Body satisfaction and disordered eating among male collegiate athletes: From point-prevalence to prediction.

Body satisfaction (BS) predicts lower levels of eating disorders and disordered eating behaviors (ED/DE) among female athletes, though recent research suggests similar effects for male athletes. However, research on male athletes' BS and ED/DE is limited, particularly in relation to times of transition, such as occurred in the months immediately following COVID-19 being recognized as a global pandemic. In this study, we surveyed 1975 male collegiate athletes in April/May 2020 to assess their body satisfaction and ED/DE symptomatology to determine prevalence and prediction between the two. First, we determined athletes' ED classification: 18.5 % (clinical) and 4.7 % (subclinical). Second, although 60 % to 70 % of the athletes reported satisfaction across five body dimensions, they were significantly more satisfied with their body muscularity and least with their leanness and thinness. Third, through hierarchical regression, athletes' body satisfaction significantly explained their ED/DE symptomatology, explaining 34 % of the variance. Of the five BS dimensions, satisfaction with body size/shape (ß = -0.19), current weight (ß = -0.22), and thinness (ß = -0.25) were associated significantly with lower DE. Our results add to the limited research that has demonstrated that during times of transition, such as when athletes retire from sport or experience a global health pandemic, female and male athletes' report more body image concerns and DE symptoms. Further, our results indicate that satisfaction is perceived as multidimensional by male athletes, and that specific dimensions (e.g., weight, thinness) are more strongly associated with disturbances in eating.

The Relationship of Resilience, Self-Compassion, and Social Support to Psychological Distress in Women Collegiate Athletes During COVID-19.

Given how COVID-19 had caused significant increases in collegiate athletes' psychological distress, we examined the extent to which such distress may have been ameliorated by the athletes' psychosocial resources (e.g., resilience). We used structural equation modeling to examine the direct and indirect relationships of resilience, self-compassion, and social support to women collegiate athletes' (N = 3,924; 81.2% White) psychological distress; athletes completed measures of these constructs from mid-April to mid-May 2020. Analyses revealed significant direct effects: More supported (ß = -0.12 to -0.19), self-compassionate (ß = -0.48 to -0.53), and resilient (ß = -0.21 to -0.35) athletes experienced less psychological distress (R2 = .61-.65). Further, self-compassion and social support were related indirectly (and inversely) to psychological distress through higher levels of resilience. These psychosocial resources appear to have played a positive role in how athletes coped with the pandemic, being associated with less psychological distress. These findings have application beyond the pandemic, providing direction for how sport psychology professionals may assist athletes in maintaining their well-being.

What facilitates collegiate athletes seeking mental health care? Athletic trainers' perceptions.

Objective: To assess athletic trainers' (ATs) perceptions regarding the importance of athletes' beliefs and athletic department stakeholders in facilitating help-seeking for mental health (MH) care.Participants: 534 ATs within collegiate athletic departments (Mage = 35.50 years; 64.2% women; 87.3% White).Methods: ATs were asked to indicate the extent to which they believed 10 student-athlete beliefs about MH (e.g. confidence MH treatments work) and 10 stakeholders (e.g. teammate) would facilitate student-athletes' help-seeking for MH care (1, Strongly Disagree, to 5, Strongly Agree).Results: We conducted separate two-way mixed design ANOVAs, one for each set of 10beliefs and 10 stakeholders; each was significant (p's < .002). The ATs perceived confidentiality as the most facilitative belief and viewed ATs as the most facilitative stakeholder.Conclusions: ATs differentiate among student-athletes' beliefs and stakeholders on how facilitative each might be in help-seeking, suggesting pathways for improving MH climate within athletic departments through education and policies.

Barriers to and Facilitators of Collegiate Athletes Seeking Mental Health Services.

CONTEXT: Approximately 1 in 5 student-athletes experience some type of mental health concern. However, fewer than half of student-athletes who report mental health concerns seek mental health treatment (ie, psychotherapy or medication). Data concerning barriers to student-athletes seeking mental health care are limited but suggest that stigma is the primary reason. Further, whether having shared identities with their sport psychologists (eg, race and gender) encourages student-athletes to seek help has been minimally explored. OBJECTIVES: To determine the frequency of internal and external barriers to athletes seeking mental health care and examine the importance of athletes and sport psychologists sharing identities as a facilitator of seeking help. DESIGN: Cross-sectional study. SETTING: Collegiate athletics. PATIENTS OR OTHER PARTICIPANTS: A total of 266 student-athletes (53.8% women, 42.5% White) from a National Collegiate Athletic Association Division I university. MAIN OUTCOME MEASURES: Student-athletes responded to 9 binary (yes or no) prompts related to internal barriers (eg, beliefs and attitudes about mental health) and 7 reflecting external barriers (ie, different stakeholders, such as the head coach). Regarding facilitators of mental health help-seeking, student-athletes rated how important it was for them to share each of 10 identities with their sport psychologist from 1 (not at all important) to 5 (extremely important). All identified barriers and facilitators were derived from existing research. RESULTS: Differences were found in athletes' ratings of internal and external barriers. For example, a belief in one's own reliance and not having enough time were significant barriers, as was their head coach having a negative attitude about the importance of mental health. Female student-athletes rated sharing a gender identity with their sport psychologist as more important than did male student-athletes. CONCLUSIONS: Despite efforts by the National Collegiate Athletic Association to reduce the stigma surrounding mental health, persisting barriers within collegiate sports may keep athletes from seeking help.

Sleep disturbances and depression are bidirectionally associated among college student athletes across COVID-19 pandemic exposure classes.

College athletes may be vulnerable to sleep disturbances and depression during the COVID-19 pandemic as a result of large shifts in social and athletic obligations. In a national sample of college athletes, we examined the associations between sleep disturbances and depression across two timepoints, using COVID-19 exposure as a moderator. Data were collected from 2098 NCAA Division I, II, and III college athletes during two timepoints, from April 10 to May 23, and from August 4 to September 15, 2020. First, a latent class analysis was conducted with five indicators of levels of COVID-19 exposure to determine different exposure profiles. Second, to examine the directionality of associations between sleep disturbance and depression, a cross-lagged panel model was added to the latent class membership structural equation model; this allowed for testing of moderation by COVID exposure class membership. Four highly homogeneous, well-separated classes of COVID-19 exposure were enumerated: Low Exposure (57%); Quarantine Only (21%); High Other, Low Self Exposure (14%); and High Exposure (8%). COVID-19 exposure class membership did not significantly moderate associations between sleep disturbances and depression. However, student athletes significantly differed in T2 depression by their COVID-19 exposure class membership. Depression and sleep disturbances were positively correlated at both timepoints (r T1 = 0.39; r T2 = 0.30). Additionally, cross-lagged associations were found such that T2 depression was associated with T1 sleep disturbances (ß = 0.14) and vice versa (ß = 0.11). These cross-lagged associations were not significantly affected by athletes' level of COVID-19 exposure during the beginning of the pandemic.

Self-compassion, body satisfaction, and disordered eating symptoms in male collegiate athletes: A longitudinal analysis.

Male athletes are a subpopulation at risk for developing eating disorders and disordered eating concerns, primarily due to the presence of socioculturally-based factors, including body dissatisfaction. Self-compassion may alleviate this risk by improving body satisfaction. To date, no study has examined longitudinally self-compassion's effect on body satisfaction and, ultimately, disordered eating in male athletes. Across two time points separated by four months, we assessed self-compassion, body satisfaction, and disordered eating in 454 male collegiate athletes. Through cross-lagged, panel analysis, after controlling for the Time 1 scores, we determined that: (a) Time 1 self-compassion was neither directly related to Time 2 body satisfaction (ß = 0.02, p = .755), nor indirectly to Time 2 disordered eating (ß = -0.002, 95% BCaCI [-0.028, 0.014]), and (b) Time 1 body satisfaction directly predicted Time 2 disordered eating (ß = -0.12, p < 0.05). Our findings extend past research, demonstrating that body satisfaction is a primary antecedent to disordered eating among male athletes. However, the proposed effects of self-compassion on the body satisfaction to disordered eating relationship were not supported and may be dependent on gender and athlete status.

The body satisfaction and psychological well-being of retired women athletes: A long-term qualitative analysis of bodies in motion.

We conducted a qualitative evaluation of Bodies in Motion (BIM), a dissonance, mindful self-compassion-based program that addresses the unique experiences and needs of female athletes with respect to their bodies and their well-being. Using semi-structured interviews, 12 collegiate female athletes (retired 2 - 6 years) reflected and provided feedback on the enduring impact of BIM on their body image, relationship to food and exercise, and overall psychological well-being. Through thematic analysis, we found that these retired athletes, extending from their initial program learning, reported increased awareness of sport and societal messages and their impact on body image, shifted perspectives in their view of themselves and their bodies, and used learned skills to manage body image in their lives. Further, with the passage of time, athletes emphasized how what they had learned in BIM remained essential as they navigated challenging life transitions, such as their retirement from collegiate sports. Our findings indicate that the benefits female athletes report accruing in the immediate aftermath of BIM remain with them, even growing and becoming more salient as they continue to reflect on the program and its impact on their body awareness and how they navigate their lives as women and former athletes.

Drinking among college student athletes during the COVID-19 pandemic.

Objective: To investigate demographics, sport type, athletic identity, and COVID-19 sport season cancelation in relation to alcohol consumption among college student athletes shortly after the pandemic emerged. Participants: College student athletes recruited from U.S. athletic departments. Methods: Survey data were collected from 5,915 college student athletes in April/May 2020. Results: Being female, Latinx, and in a relationship were associated with lower alcohol consumption. Among males, team sport participation was related to greater alcohol consumption. Among females, athletic identity was inversely related to drinking, which was moderated by sport type, such that alcohol consumption was lower as athletic identity strengthened in individual (vs. team) sport athletes. However, we did not find a relationship of COVID-19 sport season cancelation with drinking. Conclusions: Our gender-specific findings are novel and generalizable based on a large, national sample of college student athletes, and may inform strategies for alcohol consumption education among college team sport athletes.

College Student-athletes' COVID-19 Worry and Psychological Distress Differed by Gender, Race, and Exposure to COVID-19-related Events.

PURPOSE: The purpose of this study was to determine the prevalence of National Collegiate Athletic Association (NCAA) student-athletes' exposure to COVID-19-related events (e.g., canceled season, diagnosed with COVID) and their psychological distress in April/May 2020. METHODS: The link to the online survey was emailed to NCAA student-athletes by the NCAA Student Athlete Advisory Council and the athletic departments of 80 NCAA institutions. In April-May of 2020, student-athletes (N = 5915; women = 3924) completed the online survey once. The survey included measures of their psychological distress, COVID-19 worry, and their exposure to different COVID-19-related events. To examine differences in exposure to COVID-related events by racial, ethnicity, and gender identities, we conducted logistic regressions. A path analysis examined relationships between COVID-related events, COVID-19 worry, and psychological distress for men and women. RESULTS: Student-athletes' exposure to COVID-19 events differed significantly by gender, race, and ethnicity. In addition, 58.7% of women's and 54.5% of men's psychological distress variance was explained by the path model and mostly by their COVID-related worry. Student-athletes' stress was directly related to the changes that occurred in class delivery (i.e., online format) and indirectly by being quarantined. Men's psychological distress was also related through worry by their sport season being canceled. DISCUSSION: The general uncertainty and worry about COVID individuals experienced at the beginning of this pandemic primarily explained the athletes' high levels of psychological distress. As COVID-19 continues to cause quarantines and changes educational experiences, the worry and psychological distress of college students are likely to continue.

Selective Optimization and Compensation, Skilled Golf Performance, and Age.

The present study tests predictions regarding skilled golf performance and age-based upon Selection, Optimization, and Compensation (SOC) theory. Participants were 1,324 adults (17-85 years old) who competed in a three-day major amateur golf tournament. Findings indicated that older golfers were most likely to identify difficulties in their games worthy of remediation, relied on performance-enhancing equipment to the greatest degree, and scored higher on SOC selection. For such players, SOC selection and remaining competitive predicted better tournament performance. Older players were also less likely to rate a variety of game improvement techniques as effective, less likely to engage in preround preparation, and were less likely than younger players to engage in SOC optimization and compensation strategies. This pattern of findings to a large extent also characterized middle-aged players. Despite a mixed picture of support for SOC theory, these findings provide valuable insights into its application to aging and the competitive sport domain.

Eating disorder diagnosis and the female athlete: A longitudinal analysis from college sport to retirement.

OBJECTIVES: Female athletes experience eating disorders (EDs) at clinical, and subclinical, levels; most studies have determined point-prevalence rates through cross-sectional methodologies. To date, few studies have examined the long-term stability of EDs in female athletes; none extend into retirement. DESIGN: A longitudinal investigation of ED classification (i.e., Clinical ED, Subclinical ED, Healthy) and weight control behaviors (e.g., vomiting, laxative use) from when athletes actively competed (T1) into their retirement (T2). METHODS: Participants included U.S. female athletes (N=193) who were collegiate competitors (T1) and eventually were retired from their collegiate sports six years later (T2). RESULTS: At T2, athletes were classified as Healthy (69.9%), Subclinical ED (26.9%), and Clinical ED (3.1%). Overall percentage of Subclinical EDs increased from 18.7% (T1) to 26.9% (T2); 52.8% of T1 Subclinical ED athletes continued to meet criteria for either Subclinical or Clinical ED at T2. Of the 13 Clinical ED athletes at T1, six (46.2%) continued to meet criteria for either a subclinical or clinical ED at T2. Though exercising (2+ hours/day; n=8, 4.1%) and dieting/fasting (4+ times/year; n=14, 7.3%) were the most frequently used weight control behaviors at T2, rates were substantially lower than at T1. CONCLUSIONS: Retirement does not result in immediate remittance of eating concerns among female athletes; many continue or develop Subclinical and Clinical ED symptoms. Thus, addressing healthy body image and nutrition when athletes are competing is imperative to assist prevention and intervention efforts that may alleviate ED symptoms as athletes transition from sport.

Psychosocial predictors of eating classification in female athletes: From collegiate sport to retirement.

OBJECTIVE: Due to high prevalence, female athletes are considered a high-risk group for eating disorders (i.e., clinical ED = 2.0% to 19.9%; subclinical ED = 7.1% to 49.2%). Cross-sectional and longitudinal research have identified psychosocial factors that influence current and future disordered eating (e.g., appearance pressures, body satisfaction), but are limited in design (e.g., timeframe, active competitors). Quantitative evaluations of psychosocial predictors of female athletes' disordered eating in retirement are lacking. METHOD: The current study investigated the predictive ability of psychosocial risk factors (e.g., body dissatisfaction, negative affect) from Time1, when collegiate female athletes were actively competing, to Time2, 6 years later when the women were retired (N = 194; Mage = 25.75 years [SD = 1.19]). RESULTS: From Time1 to Time2, 23.5% of the women who were Healthy moved to the Disordered classification; 51% remained in Disordered. The full model for athletes who maintained their Disordered status correctly classified 76% of the athletes. Dietary intent, pressure to exercise and change appearance, body satisfaction, and internalization significantly predicted athletes' maintenance as Disordered. DISCUSSION: Early intervention efforts that address appearance pressures, body image, and healthful eating when athletes are actively competing are vital to help alleviate future distress, particularly in retirement.

Insomnia, Psychosocial Well-Being, and Weight Control Behaviors Among Healthy-Weight Adolescent Females: Brief Report.

BACKGROUND: Weight control behaviors (WCBs) typically involve appearance- or health-driven behaviors that may be influenced by physiological, psychological, or social factors. Sleep disturbances like insomnia are an important area of research for adolescent populations, as early intervention may result in improvements in other physical and mental health domains. The purpose of this study was to investigate the relationship of insomnia, psychosocial well-being, and current WCBs in healthy-weight female adolescents. METHOD: Female adolescents (N = 323; Mage = 12.33 ± .04) who had healthy body mass index (BMI) levels completed self-report items on insomnia, depression, self-esteem, and physical self-concept. Multivariate analysis of covariance (MANCOVA), controlling for age, was conducted to further examine differences in insomnia and psychosocial variables among the WCB groups. RESULTS: Compared to those who were trying to stay the same weight or not trying to do anything about their weight, the girls who were trying to lose weight had significantly greater insomnia and depression symptoms, and lower self-esteem, with small to medium effect sizes. CONCLUSIONS: Clinicians working with adolescent girls should include assessments of WCBs in addition to measures of insomnia symptoms, even for adolescent girls within a normal BMI range, as these are common and frequently co-occurring phenomena. Additional research is needed to further disentangle these complicated relationships.

Female Athletes in Retirement: A Test of a Psychosocial Model of Bulimic Symptomatology.

Although researchers have examined eating disorders in female athletes, few such studies have been done with athletes who are retired, and even fewer have been quantitative. Thus, the authors empirically tested an established eating disorder theoretical model with 218 former NCAA Division-I female collegiate athletes who had been retired for 2-6 years. In retirement, participants completed measures of general sociocultural pressures related to body and appearance, thin-ideal internalization, body dissatisfaction, dietary restraint, negative affect, and bulimic symptomatology. Through structural equation modeling, the authors examined the direct and indirect relationships among the latent variables while controlling for body mass index and years since retirement. The model fit the data well, supporting the hypothesized direct and indirect relationships among the variables and explaining 54% of the variance in bulimic symptomatology. Despite no longer being exposed to sport pressures that contribute to eating disorders, female athletes experience such symptoms long into retirement.

The frequency of weigh-ins, weight intentionality and management, and eating among male collegiate athletes.

Sociocultural pressures in male athletics emphasize masculinity in the form of muscularity, leanness, and physical strength. Although research has examined extensively weight, weigh-ins, and weight pressures among female athletes, these issues have been minimally considered with male athletes. Thus, our purpose was to examine the weight environment and practices of NCAA (i.e., Divisions I, II, III) collegiate male athletes from 19 different sports (e.g., basketball, cross country, golf, tennis, wrestling). Specifically, we surveyed 698 male athletes regarding frequency and circumstances of team weigh-ins, weight management behaviors, weight intentions, caloric intake, and guidance received for healthfully managing weight and eating. Overall, relatively few male athletes reported undergoing mandatory team weigh-ins (21.8%). However, within this subgroup required to engage in them, most weigh-ins occurred at least once per week or more (59.2%), and most athletes' weights were made public (75.7%). Just over 30% of the weighed athletes used at least one strategy to prepare for weigh-ins, primarily relying on exercise or caloric restriction. The majority (85.2%) wanted to change their weight, primarily by gaining muscle mass. Most athletes received guidance from qualified sources (e.g., athletic trainer) regarding healthy weight management (63.5%) and nutrition (70.2%). Overall, few male athletes are subjected to mandatory weigh-ins, and such participation is not related to pathological weight control behaviors. Further, male athletes appear to have access to qualified sources for information on healthful management of weight and eating, which may help them as they pursue their goals of increased muscularity and strength.

Bodies in Motion: An empirical evaluation of a program to support positive body image in female collegiate athletes.

Female athletes are at risk for eating disorders due to the experience and internalization of pressures regarding various aspects of their bodies, including weight and appearance. Evaluating programs that address psychosocial antecedents and may reduce female athletes' risk is critical. We examined Bodies in Motion, a program based on cognitive dissonance and mindful self-compassion principles that integrates components of social media. Female athletes across nine NCAA athletic departments were assigned to Bodies in Motion (n = 57) or a wait-list control group (n = 40). Athletic department personnel were trained in the standardized program. Data were collected at three time-points - baseline, post-program, and three to four months later. Using Holm's algorithm to control for multiple comparisons, repeated measures ANOVAs showed that, after program completion, Bodies in Motion athletes reported less thin-ideal internalization, as compared to the control athletes, over time. We also observed varying group trajectories in outcome responses upon visual inspection of profile plots. These findings serve as the basis for future research suggestions involving larger sample sizes and prolonged measurement of outcomes.

Bulimic Symptomatology Among Male Collegiate Athletes: A Test of an Etiological Model.

We tested Petrie and Greenleaf's psychosocial model in relation to male athletes' bulimic symptomatology. Through structural equation modeling, we cross-sectionally examined the direct and indirect effects of general and sport-specific appearance pressures, internalization, body satisfaction, drive for muscularity, negative affect, and dietary restraint on bulimic symptomatology. Participants were U.S. male collegiate athletes (N = 698; Mage = 19.87 years) representing 17 sports. With minor respecifications, the model had acceptable fit, and the psychosocial variables explained 48% of the bulimic symptomatology variance. Although all variable paths were significant, sport pressures, such as from coaches and teammates about weight, importance of appearance, and looking good in a uniform, were the most salient latent variable. Athletes' engagement in muscle-building behaviors added uniquely and substantively as well. Our analysis begins to clarify the complex interactions among these psychosocial variables in understanding male athletes' bulimic symptomatology and provides a base from which to develop prevention programming.

Better Health-Related Fitness in Youth: Implications for Public Health Guidelines.

Public health guidelines for physical activity (PA) behaviors are being updated with 2018 as a proposed release date. Currently, ≥60 minutes of daily PA are recommended for youth. Thus, the purpose of this study was to investigate the association between reported days of aerobic PA and health-related fitness (HRF). Participants included 4448 students in grades 6-8. Self-reported days of ≥60 minutes of aerobic PA was obtained. HRF was assessed with FitnessGram. Discriminant analysis indicated that weekly days of aerobic PA related to HRF. Adolescents who participated in ≥5 days of weekly aerobic PA generally had better fitness results than those with ≤4 days. Chi-square analyses indicated the highest percentages of adolescents in the FitnessGram Healthy Fitness Zone™ (HFZ) for each test item were those with ≥5 days of aerobic PA. These findings provided initial support that the impact of aerobic PA on HRF plateaus at 5 days per week. Thus, adolescents may be able to improve HRF even if they do not meet the currently recommended guidelines for daily PA.

Eating disorders and weight control behaviors change over a collegiate sport season.

OBJECTIVES: Determine whether the prevalence of eating disorder classifications (i.e., clinical eating disorder, subclinical eating disorder, and asymptomatic) and pathogenic weight control behaviors (e.g., bingeing, vomiting) change over a five-month sport season. DESIGN: Longitudinal study. METHODS: Female collegiate gymnasts and swimmers (N=325) completed the Questionnaire for Eating Disorder Diagnoses as well as six items from the Bulimia Test-Revised at Time 1 (two weeks into the beginning of their athletic season) and Time 2 (final two weeks of the athletic season); data collections were separated by five months. RESULTS: Over the course of the season, 90% of the athletes (18 out of 20) retained a clinical eating disorder diagnosis or moved to the subclinical classification. Of the 83 subclinical athletes at Time 1, 37.3% persisted with that classification and 10.8% developed a clinical eating disorder; the remainder became asymptomatic/healthy eaters by Time 2. The majority of Time 1 asymptomatic athletes (92.3%) remained so at Time 2. Exercise and dieting/fasting were the most frequent forms of weight control behaviors, though each was used less frequently at Time 2 (exercise=35.4%; dieting=9.2%) than at Time 1 (exercise=42.5%; dieting=12.3%). CONCLUSIONS: Eating disorder classifications, particularly clinical and subclinical, remain stable across a competitive season, supporting the need for early detection and purposeful intervention. Athletes engage in weight control behaviors that may be reinforced in the sport environment (e.g., supplemental exercise), making identification more challenging for sports medicine professionals.

Love me Tinder: Body image and psychosocial functioning among men and women.

Based on objectification theory, we examined the main effects of Tinder use, and its interaction with gender, in relation to men's and women's body image concerns, internalization processes, and self-esteem. Tinder users (men=31; women=69) and non-users (men=203; women=844) anonymously completed measures via an online survey. Through a series of ANCOVAs, with BMI and age as covariates, Tinder users, regardless of gender, reported significantly lower levels of satisfaction with face and body and higher levels of internalization, appearance comparisons, and body shame and surveillance than non-users. For self-esteem, male Tinder users scored significantly lower than either male or female non-users. Our results suggest that Tinder represents a contemporary medium for appearance pressures and its use is associated with a variety of negative perceptions about body and self and with increases in individuals' likelihood to internalize appearance ideals and make comparisons to others.