Determinants of anxiety in elite athletes: a systematic review and meta-analysis

Abstract

Objective

To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes.

Design

Systematic review and meta-analysis.

Data sources

Five online databases (PubMed, SportDiscus, PsycINFO, Scopus and Cochrane) were searched up to November 2018 to identify eligible citations.

Eligibility criteria for selecting studies

Articles were included if they were published in English, were quantitative studies and measured a symptom-level anxiety outcome in competing or retired athletes at the professional (including professional youth), Olympic or collegiate/university levels.

Results and summary

We screened 1163 articles; 61 studies were included in the systematic review and 27 of them were suitable for meta-analysis. Overall risk of bias for included studies was low. Athletes and non-athletes had no differences in anxiety profiles ( d=−0.11, p=0.28). Pooled effect sizes, demonstrating moderate effects, were identified for (1) career dissatisfaction ( d=0.45; higher anxiety in dissatisfied athletes), (2) gender ( d=0.38; higher anxiety in female athletes), (3) age ( d=−0.34; higher anxiety for younger athletes) and (4) musculoskeletal injury ( d=0.31; higher anxiety for injured athletes). A small pooled effect was found for recent adverse life events ( d=0.26)—higher anxiety in athletes who had experienced one or more recent adverse life events.

Conclusion

Determinants of anxiety in elite populations broadly reflect those experienced by the general population. Clinicians should be aware of these general and athlete-specific determinants of anxiety among elite athletes.

Journal

Journal ID (nlm-ta): Br J Sports Med

Journal ID (iso-abbrev): Br J Sports Med

Journal ID (hwp): bjsports

Journal ID (publisher-id): bjsm

Title: British Journal of Sports Medicine

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Print): 0306-3674

ISSN (Electronic): 1473-0480

Publication date (Print): June 2019

Publication date (Electronic): 16 May 2019

Volume: 53

Issue: 11

Pages: 722-730

Affiliations

[1 ] departmentResearch and Translation , Orygen, The National Centre of Excellence in Youth Mental Health , Melbourne, Victoria, Australia

[2 ] departmentCentre for Youth Mental Health , University of Melbourne , Melbourne, Victoria, Australia

[3 ] departmentDepartment of Psychiatry, Hotchkiss Brain Institute , University of Calgary , Calgary, Alberta, Canada

[4 ] departmentCenter for Health and Sport , Western University of Health Sciences , Pomona, California, USA

[5 ] departmentDepartment of Sport and Exercise Science , University of Portsmouth , Portsmouth, UK

[6 ] departmentDepartment of Orthopaedic Surgery, Amsterdam Movement Sciences , Amsterdam UMC, University of Amsterdam , Meibergdreef, The Netherlands

[7 ] departmentAMC/VUmc IOC Research Center of Excellence , Amsterdam Collaboration on Health and Safety in Sports (ACHSS) , Amsterdam, The Netherlands

[8 ] departmentDepartment of Psychiatry , University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin, USA

[9 ] departmentUniversity Health Services , University of Wisconsin , Madison, Wisconsin, USA

[10 ] departmentEbling Library for the Health Sciences , University of Wisconsin–Madison , Madison, Wisconsin, USA

[11 ] National Collegiate Athletic Association (NCAA) , Indianapolis, Indiana, USA

Author notes

[Correspondence to ] Dr Simon M Rice, Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC 3052, Australia; simon.rice@ 123456orygen.org.au

Article

Publisher ID: bjsports-2019-100620

DOI: 10.1136/bjsports-2019-100620

PMC ID: 6579501

PubMed ID: 31097452

Copyright statement: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Product

Categories

Subject: Systematic Review

Subject: 1506

Subject: 2314

Subject: 1767

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