The Impact of Athletic Retirement on Anxiety in Elite Athletes, A Critically Appraised Topic

ABSTRACTThis study presents qualitative data on the retirement experiences of retired professional ice hockey players and the relationship of these experiences to self-reported depressive symptoms and measures of athletic identity. Data were obtained from an online survey sent to retired professional hockey players within the Professional Hockey Players’ Association (PHPA) database. A total of 213 retired players completed the qualitative section of the survey and were included in the study. Former players expressed an array of responses to questions about the best and most difficult parts of their athletic retirement experiences, and what they believe would help future generations of retiring hockey players. Within these responses, there were two distinct patterns of identity-based challenges among depressed former players. One subset of depressed former players, captured by our proposed term athletic identity flight, scored lower in athletic identity, and emphasized positive aspects of retirement related to “building a new identity.” A second subset of depressed former players, who we described with the term athletic identity gripping, noted an identity crisis upon retiring and retained a strong athletic identity post-career. Non-depressed former players in our sample were more likely to emphasize the importance of career support to help future retiring hockey players, whereas depressed former players emphasized the importance of mental health support. Our findings may inform future preventative interventions to assist retiring hockey players in their end-of-athletic-career transition and suggest the value of tailoring interventions based on the strength of athletic identity and the presence of depressive symptoms.Lay summary: Retired professional ice hockey players with self-reported depression symptoms experienced two distinct identity challenges when transitioning out of sport. Some appeared to actively distance themselves from their former athletic identity (athletic identity flight). Others experienced an identity crisis and appeared to maintain their athletic identity over time (athletic identity gripping).Implications for practice: Based on both quantitative and qualitative data analysis, results suggest that athletic identity is a factor to consider when tailoring interventions for professional hockey players transitioning to athletic retirement. Interventions may vary based on relationship with athletic identity during the transition; some will experience an “identity crisis” and attempt to hold onto their athletic identity, which may be a risk factor for long-term depressive symptoms. Others may actively distance themselves from their athletic identity during the transition, possibly due to emotional pain associated with the athlete role.Depending on the presence of depressive symptoms, retiring players may have different intervention needs to assist with athletic retirement. Non-depressed players may benefit from practical support, such as planning their next career. Depressed players may benefit more from mental health outreach. Aligned with duty of care principles, results indicate a need for screening retiring athletes to identify those at risk for depression.

This study examined the complex associations between athletic retirement and self-esteem among former elite athletes. With reference to theoretical and empirical work on the quality of the transition out of sport, information was collected from 290 (junior) elite athletes in a retrospective-prospective design: at the first measurement, active athletes assessed satisfaction with their sporting career, athletic identity, and self-esteem. At the second measurement (12 years later), the now former athletes rated transition characteristics of their career ending, sporting career success, emotional reactions to career termination, extent of necessary adjustment required following athletic retirement, duration and quality of adjustment, and self-esteem. Structural equation modelling revealed that neither sporting career success nor sporting career satisfaction had a direct effect on adjustment. However, athletic identity and retirement planning predicted the extent of adjustment, which in turn predicted the duration and quality of adjustment, and ultimately self-esteem. Voluntariness, timeliness, and perceptions of gain predicted emotional reactions towards career termination, which also predicted the duration of adjustment. Extent of adjustment and emotional reactions mediated between preconditions of career termination and transition characteristics and self-esteem. While self-esteem after career termination was predominantly predicted by self-esteem 12 years earlier, perceived quality of adjustment to career termination had a significant effect on self-esteem in the post-athletic career. These results complement existing literature illustrating that athletic retirement is a complex and dynamic process and the quality of this transition has a small, but still noteworthy effect on self-esteem, a central construct for well-being.

Introduction
 Elite athletes spend a great amount of time training and competing. Accordingly, their live is focused on and shaped by sport. As a result, many athletes develop a strong athletic identity, which may be defined as the extent to which athletes identify with their role as athletes (Brewer, 1993). While risk and opportunities associated with a strong athletic identity are clear, little is known about how athletic identity develops over the course of a sport career. Some studies suggest that athletic identity remains stable over time (e.g., Hadiyan & Cosh, 2019), while other studies attribute some plasticity to it (e.g., Brewer et al., 2010). The purpose of this study was to examine how the athletic identity develops beyond a career in elite sport. In addition, we searched for potential predictors of athletic identity during and after career.
 Methods
 A longitudinal survey of 290 athletes (32.8% women; 67.2% men) was conducted during (t1) and after their careers (t2; 12 years later). The German version of the Athletic Identity Measurement Scale (AIMS D; Schmid & Seiler, 2003) was used to measure athletic identity. Besides, data were collected on demographic (gender, age) and sports-related variables (sporting success, career satisfaction, time of retirement, voluntariness of retirement, involvement in sport after retirement). Data were analyzed using multi-level regression models.
 Results
 The analysis revealed that athletic identity decreased over time. However, there was considerable heterogeneity across athletes. In particular, the status as an athlete (i.e., professional vs. dual career), exclusivity of the role as an athlete, and time to retirement predicted athletic identity at t1. To explain the development of athletic identity, interaction terms between time and the different predictors were also modeled. Three significant effects were found: In particular, a slower decline in athletic identity was found for athletes who were (a) working in the field of sport after their athletic retirement, (b) involved in (recreational) competitive sport, and (c) satisfied with their sport career.
 Discussion/Conclusion
 As expected, on average, the role as an athlete is reduced in an individual’s identity (and is probably replaced by other roles). However, sport may still be shaping athletes’ identity, notably their athletic career has been satisfying and if their occupation revolves around sports. Future research is needed to better understand how former athletes reshape their identity and what sources of meaning they tap into after athletic retirement to promote quality of life.
 References
 Brewer, B. W. (1993). Self-identity and specific vulnerability to depressed mood. Journal of Personality, 61(3), 343–364. https://doi.org/10.1111/j.1467-6494.1993.tb00284.x
 Brewer, B. W., Cornelius, A. E., Stephan, Y., & van Raalte, J. (2010). Self-protective changes in athletic identity following anterior cruciate ligament reconstruction. Psychology of Sport and Exercise, 11(1), 1–5. https://doi.org/10.1016/j.psychsport.2009.09.005
 Hadiyan, H., & Cosh, S. (2019). Level of physical and motor fitness post retirement and maintenance of athletic identity within active retired athletes. Journal of Loss and Trauma, 24(1), 84–95. https://doi.org/10.1080/15325024.2018.1540206
 Schmid, J., & Seiler, R. (2003). Identität im Hochleistungssport: Überprüfung einer deutschsprachigen Adaptation der Athletic Identity Measurement Scale (AIMS-D) [Identity in high-performance sport: Psychometric investigations with a German Language adaptation of the Athletic Identity Measurement Scale (AIMS-D)]. Diagnostica, 49(4), 176–183. https://doi.org/10.1026//0012-1924.49.4.176

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused the cancellation or postponement of virtually every sporting event, resulting in training disruptions, income loss, and career uncertainties for athletes around the world. At present, the effect of the COVID-19 pandemic on the mental and emotional health of athletes is not well understood. Purpose: To investigate the effect of the COVID-19 pandemic on the mental and emotional health of athletes and to identify risk factors associated with poor mental health outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed, Embase, and Cochrane Library databases were searched to identify all articles reporting on athletes’ mental and emotional health during the COVID-19 pandemic. Articles were selected based on relevant inclusion and exclusion criteria. Study characteristics, athlete demographics, and COVID-19 mental health data (sex-, type of sport—, and level of play—specific differences) were collected from each included article and analyzed. Results: A total of 35 studies were included in the final analysis, comprising athletes around the world and across numerous sports and levels of play. Most studies utilized at least 1 validated mental health questionnaire and assessed for outcomes such as depression, anxiety, stress, motivation, and athletic identity. Overall, athletes reported worse mental and emotional health during the COVID-19 pandemic, although these effects were attenuated by home training programs and quarantine training camps. Female sex and more elite levels of play were associated with an increased risk for poor mental health outcomes. Type of sport was associated with mixed results, with individual and team sports carrying different increased risks for poor mental and emotional health. Nearly all studies recommended the need for increased psychological support of athletes during the COVID-19 pandemic. Conclusion: The effect of the COVID-19 pandemic on the mental and emotional health of athletes is complex and multifaceted. Increased social interactions with coaches and teammates, continued access to training facilities and mental health professionals, and active utilization of healthy coping mechanisms can improve mental health outcomes for athletes in the era of COVID-19.

Individuals strongly tied to their athletic sense of self, athletic identity, may have increased sport specialization and behaviors elevating injury risk, overtraining, and mental health concerns. No known studies have explored the relationship between athletic identity, specialization, and youth athletes' mental health concerns, specifically anxiety and depression. This study assessed the relationship between athletic identity, specialization, and mental health symptoms among female, high school athletes. Athletic identity and mental health were assessed via the Athletic Identity Measurement Scale (AIMS) and Revised Children's Anxiety and Depression Scale (RCADS). A sport participation survey recorded injury history, specialization, and training volume. Mann -Whitney U tests compared RCADS scores between high athletic identity (>54 total AIMS) and low athletic identity (<55 total AIMS; α = 0.05) athletes. A total of 149 female volleyball athletes were included (16.0 ± 0.9 years), with 54.4% (81/149) classified as high athletic identity. Injury rates did not significantly differ between high and low athletic identity groups. Highly specialized athletes differed on multiple RCADS subscales, with high athletic identity correlated with greater separation anxiety (p = 0.012), generalized anxiety (p = 0.006), social phobia (p = 0.020), depression (p = 0.011), total anxiety (p = 0.005), and total anxiety and depression (p = 0.002). The moderately specialized group did not differ in RCADS scores between high and low athletic identity athletes. Those with high athletic identity practiced more and had more anxiety and depressive symptoms than those with low athletic identity but were not at higher injury risk for injury. Providers should consider routine mental health screenings for high athletic identity athletes and promote psychoeducation on the importance of developing coping skills and diverse interests outside of one's primary sport.

Student-athletes often identify with the athlete role and demonstrate high levels of athlete identity. High athlete identity leads to many unintended consequences such as low career maturity and difficulty adapting to a life beyond sport. Additionally, high athlete identity often leads to mental health concerns among the student-athlete population. Informed by self-categorization theory (Turner, 1982), the purpose of this study was to explore athlete identity and mental health among NCAA Division III student-athletes. The Athlete Identity Measurement Scale (AIMS) and The Depression Anxiety Stress Scales-21 were completed by 332 NCAA Division III student-athletes. The results demonstrated that Division III student-athletes did not identify highly with the athletic role and did not show concerning levels of anxiety, depression, and/or stress. Further, no relationship between athlete identity and mental health was found. This study strives to provide a keen insight into the athlete identity and mental health of Division III student-athletes in hopes of better understanding this population.

Since the end of the 20th century, the elite athlete mother has been a growing social phenomenon, with increasing numbers of female athletes returning to elite level sport postpartum. Allyson Felix and Serena Williams are two recent elite athletes who successfully transitioned into their new identity of elite athlete mother. However, there is no guarantee that all transitional journeys will be as successful. The purpose of the present study was to enhance current knowledge of the experiences during pregnancy and motherhood in elite sport by exploring how becoming a mother impacted on the perceived personal and physical identity of elite athletes. Two elite athletes who had recently given birth to their first child were interviewed at two-months, six-months, and 15–16 months post-birth. Interviews were analyzed using a reflexive thematic analysis to explore how identity may have changed over the initial 15–16 months of motherhood. Three themes were developed, comprising: athlete identity; mother identity; and athlete mother identity. The sub-themes of identity, physical identity, shifting of goals, juggling athlete and mother identity, dual identity, priorities, and lifestyle were generated and demonstrated both similarities and nuances in the experiences of the two athletes. This study is the first to provide longitudinal insights into the experiences of both para and non-para elite athlete mothers during the initial stages of motherhood. Findings highlight the individual nature of such an experience and illuminate some of the negotiations of the personal, athlete, and mother identity that an athlete mother may experience.

Context:Coaches play an important role in promoting mental health in elite sports. However, they themselves are exposed to risks affecting their mental health, and their fears and worries are often overlooked. Moreover, it remains unclear how coaches’ mental health affects their athletes’ mental health.Objective:To create a compilation of the literature on (1) elite coaches’ mental health and (2) how coaches’ mental health influences elite athletes’ mental health. Building on this, recommendations for improving coaches’ psychological well-being should be elaborated upon and discussed.Data Sources:A literature search was conducted up to November 30, 2021, using the following databases: PubMed, PsycINFO, Scopus, Web of Science, and SportDiscus.Study Selection:Studies reporting elite coaches’ mental health symptoms and disorders and the influence of elite coaches’ mental health on elite athletes’ mental health were included.Study Design:Scoping review.Level of Evidence:Level 4.Data Extraction:Data regarding elite coaches’ mental health, as well as their influence on athletes’ mental health and performance, were included in a descriptive analysis. The PRISMA guidelines were used to guide this review.Results:Little research has been done on elite coaches’ mental health disorders, although studies confirm that they do experience, for example, symptoms of burnout, anxiety, and depression. The influence of coaches’ mental health on their athletes is underinvestigated, with research focused mainly on the influence of coaches’ stress.Conclusion:Knowledge about coaches’ mental health is still limited. Coaches’ poor mental health diminishes coaching performance and might impair athletes’ mental health. Coaches should receive more support, including sports psychiatric care and education on the importance of mental health. This could improve the mental health of both coaches and athletes, and positively affect athlete performance.

Transitioning out of elite sports can be a challenging time for athletes. To illuminate the gaps and opportunities in existing support systems and better understand which initiatives may have the...

This study investigates how different coping strategies influence the psychological and social well-being of former elite Slovak athletes during their transition from professional sport to post-sport life. Grounded in the transition models developed by Taylor and Ogilvie (1994, 2001) and Stambulova (1997), as well as Ryff and Keyes’s (1995) theory of well-being and Carver’s (1997) Brief COPE framework, the research explores mechanisms that facilitate successful adaptation following athletic retirement. A mixed-methods design was employed. In the first phase, semi-structured interviews with 20 former athletes were thematically analyzed to identify key coping mechanisms and transition experiences. The second phase utilized a questionnaire completed by 200 former elite athletes, measuring the use of 11 coping strategies and their associations with five domains of well-being. Statistical analysis through factor analysis and MANOVA revealed five core coping strategies: sport-related, self-distraction, proactive, denial, and escape. Sport-related and self-distraction strategies were positively associated with higher levels of well-being, suggesting their role as adaptive responses during career transition. In contrast, denial and escape strategies were linked to reduced well-being across multiple domains. Notably, proactive strategies such as planning and information seeking - typically viewed as constructive - were associated with increased anxiety in this context. These findings underscore the complexity of coping during athletic retirement and highlight the importance of personalized psychological support. By conceptualizing coping strategies as independent variables affecting transition outcomes, this study contributes novel empirical insights to the field and emphasizes the need for tailored interventions to support athletes’ mental health and long-term adjustment after sport.

Whilst the relationship between sport-related success and its effect on the identity of athletes has been acknowledged, less attention has been paid to understanding this relationship from the perspective of the individual. Elite sport follows the logic of individualism, competitiveness, and productivity, while elite athlete performance is depicted as being a remedy for society’s ills by empowering control over health and serving as a good example for future generations. This dualism is reflected in the viewpoints of elite athletes: in their experiences, reflections, and memories. The aim of this paper is to formally examine through Hungarian elite athletes’ experiences how elite sport is related to components of the athletic identity and their potential impact on individual sustainability. Results show (1) how essential the role of coaching is in elite athletes’ careers, (2) how sport is seen as a protective shield, indicating the importance of life-long career planning, and (3) that there is cognitive dissonance regarding the identity of elite athletes.

Interest in athletes’ executive function, an umbrella term encompassing an array of complex cognitive processes that enable flexible goal-directed behaviour in real time, has increased significantly over the past decade and is the focus of the current chapter. The relationship between executive function and mental health is complex, contingent upon developmental processes (e.g., lifespan perspectives), and influenced by similar covariates (e.g., physical activity), which are highly relevant to elite level athletes (e.g., both impact on sport performance). Whilst empirical investigation of the executive function and mental health relationship in sport is lacking, the paucity of available literature is limited in theoretical approach and methodological consistency, making consensus difficult. Nonetheless, in the current chapter, we attempt to clarify the available literature by defining executive function, reviewing measurement and related issues, examining research on executive function of elite athletes, discussing the impact of executive function on mental health and vice versa, and provide some recommendations for practitioners and future directions for researchers interested in the relationship between executive function and mental health in elite-level athletes.

Elite athletes may be as likely as members of the general population to experience mental disorders, and there has recently been a surge of research examining mental health among athletes. This paper provides an overview and commentary of the literature on the mental health of elite athletes and explores how trends within and beyond the field of sport psychology have impacted this literature. Reviewing the contextual influences on this field, namely disorder prevalence, barriers to support seeking, mental toughness, and psychiatric epidemiology, are important to understand the broader picture of mental health research and to further strengthen work undertaken in sport psychology. In addition, appreciating the influence of various contextual factors on athlete mental health research can help to highlight where sport psychology practitioners may focus their attention in order to advance research and applied practice with elite athletes experiencing poor mental health. It is important that researchers consider how they measure mental health, how studies on the mental health of elite athletes are designed, implemented, and evaluated, and how both researchers and practitioners may help to combat athletes’ perceptions of stigma surrounding mental health. Considering topics such as these may lead to a deeper understanding of athlete mental health, which may in turn help to inform sport specific policies, applied practice guidelines, and interventions designed to enhance athlete mental health. Lay Summary: Recently, there has been an expansion of research on the mental health of elite athletes. We discuss some factors that have influenced the study of elite athlete mental health and how these factors continue to shape the field. We propose ways that researchers and practitioners may advance work in this area.

Cumulative lifetime stress exposure, depression, anxiety, and well-being in elite athletes: A mixed-method study

Mental health symptoms and disorders amongst elite athletes have attracted a great deal of discussion recently. Current epidemiological evidence illustrates that mental health symptoms and disorders in elite athletes are prevalent and a concern for athletes, coaches, and sport organizations. Recently, seven consensus, expert, or position statements have been written on the topic of mental health in elite sport. A strategy suggested by each of the seven statements – aimed at preventing and treating mental health symptoms and disorders in elite athletes, both individually and systemically – is to employ education interventions, specifically those based on increasing mental health literacy. Mental health literacy has come to include concepts related to knowledge of effective self-management strategies, challenging mental disorder stigma, awareness and use of mental health first-aid to assist others, and the facilitation of help seeking behaviors. In elite sport, questions remain about how mental health literacy can address the unique needs of the individual athlete, but also factor in their culture and their environment to identify how to prevent and treat mental health symptoms and disorders. The purpose of this commentary is twofold: 1) to explore the evolving concept of mental health literacy within elite sport which addresses individuals, their culture, and their environment, and 2) to propose strategies for best practice and research in mental health literacy within elite sport relying on collaboration between sports psychiatry, sport psychology, and clinical psychology. Lay summary: Expert statements on mental health in elite sport have suggested the use of educational strategies to address poor mental health in elite athletes. This commentary explores the concept of mental health literacy within elite sport which addresses individuals, their culture, and their environment, and proposes strategies for best practice. Implications for Practice Mental health literacy interventions should be based on detailed knowledge of developmental, cultural, and social issues related to sport participation and systemic issues within sport settings and organizations. Mental health literacy interventions should be designed in a manner which takes due account of cultural issues and contexts, where sport organizational goals are considered while helping organizations recognize and address mental health symptoms and disorders and also create sport environments where individuals can thrive. Mental health literacy interventions should have measurable impact on both organizations and individuals.