Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedure
2.2. Instruments
2.2.1. Anxiety
2.2.2. Depression
2.2.3. Trait Mindfulness
2.2.4. Resilience
2.2.5. Athletic Identity
2.3. Statistical Analysis
3. Results
3.1. Anxiety and Depressive Symptoms
3.2. Bivariate Analysis
3.3. Predictors of Anxiety and Depression at T2
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Patel, V.; Chisholm, D.; Parikh, R.; Charlson, F.; Degenhardt, L.; Dua, T.; Ferrari, A.; Hyman, S.; Laxminarayan, R.; Levin, C.; et al. Addressing the burden of mental, neurological, and substance use disorders: Key messages from Disease Control Priorities, 3rd edition. Lancet 2016, 387, 1672–1685. [Google Scholar] [CrossRef] [Green Version]
- Gouttebarge, V.; Castaldelli-Maia, J.M.; Gorczynski, P.; Hainline, B.; Hitchcock, M.E.; Kerkhoffs, G.M.; Rice, S.; Reardon, C.L. Occurrence of mental health symptoms and disorders in current and former elite athletes: A systematic review and meta-analysis. Br. J. Sports Med. 2019, 53, 700–706. [Google Scholar] [CrossRef] [Green Version]
- Bueno-Notivol, J.; Gracia-García, P.; Olaya, B.; Lasheras, I.; López-Antón, R.; Santabárbara, J. Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. Int. J. Clin. Health Psychol. 2021, 21, 100196. [Google Scholar] [CrossRef]
- Pierce, M.; McManus, S.; Hope, H.; Hotopf, M.; Ford, T.; Hatch, S.L.; John, A.; Kontopantelis, E.; Webb, R.T.; Wessely, S.; et al. Mental health responses to the COVID-19 pandemic: A latent class trajectory analysis using longitudinal UK data. Lancet Psychiatry 2021, 8, 610–619. [Google Scholar] [CrossRef]
- Morin, C.M.; Bjorvatn, B.; Chung, F.; Holzinger, B.; Partinen, M.; Penzel, T.; Ivers, H.; Wing, Y.K.; Chan, N.Y.; Merikanto, I.; et al. Insomnia, anxiety, and depression during the COVID-19 pandemic: An international collaborative study. Sleep Med. 2021, 87, 38–45. [Google Scholar] [CrossRef] [PubMed]
- Gulliver, A.; Griffiths, K.M.; Christensen, H. Barriers and facilitators to mental health help-seeking for young elite athletes: A qualitative study. BMC Psychiatry 2012, 12, 157. [Google Scholar] [CrossRef] [Green Version]
- Rice, S.M.; Purcell, R.; De Silva, S.; Mawren, D.; McGorry, P.D.; Parker, A. The Mental Health of Elite Athletes: A Narrative Systematic Review. Sports Med. 2016, 46, 1333–1353. [Google Scholar] [CrossRef] [Green Version]
- Wallace, A.; Jackson, S.; Dawson, M.C. Women’s experiences of rugby culture in Aotearoa/New Zealand: Naked women talk about sport. In Women in Rugby; Routledge: New York, NY, USA, 2021; pp. 101–115. [Google Scholar]
- Jones, T.-V. Predictors of perceptions of mental illness and averseness to help: A survey of elite football players. J. Ment. Heal. 2016, 25, 422–427. [Google Scholar] [CrossRef] [PubMed]
- A Griffin, S.; Perera, N.K.P.; Murray, A.; Hartley, C.; Fawkner, S.G.; Kemp, S.P.T.; A Stokes, K.; Kelly, P. The relationships between rugby union, and health and well-being: A scoping review. Br. J. Sports Med. 2021, 55, 319–326. [Google Scholar] [CrossRef] [PubMed]
- Van Pelt, K.L.; Puetz, T.; Swallow, J.; Lapointe, A.P.; Broglio, S.P. Data-Driven Risk Classification of Concussion Rates: A Systematic Review and Meta-Analysis. Sports Med. 2021, 51, 1227–1244. [Google Scholar] [CrossRef]
- Edwards, C.; Thornton, J. Athlete mental health and mental illness in the era of COVID-19: Shifting focus with a new reality. Br. J. Sports Med. 2020. Available online: https://blogs.bmj.com/bjsm/2020/04/27/anxiety-and-insomnia-in-athletes-during-the-covid-era-part-1-foundation-and-facts/ (accessed on 9 November 2021).
- Mahmood, H.J.S.; Friedman, D.J. Batting against mental health in elite cricket. Br. J. Sports Med. 2021, 55, 1–2. [Google Scholar] [CrossRef] [PubMed]
- Reardon, C.L.; Bindra, A.; Blauwet, C.; Budgett, R.; Campriani, N.; Currie, A.; Gouttebarge, V.; McDuff, D.; Mountjoy, M.; Purcell, R.; et al. Mental health management of elite athletes during COVID-19: A narrative review and recommendations. Br. J. Sports Med. 2021, 55, 608–615. [Google Scholar] [CrossRef] [PubMed]
- Chang, C.; Putukian, M.; Aerni, G.; Diamond, A.; Hong, G.; Ingram, Y.; Reardon, C.L.; Wolanin, A. Mental health issues and psychological factors in athletes: Detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary. Br. J. Sports Med. 2019, 54, 216–220. [Google Scholar] [CrossRef] [PubMed]
- Henriksen, K.; Schinke, R.; Moesch, K.; McCann, S.; Parham, W.D.; Larsen, C.H.; Terry, P. Consensus statement on improving the mental health of high performance athletes. Int. J. Sport Exerc. Psychol. 2020, 18, 553–560. [Google Scholar] [CrossRef] [Green Version]
- Kabat-Zinn, J. Mindfulness. Mindfulness 2015, 6, 1481–1483. [Google Scholar] [CrossRef]
- Perestelo-Perez, L.; Barraca, J.; Peñate, W.; Rivero-Santana, A.; Alvarez-Perez, Y. Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis. Int. J. Clin. Health Psychol. 2017, 17, 282–295. [Google Scholar] [CrossRef]
- Guendelman, S.; Medeiros, S.; Rampes, H. Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies. Front. Psychol. 2017, 8, 220. [Google Scholar] [CrossRef] [PubMed]
- Birrer, D.; Röthlin, P. Riding the Third Wave: CBT and Mindfulness-Based Interventions in Sport Psychology. Available online: https://arbor.bfh.ch/10549/ (accessed on 9 November 2021).
- Joyce, S.; Shand, F.; Tighe, J.; Laurent, S.J.; A Bryant, R.; Harvey, S.B. Road to resilience: A systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open 2018, 8, e017858. [Google Scholar] [CrossRef] [Green Version]
- Bajaj, B.; Pande, N. Mediating role of resilience in the impact of mindfulness on life satisfaction and affect as indices of subjective well-being. Pers. Differ. 2016, 93, 63–67. [Google Scholar] [CrossRef]
- Connor, K.M.; Davidson, J.R.T. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress. Anxiety 2003, 18, 76–82. [Google Scholar] [CrossRef]
- Pérez-Aranda, A.; García-Campayo, J.; Gude, F.; Luciano, J.V.; Feliu-Soler, A.; González-Quintela, A.; López-Del-Hoyo, Y.; Montero-Marin, J. Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience. Int. J. Clin. Health Psychol. 2021, 21, 100229. [Google Scholar] [CrossRef]
- Brewer, B.W. Self-Identity and Specific Vulnerability to Depressed Mood. J. Pers. 1993, 61, 343–364. [Google Scholar] [CrossRef]
- Gustafsson, H.; Martinent, G.; Isoard-Gautheur, S.; Hassmén, P.; Guillet-Descas, E. Performance based self-esteem and athlete-identity in athlete burnout: A person-centered approach. Psychol. Sport Exerc. 2018, 38, 56–60. [Google Scholar] [CrossRef]
- Costa, S.; Santi, G.; Di Fronso, S.; Montesano, C.; Di Gruttola, F.; Ciofi, E.G.; Morgilli, L.; Bertollo, M. Athletes and adversities: Athletic identity and emotional regulation in time of COVID-19. Sport Sci. Heal. 2020, 16, 609–618. [Google Scholar] [CrossRef] [PubMed]
- Swann, C.; Moran, A.; Piggott, D. Defining elite athletes: Issues in the study of expert performance in sport psychology. Psychol. Sport Exerc. 2015, 16, 3–14. [Google Scholar] [CrossRef] [Green Version]
- West, S.W.; Starling, L.; Kemp, S.; Williams, S.; Cross, M.; Taylor, A.; Brooks, J.H.M.; A Stokes, K. Trends in match injury risk in professional male rugby union: A 16-season review of 10 851 match injuries in the English Premiership (2002–2019): The Professional Rugby Injury Surveillance Project. Br. J. Sports Med. 2021, 55, 676–682. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.; Löwe, B. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review. Gen. Hosp. Psychiatry 2010, 32, 345–359. [Google Scholar] [CrossRef] [PubMed]
- Gouttebarge, V.; Bindra, A.; Blauwet, C.; Campriani, N.; Currie, A.; Engebretsen, L.; Hainline, B.; Kroshus, E.; McDuff, D.; Mountjoy, M.; et al. International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): Towards better support of athletes’ mental health. Br. J. Sports Med. 2021, 55, 30–37. [Google Scholar] [CrossRef] [PubMed]
- Spitzer, R.L.; Kroenke, K.; Williams, J.B.W.; Löwe, B. A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Arch. Intern. Med. 2006, 166, 1092–1097. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Manea, L.; Gilbody, S.; McMillan, D. Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): A meta-analysis. Can. Med. Assoc. J. 2012, 184, E191–E196. [Google Scholar] [CrossRef] [Green Version]
- Feldman, G.; Hayes, A.; Kumar, S.; Greeson, J.; Laurenceau, J.-P. Mindfulness and Emotion Regulation: The Development and Initial Validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). J. Psychopathol. Behav. Assess. 2007, 29, 177–190. [Google Scholar] [CrossRef]
- MacDougall, H.; O’Halloran, P.; Sherry, E.; Shields, N. A Pilot Randomised Controlled Trial to Enhance Well-Being and Performance of Athletes in Para Sports. Eur. J. Adapt. Phys. Act. 2019, 12, 7. [Google Scholar] [CrossRef] [Green Version]
- Gucciardi, D.; Jackson, B.; Coulter, T.; Mallett, C.J. The Connor-Davidson Resilience Scale (CD-RISC): Dimensionality and age-related measurement invariance with Australian cricketers. Psychol. Sport Exerc. 2011, 12, 423–433. [Google Scholar] [CrossRef]
- Brewer, B.W.; Van Raalte, J.L.; Linder, D.E. Athletic Identity Measurement Scale; American Psychological Association (APA): Washington, DC, USA, 2012. [Google Scholar]
- Dalecki, M.; Willits, F.K. Examining change using regression analysis: Three approaches compared. Sociol. Spectr. 1991, 11, 127–145. [Google Scholar] [CrossRef]
- Di Fronso, S.; Costa, S.; Montesano, C.; Di Gruttola, F.; Ciofi, E.G.; Morgilli, L.; Robazza, C.; Bertollo, M. The effects of COVID-19 pandemic on perceived stress and psychobiosocial states in Italian athletes. Int. J. Sport Exerc. Psychol. 2020, 1–13. [Google Scholar] [CrossRef]
- Şenışık, S.; Denerel, N.; Köyağasıoğlu, O.; Tunç, S. The effect of isolation on athletes’ mental health during the COVID-19 pandemic. Physician Sportsmed. 2021, 49, 187–193. [Google Scholar] [CrossRef] [PubMed]
- Haslam, C.; Lam, B.C.P.; Yang, J.; Steffens, N.K.; Haslam, S.A.; Cruwys, T.; Fransen, K. When the final whistle blows: Social identity pathways support mental health and life satisfaction after retirement from competitive sport. Psychol. Sport Exerc. 2021, 57, 102049. [Google Scholar] [CrossRef]
- Taku, K.; Arai, H. Impact of COVID-19 on Athletes and Coaches, and Their Values in Japan: Repercussions of Postponing the Tokyo 2020 Olympic and Paralympic Games. J. Loss Trauma 2020, 25, 623–630. [Google Scholar] [CrossRef]
- Stroud, I.; Gutman, L.M. Longitudinal changes in the mental health of UK young male and female adults during the COVID-19 pandemic. Psychiatry Res. 2021, 303, 114074. [Google Scholar] [CrossRef]
- Kesebir, S.; Gündoğar, D.; Küçüksubaşı, Y.; Yaylacı, E.T. The relation between affective temperament and resilience in depression: A controlled study. J. Affect. Disord. 2013, 148, 352–356. [Google Scholar] [CrossRef] [PubMed]
n (T1) | % (T1) | n (T2) | % (T2) | Prop Diff (p) | Mean (T1) | SD (T1) | Mean (T2) | SD (T2) | Mean Diff (p) | |
---|---|---|---|---|---|---|---|---|---|---|
Country | ||||||||||
England | 135 | 84.38 | 135 | 84.38 | ||||||
Ireland | 23 | 14.38 | 23 | 14.38 | ||||||
Scotland | 2 | 1.25 | 2 | 1.25 | ||||||
Sex | ||||||||||
Male | 151 | 94.38 | 151 | 94.38 | ||||||
Female | 9 | 5.63 | 9 | 5.63 | ||||||
Age | ||||||||||
18–22 | 39 | 24.38 | 39 | 24.38 | ||||||
23–27 | 59 | 36.38 | 59 | 36.38 | ||||||
28–32 | 53 | 33.13 | 53 | 33.13 | ||||||
≥33 | 9 | 5.63 | 9 | 5.63 | ||||||
Fitness status | ||||||||||
Fit | 122 | 76.25 | 147 | 91.88 | ||||||
Injured | 38 | 23.75 | 13 | 8.12 | ||||||
Anxiety | 160 | 160 | 160 | 160 | 4.43 | 3.52 | 3.87 | 3.61 | 0.16 | |
Mild | 63 | 39.38 | 51 | 31.88 | 0.19 | |||||
Moderate | 15 | 9.34 | 12 | 7.5 | 0.68 | |||||
Mod-Severe | 2 | 1.25 | 2 | 1.25 | 1 | |||||
Depression | 160 | 160 | 160 | 160 | 4.2 | 3.59 | 2.97 | 3.24 | <0.01 | |
Mild | 58 | 36.25 | 33 | 20.63 | <0.01 | |||||
Moderate | 12 | 7.5 | 6 | 3.75 | 0.23 | |||||
Mod-Severe | 4 | 2.5 | 2 | 1.25 | 0.68 | |||||
Mindfulness | 160 | 160 | 160 | 160 | 32.16 | 5.1 | ||||
Resilience | 160 | 160 | 160 | 160 | 29.48 | 5.22 | ||||
Athletic ID | 160 | 160 | 160 | 160 | 48.77 | 8.28 |
Anxiety (T1) | Depression (T1) | Anxiety (T2) | Depression (T2) | Resilience | Mind | Athletic ID | |
---|---|---|---|---|---|---|---|
AnxietyT1 | - | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | >0.05 |
DepressionT1 | 0.50 | - | <0.001 | <0.001 | <0.001 | <0.001 | 0.17 |
AnxietyT2 | 0.55 | 0.45 | - | <0.001 | <0.001 | <0.001 | 0.08 |
DepressionT2 | 0.40 | 0.55 | 0.65 | - | <0.001 | <0.001 | 0.09 |
Resilience | −0.32 | −0.32 | −0.35 | −0.22 | - | <0.001 | 0.72 |
Mindfulness | −0.38 | −0.35 | −0.41 | −0.38 | 0.58 | - | <0.01 |
Athletic ID | 0.15 | 0.11 | 0.14 | 0.14 | 0.03 | −0.32 | - |
Model 1: Stepwise Regression Model for Depression (PHQ9) at T2 | ||||||
AdjR2 | F-Statistic | B | β | SE | p | |
0.37 | 12.8 | <0.001 | ||||
T1 Depression | 0.44 | 0.50 | 0.06 | <0.001 | ||
T1 Mindfulness | −0.10 | −0.14 | 0.04 | 0.03 | ||
Country (Ireland) | −1.50 | 0.59 | 0.01 | |||
Age (28–32) | −1.25 | 0.55 | 0.03 | |||
Sex (M) | −1.47 | 0.89 | 0.10 | |||
Model 2: Stepwise Regression Model for Anxiety (GAD7) at T2 | ||||||
Adj- | F-Statistic | B | β | SE | p | |
0.32 | 13.49 | <0.001 | ||||
T1 Anxiety | 0.44 | 0.44 | 0.07 | <0.001 | ||
T1 Fitness (Injured) | 1.27 | 0.56 | 0.02 | |||
T1 Mindfulness | −0.13 | −0.17 | 0.05 | 0.01 | ||
Country (Ireland) | −1.59 | 0.67 | 0.02 | |||
Sex (M) | −1.81 | 1.03 | 0.08 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Myall, K.; Montero-Marin, J.; Kuyken, W. Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills. Int. J. Environ. Res. Public Health 2021, 18, 11940. https://doi.org/10.3390/ijerph182211940
Myall K, Montero-Marin J, Kuyken W. Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills. International Journal of Environmental Research and Public Health. 2021; 18(22):11940. https://doi.org/10.3390/ijerph182211940
Chicago/Turabian StyleMyall, Kearnan, Jesus Montero-Marin, and Willem Kuyken. 2021. "Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills" International Journal of Environmental Research and Public Health 18, no. 22: 11940. https://doi.org/10.3390/ijerph182211940