISCUSSION: The general uncertainty and worry about COVID individuals experienced at the beginning of this pandemic primarily explained the athletes' high levels of psychological distress. As COVID-19 continues to cause quarantines and changes educational experiences, the worry and psychological distress of college students are likely to continue.

Eating disorder diagnosis and the female athlete: A longitudinal analysis from college sport to retirement.

OBJECTIVES: Female athletes experience eating disorders (EDs) at clinical, and subclinical, levels; most studies have determined point-prevalence rates through cross-sectional methodologies. To date, few studies have examined the long-term stability of EDs in female athletes; none extend into retirement. DESIGN: A longitudinal investigation of ED classification (i.e., Clinical ED, Subclinical ED, Healthy) and weight control behaviors (e.g., vomiting, laxative use) from when athletes actively competed (T1) into their retirement (T2). METHODS: Participants included U.S. female athletes (N=193) who were collegiate competitors (T1) and eventually were retired from their collegiate sports six years later (T2). RESULTS: At T2, athletes were classified as Healthy (69.9%), Subclinical ED (26.9%), and Clinical ED (3.1%). Overall percentage of Subclinical EDs increased from 18.7% (T1) to 26.9% (T2); 52.8% of T1 Subclinical ED athletes continued to meet criteria for either Subclinical or Clinical ED at T2. Of the 13 Clinical ED athletes at T1, six (46.2%) continued to meet criteria for either a subclinical or clinical ED at T2. Though exercising (2+ hours/day; n=8, 4.1%) and dieting/fasting (4+ times/year; n=14, 7.3%) were the most frequently used weight control behaviors at T2, rates were substantially lower than at T1. CONCLUSIONS: Retirement does not result in immediate remittance of eating concerns among female athletes; many continue or develop Subclinical and Clinical ED symptoms. Thus, addressing healthy body image and nutrition when athletes are competing is imperative to assist prevention and intervention efforts that may alleviate ED symptoms as athletes transition from sport.