Depressive symptom profiles in Icelandic team sport athletes: nine quantitative case analyses over a 6-month period

Authors

  • Frida Run Einarsdottir University of Akureyri, Faculty of Psychology, Akureyri, Iceland
  • Nanna Yr Arnardottir
  • Hafrun Kristjansdottir
  • Johanna Belz
  • Göran Kenttä
  • Richard E. Tahtinen

DOI:

https://doi.org/10.7146/sjsep.v6i.147420

Keywords:

Self-compassion, Screening, Performance, Coach-athlete relationship, Injury

Abstract

Most studies to-date have used mean difference analyses to explore group differences in depressive symptoms among athletes. However, these traditional group mean analyses may mask important information concerning symptom profiles such as the severity, type, and number of symptoms. In this study, we examined idiographic depressive symptom profiles in nine Icelandic team sport athletes with recurrent clinically significant depressive symptoms (clinical symptoms at baseline and six-month follow-up) and those with depressive symptoms only at one time point. The aim was to explore depressive symptoms patterns in these two groups and their relationship with daily functioning and changes in sport-specific factors. Among those with recurrent clinical symptoms, depressive symptom profiles were stable, both in terms of type and severity of symptoms, while those with clinically significant symptoms observed only at one time point showed generally fewer symptoms, symptoms profiles were more variable, and total symptom scores were less severe. Interestingly, no clear associations were found between sport-specific variables, such as satisfaction with the head coach or subjective athletic performance, and depressive symptoms, as several cases reported satisfaction in these areas despite significant depressive symptoms. This idiographic approach highlights the need for targeted and continuous assessment to better understand depressive symptoms in athletes.

References

American Psychiatric Association, D., & Association, A. P. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5). American psychiatric association Washington, DC.

Appaneal, R. N., Levine, B. R., Perna, F. M., & Roh, J. L. (2009). Measuring Postinjury Depression among Male and Female Competitive Athletes. Journal of Sport and Exercise Psychology, 31(1), 60–76. https://doi.org/10.1123/jsep.31.1.60

Belz, J., Kleinert, J., Ohlert, J., Rau, T., & Allroggen, M. (2018). Risk for Depression and Psychological Well-Being in German National and State Team Athletes—Associations With Age, Gender, and Performance Level. Journal of Clinical Sport Psychology, 12(2), 160–178. https://doi.org/10.1123/jcsp.2016-0024

Berntsen, H., & Kristiansen, E. (2018). Guidelines for Need-Supportive Coach Development: The Motivation Activation Program in Sports (MAPS). International Sport Coaching Journal, 6(1), 88–97. https://doi.org/10.1123/iscj.2018-0066

Burcusa, S. L., & Iacono, W. G. (2007). Risk for recurrence in depression. Clinical Psychology Review, 27(8), 959–985. https://doi.org/10.1016/j.cpr.2007.02.005

Cormier, D. L., Kowalski, K. C., Ferguson, L. J., Mosewich, A. D., McHugh, T.-L. F., & Röthlin, P. (2023). Self-compassion in sport: A scoping review. International Review of Sport and Exercise Psychology, 1–40.

Dawes, A. J., Maggard-Gibbons, M., Maher, A. R., Booth, M. J., Miake-Lye, I., Beroes, J. M., & Shekelle, P. G. (2016). Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery: A Meta-analysis. JAMA, 315(2), 150–163. https://doi.org/10.1001/jama.2015.18118

Doherty, S., Hannigan, B., & Campbell, M. J. (2016). The Experience of Depression during the Careers of Elite Male Athletes. Frontiers in Psychology, 7. https://www.frontiersin.org/articles/10.3389/fpsyg.2016.01069

Eaton, W. W., Shao, H., Nestadt, G., Lee, H. B., Bienvenu, O. J., & Zandi, P. (2008). Population-based study of first onset and chronicity in major depressive disorder. Archives of General Psychiatry, 65(5), 513–520. https://doi.org/10.1001/archpsyc.65.5.513

Edmondson, D., Richardson, S., Fausett, J. K., Falzon, L., Howard, V. J., & Kronish, I. M. (2013). Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review. PLOS ONE, 8(6), e66435. https://doi.org/10.1371/journal.pone.0066435

Fried, E. I., (2017). Moving forward: How depression heterogeneity hinders progress in treatment and research. Expert Review of Neurotherapeutics, 17. https://doi.org/10.1080/14737175.2017.1307737

Fried, E. I., & Nesse, R. M. (2014). The Impact of Individual Depressive Symptoms on Impairment of Psychosocial Functioning. PLoS ONE, 9(2), e90311. https://doi.org/10.1371/journal.pone.0090311

Fried, E. I., & Nesse, R. M. (2015a). Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study. Journal of Affective Disorders, 172, 96–102. https://doi.org/10.1016/j.jad.2014.10.010

Fried, E. I., & Nesse, R. M. (2015b). Depression sum-scores don’t add up: Why analyzing specific depression symptoms is essential. BMC Medicine, 13(1), 72. https://doi.org/10.1186/s12916-015-0325-4

Golding, L., Gillingham, R. G., & Perera, N. K. P. (2020). The prevalence of depressive symptoms in high-performance athletes: A systematic review. The Physician and Sportsmedicine, 48(3), 247–258.

Gorczynski, P. F., Coyle, M., & Gibson, K. (2017). Depressive symptoms in high-performance athletes and non-athletes: A comparative meta-analysis. British Journal of Sports Medicine, 51(18), 1348–1354. https://doi.org/10.1136/bjsports-2016-096455

Gunnarsdóttir, Á. S. (2019). Correlation of self-compassion, BMI, depression, anxiety, stress and gender in individuals seeking obesity treatment and university students [Thesis]. https://skemman.is/handle/1946/32924

Howells, K., & Lucassen, M. (2018). ‘Post-Olympic blues’ –The diminution of celebrity in Olympic athletes. Psychology of Sport and Exercise, 37, 67–78. https://doi.org/10.1016/j.psychsport.2018.04.008

James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., & Abdelalim, A. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789–1858.

Jónsdóttir, K., & Sigurðardóttir, S. (2016). Próffræðilegir eiginleikar íslenskra þýðinga á Sheehan Disability Scale, Quality of Life Scale og The Patient Health Questionnaire [Thesis]. https://skemman.is/handle/1946/24874

Kessler, R. C., & Bromet, E. J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health, 34, 119–138. https://doi.org/10.1146/annurev-publhealth-031912-114409

Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32, 509–515. https://doi.org/10.3928/0048-5713-20020901-06

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Kuettel, A., & Larsen, C. H. (2020). Risk and protective factors for mental health in elite athletes: A scoping review. International Review of Sport and Exercise Psychology, 13(1), 231–265. https://doi.org/10.1080/1750984X.2019.1689574

Leary, M. R., Tate, E. B., Adams, C. E., Batts Allen, A., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5), 887–904. https://doi.org/10.1037/0022-3514.92.5.887

Levis, B., Yan, X. W., He, C., Sun, Y., Benedetti, A., & Thombs, B. D. (2019). Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: A meta-research review. BMC Medicine, 17(1), 65. https://doi.org/10.1186/s12916-019-1297-6

MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552. https://doi.org/10.1016/j.cpr.2012.06.003

Malhi, G. S., & Mann, J. J. (2018). Depression. Lancet (London, England), 392(10161), 2299–2312. https://doi.org/10.1016/S0140-6736(18)31948-2

Manea, L., Gilbody, S., & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the patient health questionnaire (PHQ-9): A meta-analysis. Canadian Medical Association Journal, 184(3), E191–E196. PubMed ID: 22184363 https://doi.org/10. 1503/cmaj.110829

Moffitt, T. E., Caspi, A., Taylor, A., Kokaua, J., Milne, B. J., Polanczyk, G., & Poulton, R. (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine, 40(6), 899–909. https://doi.org/10.1017/S0033291709991036

Mosewich, A. D., Crocker, P. R. E., Kowalski, K. C., & DeLongis, A. (2013). Applying Self-Compassion in Sport: An Intervention With Women Athletes. Journal of Sport and Exercise Psychology, 35(5), 514–524. https://doi.org/10.1123/jsep.35.5.514

Neff, K. D. (2003). The Development and Validation of a Scale to Measure Self-Compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027

Neff, K. D. (2023). Self-Compassion: Theory, Method, Research, and Intervention. Annual Review of Psychology, 74(1), 193–218. https://doi.org/10.1146/annurev-psych-032420-031047

Neff, K. D., Kirkpatrick, K. L., & Rude, S. S. (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality, 41(1), 139–154. https://doi.org/10.1016/j.jrp.2006.03.004

Nixdorf, I., Beckmann, J., & Nixdorf, R. (2020). Psychological predictors for depression and burnout among German junior elite athletes. Frontiers in Psychology, 11, 601.

Odou, N., & Brinker, J. (2014). Exploring the relationship between rumination, self-compassion, and mood. Self and Identity, 13(4), 449–459.

Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., Derevensky, J. L., Glick, I. D., Gorczynski, P., Gouttebarge, V., Grandner, M. A., Han, D. H., McDuff, D., Mountjoy, M., Polat, A., … Engebretsen, L. (2019). Mental health in elite athletes: International Olympic Committee consensus statement (2019). British Journal of Sports Medicine, 53(11), 667–699. https://doi.org/10.1136/bjsports-2019-100715

Rice, S. M., Parker, A. G., Rosenbaum, S., Bailey, A., Mawren, D., & Purcell, R. (2018). Sport-related concussion and mental health outcomes in elite athletes: A systematic review. Sports Medicine, 48, 447–465.

Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G. (2016). The Mental Health of Elite Athletes: A Narrative Systematic Review. Sports Medicine (Auckland, N.Z.), 46(9), 1333–1353. https://doi.org/10.1007/s40279-016-0492-2

Saw, A. E., Main, L. C., & Gastin, P. B. (2016). Monitoring the athlete training response: Subjective self-reported measures trump commonly used objective measures: a systematic review. British Journal of Sports Medicine, 50(5), 281–291. https://doi.org/10.1136/bjsports-2015-094758

Schaal, K., Tafflet, M., Nassif, H., Thibault, V., Pichard, C., Alcotte, M., Guillet, T., Helou, N. E., Berthelot, G., Simon, S., & Toussaint, J.-F. (2011). Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns. PLOS ONE, 6(5), e19007. https://doi.org/10.1371/journal.pone.0019007

Smith, W. (2008). Does Gender Influence Online Survey Participation? A Record-Linkage Analysis of University Faculty Online Survey Response Behavior. Online Submission.

Stambulova, N. B. (2017). Crisis-transitions in athletes: Current emphases on cognitive and contextual factors. Current Opinion in Psychology, 16, 62–66.

Stutts, L. A., Leary, M. R., Zeveney, A. S., & Hufnagle, A. S. (2018). A longitudinal analysis of the relationship between self-compassion and the psychological effects of perceived stress. Self and Identity, 17(6), 609–626. https://doi.org/10.1080/15298868.2017.1422537

Tahtinen, R. E., Shelley, J., & Morris, R. (2021). Gaining perspectives: A scoping review of research assessing depressive symptoms in athletes. Psychology of Sport and Exercise, 54, 101905. https://doi.org/10.1016/j.psychsport.2021.101905

Tahtinen, R., Kristjansdottir, H., Olason, D. T., & Morris, R. (2021). What Lies Beneath: Exploring Different Depressive Symptoms Across Selected Risk Factors in Icelandic Team Sport Athletes. Journal of Clinical Sport Psychology, 15(1), 54–79. https://doi.org/10.1123/jcsp.2020-0040

Toenders, Y. J., Schmaal, L., Harrison, B. J., Dinga, R., Berk, M., & Davey, C. G. (2020). Neurovegetative symptom subtypes in young people with major depressive disorder and their structural brain correlates. Translational Psychiatry, 10(1), Article 1. https://doi.org/10.1038/s41398-020-0787-9

Wolanin, A., Gross, M., & Hong, E. (2015). Depression in Athletes: Prevalence and Risk Factors. Current Sports Medicine Reports, 14(1), 56. https://doi.org/10.1249/JSR.0000000000000123

World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. World Health Organization.

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Published

2024-11-14

How to Cite

Einarsdottir, F. R., Arnardottir, N. Y., Kristjansdottir, H., Belz, J., Kenttä, G., & Tahtinen, R. E. (2024). Depressive symptom profiles in Icelandic team sport athletes: nine quantitative case analyses over a 6-month period. Scandinavian Journal of Sport and Exercise Psychology, 6, 46–55. https://doi.org/10.7146/sjsep.v6i.147420

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Research section