The Routledge Handbook of Mental Health in Elite Sport

Cover
Half Title
Title Page
Copyright Page
Contents
List of Figures
List of Tables
List of Contributors
Section A: Mental Health
Introduction to the Section
1. Mental Health in Athletes
	Understanding of Mental Health in Contrast to Mental Illness
		Ill or Not Ill? - Categorization of Abnormality
		Dimensional Approach to Mental Health
		Keyes' Two-Dimensional Model
	Elements of Mental Health
		Well-Being
		Quality of Life
	Assessment of Mental Health
	Practical Implications
	Research Perspectives
	References
2. Thriving in Elite Athletes
	Introduction
	Theoretical Foundations of Thriving
	A Humanistic Model for Thriving Through Being in Elite Sport
	Guidelines for Practitioners
		Practitioners as Exemplars of Thriving
		Practitioners as Advocates for a Culture of Thriving
			Business Models to Support Thriving
			Processes of Thriving Sport Organizations
		Practitioners as Enablers of Thriving through Interpersonal Relationships
			Intrapersonal Strategy: Self-Awareness of the Opposites of UPR
			Interpersonal Strategy: Direction of Relational Movement
			UPR: A Secure Base from Which to Challenge
	Unanswered Questions and Future Directions
	Notes
	References
3. Meaning and Meaninglessness in Elite Sport
	Introduction
	What Is Meaning in Life?
	Meaning in Life and Health
	Finding Meaning in Life
	What Makes Athletes Particularly Vulnerable to a Lack of Meaning
	Finding Meaning in the Athletic World
	Conclusion
	References
4. Resilience and Mental Health in Competitive Sport: A Narrative Review of the Literature
	Introduction
		Conceptualising Resilience and Mental Health
	Summary of the Literature
		Resilience and Mental Health
		Resilience and Mental Ill-Health
			Clinical Indices
			Subclinical Indices
	Critique of the Literature and Future Research
	Practical Implications
		Developing Personal Qualities
		Strengthening Social Support
		Coach-Created Facilitative Environment
		COVID-19 Impact on Sport, Resilience, and Mental Health
	Conclusion
	References
5. The Social Network and the Coach
	Introduction
	Relevant Athlete Mental Health Frameworks
		Keyes' (2002) Continuum of Mental Health and Illness
		Neurobiopsychosocial Model
	Relevant Athlete Mental Health Outcomes
		Depression
		Anxiety
		Burnout
	Relevance of the Athlete's Social Network, Including the Coach, to the Athlete's Mental Health
		Key Sport-Based Social Actors
		Environmental and Training Influences on the Athlete's Social Perceptions
			Sport Culture and Stigma
			Social Support and Negative Social Interactions
		Mechanisms for Social Network Impact on Athlete Mental Health
			Identification
			Help-Seeking Behaviours
			Referral to Mental Health Services/Sources
			Coaches' Mental Health and Its Potential Influence on Athletes They Serve
	Review of Relevant Social Network Research
		Coach-Athlete Relationship
		Coach's Impact on the Athlete's Mental Health Outcomes
		Teammates' Impact on the Athlete's Mental Health Outcomes
		Total Network Impact on the Athlete's Mental Health Outcomes
	Practical Considerations
		Social-Actor-Focused Mental Health Interventions
		Social Network "Awareness" Trainings for the Athlete's Mental Health
		Mental Health Intervention Impacting Knowledge and Behaviours
		Integration of Social Actors within a Holistic Athlete Support Network
	Future Research Directions
		Longitudinal Tracking of Social Network Impact on Athlete Mental Health
		Assessment of Mental Health Interventions
		Assessment of Social Support Interventions
		Social Network Analysis
	Conclusion
	References
Section B: Mental Illness
Introduction to the Section
6. Depression in Elite Athletes
	Introduction
	Definition of Depression in Athletes
		Sport-Specific Considerations
	Prevalence of Depression in Athletes
		College Athletes
		International Elite Athletes
		Sport-Specific Differences
	Assessment and Diagnostic
		Self-Rating Questionnaires
		Indirect Measurements
	Aetiology
	Important Vulnerabilities and Stressors
		Stress and Stressors
			Lack of Recovery
		Psychological Vulnerabilities
			Coping Strategies
			Dysfunctional Attitudes and Perfectionism
		Sport-Specific Mechanisms
			Attribution Mediates Differences Between Individual and Team Sport
	Practical Implications and Guidelines
	Research Perspectives
	Summary
	References
7. Recognition, Prevention, and Treatment of Disordered Eating and Body Dissatisfaction in Athletes
	Introduction
	Historical Perspective of Disorder Eating and Associated Behaviours
	Biopsychosocial Influences and Pressures of Athleticism
	Types of Eating Disorders and Associated Dysfunctional Behaviours
		Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder
		Body Dysmorphic Disorder (BDD)
		Orthorexia Nervosa (ON)
		Case Vignette: What's Happening!
		Summary of Key Components Regarding Case Vignette
	Eating Disorders, Body Image, and Weight Control Actions
	Health Risks, Well-Being, and Quality of Life
	Individual and Team-Based Assessment, Prevention, and Treatment
		Cognitive Behavioural Therapy (CBT)
		Mindfulness
	Support Groups for Eating Disorders
	Conclusion
	References
8. Addiction (Drugs and Gambling) Disorders in Athletes
	Introduction
		Definitions and Reasons for Use/Participation in Addictive Behaviours
	General Prevalence
	Specific Substances
		Alcohol
		Cannabinoids
		Nicotine
		Stimulants
		Prescription Drugs
		Sport-Related Gambling
		Mental Health Symptoms and Disorders Associated with Problem Gambling
	Prevention
		Drugs
		Gambling
	Management
		Drugs
		Gambling
	Practical Implications
	Summary
	References
9. The Role of Executive Functions in Elite Athletes' Mental Health
	Introduction
		Definition
		Measurement
		Elite Athletes
		Impact on Mental Health
	Implications for Practitioners
	Conclusion
	References
10. Personality Disorders in Elite Athletes
	Introduction
	Theoretical Approaches
		History of Personality
		Personality and Its Disorders Defined
			Personality
			Personality Disorders
		Factors Involved in the Development of Personality and Its Disorders
		Characterisation of Personality Disorders
		Biopsychosocial Model (BPS)
		Diagnosing Personality Disorders
		Impact on Social-Emotional Functioning
		Impact on Elite Athletes
		Treatment of Personality Disorders
	Practical Applications and Guidelines
	Summary
	Case Presentation
	References
11. Anxiety Disorders Among Elite Athletes
	The Spectrum of Anxiety in Elite Sport
	Anxiety Disorders: An Overview
	Prevalence Rates of Anxiety Among Athletes
		Generalised Anxiety Disorder
		Social Anxiety Disorder
		Panic Disorder
		Related Disorders
	Contributing Factors to Athlete Anxiety
	Assessment of Anxiety Disorders
	Treatment of Anxiety Disorders
		Non-Pharmacological Treatment
		Pharmacological Treatment
	Future Directions
	Summary
	References
Section C: Subclinical and Related Challenges
Introduction to the Section
12. Reducing Burnout in Athletes
	Introduction
		What Is Burnout?
		How Does Burnout Develop?
			Smith's (1986) Cognitive-Affective Model
			Raedeke's (1997) Commitment Model
			Deci and Ryan's (2002) Self-Determination Theory (SDT)
		Why Is Burnout Important?
		Reducing Burnout in Athletes
		The Current Review
		Overview of Meta-Analyses
		Individual Interventions
		Organisational Interventions
		Individual and Organisational Interventions
		Key Findings, Critical Considerations, and Recommendations
	Summary
	References
13. Depression, Athlete Burnout, and Overtraining: A Review of Similarities and Differences
	Introduction
		Depression
		Burnout
		Increased Complexity in Sport: The Overtraining Syndrome
			Definition and Models
	Similarities and Differences Between Depression, Burnout, and Overtraining
		Definitional Similarities and Differences
		Aetiological Similarities and Differences
			An Integrative Model of Depression, Burnout, and Overtraining
	Future Research
	Practical Recommendations
	Conclusion
	References
14. Concussions in Athletes
	Definition of Concussion
	Causes of Concussions
	Prevalence of Concussion in Elite Sport
		Concussion in Professional Sport
		Concussions in Collegiate Sport
	Concussion Symptoms and Symptom Profiles
	Diagnosis of Concussions
		Clinical History
		Physical Examination
	Management of Concussions
	Common Mental Health Symptoms Following a Concussion
		A Model of the Anxiety and Mood Clinical Profile Following a Concussion
		Persistent Post-Concussive Symptoms and Post-Concussion Syndrome (PCS)
		Depression, Depressive Symptoms, and Anxiety
		Other Mental Health Issues
		Other Health-Related Problems Following a Concussion
	Major Risk Factors of Concussion-Related Mental Health Symptoms
		Sex, Race, and Sport
		Repeated Concussions
		Pre-Existing Mental Health Symptoms
		Symptom Overlap Between Mental Health Disorders and Concussions
	Strategies to Prevent and Mitigate Concussion-Related Mental Health Consequences in Elite Sport
		Primary Prevention Strategies
		Secondary Prevention Strategies
		Tertiary Prevention Strategies
	Implications for Future Research and Practice
		Implications for Research
		Implications for Practice
			Medical Staff
			Applied Sport Psychologists
			Team
	Conclusions
	References
15. Fear and Anxiety in Elite Sport
	Anxiety in Competitive Sport
		Defining of Terms
		Emergence of Anxiety
	Forms of Anxiety in Sport
		Competitive Anxiety
		Injury Anxiety
		Social Physique Anxiety
	Relation of Anxiety with Performance, Well-Being, and Mental Health
		Performance
		Mental Health and Well-Being
	Assessment of Anxiety in Sport
	Determinants and Risk Factors
		Person Factors
		Situation Factors
	Practical Implications
		Prevention Strategies
		Intervention Strategies
	Future Directions
	Summary
	References
16. Stress in Elite Sport
	Introduction
	Stress in Sport
	TCTSA-R Framework
	TCTSA-R and Mental Health
		Pre-Dispositions
		Demands Versus Resources
		Self-Efficacy
		Control
			Perceived Control
			Emotion Control
		Social Support
		Achievement Goals
		Physiological Indicators of Challenge and Threat
	Conclusion
		Practical Implications
		Research Perspectives
		Summary
	References
17. Stigmatisation of Mental Illness and Seeking Sport Psychology Services
	Introduction
	Stigma Toward Mental Health and Sport Psychology Services
	Important Others' Stigma Toward Seeking Service Provision
	Intra and Interpersonal Strategies to Decrease Stigma and Enhance Personal Openness
	Structural Efforts to Reduce Stigma
		Evaluation and Assessment
	Future Directions
	References
18. Career Transitions in Sport
	Introduction
		What Are the Different Career Transitions Athletes Might Experience?
	How Do Transitions Relate to Mental Health?
	A Social Identity Approach to Career Transitions and Mental Health
	Guidelines for Practitioners
		Case Studies
			Case study 1 - Responsive approach to a crises-coping transition
			Case study 2 - Crisis-prevention approach using an athlete-centred perspective
			Case study 3: Preventative approach using a holistic perspective
	Overall Recommendations
		Recommendation 1: It is Important to Use All of Athletes' Available Resources When Supporting Their Transition
		Recommendation 2: Social Support Is One of the Most Crucial Coping Mechanisms That Can Be Called Upon by Athletes and This Is Something That Should Be Mobilised During Transition
		Recommendation 3: Help Athletes Find Alternative Scope to Their Lives
		Recommendation 4: Support for Transition Should Be Long not Short Term
	Conclusion
	References
19. Doping and Drug Misuse in Elite Sport
	Introduction
	Sport Organisation Policies
	General Prevalence and Risk Factors for Use of Performance-Enhancing Substances
	Specific Performance-Enhancing Substances/Methods and Their Impact on Performance and Side Effects
		Androgens
		Growth Hormone and Growth Factors
		Stimulants
		Beta Agonists
		Beta Blockers
		Methods to Increase Oxygen Transport
		Nutritional Supplements
		Other Prescription Drugs
		Recreational Drugs
		Other Non-Drug Performance-Enhancing Measures
	Doping and Mental Health
		Prevention
		Management
	Practical Implications
	Summary
	References
Section D: Application and Care
††††††††Introduction to the Section
20. Professional Considerations for the Clinician
	Introduction
	Competence and Appropriate Use of Referrals
		Multicultural Competencies in Sport Psychology
		Becoming an Effective Professional
		Referrals
	Confidentiality and Informed Consent
	Telepsychology
		Legal Issues Associated with Telepsychology
		Ethical Issues Associated with Telepsychology
	Multiple Role Relationships
		Teacher-Clinician Multiple Role Relationships
		Ethical Considerations Associated with Multiple Role Relationships
	Ethical Issues Regarding Supervision
		Supervision Implications for Client Welfare, Supervisors, and Trainees
	Conclusion
	References
21. Psychotherapeutic Applications in Elite Sport: Promoting Mental Health Among Athletes
	Introduction
	Psychotherapy
		Individual Psychotherapy
		Couples/Family Psychotherapy
		Group Psychotherapy
	Unique Challenges
		Diagnostic Ambiguity
	Barriers and Resistances to Help-Seeking Behaviours
		Altered Expectations About Services
		Personality Factors
	Conclusion
	References
22. Recovery as the Centrepiece for Mental Health Promotion in Elite Athletes
	Introduction
	The Impact of COVID-19 on Athletes
	Mental Health in Athletes
	The Relationship Between Recovery, Stress, and Well-Being
	Recovery and Stress Monitoring for Mental Health Prevention in Athletes
	Practical Implications
	Summary and Future Directions
	References
23. Injury Prevention and Rehabilitation
	Introduction
	Biopsychosocial Approach to Injury Prevention and Rehabilitation
	iTeam for Injury Prevention and Rehabilitation
	iTeam Checklist
	Biopsychosocial and Interprofessional iTeam Considerations for Injury Prevention
		Case Vignette 1: Achieving the Olympic Dream during a Pandemic
		Case Summary and Guidelines for Practice
	Biopsychosocial and Interprofessional iTeam Considerations for Injury Rehabilitation
		Case Vignette 2: A Professional Cyclist's Recovery and Return to Racing
		Case Vignette 2 Summary and Guidelines for Practice
	Conclusion
	Acknowledgment
	References
24. Nature-Based Interventions in Elite Sport
	Introduction
	Theoretical Explanations
		Nature Connectedness
	What Are Nature-Based Interventions?
	Nature-Based Therapies
		Green and Blue Exercise Interventions
	Technological and Virtual Nature
	Application by Sport Typology
	Potential Adverse Effects
	Recommendations for Further Enquiry
		Efficacy of Nature-Based Interventions
			Acceptability of Approach
	Actions for Researchers and Practitioners
		Key Objectives
	Conclusions
	Funding Acknowledgement
	References
25. Young Athletes' Mental Health and Well-Being
	Introduction
		Defining Elite Youth Athletes
	What Is the Prevalence of Mental Health Symptoms in Elite Young Athletes?
		Mental Health Stigma in Young Elite Athletes
	Risk Factors for Mental Well-Being in Elite Young Athletes
		Pressure to Perform and Perfectionism
		Overtraining and Burnout
		Parental and Peer Conflict
		Athlete Abuse and Maltreatment
		Injury and Concussion
		Body Image Concerns
		Sleep Disturbance
	Applying Research into Practice: Bolstering Mental Well-Being in Elite Young Athletes
		Responding to Risk Factors
		Pharmacological Considerations
	Summary
	References
Index