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Mind, Body and Sport: Depression and anxiety prevalence in student-athletes

An excerpt from the Sport Science Institute’s guide to understanding and supporting student-athlete mental wellness

By Ann Kearns Davoren and Seunghyun Hwang

In 2011, more than 41 million U.S. adults over the age of 18 (about 18 percent) had a mental disorder, and nearly 9 million U.S. adults (4 percent) had a mental illness that greatly affected day-to-day living or resulted in serious functional impairment. Almost three-fourths of those who have been diagnosed with a mental disorder, such as anxiety, mood disorders, etc., have their first onset by age 24.

College students – including student-athletes – are not immune to struggles with mental well-being. About 30 percent of the 195,000 respondents to a recent American College Health Association (ACHA) survey reported having felt depressed in the last 12 months, and 50 percent reported having felt overwhelming anxiety during the same period.

One of the primary concerns regarding the prevalence of mental illness among student-athletes is that it may affect not only their success in academics and athletics but also their general well-being. While depression and anxiety have been found to be significant predictors of a lower grade-point average and poor athletics performance, they’re also highly correlated with other risky behaviors, including suicide.

While it’s not clear whether the source of challenges to student-athlete mental well-being is the same as those non-athletes face, collegiate athletes are known to encounter unique stressors that the general population doesn’t have to deal with, such as time demands, relationships with coaches, and missed scheduled classes.

To help determine the prevalence and effects of anxiety and depression in the student-athlete population, we studied data from eight National College Health Assessment surveys the ACHA administered from 2008 through 2012. Those surveys cover issues including substance use, sexual behavior, physical health, weight, personal safety, violence, and mental health and well-being.

Varsity student-athletes were identified as those who answered “yes” to the question: “Within the last 12 months, have you participated in organized college athletics at any of the following levels…a) Varsity?” The others compose the non-athlete comparison group. In total, 19,733 student-athletes and 171,601 non-athletes were included in the analyses.

Both associated and demographic variables were included in the models. Demographic variables included sex, race, sexual orientation, transfer student status in the last 12 months and varsity athlete status in the last 12 months. The associated variables included perceptions of general health, perceptions of stress and substance use.

Additionally, a multi-part item asking whether a series of events or situations had been traumatic or difficult for one to handle was included in the model. These included:

  • Academics
  • Career-related issue
  • Death of a family member or friend
  • Family problem
  • Intimate relationship
  • Other social relationship
  • Finance
  • Health problem of a family member or partner
  • Personal appearance
  • Personal health issue
  • Sleep difficulty

After accounting for the demographics, nearly all of the associated variables were significant predictors for depression and anxiety, including student-athlete status, which was a negative predictor.

A few factors presented a comparatively strong relationship with depression and anxiety. Not surprisingly, the strongest was the perceived level of stress in the last 12 months. Stress can be associated with a number of the daily challenges college students face, including academics, interpersonal relationships, health concerns of a family member and financial concerns. Symptoms such as fatigue, hypertension, headaches, depression and anxiety can be attributed to stress.

The ACHA data show that sleep difficulties, and difficulties with intimate relationships and other social relationships also are strongly related to depression and anxiety.

Sleep difficulty was a self-reported measure asking if the respondent had experienced trouble sleeping in the last 12 months. Of those who reported yes, just 9 percent indicated that they had been diagnosed with insomnia in the last 12 months, and an additional 4 percent reported they had been diagnosed with another sleep disorder.

Fewer are being treated with medication for their diagnoses – just 7 percent in total. While few are reporting official diagnoses, a significantly greater percentage is reporting that difficulties with sleep are affecting them. Among those who said they are experiencing difficulty sleeping, 34 percent indicated that sleep difficulties resulted in a lower grade on an exam or test, and an additional 13 percent reported that it resulted in a lower grade in the course. (See Michael Grandner’s article later in this chapter for more on sleeping disorders.)

The data also show that females and underclassmen were more likely to report difficulties with intimate relationships and other relationships. While reports of physical or sexual abuse in an intimate relationship are generally low (around 2 percent of all respondents), emotional abuse appears to be a greater concern, with 10 percent overall report having been in an emotionally abusive relationship. In all, 22 percent of those who claim having experienced difficulties in an intimate relationship report emotional abuse.

Loneliness is a common factor related to difficulties in relationships. Among those who reported relationship problems, 85 percent reported feeling very lonely in the last 12 months, compared with 50 percent of those who did not report problems with relationships. The data indicate that loneliness also is highly correlated with both anxiety and depression.

Anxiety also was strongly related to difficulties with academics. An additional factor with a significant relationship to both depression and anxiety was a catch-all category of “other” traumatic events. This may potentially include characteristics of collegiate student-athletes that were not covered in the survey. For example, poor athletics performance or loss of an athletics scholarship may be traumatic for student-athletes who are highly motivated athletically.

Seeking help. Most student-athletes and non-athletes in the study indicated a willingness to seek help for mental health concerns in the future (63 percent of student-athletes, compared with 68 percent of their non-athlete peers). However, the data indicate that student-athletes are less likely to report having received psychological or mental health services from a variety of providers, including counselors and psychiatrists. This could be due either to a reduced need among the student-athlete population or because they are less likely to report and seek treatment for these concerns.

Overall, while college student-athletes do struggle with depression and anxiety, the data indicate they are less likely than their non-athlete peers to report issues with either. Stress, interpersonal relationships and difficulty sleeping are strongly associated with depression and anxiety. Moreover, academic difficulties also are related to higher anxiety. Given the reluctance of student-athletes to report challenges with mental well-being, coaches, team physicians and athletic trainers are a good potential line of defense in encouraging their athletes to seek help when needed.


About the Authors

Ann Kearns Davoren joined the NCAA staff in 2004 and has focused primarily on student-athlete survey research. She has worked extensively with the NCAA Study of College Outcomes and Recent Experiences (SCORE) and the NCAA Growth, Opportunities, Aspirations and Learning of Students in college (GOALS) study. Ann also is involved in academic, governance and health and safety research across all three membership divisions. Before joining the NCAA, Ann was the assistant staff director at the Advisory Committee on Student Financial Assistance, a federal committee that advises Congress and the U.S. Department of Education on issues affecting student financial aid policy. Ann received her B.A. in speech communication from Saint Mary’s College in Notre Dame, Indiana, and her M.P.A. with a focus on policy analysis and comparative international affairs from Indiana University in Bloomington. She currently is pursuing her Ph.D. in research methodology at Loyola University, Chicago.

Seunghyun Hwang is currently a researcher at the Korea Institute of Sport Science. He holds a dual Ph.D. from the College of Education at Michigan State University, where he specialized in the psychosocial aspects of sport and physical activity. He also has conducted research on student-athletes with respect to their academics and psychological well-being. He recently completed a Postdoctoral Research Fellowship in the Sport Science Institute at the NCAA national office in Indianapolis.