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      Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns

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          Few epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced.


          Multivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations.


          A representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%).


          This study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.

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          Most cited references 62

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              Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety.

              Although substantial evidence suggests that stressful life events predispose to the onset of episodes of depression and anxiety, the essential features of these events that are depressogenic and anxiogenic remain uncertain. High contextual threat stressful life events, assessed in 98 592 person-months from 7322 male and female adult twins ascertained from a population-based registry, were blindly rated on the dimensions of humiliation, entrapment, loss, and danger and their categories. Onsets of pure major depression (MD), pure generalized anxiety syndrome (GAS) (defined as generalized anxiety disorder with a 2-week minimum duration), and mixed MD-GAS episodes were examined using logistic regression. Onsets of pure MD and mixed MD-GAS were predicted by higher ratings of loss and humiliation. Onsets of pure GAS were predicted by higher ratings of loss and danger. High ratings of entrapment predicted only onsets of mixed episodes. The loss categories of death and respondent-initiated separation predicted pure MD but not pure GAS episodes. Events with a combination of humiliation (especially other-initiated separation) and loss were more depressogenic than pure loss events, including death. No sex differences were seen in the prediction of episodes of illness by event categories. In addition to loss, humiliating events that directly devalue an individual in a core role were strongly linked to risk for depressive episodes. Event dimensions and categories that predispose to pure MD vs pure GAS episodes can be distinguished with moderate specificity. The event dimensions that preceded mixed MD-GAS episodes were largely the sum of those that preceded pure MD and pure GAS episodes.

                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                4 May 2011
                : 6
                : 5
                [1 ]Institut de Recherche Bio-Médicale et Epidémiologique du Sport (IRMES), Institut National du Sport, de l'Expertise et de la Performance (INSEP), Paris, France
                [2 ]Institut National de la Santé et de la Recherche Médicale(INSERM), Unit 970, Paris, France
                [3 ]Université Paris-Descartes, Paris, France
                [4 ]Centre d'Accompagnement et de Prévention pour les Sportifs (CAPS), Centre Hospitalier Universitaire, Bordeaux, France
                [5 ]Département Médical, Institut National du Sport, de l'Expertise et de la Performance (INSEP) Paris, France
                [6 ]Centre d'Investigations en Médecine du Sport (CIMS), Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
                University of Michigan, United States of America
                Author notes

                Conceived and designed the experiments: MT JF-T. Performed the experiments: MT KS SS JF-T CP. Analyzed the data: MT KS HN VT NEH CP MA TG. Wrote the paper: KS JF-T. Reviewed and proofread the manuscript: SS GB.

                Schaal et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                Page count
                Pages: 9
                Research Article
                Mental Health
                Anxiety Disorders
                Mood Disorders
                Human Performance
                Social Psychology
                Non-Clinical Medicine
                Health Care Policy
                Health Risk Analysis
                Sexual and Gender Issues
                Sports and Exercise Medicine
                Social and Behavioral Sciences
                Human Performance
                Social Psychology



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