Simon M Rice , 1 , 2 , Kate Gwyther 1 , 2 , Olga Santesteban-Echarri 3 , David Baron 4 , Paul Gorczynski 5 , Vincent Gouttebarge 6 , 7 , Claudia L Reardon 8 , 9 , Mary E Hitchcock 10 , Brian Hainline 11 , Rosemary Purcell 1 , 2
16 May 2019
To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes.
Five online databases (PubMed, SportDiscus, PsycINFO, Scopus and Cochrane) were searched up to November 2018 to identify eligible citations.
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.
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.