Expert Commentary

Psychological balance in high-level athletes: Gender-based differences and sport-specific patterns

2011 study in PLoS ONE on rates of psychological problems among athletes by the sport practiced and gender.

According to the 2010 Census, the most widely practiced participatory athletic activity in the United States is walking; other popular options include swimming (third most practiced), camping (fourth), bicycling (sixth) and fishing (seventh). All exercise has a wide range of benefits — it improves health, is a great way to socialize, and can reduce stress.

As the level of athletic competition rises, however, so too can stress. Exacting preparation is followed by judgment against pitiless standards; unexpected injuries can end seasons and sometimes careers. Such pressure can take its toll on mental health, but up until now the extent of its effects on high-performing athletes has been unknown.

A 2011 study published in PLoS ONE, “Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns,” uses the annual psychological evaluations of more than 2,000 high-performing French athletes to rates of various psychological problems by the sport practiced and gender. The sample represented 13% of the country’s high-level athletes at the time.

The findings include:

  • 17% of the athletes had a current or recent psychopathology at the time of their evaluation, with generalized anxiety disorder being the most prevalent at 6%.
  • Women were 33% more likely than men to have a current or recent psychopathology, with the prevalence being 20.2% for women and 15.1% for men. Pathologies present among the women included anxiety, eating disorders, depression, and sleep problems.
  • A large gender disparity was found for those suffering from anxiety-related pathologies: Women were 56% more likely than men to have suffered from anxiety disorders over their lifetime.
  • Significantly higher rates of anxiety disorders were found in aesthetic sports such as gymnastics, synchronized swimming and figure skating: 38.9% versus 10.3% for women in all other sports, and 16.7 versus 6.8% for men in all other sports, respectively.
  • For women, eating disorders were most prevalent in particularly track and field and other racing sports (14 versus 9%). For men, eating disorders were most prevalent in those that played combat sports (7 vs. 4.8%).

One bias the researchers noted is that 61% of the athletes studied were seen by psychologists and 38% by physicians, which probably resulted in lower rates of psychopathology than would have been reported by psychologists only.

Overall, however, the study indicates that playing a high-level sport did not appear to be associated with a higher incidence of psychopathologies as compared to not playing a high-level sport. In addition, researchers found that among the population of athletes studied, “the sex-specific trends in psychopathology resemble those of the population at large.” The authors conclude, “The practice of a sport at the high level, in itself, does not appear psychopathogenic, since the prevalence of psychopathology identified is no higher than in the general population. Rather, it is the presence of very particular stressors, such as problems in the athletes’ social, personal and sporting environment that is associated with psychopathology.”

Tags: sports, mental health, cognition

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