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Sport Psychiatry: Aspects of a Developing Field

  • David Baron
  • Thomas Wenzel
Chapter

Abstract

Sport psychiatry can be seen as a new and rapidly developing global field, due not only to the growing popularity of sports in the general population but also to the highly challenging environments in a professional setting. Mental health problems like brain trauma, depression, suicide, doping, physical trauma and abuse, and also sport-specific problems like the female athletic triad or overtraining are risks endangering the physical and psychological benefits that can be expected from sport and exercise. Working with individual athletes or teams requires special knowledge and skills but also awareness of ethical challenges encountered especially in high-performance sports.

Keywords

Sport Exercise Brain trauma Mental health education 

References

  1. 1.
    Biddle S. Physical activity and mental health: evidence is growing. World Psychiatry. 2016;15(2):176–7.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, et al. Effects of exercise training on older patients with major depression. Arch Intern Med. 1999;159(19):2349–56.CrossRefPubMedGoogle Scholar
  3. 3.
    Begel D. Sport psychiatry twenty-four years later. Int Rev Psychiatry. 2016;28(6):547–50.CrossRefPubMedGoogle Scholar
  4. 4.
    Clark TP, Tofler IR, Lardon MT. The sport psychiatrist and golf. Clin Sports Med. 2005;24(4):959–71, xi.CrossRefPubMedGoogle Scholar
  5. 5.
    Bothe N, Zschucke E, Dimeo F, Heinz A, Wustenberg T, Strohle A. Acute exercise influences reward processing in highly trained and untrained men. Med Sci Sports Exerc. 2013;45(3):583–91.CrossRefPubMedGoogle Scholar
  6. 6.
    Audrain-McGovern J, Rodriguez D, Wileyto EP, Schmitz KH, Shields PG. Effect of team sport participation on genetic predisposition to adolescent smoking progression. Arch Gen Psychiatry. 2006;63(4):433–41.CrossRefPubMedGoogle Scholar
  7. 7.
    Conant-Norville DO. Child and adolescent sports psychiatry in the US. Int Rev Psychiatry. 2016;28(6):556–63.CrossRefPubMedGoogle Scholar
  8. 8.
    Reynolds BB, Patrie J, Henry EJ, Goodkin HP, Broshek DK, Wintermark M, et al. Comparative analysis of head impact in contact and collision sports. J Neurotrauma. 2017;34(1):38–49.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kucera KL, Yau RK, Register-Mihalik J, Marshall SW, Thomas LC, Wolf S, et al. Traumatic brain and spinal cord fatalities among high school and college football players – United States, 2005–2014. MMWR Morb Mortal Wkly Rep. 2017;65(52):1465–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Winkler EA, Yue JK, Burke JF, Chan AK, Dhall SS, Berger MS, et al. Adult sports-related traumatic brain injury in United States trauma centers. Neurosurg Focus. 2016;40(4):E4.CrossRefPubMedGoogle Scholar
  11. 11.
    Thiel A, Gottfried H, Hesse FW. Subclinical eating disorders in male athletes. A study of the low weight category in rowers and wrestlers. Acta Psychiatr Scand. 1993;88(4):259–65.CrossRefPubMedGoogle Scholar
  12. 12.
    Giel KE, Hermann-Werner A, Mayer J, Diehl K, Schneider S, Thiel A, et al. Eating disorder pathology in elite adolescent athletes. Int J Eat Disord. 2016;49(6):553–62.CrossRefPubMedGoogle Scholar
  13. 13.
    Joy E, Kussman A, Nattiv A. 2016 update on eating disorders in athletes: a comprehensive narrative review with a focus on clinical assessment and management. Br J Sports Med. 2016;50(3):154–62.CrossRefPubMedGoogle Scholar
  14. 14.
    Pettersen I, Hernaes E, Skarderud F. Pursuit of performance excellence: a population study of Norwegian adolescent female cross-country skiers and biathletes with disordered eating. BMJ Open Sport Exerc Med. 2016;2(1):e000115.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Rousselet M, Guerineau B, Paruit MC, Guinot M, Lise S, Destrube B, et al. Disordered eating in French high-level athletes: association with type of sport, doping behavior, and psychological features. Eat Weight Disord. 2016;22(1):61–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Kolnes LJ. ‘Feelings stronger than reason’: conflicting experiences of exercise in women with anorexia nervosa. J Eat Disord. 2016;4:6.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Johnson C, Crosby R, Engel S, Mitchell J, Powers P, Wittrock D, et al. Gender, ethnicity, self-esteem and disordered eating among college athletes. Eat Behav. 2004;5(2):147–56.CrossRefPubMedGoogle Scholar
  18. 18.
    Fortes Lde S, Ferreira ME, de Oliveira SM, Cyrino ES, Almeida SS. A socio-sports model of disordered eating among Brazilian male athletes. Appetite. 2015;92:29–35.CrossRefPubMedGoogle Scholar
  19. 19.
    Weiss Kelly AK, Hecht S, Council On Sports Medicine and Fitness. The female athlete triad. Pediatrics. 2016;138(2):e20160922.CrossRefPubMedGoogle Scholar
  20. 20.
    Loud KJ, Gordon CM, Micheli LJ, Field AE. Correlates of stress fractures among preadolescent and adolescent girls. Pediatrics. 2005;115(4):e399–406.CrossRefGoogle Scholar
  21. 21.
    Pepper M, Akuthota V, McCarty EC. The pathophysiology of stress fractures. Clin Sports Med. 2006;25(1):1–16, vii.CrossRefPubMedGoogle Scholar
  22. 22.
    Nichols DL, Sanborn CF, Essery EV. Bone density and young athletic women. An update. Sports Med. 2007;37(11):1001–14.CrossRefPubMedGoogle Scholar
  23. 23.
    Beals KA, Manore MM. Behavioral, psychological, and physical characteristics of female athletes with subclinical eating disorders. Int J Sport Nutr Exerc Metab. 2000;10(2):128–43.CrossRefPubMedGoogle Scholar
  24. 24.
    Currie A, Morse ED. Eating disorders in athletes: managing the risks. Clin Sports Med. 2005;24(4):871–83, ix.CrossRefPubMedGoogle Scholar
  25. 25.
    Elliot DL, Moe EL, Goldberg L, DeFrancesco CA, Durham MB, Hix-Small H. Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use. J Sch Health. 2006;76(2):67–73.CrossRefPubMedGoogle Scholar
  26. 26.
    Meltzer H, Griffiths C, Brock A, Rooney C, Jenkins R. Patterns of suicide by occupation in England and Wales: 2001–2005. Br J Psychiatry. 2008;193(1):73–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Dugas E, Low NC, Rodriguez D, Burrows S, Contreras G, Chaiton M, et al. Early predictors of suicidal ideation in young adults. Can J Psychiatr. 2012;57(7):429–36.CrossRefGoogle Scholar
  28. 28.
    Shah A, Sava-Shah S, Wijeratne C, Draper B. Are elite cricketers more prone to suicide? A psychological autopsy study of test cricketer suicides. Australas Psychiatry. 2016;24(3):295–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Ellis MJ, Ritchie LJ, Koltek M, Hosain S, Cordingley D, Chu S, et al. Psychiatric outcomes after pediatric sports-related concussion. J Neurosurg Pediatr. 2015;16(6):709–18.CrossRefPubMedGoogle Scholar
  30. 30.
    Korngold C, Farrell HM, Fozdar M. The National Football League and chronic traumatic encephalopathy: legal implications. J Am Acad Psychiatry Law. 2013;41(3):430–6.PubMedGoogle Scholar
  31. 31.
    Baum AL. Suicide in athletes: a review and commentary. Clin Sports Med. 2005;24(4):853–69, ix.CrossRefPubMedGoogle Scholar
  32. 32.
    Muller B, Georgi K, Schnabel A, Schneider B. Does sport have a protective effect against suicide? Epidemiol Psichiatr Soc. 2009;18(4):331–5.CrossRefPubMedGoogle Scholar
  33. 33.
    Wenzel TZ, Zhu LJ. Posttraumatic stress in athletes. In: Baron D, Reardon CL, Baron S, editors. Clinical sports psychiatry: an international perspective. New York: Wiley; 2013. p. 102–13.CrossRefGoogle Scholar
  34. 34.
    Reardon CL, Factor RM. Sport psychiatry: a systematic review of diagnosis and medical treatment of mental illness in athletes. Sports Med. 2010;40(11):961–80.CrossRefPubMedGoogle Scholar
  35. 35.
    Glick ID, Stillman MA, Reardon CL, Ritvo EC. Managing psychiatric issues in elite athletes. J Clin Psychiatry. 2012;73(5):640–4.CrossRefPubMedGoogle Scholar
  36. 36.
    Kwan M, Bobko S, Faulkner G, Donnelly P, Cairney J. Sport participation and alcohol and illicit drug use in adolescents and young adults: a systematic review of longitudinal studies. Addict Behav. 2014;39(3):497–506.CrossRefPubMedGoogle Scholar
  37. 37.
    Brower KJ, Blow FC, Eliopulos GA, Beresford TP. Anabolic androgenic steroids and suicide. Am J Psychiatry. 1989;146(8):1075.PubMedGoogle Scholar
  38. 38.
    Brennan BP, Kanayama G, Hudson JI, Pope HG Jr. Human growth hormone abuse in male weightlifters. Am J Addict. 2011;20(1):9–13.CrossRefPubMedGoogle Scholar
  39. 39.
    Pope HG Jr, Kanayama G, Hudson JI. Risk factors for illicit anabolic-androgenic steroid use in male weightlifters: a cross-sectional cohort study. Biol Psychiatry. 2012;71(3):254–61.CrossRefPubMedGoogle Scholar
  40. 40.
    Lindqvist AS, Moberg T, Eriksson BO, Ehrnborg C, Rosen T, Fahlke C. A retrospective 30-year follow-up study of former Swedish-elite male athletes in power sports with a past anabolic androgenic steroids use: a focus on mental health. Br J Sports Med. 2013;47(15):965–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Bergamaschi MM, Crippa JA. Why should cannabis be considered doping in sports? Front Psych. 2013;4:32.Google Scholar
  42. 42.
    Brisola-Santos MB, Gallinaro JG, Gil F, Sampaio-Junior B, Marin MC, de Andrade AG, et al. Prevalence and correlates of cannabis use among athletes-a systematic review. Am J Addict. 2016;25(7):518–28.CrossRefPubMedGoogle Scholar
  43. 43.
    Solomon ML, Weiss Kelly AK. Approach to the underperforming athlete. Pediatr Ann. 2016;45(3):e91–6.CrossRefPubMedGoogle Scholar
  44. 44.
    Pierce EF, Daleng ML, McGowan RW. Scores on exercise dependence among dancers. Percept Mot Skills. 1993;76(2):531–5.CrossRefPubMedGoogle Scholar
  45. 45.
    Pierce EF, McGowan RW, Lynn TD. Exercise dependence in relation to competitive orientation of runners. J Sports Med Phys Fitness. 1993;33(2):189–93.PubMedGoogle Scholar
  46. 46.
    Pierce EF, Morris JT. Exercise dependence among competitive power lifters. Percept Mot Skills. 1998;86(3 Pt 1):1097–8.CrossRefPubMedGoogle Scholar
  47. 47.
    Baron DA, Foley T. Doping in sports. Psychiatriki. 2009;20(4):336–41.PubMedGoogle Scholar
  48. 48.
    Baron DA, Martin DM, Abol Magd S. Doping in sports and its spread to at-risk populations: an international review. World Psychiatry. 2007;6(2):118–23.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Gil F, de Andrade AG, Castaldelli-Maia JM. Discussing prevalence, impacts, and treatment of substance use disorders in athletes. Int Rev Psychiatry. 2016;28(6):572–8.CrossRefPubMedGoogle Scholar
  50. 50.
    Reverter-Branchat G, Bosch J, Vall J, Farre M, Papaseit E, Pichini S, et al. Determination of recent growth hormone abuse using a single dried blood spot. Clin Chem. 2016;62(10):1353–60.CrossRefPubMedGoogle Scholar
  51. 51.
    Ahern DK, Lohr BA. Psychosocial factors in sports injury rehabilitation. Clin Sports Med. 1997;16(4):755–68.CrossRefPubMedGoogle Scholar
  52. 52.
    Perna FM, Antoni MH, Baum A, Gordon P, Schneiderman N. Cognitive behavioral stress management effects on injury and illness among competitive athletes: a randomized clinical trial. Ann Behav Med. 2003;25(1):66–73.CrossRefPubMedGoogle Scholar
  53. 53.
    Galambos SA, Terry PC, Moyle GM, Locke SA, Lane AM. Psychological predictors of injury among elite athletes. Br J Sports Med. 2005;39(6):351–4. discussion-4CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Smith AM, Scott SG, O’Fallon WM, Young ML. Emotional responses of athletes to injury. Mayo Clin Proc. 1990;65(1):38–50.CrossRefPubMedGoogle Scholar
  55. 55.
    Smith AM, Scott SG, Wiese DM. The psychological effects of sports injuries. Coping. Sports Med. 1990;9(6):352–69.CrossRefPubMedGoogle Scholar
  56. 56.
    Baranoff J, Hanrahan SJ, Connor JP. The roles of acceptance and catastrophizing in rehabilitation following anterior cruciate ligament reconstruction. J Sci Med Sport. 2015;18(3):250–4.CrossRefPubMedGoogle Scholar
  57. 57.
    Sundgot-Borgen J, Fasting K, Brackenridge C, Torstveit MK, Berglund B. Sexual harassment and eating disorders in female elite athletes – a controlled study. Scand J Med Sci Sports. 2003;13(5):330–5.CrossRefPubMedGoogle Scholar
  58. 58.
    Short SE, Short MW. Essay: role of the coach in the coach-athlete relationship. Lancet. 2005;366(Suppl 1):S29–30.CrossRefPubMedGoogle Scholar
  59. 59.
    Vertommen T, Schipper-van Veldhoven N, Wouters K, Kampen JK, Brackenridge CH, Rhind DJ, et al. Interpersonal violence against children in sport in the Netherlands and Belgium. Child Abuse Negl. 2016;51:223–36.CrossRefPubMedGoogle Scholar
  60. 60.
    Mountjoy M, Rhind DJ, Tiivas A, Leglise M. Safeguarding the child athlete in sport: a review, a framework and recommendations for the IOC youth athlete development model. Br J Sports Med. 2015;49(13):883–6.CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Hobbs JG, Young JS, Bailes JE. Sports-related concussions: diagnosis, complications, and current management strategies. Neurosurg Focus. 2016;40(4):E5.CrossRefPubMedGoogle Scholar
  62. 62.
    Feden JP. Current concepts in sports-related concussion. R I Med J (2013). 2016;99(10):23–6.Google Scholar
  63. 63.
    McMillan TM, McSkimming P, Wainman-Lefley J, Maclean LM, Hay J, McConnachie A, et al. Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players. J Neurol Neurosurg Psychiatry. 2016;88(6):505–11.CrossRefPubMedGoogle Scholar
  64. 64.
    McLendon LA, Kralik SF, Grayson PA, Golomb MR. The controversial second impact syndrome: a review of the literature. Pediatr Neurol. 2016;62:9–17.CrossRefPubMedGoogle Scholar
  65. 65.
    Kroshus E, Garnett BR, Baugh CM, Calzo JP. Engaging teammates in the promotion of concussion help seeking. Health Educ Behav. 2016;43(4):442–51.CrossRefPubMedGoogle Scholar
  66. 66.
    Meier TB, Brummel BJ, Singh R, Nerio CJ, Polanski DW, Bellgowan PS. The underreporting of self-reported symptoms following sports-related concussion. J Sci Med Sport. 2015;18(5):507–11.CrossRefPubMedGoogle Scholar
  67. 67.
    Currie A, Johnston A. Psychiatric disorders: the psychiatrist’s contribution to sport. Int Rev Psychiatry. 2016;28(6):587–94.CrossRefPubMedGoogle Scholar
  68. 68.
    Calhoun JW, Ogilvie BC, Hendrickson TP, Fritz GK. The psychiatric consultant in professional team sports. Child Adolesc Psychiatr Clin N Am. 1998;7(4):791–802.CrossRefPubMedGoogle Scholar
  69. 69.
    Begel D. The psychotherapist and the adolescent athlete. Child Adolesc Psychiatr Clin N Am. 1998;7(4):867–77.CrossRefPubMedGoogle Scholar
  70. 70.
    Carter-Allison SN, Potter S, Rimes K. Diagnosis threat and injury beliefs after mild traumatic brain injury. Arch Clin Neuropsychol. 2016;31(7):727–37.CrossRefGoogle Scholar
  71. 71.
    Reardon CL, Creado S. Psychiatric medication preferences of sports psychiatrists. Phys Sportsmed. 2016;44(4):397–402.CrossRefPubMedGoogle Scholar
  72. 72.
    Borducchi DM, Gomes JS, Akiba H, Cordeiro Q, Borducchi JH, Valentin LS, et al. Transcranial direct current stimulation effects on Athletes’ cognitive performance: an exploratory proof of concept trial. Front Psych. 2016;7:183.Google Scholar
  73. 73.
    Bernstein J, Perlis C, Bartolozzi AR. Ethics in sports medicine. Clin Orthop Relat Res. 2000;378:50–60.CrossRefGoogle Scholar
  74. 74.
    Bernstein J, Perlis C, Bartolozzi AR. Normative ethics in sports medicine. Clin Orthop Relat Res. 2004;420:309–18.CrossRefGoogle Scholar
  75. 75.
    Brown JL, Cogan KD. Ethical clinical practice and sport psychology: when two worlds collide. Ethics Behav. 2006;16(1):15–23.CrossRefPubMedGoogle Scholar
  76. 76.
    Dasgupta I, O’Connor D. From sports ethics to labor relations. Am J Bioeth. 2013;13(10):17–8.CrossRefPubMedGoogle Scholar
  77. 77.
    Anderson LC, Gerrard DF. Ethical issues concerning New Zealand sports doctors. J Med Ethics. 2005;31(2):88–92.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    Olivardia R, Pope HG Jr, Hudson JI. Muscle dysmorphia in male weightlifters: a case-control study. Am J Psychiatry. 2000;157(8):1291–6.CrossRefPubMedGoogle Scholar
  79. 79.
    Anderson L. Contractual obligations and the sharing of confidential health information in sport. J Med Ethics. 2008;34(9):e6.CrossRefPubMedGoogle Scholar
  80. 80.
    Collins D, Moore P, Mitchell D, Alpress F. Role conflict and confidentiality in multidisciplinary athlete support programmes. Br J Sports Med. 1999;33(3):208–11.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Carneiro LS, Fonseca AM, Vieira-Coelho MA, Mota MP, Vasconcelos-Raposo J. Effects of structured exercise and pharmacotherapy vs. pharmacotherapy for adults with depressive symptoms: a randomized clinical trial. J Psychiatr Res. 2015;71:48–55.CrossRefPubMedGoogle Scholar
  82. 82.
    Carneiro LS, Mota MP, Vieira-Coelho MA, Rosenbaum S, Fonseca AM, Vasconcelos-Raposo J. Exercise for adults with depressive symptoms: beyond the weight loss paradigm. Psychiatry Res. 2016;246:364–5.CrossRefPubMedGoogle Scholar
  83. 83.
    Cheng ST, Chow PK, EC Y, Chan AC. Leisure activities alleviate depressive symptoms in nursing home residents with very mild or mild dementia. Am J Geriatr Psychiatry. 2012;20(10):904–8.CrossRefPubMedGoogle Scholar
  84. 84.
    Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;9:CD004366.Google Scholar
  85. 85.
    Cotton S, Butselaar F. Outdoor adventure camps for people with mental illness. Australas Psychiatry. 2013;21(4):352–8.CrossRefPubMedGoogle Scholar
  86. 86.
    Crawford C, Burns J, Fernie BA. Psychosocial impact of involvement in the Special Olympics. Res Dev Disabil. 2015;45–46:93–102.CrossRefPubMedGoogle Scholar
  87. 87.
    Sealey RM. Acute exercise in Vietnam veterans is associated with positive subjective experiences. Int J Exerc Sci. 2010;3(1):36–42.PubMedPubMedCentralGoogle Scholar
  88. 88.
    Laverty D, Garnham N. Football in inter-war Northern Ireland: Ballymena football and athletic Club limited – religious and political exclusivity or civic inclusivity? Int J Hist Sport. 2010;27(13):2212–33.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Keck Hospital of USC, Global Center for Exercise, Psychiatry and Sport at USC, Keck School of Medicine at USCLos AngelesUSA
  2. 2.Department of Psychiatry and PsychotherapyWorld Psychiatric Association Section on Sport and Exercise Psychiatry, Medical University of Vienna, Division Social Psychiatry, Wellcome CenterViennaAustria

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