Symptoms of depression and anxiety among elite high school student-athletes in Sweden during the COVID-19 pandemic: A repeated cross-sectional study.

The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports globally. Because sports participation contributes positively to the development of student-athletes, restricting these activities may have led to long-term mental health changes in this population. Using a repeated cross-sectional study design, we measured rates of depression using the Patient Health Questionnaire-2 and anxiety using the Generalized Anxiety Disorder-2 scale in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021; n = 7021) and after all restrictions were lifted (February 2022; n = 6228). Depression among student-athletes decreased from 19.8% in 2021 to 17.8% in 2022 (p = .008, V = .026), while anxiety screening did not change significantly (17.4% to 18.4%, p > .05). Comparisons between classes across years revealed older students exhibited decreases in depressive symptoms, while younger cohorts experienced increases in symptoms of anxiety from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one's career in sports were significant predictors of both depression and anxiety screenings in 2022. Compared to times when sports participation was limited, the lifting of restrictions was associated with overall reduced levels of depression, but not anxiety.

Assessing depressive symptoms with the Borg centiMax Scale® in a Swedish sample of patients and students.

The Borg centiMax Scale, is a psychophysically composed general intensity ratio scale, which could enable more precise inter- and intraindividual comparisons of the intensity of depressive symptoms. In the present study, the properties of the centiMax scale were examined in 38 patients with clinical depression and 109 students. Additionally, preliminary centiMax cut-off scores for mild, moderate and severe depression were estimated. The psychometric properties of the centiMax were found to be satisfactory regarding internal consistency, convergent, discriminative and predictive validity. Moreover, the centiMax was demonstrated to provide meaningful comparisons of symptom intensity, which makes it possible to evaluate the relative importance of individual symptoms in a profile and make more precise comparisons within and between individuals. With regard to intraindividual comparisons, patients rated , for example, the intensity of feeling "guilt" twice as strong as feelings of "being punished," and the intensity of "loss of pleasure" almost three times as strong as "being punished." With regard to interindividual comparisons, patients rated e.g., the intensity of "being punished" as 12 times stronger than controls, and the intensity of "worthlessness" about nine times stronger. In conclusion, the centiMax was shown to be reliable and valid for assessing depressive symptoms. The centiMax with level anchored ratio data, appears to be highly advantageous as it permits rather precise values of symptom intensity for intra- and interindividual comparisons that could be useful in the diagnostic process and in treatment planning.

Reliability of Hypernasality Rating: Comparison of 3 Different Methods for Perceptual Assessment.

OBJECTIVE: To compare reliability in auditory-perceptual assessment of hypernasality for 3 different methods and to explore the influence of language background. DESIGN: Comparative methodological study. PARTICIPANTS AND MATERIALS: Audio recordings of 5-year-old Swedish-speaking children with repaired cleft lip and palate consisting of 73 stimuli of 9 nonnasal single-word strings in 3 different randomized orders. Four experienced speech-language pathologists (2 native speakers of Brazilian-Portuguese and 2 native speakers of Swedish) participated as listeners. After individual training, each listener performed the hypernasality rating task. Each order of stimuli was analyzed individually using the 2-step, VISOR and Borg centiMax scale methods. MAIN OUTCOME MEASURES: Comparison of intra- and inter-rater reliability, and consistency  for each method within language of the listener and between listener languages (Swedish and Brazilian-Portuguese). RESULTS: Good to excellent intra-rater reliability was found within each listener for all methods, 2-step: κ = 0.59-0.93; VISOR: intraclass correlation coefficient (ICC) = 0.80-0.99; Borg centiMax (cM) scale: ICC = 0.80-1.00. The highest inter-rater reliability was demonstrated for VISOR (ICC = 0.60-0.90) and Borg cM-scale (ICC = 0.40-0.80). High consistency within each method was found with the highest for the Borg cM scale (ICC = 0.89-0.91). There was a significant difference in the ratings between the Swedish and the Brazilian listeners for all methods. CONCLUSIONS: The category-ratio scale Borg cM was considered most reliable in the assessment of hypernasality. Language background of Brazilian-Portuguese listeners influenced the perceptual ratings of hypernasality in Swedish speech samples, despite their experience in perceptual assessment of cleft palate speech disorders.

A demonstration of level-anchored ratio scaling for prediction of grip strength.

Level-anchored ratio scaling, such as the Borg CR10 scale(®) and the Borg CR100 scale(®), uses verbal anchors in congruence with numbers to give ratio data together with natural levels of intensity. This presupposes that the anchors possess natural positions in the subjective dynamic range and also "numerical" inter-relations. In an experiment, subjects had to produce a force of handgrip corresponding to their conception of "Strong", followed by a "Maximal" performance. By using the previously found relationship between "Strong" and "Maximal" of 1:2 together with knowledge of the exponent in the power S-R-function (R = c × S(n)) for grip strength, n = 1.8, predictions of individual maximal performances were obtained. The predicted values correlated 0.76 with, and deviated only 3% (ns) from, actual maximal performances of grip strength. This result -as previously also found for aerobic capacity-gives a strong support for the use of verbal anchors, so common in category scaling, also in "ratio scaling" and that the Borg CR-scales fulfill the requirements for ratio scales. For estimation of muscular strength, such as grip strength, this present study points to the value of using submaximal determinations as a compliment to maximal performances (e.g., to obtain measures of functional capacity). The results also support the increasingly common use of the CR-methodology in other ergonomic settings concerning suitable design of tools and equipment.

Regulating Force in Putting by Using the Borg CR100 scale(®).

Studies investigating the regulation of force of motor actions are scarce, and particularly so in the area of sports. This is surprising, considering that in most sports precise force is of great importance. The current study demonstrates how a psychophysical scale, the Borg CR100 scale(®) (Borg and Borg, 2001), can be used to assess subjective force as well as regulate force in putting. Psychophysical functions were calculated on the relationships between judgments of force using the CR100 scale and the length of putting shots, examined in a laboratory setting, where 44 amateur golfers played on both flat and uphill surfaces. High agreement and consistency between CR 100 ratings and distances putted was demonstrated. No significant differences in handling the scale were observed between younger (mean age ≈37 years) and older (mean age ≈69 years) players or between players of different skill level. This study provides a new innovative use of an existing instrument, the Borg CR 100 scale(®), in order to understand the regulation of force needed for putts of various lengths and surfaces. These results and the potential future benefits of the psychophysical approach in golf are discussed.

A comparison of AME and CR100 for scaling perceived exertion.

In psychophysical studies of the relation between perceived magnitude and physical stimulus, interest has focused on the preciseness of growth functions. Very little interest has been devoted to natural levels of an "absolute" character and to the validity of direct measurements. In this article, the Category (C)-Ratio (R) (CR) scaling methodology, developed by Borg (1973, 1977, 1982) is presented together with a new CR scale: the CR100 scale. In an experiment on perceived exertion, CR100 was compared with Absolute Magnitude Estimation (AME). Perceived exertion has the advantage of having easily measured physiological variables that can function as validity criteria. 32 persons (16 men and 16 women) participated as subjects on two different occasions, and the presentation order was counterbalanced. Results from CR100 and AME could be described equally well with psychophysical functions. The exponents obtained with CR100 were n = 1.60 for women and n = 1.69 for men, and the corresponding exponents for AME were n = 1.60 for women and n = 1.46 for men (with a "noise" constant included in the function). ANOVA showed that CR100 could make the predicted differentiation between sexes, whereas AME could not. This drawback with AME was also found when using the methods to predict working capacity.