Authors: Philip J. Brenner1, JoAnne Bullard2, and Robert Weaver2
1Graduate student from the Athletic Training Program, Rowan University, Glassboro, NJ, USA
2Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
Philip J. Brenner, MS, LAT, ATC
201 Mullica Hill Road
Glassboro, NJ 08028
Philip J. Brenner, MS, LAT, ATC graduated from Rowan University with a Masters in Athletic Training. Philip’s areas of research interest include: Mindfulness interventions for student athletes’ and the impact of COVID-19 on student athletes.
JoAnne Bullard, PsyD., CMPC, CSCS is currently an assistant professor at Rowan University in the Health and Exercise Science department. JoAnne’s areas of research interests include well-being of student athletes, mindfulness for performance, motivation and anxiety in athletics and academics, and athletic transitioning.
Robert Weaver, Ph.D is a professor and community health program coordinator at Rowan University in the Health and Exercise Science department. Robert’s research interests include social determents of health, food security and insecurity, and research methods in health science.
Factors Associated with Anxiety Among Division III Student-Athletes During the COVID-19 Pandemic: A Cross-Sectional Study
The COVID-19 pandemic disrupted the lives of collegiate student-athletes due to canceled sports seasons. This led to an increase in anxiety symptoms among Division III student-athletes. Collegiate female student-athletes have reported increased anxiety during the pandemic, but it is unknown if individualized or team sport athletes have similar anxiety symptoms. The purpose of this study is to determine the association between anxiety symptoms, gender, and sport-type of Division III student-athletes during the COVID-19 pandemic. A Qualtrics survey assessed demographic information, concerns and worries surrounding the pandemic, and generalized anxiety symptoms using the Generalized Anxiety Disorder 7-Item Scale (GAD-7). Participants were male and female Division III collegiate student-athletes in New Jersey Athletic Conference (NJAC) during the 2020-2021 fall, winter, and spring sports-seasons. They were categorized as either an individual athlete or a team sport athlete. Chi-square analyses and prevalence ratios were conducted on SPSS version 27. There were significant differences between male and female GAD-7 responses X2= 30.119 (df=3, n=435), p=.000. There were no significant differences between non-gender specific sport-type athletes and anxiety. Female individual sport athletes were three times more likely to report mild-severe anxiety symptoms than female team sport athletes (PR=3.2, 95% CI, 1.66-6.16, p=0.000). In conclusion, female individual sport athletes were at greater risk for reporting anxiety symptoms compared to female team sport athletes, male individual sport athletes, and male team sport athletes. The application of sports is that associated colleges need to provide additional assistance in counseling, telehealth, and social support to collegiate student-athletes to help lessen the mental distress associated with the COVID-19 pandemic.
Key Words: athletes, Division III, anxiety, sport type, COVID-19 pandemic
The COVID-19 pandemic has caused intense disruption in college student-athletes’ academic and athletic lives by causing them to transition to remote learning, uproot their living situation and in addition, cancelling their sporting season and removing them from training with their teams. Research suggests that this type of significant adjustment has led to an increase in mental distress such as anxiety, stress, depression, isolation, and fear for college student-athletes.[1-6] Additionally, Cao et al  reported that college students have been anxious regarding academic setbacks, economic instability, and the disruption it has caused their lives. It was reported by the NCAA that lack of sleep, sense of grief, and loss were associated with mental distress in college student-athletes. Graupensberger et al  has indicated that during the necessary cancellation of sports and team isolation, the athletes’ athletic identity has been threatened and thus could be a contributor to their deteriorating mental health.
Research suggests that anxiety symptoms in student-athletes have increased during the COVID-19 pandemic. The NCAA conducted a well-being study for all three divisions and reported that 1 in 12 respondents in their study had significant depressive or anxiety symptoms that affected their day-to-day life . NCAA compared results in their COVID-19 well-being study to a previous study they conducted prior to COVID-19 and reported a 200% increase in mental distress in men and women Division III student-athletes.
Additionally, Bullard conducted a study on Division III student athletes and reported that student athletes are experiencing some level of anxiety during the COVID-19 pandemic. The reason for the increase in anxiety may be due to isolation, lack of training facilities and resources, and fear and stress related to the uncertainty surrounding the pandemic. Lastly, The NCAA’s well-being study and Bullard have suggested that female student athletes have higher anxiety levels than male student-athletes during COVID-19 [6, 8].
There is a variety of models and theories that can illustrate the multi-dimensional framework of college student well-being during the COVID-19 pandemic [9-11]. Student well-being is an ever-growing theoretical concept that cannot be concretely defined, but rather, described as a unique subjective feeling by the student [9, 10]. Students form their personal well-being through their attitudes and outlook towards their life events “in combination with environmental factors such as family well-being, community well-being, and societal well-being” .
Burns et al  theorizes that the PERMA model can be used to illustrate positive psychological well-being for students, and it is broken down as “positive emotion, engagement, relationship, meaning, and accomplishment”. These pillars illustrate that individuals have positive well-being if they have positive outlook on life, actively engage in all aspects of their life, maintain positive relationships with family and peers, have meaning in their work, and feel accomplished by their achievements . It has also been theorized by Burns et al  that individuals who utilize the PERMA model are more resilient throughout their life.
Additionally, Mosanya et al  states that there is a theoretical model regarding resilience, growth, and grit and its link to positive well-being and reducing loneliness. Resilience is defined as an individual’s ability to overcome moments of stress and uncontrollable moments in their life . Individuals who are more resilient have a more developed and replenished coping reservoir to overcome stressful situations, such as the life disruption brought on by COVID-19 [9, 10]. In addition to the theoretical model, a growth mindset and grit can assist resilience in promoting a positive well-being, improved attitude, and positive thinking for a college student [9, 10]. Having a growth mindset is linked to a college student’s achievements and their ability to develop progress through challenges and their ability to overcome setbacks . This growth mindset is linked to the PERMA model of achievement and an individual’s pilar of positive well-being to accomplishing their achievements [9, 10]. If a college student improved their growth mindset they could reduce scholastic stress, worry, and improve their academic well-being during the unforeseen academic setback caused by COVID-19 . Such as the growth mindset, grit is a student’s ability to persist, preserve, and stay determined towards one’s goals and achievements . Mosanya et al  suggests that individuals who are resilient and develop grit have lower stress, anxiety, and depression due to their ability to stay focused, overcome challenges, and their ability to preserver through stressful times.
Playing a sport is linked to be better mental health, lower levels of depression, increased self-worth, and confidence, and increased social capabilities . The main difference between team and individual is the pressure associated with sport [12, 13]. Individual sport athletes reported higher levels of anxiety and depression compared to team sport athletes because of the pressure they place upon themselves to be successful [12, 13]. There are limited studies specific to individual sport student-athletes and team sport student-athletes mental health during COVID-19.
The purpose of this research study was to analyze if female Division III collegiate student-athletes reported higher levels of anxiety as compared to male Division III collegiate student-athletes and to determine if individual sport student-athletes will report higher levels of anxiety than team sport student-athletes. This is a follow-up study to a study conducted by Bullard  on the impact COVID-19 posed on Division III student-athletes.
Specific Aims and Hypotheses’
Specific Aim 1: Identify the difference in reported anxiety of female and male Division III student-athletes during COVID-19.
Hypothesis 1: Division III female student-athletes will report more anxiety symptoms than male student-athletes.
Specific Aim 2: Identify the difference in reported anxiety of Division III student-athletes in individualized sport and team sports.
Hypothesis 2: Division III Individualized sport athletes will report higher anxiety symptoms than those in team sports.
The participants included in this study were Division III collegiate student-athletes who participated in the New Jersey Athletic Conference (NJAC) during the 2020-2021 sports seasons. Institutions were contacted to see if they were interested in the study and provided an agreement to participate. Athletic Directors were contacted regarding the research study from the principal investigator with study information, potential benefits, and a Qualtrics link including the study survey. The athletic departments forwarded the Qualtrics link and an informed consent to their athletic teams. The study was available for two weeks to provide ample time for participants to respond. The number of participants that completed the survey was N=581. The study has received approval from the Rowan Institutional Review Board #Pro2020001054.
The participants’ demographic information included: sport-team, if they are a fall sport athlete, university attended, academic year, gender, race/ethnicity, and if they completed the survey The Impact of COVID-19 on the Well-Being of Division III Student-Athletes  in the spring.For this research study, the researchers primarily focused on the quantitative results from the demographic questionnaire in relation to the generalized anxiety disorder 7 item scale.
Generalized Anxiety Disorder 7 Item (GAD-7) Scale. The Generalized Anxiety Disorder 7-Item Scale (GAD-7) was used to assess seven distinct anxiety symptoms the participants had experienced in the past two-weeks prior to completing this survey. These symptoms included inability to relax, feeling restless, feeling afraid, irritability, constant worry, inability to control worrying, and feeling nervous, anxious, or on edge. The participants reported their symptoms on a 4-item Likert scale ranging from “not at all sure (0)” to “nearly every day (4)”. The GAD-7 is reliable and valid tool to assess generalized anxiety with an 89% sensitivity and 82% specificity .
The researchers used SPSS (version 27) for statistical analysis. The researchers conducted the standard univariate statistical analysis to describe the demographic characteristics of our sample. The researchers set the alpha level at 0.05. Bivariate correlations, chi-square tests, and cross tabulations were performed to determine significance amongst variables. Odds ratios were computed. To compute odds ratios, the GAD7 scores were divided into two categories — (1) “minimal” anxiety and (2) “mild to severe” anxiety.
The participants included in this research study were Division III student-athletes of the New Jersey Athletic Conference that participated in the 2020-2021 academic year. The number of student-athletes who responded to the survey was 559. A total of 211 males (36.3%) and 348 females (59.9%) participated in this study. Representation was reported from all 10 institutions from the NJAC as shown in Table 1.There was a diverse representation of race and ethnicity in this study as portrayed in Table 1.
A total of 558 participants reported what sport team they participated, and the breakdown is represented in Table 1 with 397 (71.2%) participants reporting that they participate in a team with teammates and 161 (28.8%) participants reporting that they participate in an individual competition sport. Of the 581 participants, 146 (25.1%) participants did not respond to the GAD-7 questionnaire. The 435 (74.9%) participants who did respond divided into four categories: 230 (52.9%) reported having minimal anxiety, 116 (26.7%) reported having mild anxiety, 51 (11.7%) reported having moderate anxiety, and 38 (8.7%) reported having severe anxiety
A chi-square was used to examine the relationships between gender, sport type, and anxiety. Significant differences among gender and Generalized Anxiety Disorder (GAD-7) Scale were reported by the chi-square (p=0.000) as shown in Table 2. Male and female participants reported different prevalence of anxiety. Female student-athletes had an increase in mild, moderate, and severe cases in comparison to the male student-athletes. Females report almost three times more likely than males to report some level of anxiety (OR=2.942, CI 95%, 1.958-4.421, p=.000). Lastly, differences reported among sport type (individual versus team) and GAD-7 Scale were insignificant.
Significant correlations among gender and sport type were reported within the four categories of the GAD-7 Scale. Specifically, significant differences were reported among female participants rostered on an individual sport team in comparison to female participants rostered on a team with teammates (p=0.000). Female student-athletes rostered in an individual sport were over three times more likely (PR=3.2, 95% CI, 1.66-6.16) than female athletes rostered in a team sport to report experiencing mild to severe anxiety (Table 3).No such difference was found for male participants (p=.920). For student-athletes who participated in team sports, females were almost two-and-half times more likely than men to report mild to severe anxiety (PR=2.45, CI 1.48-4.07). An odd’s ratio among female and male rostered on a team with teammates within GAD-7 Scale responses reported that female team sport athletes had 2.449 times more chance (p=0.000) of reporting anxiety than male individual sport athletes.
The COVID-19 pandemic has caused a disruption in the lives of student-athletes due to cancellation of sports, remote learning, and isolation from teammates. That disruption can lead to an increase in mental distress. Various studies have examined how the COVID-19 pandemic has increased an individual’s anxiety, stress, isolation, and depression [2-5, 15]. Although, there are limited published studies analyzing the negative impact of COVID-19 on collegiate student-athletes, these studies have reported similar increases in anxiety, depression, and stress in collegiate student-athletes [6, 7, 16]. The current study is one of the first studies alongside Bullard  to analyze the impact of COVID-19 among Division III collegiate student-athletes in the New Jersey Athletics Conference (NJAC).
Female Student-Athlete and Male Student-Athlete-Anxiety
The results of this study support the increase in reported anxiety during the COVID-19 pandemic among collegiate student-athletes. Previous research prior to the COVID-19 pandemic reported that females have higher incidences of anxiety than males in athletics and in the general population [4, 17].However, Cao et al  conducted a study among Chinese college students after the pandemic had begun and reported no significant difference in anxiety symptoms among males and females.
The study’s findings support the first hypothesis and suggest that female Division III collegiate student-athletes reported higher anxiety than male Division III collegiate student-athletes. Bullard  reported similar findings that female collegiate student-athletes have higher levels of anxiety compared to male collegiate athletes. The “NCAA’s Student Athlete Well-Being Survey” during fall 2020 also suggested that female collegiate student-athletes have higher incidences of anxiety than male collegiate student-athletes . Şenışık et al  conducted a study analyzing mental health with non-collegiate athletes and reported that there is no significant difference in anxiety between males and females. However, these findings were not conducted on collegiate athletes. The possible reason females reported higher anxiety symptoms in this study could be due to the societal constructs surrounding femininity and masculinity . Females are more inclined to be open regarding their mental health concerns rather than males because of the surrounding societal stigma .
Individual and Team Sport
There is limited research analyzing the difference of anxiety symptoms in individual sport athletes and team sport athletes during COVID-19 .The study’s findings do not support the second hypothesis and suggest that there are no significant differences in anxiety amongst team sport athletes and individual sport athletes without regard to gender. These results support research suggesting that team and individual sport athletes have similar levels of anxiety during the COVID-19 pandemic .The possible reasoning as to why there was no significant difference in anxiety among individual and team sport athletes may be because there was an increase in anxiety amongst collegiate athletes throughout individual and team sport competition . The NCAA reported an increase of 150%-250% in reported anxiety during the COVID-19 pandemic amongst collegiate student-athletes .
To the best of the researcher’s knowledge, this is the first research analyzing the gender-specific difference of anxiety symptoms in individual sport athletes and team sport athletes during the COVID-19 pandemic. Even though it did not support the second hypothesis, the study’s findings suggest that female individual sport athletes who participated in this research reported significantly higher levels of anxiety as compared to female team sport athletes. Additionally, female team sport athletes had significantly higher anxiety symptoms than male individual and team sport athletes. When analyzing anxiety symptoms for male participants, there was no significant difference for male individual sport athletes and male team sport athletes. Therefore, female collegiate athletes who participate in individual competition had the highest incidence of reporting anxiety symptoms than any other collegiate competitor in our study.
These results may have occurred because of the higher reported incidence of anxiety symptoms in females over males in our study . Also, previous research suggests that individual sport athletes have higher reported anxiety symptoms than team sport athletes [12, 18].Pluhar et al  reported that individual sport athletes may have higher reported anxiety due to the increased pressure associated with their sport. The individual competitormay perceive a loss in sport as a personal failure and fault whereas a team competitor has their team alongside them to relieve some of the pressure with loss . Also, when an individual competitor is not successful in competition, they do not have other teammates to share grief over loss with whereas team sport athletes can grieve with one another.
A strength of this study was that there were participants from seven of the ten Division III schools in the NJAC and this is a strength because the findings can make suggestions about student-athletes that participate in the NJAC during the 2020-2021 sports season. Another strength was that our participant sample was large and diverse enough to detect various associations.
The current study only included Division III student-athletes in the NJAC conference. Future research could analyze collegiate student-athletes in all three divisions of collegiate competition and expand outside of this New Jersey conference. Anxiety levels of student-athletes may differ across Division I, II, and III because of the scholarship implications in Division I and II. Also, student-athletes in Division I and II may have increased anxiety during the pandemic if they had the possibility of being scouted for professional teams during this sporting season. It is important to analyze other regions of the country outside New Jersey because the pandemic has affected other states differently than others. New Jersey was one of the first states affected by the pandemic so it would be interesting to analyze the anxiety levels of student-athletes in other states or conferences. Since this research study was conducted in the early fall of 2020, future research could be conducted in the spring or fall of 2021 to determine if Division III student-athletes’ psychological well-being has improved.
While all athletes included in this study may struggle with mental distress during the COVID-19 pandemic, based on this current study, student-athlete services should target resources for female individual sport athletes. Stress and anxiety interventions could be beneficial for the mental health and psychological well-being of these student-athletes. These interventions could be included in the weekly team-workouts or routine so it could be more of a team activity. Coaches and teams should incorporate more social support for one another to help raise morale during this unprecedented time. Even though these competitors are in individualized sports, they are still part of a team at the university and could all benefit from social support from one another.
The unique circumstances under which this study was conducted — during a pandemic that compromised athletic participation — offers a strength, it also is considered a limitation. The COVID-19 pandemic is unique in student-athletes’ lives, and it remains unclear whether the findings and results provided in this study will apply post-pandemic. Additionally, response-rates were most likely lowered as student-athletes were over-surveyed during the pandemic and more inclined to decline participation. There may have been an under-reporting of participants with mental distress. This is because student-athletes that may be experiencing anxiety, depression, or stress may not have responded because they may lack motivation, forgot to respond, or did not see the email.
This study is a cross-sectional study so there is no baseline or follow-up survey to compare our results. This current study is only representative of one moment of time. That moment could have been a considerable good or bad moment for each participant, so the researchers are unable to track changes in anxiety over time.
The population included in this study can be considered a limitation. The participants included in this study are only from the NJAC so the results cannot be generalized to other universities outside of the NJAC. The student-athletes are only from Division III so these results cannot be generalized to student-athletes from Division I or Division II. The NCAA’s Fall 2020 COVID-19 well-being study outlined the differences amongst each division regarding mental health concerns. The anxiety concerns of Division III athletes had a higher decrease during the pandemic than Division I or Division II .
The research could not account for covariates that may have complicated the independent variables and anxiety symptoms. For instance, these confounding variables include life stress, financial issues, housing issues, social media usage, and communication with coaches or teammates. Participants may have had worries about their families’ financial situations that could have impacted their anxiety . Their living arrangements may have been disrupted during COVID-19 and may be living in an environment they are unfamiliar with. Due to the increased time at home, social media usage may be on the rise and that increased exposure to negative content could be increasing anxiety and stress. Additionally, lack of communication and social support from coaches and teammates while in isolation may have been detrimental to their psychological well-being. Other researchers have examined the impact these variables may have on collegiate student-athletes [6, 16, 19].
Overall, the COVID-19 pandemic has had an impact on the mental health of Division III student-athletes in the NJAC. The COVID-19 pandemic disrupted student-athletes’ lives and has generated uncertainty regarding academics and their sports season competition. Student-athletes that participated in this study reported some level of anxiety during the COVID-19 pandemic. It has been indicated based on the study’s results that female student-athletes have reported more anxiety symptoms than their male student-athlete counterparts. Specifically, it is suggested that female student-athletes that compete in individualized competition sports are at a greater risk for developing anxiety than their male student-athlete counterparts.
APPLICATIONS IN SPORT
This study was conducted in September 2020 during the COVID-19 pandemic. The results provide immediate and necessary insight to prospective schools on strategies and programs to assist their student-athletes. Therefore, another strength of our study was that the researchers provided the athletic departments of each NJAC school with the results of this study. The researchers provided suggestions based on the research study to each institution on how they can assist their student-athletes during the COVID-19 pandemic. Furthermore, the researchers provided ways that each school can target programs and resources addressing student-athletes needs based on the findings of the study.
Research has suggested that collegiate student-athletes who have received social support during the COVID-19 pandemic have had increased psychological well-being than those that did not receive social support . Associated colleges need to provide additional assistance in counseling, telehealth, and social support to collegiate student-athletes to help lessen the mental distress associated with the COVID-19 pandemic.
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