Authors: Nathan D. Grimm1, Krista K. Fritson1, John Duff2, Micah Stall2, and Christopher Waples1
1Department of Psychology, University of Nebraska at Kearney, Kearney, NE, USA
2Department of Intercollegiate Athletics, University of Nebraska at Kearney, Kearney, NE, USA
Nathan D. Grimm
1011 Hope St
Mankato, MN 56001
Nathan D. Grimm was an undergraduate psychology student at the University of Nebraska at Kearney during the completion of this study and is now a graduate student in the Sport, Exercise, and Performance Psychology program at Minnesota State University, Mankato.
Krista K. Fritson, PsyD is a professor of Psychology at the University of Nebraska at Kearney and Licensed Clinical Psychologist. She serves as the university’s psychologist with athletes. Krista’s areas of research interest include self-efficacy, therapy outcomes, effects of journaling on student learning/engagement/wellness.
Micah Stall, MS, LAT, ATC is an Assistant Athletic Trainer at the University of Nebraska at Kearney.
John Duff, MA, ATC, LAT. is an Assistant Athletic Trainer at the University of Nebraska at Kearney.
Christopher Waples, PhD is an associate professor of Psychology at the University of Nebraska at Kearney. His recent research interests involve quantitative methods, psychometrics, performance feedback, and the recruitment and retention of talent.
Exploring the Mental Health Needs of University Student-Athletes During COVID-19
Purpose: The COVID-19 pandemic has had a tremendous effect on the world of athletics. At the beginning of the pandemic, factors like strict health measures and protocols, social isolation, and uncertainties about the future negatively affected athletes’ well-being. The present study explores if student-athletes’ mental health, specifically depression, anxiety, and reactions to competition has improved as the pandemic restrictions/impact decreased. Additionally, we examine the impact that participation in team meetings with a psychologist had on these factors.
Methods: To research this, 166 student-athletes (18-24 years old) attending a Division-II University from the Midwest completed three different questionnaires, the PHQ-9, GAD-7, and SAS-2, across three successive semesters.
Results: Two mixed factorial MANOVA were conducted in this study. The first MANOVA revealed a significant decrease in anxiety (F(2,318) = 11.08, p < .001, ηp2 = 0.07) and depression (F(2,318) = 19.79, p < .001, ηp2 = 0.11) symptoms among the sample athletes as pandemic restrictions decreased. The second MANOVA revealed athletes involved in team meetings reported higher levels of worry (F(1,162) = 11.94, p < .001, ηp2 = 0.07), concentration disruption (F(1,162) = 20.46, p < .001, ηp2 = 0.11), and somatic anxiety (F(1,162) = 4.22, p = .042, ηp2 = 0.03).
Conclusions: Possible explanations for these findings are discussed. Identifying the effects of the COVID-19 pandemic can further assist professionals in developing strategies to boost student-athlete mental well-being and performance during major disruptions to their lives.
Applications in Sports: This study provides evidence of the trends seen in the mental health and resilience of student-athletes as the pandemic progressed and their overall needs from coaches and administrators.
Keywords: sports, college, pandemic, anxiety, depression, reaction to competition
Between 2020 and 2021, 35% of college students reported they had been diagnosed with some sort of mental health disorder, and anxiety and depression were the two most diagnosed disorders (3). During the COVID-19 pandemic, the everchanging restrictions, overall health concerns, and social isolation have further increased these already concerning mental health issues (17). At the start of the pandemic, NCAA Research (12) released results from a survey that examined how student-athletes at all levels were responding to the pandemic in the spring of 2020. This survey revealed that student-athletes have been significantly impacted by the pandemic environment, with various mental health concerns being reported at their highest rates since the NCAA started collecting data on student-athletes. The goal of this study is to examine if these mental health concerns are subsiding as the pandemic environment and restrictions become more relaxed. With the additional stressors that come with the pandemic and athletic competition, we also explore whether involvement in organized team meetings with a psychologist positively affected student-athletes’ mental health during this period. Through identifying how the pandemic is affecting student-athletes and measuring the impacts of additional resources, the outcomes from this study may assist professionals in determining strategies to best care for student-athletes during major life stressors such as the COVID-19 pandemic.
Decreasing COVID-19 Pandemic Restrictions
Overall, college students reported that the pandemic has caused disruptions in their sleep and eating patterns, decreased academic performance, concentration difficulties, changes in living environments, increased social isolation, and financial difficulties (17). Of these students, 44% also reported experiencing depressive thoughts, and 8% had thoughts of suicide. Pair these concerns with the typical stresses that are already associated with higher education (20), and the level of concern for the mental health for any college students due to the pandemic increases.
In a non-pandemic environment, student-athletes typically practice 20 hours per week and participate in competitions that can be disruptive to their class schedules which can create higher levels of exhaustion and stress (9). Additionally, student-athletes have similar or higher rates of depressive disorders compared to other students, and also tend to underutilize mental health resources (9). With the additional stressors associated with athletic participation, along with the challenges of the pandemic, student-athletes have had to face overwhelming obstacles during the onset of the pandemic. Many concerns were reported by student-athletes at the start of the pandemic. These included sleep difficulties, mental distress, inadequate training opportunities, and struggles with motivation (12). Şenışık et al. (15) found that in some athletes, during the initial phase of isolation due to the pandemic, the positive effects from exercise and sport participation, that normally improve mental health, diminished with the presence of negative thoughts concerning the pandemic.
In 2021, NCAA Research (13) released a follow-up report to their initial well-being survey from the fall of 2020. While rates of anxiety and symptoms of depression remained high in this report, athletes reported fewer levels of loneliness, sadness, and sleep difficulties. Part of this current study’s goal is to continue the exploration of how student-athletes’ mental health is being impacted by the COVID-19 pandemic as the pandemic’s restrictions/impacts decrease. As the challenges and concerns that were initially reported by Son et al. (17) subside, the negative effects that were initially reported with student-athletes may also decrease. This study looks to measure changes in student athletes reported frequency of depressive and anxiety symptoms and their reaction to competition as time passes since their return to campus and competition. It is expected that the frequency of depressive and anxiety symptoms will decrease as the COVID-19 restrictions decline. Along with such changes, it was also expected that student-athletes would report more positive reactions to competition.
Team Meetings with a Psychologist
With the growing number of concerns regarding student-athletes’ mental health during the pandemic, the need for care and resources to alleviate these concerns is essential. If not properly addressed and managed, the daily stressors student-athletes face can lead to higher rates of mental health issues which could lead to the presence of mental illness in the future (5). Research shows that utilizing psychological techniques and interventions has had a positive history in helping reduce mental health concerns in student-athletes (2). For example, adaptive psychological skills training (PST) has produced increases in mental toughness as well as perceived self-efficacy, positive affect, and positive self-esteem in student-athletes (7). Much of the stress that athletes face could also derive from beyond their roles as athletes. Research on an intervention that focuses on improving coping and social support found that the skills taught to athletes not only helped their performance but also translated to other life domains (7). Since the onset of the pandemic, student-athletes have had an increased desire for coaches and athletic staff members to provide a greater focus on their mental health and offer resources to help them traverse the pandemic environment (12, 13).
Due to the increased desire for resources to help address mental health concerns, coaches from three different athletic teams associated with this study worked with a local psychologist to organize team sessions to discuss topics relating to the pandemic as well as team- and sport-related issues. This study seeks to see if participation in these organized team meetings with a local psychologist positively affected student-athlete well-being during the pandemic. It is hypothesized that athletes who were involved in these team meetings would report less frequent symptoms of anxiety and depression and also report more positive reactions to competing in their sport.
There is also the potential for an interaction between the athletes’ involvement in the team meetings with a psychologist and the declining pandemic restrictions. As the additional environmental stressors associated with COVID-19 pandemic restrictions decline, the positive benefits of learning and applying psychological skills in these team meetings could lead to a greater reduction in perceived anxiety and depressive symptoms and more positive feelings during competition. We hypothesized that student-athletes who are involved in team meetings with a psychologist would report significantly less frequent depressive and anxiety symptoms and experience a more positive reaction to the competition compared to athletes not involved in team meetings when COVID-19 pandemic restrictions were at their lowest. Table 1 provides a full summary of the study’s hypotheses.
This study analyzed data from 166 student-athletes. The sample consisted of 74 women (45%) and 92 men (55%) ranging from 18-24 years of age, with one participant reporting being over the age of 24. The sample included athletes involved in football (N = 65), wrestling (N = 19), soccer (N = 16), cross-country and track & field (N = 15), volleyball (N = 13), softball (N = 12), women’s basketball (N = 9), dance (N = 6), cheer (N = 4), tennis (N = 2), women’s golf (N = 2), swimming (N = 2), and men’s basketball (N = 1). Of the 166 participants, 22 athletes were involved in team meetings with a psychologist with their fellow team members. The teams that participated in team meetings were volleyball (N = 13), women’s basketball (N = 9), and men’s basketball (N = 1). The athletes involved in these meetings were encouraged to attend by their coaches who scheduled the meetings with the psychologist with no compensation.
The 9-item Patient Health Questionnaire (PHQ-9) (a ≥ .79) (11) was used to measure athletes’ frequency of depressive symptoms (e.g., “Over the last two weeks, how often have you been bothered by any of the following problems? Little interest or pleasure in doing things.”). All items were indicated on a 4-point scale from 0 (not at all) to 3 (nearly every day). Total scores were calculated by the summation of all item scores.
The General Anxiety Disorder 7-item scale (GAD-7) (a ≥ .87) (18) was used to measure athletes’ frequency of anxiety symptoms (e.g., “Over the last two weeks, how often have you been bothered by the following problems? Feeling nervous, anxious, or on edge.”). All items were reported on a 4-point scale from 0 (not at all) to 3 (nearly every day). Total scores were calculated by the summation of all item scores.
Reactions to Competition
Athletes’ reactions to competing in their sport were measured with the Sports Anxiety Scale-2 (SAS-2) 15-item scale which consists of three subscales, each with 5-items (16). This questionnaire measures symptoms of somatic anxiety (a ≥ .83) (e.g., “Before or while I compete in sports, my body feels tense); worry (a ≥ .93) (e.g., “Before or while I compete in sports, I worry that I will not play well); and concentration disruption (a ≥ .74) (e.g., “Before or while I compete in sports, it is hard for me to concentrate on the game). All items were indicated on a 4-point scale from 1 (not at all) to 4 (very much). Subscale scores were calculated by the summation of all item scores assigned to the subscale.
The data in this study was archival data collected by the host school’s athletic department. The majority of data was collected through an optional online Qualtrics questionnaire that was emailed to every student-athlete by the school’s athletic department. Athletes involved in the team meetings completed a paper version of this questionnaire during the first fall semester that data was collected. Data from subsequent semesters were collected by the school’s athletic department via the online questionnaire. The survey was distributed during three time periods, the school’s fall semester of 2020 (released in November of 2020), the spring semester of 2021 (released in April of 2021), and the fall semester of 2021 (released between August and October of 2021). The survey consisted of various questionnaires regarding athletes’ sleep habits, self-efficacy, mental health, and feelings towards the COVID-19 pandemic. The questionnaires of interest for this study included the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 (GAD-7), and the Sports Anxiety Scale-2 (SAS-2). The PHQ-9 and GAD-7 are standard assessments used to measure the frequency of depressive and anxiety symptoms in a variety of medical, clinical, and educational settings. All potential identifiers were removed by the school’s athletic department prior to releasing the data for analysis. The data was then filtered so that only athletes who completed the questionnaires during all three semesters were included in the analyses. This strategy allowed for responses to be examined across the changing COVID-19 pandemic environment.
The restrictions and mandates associated with the COVID-19 pandemic that athletes in this sample experienced decreased throughout the duration of this study. Furthermore, greater education and overall public knowledge of the virus increased such as knowledge on the symptoms associated with the virus, the effectiveness of masks in preventing the spread of the virus, and treatment options. Upon the initial distribution of the survey, these athletes experienced the greatest restrictions due to the pandemic. Restrictions included continuous school-wide mask mandates and a city-wide mask mandate, regular COVID-19 testing and screenings, longer periods of isolation (protocol was 14 days) if exposed to or positively tested for the virus, minimal social gatherings, a greater emphasis on social distancing, a higher percentage of classes converted to virtual learning, and postponements/cancellations of games and practices due to COVID-19 outbreaks. Additionally, the distribution of a vaccine had not yet been made available to these students.
In the spring of 2021, many of these restrictions and precautions remained; however, the emergence of vaccines provided another option for these athletes to further protect themselves, and the cancellation of sports activities decreased. By the fall of 2021, the wide distribution of vaccines allowed for minimal university mandates at this institution. Mask requirements decreased, isolation periods shortened, and a vaccine booster was distributed to further combat the virus. While precautions were still in place to combat the pandemic, the disruption of regular sports activities due to the pandemic was at its lowest levels.
As part of the school’s programming for athletes since 2013, coaches could request that their team’s athletes participate in team meetings with a local psychologist. Three of the school’s athletic teams organized team meetings with a local psychologist to facilitate discussions on current issues the team and athletes were facing during the pandemic. These meetings included all team members and occurred twice every month throughout the duration of this study. The coaches were not included in these meetings to better ensure confidentiality and foster a space where athletes were comfortable talking about the topics that were brought up.
The topics covered in these meetings ranged from team- and sport-specific concerns to challenges due to the pandemic as a whole. Team- and sport-specific items included topics of team building, conflict resolution, expression of feelings regarding team members and coaches, enhancing performance, learning visualization techniques, assessment of their role on the team, and recognizing the value of fellow team members. Discussions about the pandemic revolved around feelings such as anxiety about the uncertainty of whether athletes would be allowed to compete or have their season, the fear of the unknown associated with the pandemic, locus of control, how one prioritizes their sport along with other issues relating to the pandemic, and the normalization and validation of any feelings associated with the pandemic. When these meetings first commenced, the majority of the conversation consisted of talk associated with the effects of the pandemic. Throughout the duration of the three semesters, the topics of discussion slowly changed to where meeting conversations revolved less around dealing with the pandemic and focused more on with team- and sport-related matters.
This study used a 2 x 3 mixed factorial design (MANOVA) to analyze the data. The independent variables consisted of athletes’ participation in team meetings with a psychologist and the declining restrictions associated with the COVID-19 pandemic. Participation in team meetings had two levels, individuals involved in team meetings and individuals not involved in team meetings. To measure participants’ responses as COVID-19 restrictions decreased, the collection of data occurred across three successive semesters: fall 2020, spring 2021, and fall 2021. The dependent variables measured included student athletes’ mental health, specifically frequency of depressive and anxiety symptoms, and their reactions to competition which included feelings of somatic anxiety, worry, and concentration disruption.
To examine the effects of the alleviated COVID-19 pandemic restrictions and participation in team meetings with a psychologist on student athletes’ frequency of depressive and anxiety symptoms, a 2 (team meetings) x 3 (COVID-19 restrictions) mixed factorial MANOVA was conducted. After checking for multivariate outliers using Mahalanobis distance, data from five participants were removed. At the multivariate level, there was a significant main effect of decreasing COVID-19 pandemic restrictions on the sample’s PHQ-9 and GAD-7 scores (Pillai’s = 0.22, F(4,156) = 11.18, p < .001, ηp2 = 0.22). Unlike what was outlined in hypotheses 4 and 5, the main effect of team meeting participation on the frequency of depressive and anxiety symptoms was not significant. The multivariate interaction between decreasing COVID-19 restrictions and participation in team meetings was also significant (Pillai’s = 0.13, F(4,156) = 5.56, p < .001, ηp2 = 0.13). These significant effects were further explored at the univariate level.
Looking at the main effect of the decreasing COVID-19 restrictions, athletes reported a significant decrease in their PHQ-9 scores (F(2,318) = 19.79, p < .001, ηp2 = 0.11). Pairwise comparisons revealed this decrease was significant across all three semesters (p < .05). Furthermore, athletes’ GAD-7 scores significantly decreased as COVID-19 restrictions decreased (F(2,318) = 11.08, p < .001, ηp2 = 0.07). Pairwise comparisons showed that scores reported in the spring of 2021 and fall of 2021 were significantly lower than scores reported in the fall of 2020 (p < .05), but not significantly different from one another (p > .05). These findings support hypothesis 1 and partially support 2. Results indicate that since the initial semester of returning to in-person classes and sports activities, athletes’ frequency of depressive and anxiety symptoms significantly decreased. See Table 2 for sample PHQ-9 and GAD-7 means and standard deviations across the three semesters.
Further analysis of the significant interaction revealed that the combination of athletes’ participation in team meetings with a psychologist along with the current time during the pandemic had a significant effect on the changes in athletes’ PHQ-9 (F(2,318) = 5.95, p = .003, ηp2 = 0.04) and GAD-7 (F(2,318) = 7.82, p < .001, ηp2 = 0.05) scores. Athletes involved in team meetings with a psychologist reported a significant decrease in reported frequency of depressive symptoms between the fall 2020 semester (M = 6.62, SD = 4.15) and spring 2021 semester (M = 3.95, SD = 2.67). There was no significant change between the fall 2020 semester (M = 3.99, SD = 3.57) and the spring 2021 semester (M = 3.79, SD = 3.41) for the athletes not involved in team meetings. This interaction is highlighted in Figure 1. Furthermore, athletes participating in team meetings also reported a significant decrease in anxiety symptoms between the fall 2020 semester (M = 5.76, SD = 4.16) and spring 2021 semester (M = 2.76, SD = 2.55). Athletes not involved in meetings showed no significant change between the fall 2020 (M = 3.28, SD = 3.68) and spring 2021 (M = 3.14, SD = 3.50) semesters. Figure 2 depicts this interaction. While the interactions that were outlined in hypotheses 7 and 8 were not observed from these results, possible explanations for the current findings will be discussed.
To test the effects of alleviated COVID-19 pandemic restrictions and participation in team meetings with a psychologist on student athletes’ reactions to competition, a second 2 (team meetings) x 3 (COVID-19 restrictions) mixed factorial MANOVA was performed. Data from two participants were removed after checking for multivariate outliers using Mahalanobis distance. At the multivariate level, there was a significant main effect of participation in team meetings with a psychologist on athlete’s reactions to competition (Pillai’s = 0.13, F(6,160) = 7.94, p < .001, ηp2 = 0.13). The main effect of the decreasing pandemic restrictions and the multivariate interaction were not significant which did not support hypotheses 3 and 9. The significant main effect of team meetings with a psychologist was further explored at the univariate level.
Looking at the effect of team meeting participation, athletes attending meetings reported significantly higher scores on all three of the subscales of somatic anxiety (F(1,162) = 4.22, p = .042, ηp2 = 0.03), worry (F(1,162) = 11.94, p < .001, ηp2 = 0.07), and concentration disruption (F(1,162) = 20.46, p < .001, ηp2 = 0.11) compared to athletes not involved in these meetings. These findings contradict hypothesis 6. This seems to indicate that athletes involved in team meetings with a psychologist appear to be reporting more negative reactions to competition compared to the athletes not involved in these meetings. See Table 3 for SAS-2 means and standard deviations for both groups.
As the use of a sports psychologist in athletic programming is a new development at the university from which data were collected, team meetings were not available for all sports teams. Limited opportunities, combined with inconsistencies in responses from some teams resulted in the observed discrepancy. Cell sizes were considered in identifying an appropriate analytical approach, and MANOVA was selected. Though it is possible that smaller cell sizes could explain high baseline scores, the underlying data do not support that explanation in this case. Across all dependent variable measurements, minimum and maximum scores on all assessments were essentially equivalent between those attending and those not attending team meetings, and variance tended to be larger in cells comprised of more participants (exception: concentration disruption in Fall 2020).
Generally speaking, MANOVA is considered to be robust in the face of unequal cell sizes, as long as the covariance matrices are not unduly heterogenous (19). Box’s Test was examined for both MANOVAs. In the first analysis, used to test Hypotheses 1, 2, 4, 5, 7, and 8, Box’s M did not violate the conventional p < .001 indicator of concern (observed p = .002). For the second analysis, Box’s M did meet that conventional standard (observed p < .001). In such cases, it is recommended use Pillai’s trace in testing multivariate effects, which we have done. Further, researchers are encouraged to examine variances within each cell to identify the source of heterogeneity (19). When substantially larger variances are observed in small-group cells, α-levels can be inflated (i.e., too liberal). Such a pattern was observed for only one dependent variable (concentration disruption), and at only one time point (Fall 2020).
To summarize, as time passed and COVID-19 restrictions decreased, athletes in this sample reported significantly fewer symptoms of depression and anxiety. Additionally, athletes involved in team meetings with a psychologist reported an even greater significant decrease in the frequency of these mental health symptoms compared to athletes not involved, specifically between the first and second semester after athletic activities resumed. Looking at athletes’ reaction to competition, athletes who attended the team meetings with the psychologist reported significantly higher levels of somatic anxiety, feelings of worry, and concentration disruption throughout the three semesters compared to athletes not involved in team meetings.
This study was designed in response to the outcomes reported by the NCAA’s Student-Athlete COVID-19 Well-being Surveys (12, 13), which were released during the initial spring and fall semesters of the COVID-19 pandemic outbreak in the U.S. Results from the spring NCAA survey (12) and several other studies revealed a significant rise in mental health-related concerns for college students and student-athletes during the onset of the pandemic (4, 15, 17). As the pandemic progressed, it was important to investigate how its everchanging climate impacted student-athletes’ mental health and their return to competition.
Results revealed that student-athletes in this study reported significant decreases in the frequency of anxiety and depressive symptoms since the return to in-person classes and competition after the initial pandemic-related lockdown. This supports that the adverse effects that were first associated with the beginning of the pandemic may no longer have had as negative of an impact on student-athletes’ mental health. Whether it was from a minimal degree of disruptions from the decreased pandemic climate, a better adjustment to pandemic life, or the possible sense of hope that the pandemic was coming to an end, results from this study appear to indicate that the mental health of student-athletes was moving in a more positive direction. In contrast, the hypothesis that student-athletes would experience more positive reactions to competition as the pandemic restrictions decreased was not supported. The timing of the release of the athletic department’s wellness survey may partially explain the lack of relationship. This study examined responses across three different semesters from athletes at various stages in their athletic seasons. Their reactions to competition may be at least somewhat dependent on the current stage in their season rather than the current stage of the pandemic.
Additionally, due to the desirability of student-athletes wishing for more mental health resources during the pandemic (12, 13), we examined how participation in team meetings with a psychologist impacted this sample of student-athletes. Results indicated that participation in team meetings did not produce lower levels of anxiety and depression compared to athletes not involved in team meetings with a psychologist. Contrary to what was initially hypothesized, student-athletes involved in team meetings reported higher levels of worry, concentration, and somatic anxiety when in a competitive setting compared to athletes who did not attend the meetings. However, a meta-analysis by Ong & Chua (14) along with other literature (2, 6-8) greatly supports that learning psychological skills and the use of intervention techniques have positive impacts on student-athletes’ mental health during competition.
Some possible explanations for the findings in this research include the following. First, there could be a potential gender difference associated with this effect. A significant majority of athletes involved in the team meetings from this sample were women (N = 21) with only one athlete identifying as a man. The reports released by NCAA Research (12, 13) showed a gender difference with women, on average, reporting higher scores on all mental health-related items compared to men, and women emphasized more that the negative impacts of the pandemic affected their mental and physical conditioning. This could help explain the higher reactions to competition seen by the participants involved in the team meetings compared to the athletes not involved.
Furthermore, athletes involved in these meetings participated in several conversations regarding their feelings and thoughts about competing during the pandemic while developing skills and a sense of comfort in identifying and labeling their feelings. Therefore, when prompted to report their reactions to competition, these athletes may have been more likely to reflect on their feelings more openly and accurately during athletic competition compared to athletes not involved in such discussions. Likewise, athletes who had not been contemplating and sharing about their pandemic-related feelings and competition experiences may not have been aware of or accurately remembered their mental state the last time they participated in their sport. Finally, athletes involved in team meetings established a trusting relationship with the psychologist conducting these meetings. Therefore, when completing the athletic department’s wellness surveys, these athletes were likely more motivated and felt secure in responding more truthfully and accurately compared to the athletes not involved with the psychologist.
The statistically significant interaction observed in this study revealed an interesting relationship between participation in the team meetings across the decreasing pandemic restrictions. While the interaction had no effect on reactions to competition, there was a significant effect on student-athletes’ frequency of depressive and anxiety symptoms. We hypothesized that athletes involved in team meetings would report the lowest frequency of depressive and anxiety symptoms when the pandemic restrictions were at their lowest compared to athletes not involved in such meetings. This, however, was not observed. The results showed that involvement in team meetings helped to significantly lower student-athletes’ frequency of depressive and anxiety symptoms between the first and second semesters examined in this study but not at the third semester. This suggests that during the initial semester, athletes involved in these sessions were experiencing their highest frequency of depressive and anxiety symptoms, and their participation in these meetings could have aided in the initial decrease of these symptoms. The implications from this suggest that participating in these team meetings provided the greatest assistance for these athletes during their initial return to in-person classes and athletic competition when the pandemic environment was most prevalent.
A plausible explanation for this finding is that student-athletes’ were at their highest levels of emotional/psychological distress at the early stages of the pandemic, and the team meetings with the psychologist may have provided a means of exploring and processing the unknown regarding the pandemic. The meetings facilitated opportunities for the athletes to express their thoughts, feelings, or needs regarding their individual circumstances, and a secure venue to experience universality, validation, catharsis, instillation of hope, and process internal and external factors related to their lives and the pandemic. This explanation is consistent with literature about the positive effects of group therapy in a variety of settings (1, 10).
Like most “field” research, this study has some limitations. One limitation is the inconsistency of the release times of surveys during each of the three semesters. While the surveys during the fall of 2020 and spring of 2021 were released towards the end of those semesters, the fall of 2021 survey was released towards the beginning of the semester. Additionally, there could be potential differences in responses based on athletes’ involvement in their sports as some athletes were in the middle of their seasons at the times the surveys were completed, and others were in their off-season. Athletes who were in the middle of their seasons when they completed their surveys would likely be facing different stressors and environments that could affect their responses compared to athletes in their off-season. It is also possible that in-season athletes could have more accurately completed the SAS-2 and be able to better recall their time in a competitive setting because their last moment in competition would be more recent.
This data was also all self-reported through an electronic email survey which at times could be prone to subjectivity and inaccuracies if the participants are not properly motivated. Athletes involved in team meetings did complete paper surveys during the initial fall 2020 semester. This potentially could have affected these athletes’ responses and be another reason they responded high on the GAD-7 and PHQ-9 during the initial semester. There then could be the possibility of regression to the mean between the fall 2020 and spring 2021 semesters with this group which could explain the interaction that was observed.
Another limitation is the disparity between the group sizes. Specifically, the number of athletes who participated in team meetings was smaller than the group of athletes who were not involved. While the ratio between the two groups was at a statistically acceptable level, data from a large portion of athletes involved in the team meetings could not be used as they did not complete the survey all three times. This group size disparity may have inflated the α-level associated with the effect of team meetings on concentration disruption, and that effect should be interpreted carefully until further research has been conducted.
Additional analyses of data collected during the pandemic will further our understanding of how this unprecedented pandemic affected the realm of athletics. Based on the results from this study, it is important to explore if there are still gender differences in the mental health and reactions to competition seen in student-athletes as this was initially reported in the findings at the beginning of the pandemic (12, 13). This study also did not account for athletes’ current status of athletic participation, whether in-season or out-of-season. The effects of being actively involved in one’s sport may produce insightful results. The potential social and physical benefits associated with athletic participation could have alleviated mental health-related concerns revolving around the pandemic. Consequentially, the stressors involved in competition and adherence to strict procedures may have increased mental health concerns compared to the athletes who were in their off-season. Additionally, researchers may be interested in the differences between participation in team sports (e.g., basketball, football, etc.) and individualized sports (e.g., wrestling, track, and field, etc.). The different expectations and challenges associated with the two, along with the challenges of the pandemic, may produce interesting results.
It is important to continue monitoring the effects that the pandemic has had and could still be having on student-athletes’ mental health in order to better understand the impacts that this environment has had on athletics. While we may never see an event like this again, instances of social isolation, health concerns, and worry for the future, which were heavily associated with the COVID-19 pandemic, are still a possibility within the day-to-day lives of student-athletes. Results from this and other studies looking at the effects of the pandemic on collegiate athletics could help coaches, administrators, and practitioners identify areas of concern and develop strategies to care for the best interests of student-athletes.
APPLICATIONS IN SPORT
Without a doubt, a great deal of stress and high demands for time, emotional strength, and physical energy are required to be an NCAA student-athlete, and the challenges escalated as the COVID-19 pandemic unfolded. The present study provides evidence that student-athletes are resilient (even in times of a pandemic), and feelings of anxiety and depression can significantly improve as stressors are removed or addressed. This reflects the need for coaches and administrators to recognize what barriers and events can be altered to improve student-athletes’ emotional and physical well-being. Additionally, as a result of this study, athletic departments and administrators can recognize the need for psychological support for student-athletes, possibly promoting the inclusion of such services consistently in athletic departments.
- Bloch, S., Crouch, E., & Reibstein, J. (1981). Therapeutic factors in group psychotherapy: A review. Arch Gen Psychiatry, 38(5), 519-526. 10.1001/archpsyc.1980.01780300031003
- Breslin, G., Shannon, S., Haughey, T., Donnelly, P., & Leavey, G. (2017). A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches, and officials. Systematic Reviews, 6(177), 1-15. https://doi.org/10.1186/s13643-017-0568-6
- Elflein, J. (2021, October 21). Percentage of college students with diagnosed mental disorders in the United States in 2020. Statista. https://www.statista.com/statistics/ 1126287/percentage-of-college-students-with-mental-disorders-us/
- Elharake, J. A., Akbar, F., Malik, A. A., Gilliam, W., & Omer, S. B. (2022). Mental health impact of COVID-19 among children and college students: A systematic review. Child Psychiatry & Human Development, 1-13. https://doi.org/10.1007/s10578-021-01297-1
- Fogaca, J. L. (2019). Combining mental health and performance interventions: Coping and social support for student-athletes. Journal of Applied Sport Psychology, 33(1), 4-19. https://doi.org/10.1080/10413200.2019.1648326
- Foster, B. J., & Chow, G. M. (2020). The effects of psychological skills and mindfulness on well-being of student-athletes: A path analysis. Performance Enhancement & Health, 8(2-3), 1-8. https://doi.org/10.1016/j.peh.2020.100180
- Golby, J., & Wood, P. (2016). The effects of psychological skills training on mental toughness and psychological well-being of student-athletes. Psychology, 7(6), 901-913. http://dx.doi.org/10.4236/psych.2016.76092
- Gross, M., Moore, Z. E., Gardner, F. L., Wolanin, A. T., Press, R., & Marks, D. R. (2018). An empirical examination comparing the mindfulness-acceptance-commitment approach and psychological skills training for the mental health and sport performance of female student athletes. International Journal of Sport and Exercise Psychology, 16(4), 431-451. https://doi.org/10.1080/1612197X.2016.1250802
- Hurr, W. (2011). Book review [Review of the book Counseling and psychological services for college student-athletes,by E. F. Etzel, Ed.]. Journal of College Student Psychotherapy, 25(3), 269-273. https://doi.org/10.1080/87568225.2011.581945
- Kivlighan, D. M., Jr., & Holmes, S. E. (2003). The importance of therapeutic factors: A typology of therapeutic factors studies. In J. L. DeLucia-Waack, C. R. Kalodner, D.A. Gerrity, & M. Riva (Eds.), Handbook of group counseling and psychotherapy (pp. 23-36). Sage Publications.
- Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. 10.1046/j.1525-1497.2001.016009606.x
- NCAA Research (2020). NCAA student-athlete COVID-19 well-being survey (spring 2020). National Collegiate Athletic Association. https://ncaaorg.s3.amazonaws.com/research/ other/2020/2020RES_NCAASACOVID-19SurveyPPT.pdf
- NCAA Research (2021). NCAA student-athlete COVID-19 well-being survey (fall 2020). National Collegiate Athletic Association. https://ncaaorg.s3.amazonaws.com/research/other/2020/2021RES_NCAA-SA-Well-BeingSurveyPPT.pdf
- Ong, N. C. H., & Chua, J. H. E. (2021). Effects of psychological interventions on competitive anxiety in sport: A meta-analysis. Psychology of Sport and Exercise, 52, 1-16. https://doi.org/10.1016/j.psychsport.2020.101836
- Şenışık, S., Denerel, N., Köyağasıoğlu, O., & Tunç, S. (2021). The effect of isolation on athletes’ mental health during the COVID-19 pandemic. The Physician and Sportsmedicine, 49(2), 187-193. https://doi.org/10.1080/00913847.2020.1807297
- Smith, R. E., Smoll, F. L., Cumming, S. P., & Grossbard, J. R. (2006). Measurement of multidimensional sport performance anxiety in children and adults: The sport anxiety scale-2. Journal of Sport and Exercise Psychology, 28(4), 479-501. https://doi.org/10.1123/jsep.28.4.479
- Son, C., Hedge, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on college students’ mental health in the United States: Interview survey study. Journal of Medical Internet Research, 22(9), Article e21279. 10.2196/21279
- Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med, 166(10) 1092-1097. 10.1001/archinte.166.10.1092
- Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Allyn & Bacon/Pearson Education.
- Thawabieh, A. M., & Qaisy, L. M. (2012). Assessing stress among university students. American International Journal of Contemporary Research, 2(2), 110-116.