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Socioecological Perspectives Toward Mental Health Symptoms and Disorders in Sport

This is an excerpt from Social Psychology in Sport-2nd Edition by Louise Davis,Richard Keegan & Sophia Jowett.

By Paul Gorczynski, PhD; Cindy Miller Aron, LCSW; and Claudia L. Reardon, MD

Socioecological models (e.g., McLaren & Hawe, 2005; McLeroy et al., 1988; Sallis et al., 2006) help individuals better understand the multiple factors that influence their health. Born out of ecological systems theory (Bronfenbrenner, 1979), such models recognize the importance of broader social factors (e.g., ethnicity, class, environment) that have an influence on the individual with respect to their health (Bronfenbrenner, 1979; Golden & Earp, 2012). In a sense, the individual exists within, and is inextricable from, a wider social system—able to access numerous behavioral settings and interact with other individuals, organizations, and communities, all the while influenced by political forces, attitudes, and cultural practices that change with time (Bronfenbrenner, 1979). For instance, professional athletes need to traverse between their homes, hotels, and training and competitive facilities, while interacting with friends, partners, families, coaches, support staff, trainers, and other health professionals. Some professional athletes also need to consider other environments, such as school or other occupational settings, and additional individuals such as teachers or professors and employers. These professional athletes will be guided by local, regional, national, and international organizations and bodies that oversee their respective sports, bound by various geographic districts and countries, each with their own unique laws.

The nature of sport changes constantly, requiring individuals to be mindful of how attitudes, values, beliefs, and formal and informal rules shift with time. Here, think of how perspectives have shifted and changed in sport with respect to gender identity, race, ethnicity, and (dis)ability. Although there has been progress with greater inclusivity and diversity in sport, other cultural practices of exclusion still persist (e.g., disclosure of sexuality of athletes). Such socioecological models force us to explore a variety of factors with respect to the etiology of mental health symptoms and disorders (Dick, 2011; Uher & Zwicker, 2017). Such models also recognize the diverse and multiple roles individuals have in life. As Schinke and Stambulova (2017, p. 73) note, it is important to consider the context when examining individuals in sport, “given that people are influential and influenced products in their environments.” For athletes, coaches, and referees, the holistic life span perspective acknowledges the whole person, not just the individual role one occupies in a particular sport setting (Stambulova & Wylleman, 2014; Wylleman et al., 2013).

Research has shown that the following individual-level factors have an influence on mental health symptoms and disorders in elite athletes (for a review, see Castaldelli-Maia et al., 2019; Küttel & Larsen, 2019; Reardon et al., 2019):

  • Family history
  • Female sex
  • Personality
  • Competitive anxiety
  • Health status
  • Severity of injury
  • Surgery
  • Adverse life events
  • Career satisfaction

From an environmental perspective, the following factors have an impact on an athlete’s mental health (Castaldelli-Maia et al., 2019; Küttel & Larsen, 2019; Reardon et al., 2019):

  • Sporting pressure
  • Sporting type (i.e., individual, aesthetic)
  • Poor team dynamics
  • Player status and deselection
  • Retirement uncertainty
  • Nonaccidental violence (i.e., harm arising from harassment and abuse)

Regarding the latter, Mountjoy and colleagues (2016) illustrated the effects of nonaccidental violence, be it psychological, physical, sexual, or through neglect. Specifically, situated in a competitive sporting culture, nonaccidental violence exploits power differentials between individuals based on sex, gender identity, race, ethnicity, sexuality, indigeneity, (dis)ability, age, athletic ability, athletic longevity, organizational status, faith, and class. Nonaccidental violence delivered through contact, noncontact, social media, negligence, bullying, or hazing has consequences on the athlete and the organization. For the athlete, this may result in physical, cognitive, behavioral, emotional, relational, and economic consequences. For instance, an exploration of the USA Gymnastics program described the consequences associated with years of systemic sexual exploitation on the lives of thousands of girls and women and their families (Fasting et al., 2002; Fisher & Anders, 2020; Freeman, 2018). As noted by Mountjoy and colleagues (2016), none of these factors—be they individual or environmental—occurs in isolation, and sometimes the cumulative and compounded effect of multiple factors acting on the individual can result in mental health symptoms and disorders.

Of course, individual and environmental factors not only influence mental health symptoms and disorders but also have an impact on how individuals understand and perceive their mental health, as well as how they seek support (Castaldelli-Maia et al., 2019). Coyle and colleagues (2017) found that elite athletes have a poor understanding of mental health symptoms and disorders, have negative attitudes toward mental health symptoms and disorders, and are generally not able to articulate how to seek support. Furthermore, their research has illustrated that elite athletes have a sense of hesitancy with respect to disclosing mental health symptoms and disorders and a lack of trust in their coaches and sport psychology consultants for fear that any admission of mental health symptoms and disorders would result in deselection from their team. Such perspectives are not unique to athletes; they have recently been captured for football referees in the United Kingdom (Webb et al., 2021). Other factors associated with poor help-seeking behaviors include public and self-stigma, low mental health literacy, negative past experiences with respect to pharmacological and psychological interventions, busy schedules, and hypermasculinity (Castaldelli-Maia et al., 2019).

One mental health promotion strategy aimed at addressing both the causes of mental health symptoms and disorders and helping individuals in sport seek support is mental health literacy (Gorczynski et al., 2021). As noted by Castaldelli-Maia and colleagues (2019) and Küttel and Larsen (2019), strategies rooted in mental health literacy help address low knowledge of mental health symptoms and disorders, public and self-stigma, and access to mental health support. Mental health literacy strategies can help identify positive, supportive, and trusting relationships, within teams and organizations. They can identify where individuals can go for support. They can also be used to clarify individual, team, and organizational needs, values, beliefs, and goals, and how mental health should be taken into account. Such strategies also acknowledge the important roles of coaches in supporting athletes with mental health support. Mental health literacy strategies can also benefit other individuals involved in sport, such as support staff and referees. Overall, mental health literacy can help establish a framework for early intervention that is responsive to the needs of not only athletes but also other individuals in sport (Purcell et al., 2019; Sebbens et al., 2016). As noted by Kutcher and colleagues (2016), mental health literacy represents the foundation of mental health promotion, the prevention of mental health symptoms and disorders, treatment, and support through recovery (Kutcher & Wei, 2020). It should also be noted that such programs are in their infancy and are undergoing development to address the diverse needs of individuals involved in sport.

More Excerpts From Social Psychology in Sport 2nd Edition