HIGH SCHOOL ATHLETIC PARTICIPATION AND ADOLESCENT SUICIDE: A Nationwide US Study

Assessing the Role of Sports Participation on Depression, Suicide Ideation, and Suicide Behaviors Among Adolescents Before and During COVID-19

PURPOSE

To assess the association between sports participation, depression, suicide ideation, and suicide behaviors in a nationally representative sample of US adolescents before COVID-19 and during COVID-19.

METHODS

Data from the 2019 Youth Risk Behavior Survey (n = 13,526) and the 2021 Adolescent Behaviors and Experiences Survey (n = 7677) were used to analyze the association between past-year depression/suicide ideation/suicide behaviors and past-year sports participation.

RESULTS

The analysis found that 57.4% of adolescents indicated participating in at least 1 sport in 2019; this dropped to 47.7% in 2021. Furthermore, 36.7% of adolescents indicated feeling sad or hopeless almost every day for 2 weeks or more in a row in 2019; this increased to 44.2% in 2021. The percentage of adolescents who indicated considering suicide, making a suicide plan, attempting suicide, and attempted suicide that lead to an injury was similar during 2019 and 2021. Multivariable analysis found that participation in 2 or more sports in 2019 was associated with lower odds of each of the outcomes for depression, suicide ideation, and suicide behaviors, whereas in 2021, participation in 2 or more sports was only associated with lower odds of indicating being sad or hopeless (an indicator for depression) for a 2-week period (adjusted odds ratios = 0.70; 95% confidence interval, 0.58-0.85).

CONCLUSIONS

Participation in 2 or more sports lowered the risk of feeling sad or hopeless, suicide ideation, and suicide behaviors in 2019, but this effect was absent in 2021. Given the presence of multiple stressors during the COVID-19 pandemic, sports participation alone may not offer sufficient protective effects against suicide behaviors as it did pre pandemic.

The Mediating Effect of Stress between Extracurricular Activities and Suicidal Ideation in Chinese College Students

OBJECTIVE

The objective of this study was to explore the relationship between extracurricular activities, stress, and suicidal ideation and to examine the mediating effect of stress between extracurricular activities and suicidal ideation in Chinese college students.

METHOD

A total of 6446 college students were surveyed with a web-based online data collection system using the self-made demographic questionnaire, Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the 21-Item Depression Anxiety Stress Scales (DASS-21). SPSS 24.0 was used for descriptive statistics and correlation analysis, and the bootstrap method in the process procedure for SPSS Version 3.4.1 was used to construct the mediating effect model.

RESULTS

Gender, school grades, living area, and family income status were influencing factors for suicidal ideation, stress, and extracurricular activities. Extracurricular activities were negatively correlated with stress (r = -0.083, p < 0.001) and suicidal ideation (r = -0.039, p < 0.01). Extracurricular activities had no direct predictive effect on college students' suicidal ideation (c = -0.198, CI: -0.418, 0.023), while stress had a mediating effect between extracurricular activities and suicidal ideation; the indirect mediating effect was 0.159.

CONCLUSIONS

Extracurricular activities indirectly predict college students' suicidal ideation through stress. A variety of extracurricular activities can decrease the stress and suicidal ideation of college students and benefit their mental health.

Perceived cognitive impairment in high school students in the United States

Introduction

Some youth experience cognitive difficulties that interfere with their ability to learn and function well in a school environment. We examined correlates of perceived cognitive impairment among high school students who completed a national survey conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019.

Methods

Participants were high school students (grades 9–12) who completed the Youth Risk Behavior Survey (YRBS) in 2019. The CDC uses this survey to monitor risk behaviors. Students answered the following question ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ as either ‘yes’ or ‘no.’ Student responses to this question were analyzed in relation to demographic variables and variables pertaining to adversity, mental health problems, and drug use.

Results

The sample included 8,349 students between the ages of 14 and 18, with 4,093 boys (49%) and 4,256 girls (51%). A large proportion reported having serious difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional problems (38%). A significantly larger proportion of girls (45%) than boys (30%) reported experiencing cognitive impairment [χ²(1) = 212.23, p < 0.001; Odds Ratio = 1.95, 95% confidence interval = 1.78–2.13]. Youth who exercised regularly were significantly less likely to report cognitive impairment. Binary logistic regression was used to examine the associations between perceived cognitive impairment and adversity, mental health, and lifestyle variables separately for boys [χ²(11) = 569.158, p < 0.001; Nagelkerke R² = 0.212] and girls [χ²(11) = 1,026.189, p < 0.001; Nagelkerke R² = 0.321]. Being bullied, feeling unsafe or threatened at school, getting very low grades, insufficient sleep, and using illicit drugs were independently associated with perceived cognitive impairment in both boys and girls—after controlling for associations with depression and suicidality. Youth who denied mental health problems, psychosocial adversities, and using illicit drugs reported much lower rates of perceived cognitive impairment (boys = 13%, girls = 15%).

Conclusion

A remarkably large proportion of high school students in the United States reported experiencing serious difficulty with their cognitive functioning over the past year. Girls were significantly more likely to endorse perceived cognitive difficulties compared to boys. There was a strong association between perceived cognitive impairment and the experience of psychosocial adversity.

Examining the Provision of School-Based Athletics in Public High Schools Among Girls in the United States

BACKGROUND

In order to better understand some of the barriers to athletic opportunities for girls, we examined school-level characteristics to assess how they are associated with both the provision and participation in athletic opportunities for girls across US public high schools.

METHODS

Cross-sectional data for this study comes from the bi-annual Civil Rights Data Collection which collects school-level information for all US public schools between the 2009-2010 through 2017-2018 school years.

RESULTS

Several important school-level characteristics were found to limit the provision of athletic opportunities, participation rates and athletic participation gender equity ratios for girls and included the percent of the student body who were eligible for free lunch and who were racial minorities. Moreover, the analysis found that greater provision of athletic opportunities for boys was associated with lower athletic participation gender equity ratios across US public high schools (ie, lower participation for girls when compared to boys).

CONCLUSIONS

This study provides evidence that schools with fewer resources and a higher proportion of disadvantaged students tend to have the fewest opportunities to participate in school-based athletics, particularly among girls. Moreover, girls' participation rates in athletics still lag behind boys despite having similar numbers of sports and sport teams.

Association Between Concussions and Suicidality in High School Students in the United States

Importance

Prior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality.

Objective

To examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables.

Design

This study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender.

Setting

A national sampling of U.S. high school students.

Participants

Eleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls.

Exposure(s)

Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality.

Main Outcomes and Measures

The main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis.

Results

The final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)].

Conclusions and Relevance

There was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.

Cardiorespiratory Fitness and Health-Related Quality of Life in Secondary School Children Aged 14 to 18 Years: A Cross-Sectional Study

The main aim of this study is to examine age and gender differences in cardiorespiratory fitness (CRF) among Serbian secondary school children. The secondary aim is to explore the association between CRF and quality of life in Serbian adolescents. The sample consisted of 579 adolescents (285 males), aged from 14 to 18 years old. To evaluate their anthropometric measurements, body height and body weight were examined, the 20 m shuttle run test was used to access CRF, and the standardized global measure of wellbeing KIDSCREEN was used to access the wellbeing of adolescents. The results show that the boys possessed higher CRF compared to the girls, as well as higher scores on variable distance, but there were no significant differences according to age. CRF was positively associated with physical wellbeing, psychological wellbeing, total score HRQL, body height and body weight, and negatively correlated with BMI. Conversely, physical wellbeing showed positive correlation with the other subscales of KIDSCREEN (psychological wellbeing, autonomy and parents, peers and social support, and school environment), and total score of (Health–Related Quality of Life) HRQL. The results showed that better CRF would be beneficial for quality of life among Serbian adolescents, especially among girls. Moreover, the relationship between CRF and BMI shows that adolescents with regular values of BMI have better physical fitness and wellbeing.

Parental education and youth suicidal behaviours: a systematic review and meta-analysis

AIMS

Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations.

METHODS

We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0-18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity.

RESULTS

We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04-1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98-1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10-1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54-0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05-1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77-1.08).

CONCLUSIONS

The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.

The long-run effects of adolescent athletic participation on women's health

Increased athletic opportunities have been shown to improve educational and labor force outcomes, however few studies have linked athletic participation to health later in life. We use the implementation of Title IX, legislation banning gender discrimination in educational programs in the U.S., to estimate the effect of increased access to high school athletic opportunities on women's later life health. Our results indicate that increased participation leads to fewer days in poor mental health, reduced BMI and rates of obesity, lower smoking rates, and some evidence of a reduced likelihood of a diabetes diagnosis. However, we find no impact of high school athletic participation on the number of days in poor physical health and current exercise, and a positive relationship between participation and alcohol consumption.

Psychological Resilience in Young Female Athletes

Psychological resilience is an important construct that can enhance athletic performance and foster valuable life skills. Through positive adaptation to adversity and stressors in the athletic arena, athletes are able to cultivate their ability to effectively respond to negative stimuli, ultimately evolving to personal growth. For young female athletes, development of resilience may be particularly important. Young female athletes face distinct challenges in sport including sport inequity, body image issues, eating disorders, increased mental distress, and internalization of emotions. The aim of this review is to define and describe the construct of resilience and discuss the implications and applications relevant to young female athletes. By understanding how to foster resilience strategies in this population, we can enhance sport performance and enjoyment, as well as bolster valuable life skills that facilitate personal growth.

Validation of the ask suicide-screening questions (ASQ) with youth in outpatient specialty and primary care clinics

OBJECTIVE

Validate the Ask Suicide-Screening Questions (ASQ) with youth in outpatient specialty and primary care clinics.

METHOD

This is a cross sectional instrument validation study assessing the validity of the ASQ with respect to the standard criterion, Suicidal Ideation Questionnaire (SIQ/SIQ Jr.). The sample included 515 English speaking youth ages 10-21 years old from outpatient specialty and primary care clinics. ASQ sensitivity, specificity, positive and negative predictive values (PPV/NPV), positive and negative likelihood ratios, c statistic and respective receiver operating characteristic curves were assessed.

RESULTS

A total of 335 outpatient specialty and 180 primary care clinic participants completed the study. In outpatient specialty clinics, the ASQ showed a sensitivity of 100.0% (95% CI: 80.5-100.0%), specificity of 91.2% (95% CI: 87.5-94.1%), and NPV of 100.0% (95% CI: 98.7-100.0). In the primary care clinic, the ASQ showed a sensitivity of 100.0% (95% CI: 59.0-100.0%), specificity of 87.9% (95% CI: 82.0-92.3%), and NPV of 100.0% (95% CI: 97.7-100.0). Forty-five (13.4%) outpatient specialty clinic participants and 28 (15.6%) primary care clinic participants screened positive for suicide risk on the ASQ.

CONCLUSIONS

The ASQ is a valid screening tool for identifying youth at elevated suicide risk in outpatient clinical settings.

Nonsuicidal self-injury, suicidal ideation, and suicide attempt among collegiate athletes: Findings from the National College Health Assessment

To evaluate whether collegiate athletes and nonathlete college students differ in nonsuicidal self-injury (NSSI), suicidal ideation, suicide attempt, and help-seeking behaviors. Participants: 165,210 respondents to the American College Health Association's National College Health Assessment (NCHA), a survey administered to college students by participating institutions during Fall 2011 to Spring 2015. Methods: Single-level binary logistic regression with equality of coefficients tests and chi-square analyses. Results: The models for NSSI and suicide attempt differed slightly between student-athletes and nonathletes. Most notably, stress is a stronger correlate of NSSI (Z = 3.03, p < .01) for nonathletes while difficulties with social relationships is a stronger correlate of suicide attempt for student-athletes (Z=-3.13, p < .01). Conclusion: Our findings highlight the salience of relationship problems as a correlate with suicide attempts in student-athletes. Difficulty in romantic or other social relationships could be a marker of risk or an identifiable, actionable target for preventing future suicidal behaviors among collegiate athletes.

Positive mental health mediates the relationship between physical activity and suicide-related outcomes: a three-year follow-up study

Suicide belongs to the leading causes of death worldwide. The present longitudinal study investigated physical activity (for example jogging, cycling) and positive mental health (PMH) as potential factors that can reduce the risk of suicide ideation and suicidal behavior. Data of 223 participants (79.4% women; Mage(SDage) = 22.85 (4.05)) were assessed at two measurement time points over a three-year period (2016: first measurement = baseline (BL); 2019: second measurement = follow-up (FU)) via online surveys. The results reveal a significant positive relationship between higher physical activity (BL) and higher PMH (BL). Higher scores of both variables were significantly negatively linked to lower suicide-related outcomes (FU). Moreover, the association between higher physical activity (BL) and lower suicide-related outcomes (FU) was significantly mediated by higher PMH (BL). The current findings demonstrate that physical activity in combination with PMH can reduce the risk of suicide-related outcomes. Fostering physical activity and PMH may be relevant strategies in the prevention of suicide ideation and suicide behavior.

Mental Health in the Young Athlete

PURPOSE OF REVIEW

The goal of the present paper is to provide a comprehensive overview of mental health concerns in young athletes, with a focus on common disorders, as well as population-specific risk factors.

RECENT FINDINGS

Athletes experience similar mental health concerns as non-athlete peers, such as anxiety, depression and suicidal ideation, ADHD, eating disorders, and substance abuse. However, they also experience unique stressors that put them at risk for the development or exacerbation of mental health disorders. Student athletes have to balance academics with rigorous training regimens while focusing on optimal performance and managing high expectations. Physical injuries, overtraining, concussion, sleep disorders, and social identity are some of the factors that also impact the mental health of student athletes. Existing literature highlights the need to develop proactive mental health and wellness education for young athletes, and to develop services that recognize the unique needs of this population.

Organized Sports for Children, Preadolescents, and Adolescents

Interest and participation in organized sports for children, preadolescents, and adolescents continue to grow. Because of increased participation, and younger entry age, in organized sports, appropriate practice, game schedules, and content become more important, taking into account athlete developmental stage and skills. Parental support for organized sports in general, with focus on development and fun instead of winning, has emerged as a key factor in the athlete's enjoyment of sports. Schools and community sports organizations who support multiple levels of sport (eg, recreational, competitive, elite) can include more youth who want to play sports and combat sport dropout. This report reviews the benefits and risks of organized sports as well as the roles of schools, community organizations, parents, and coaches in organized sports. It is designed to complement the American Academy of Pediatrics clinical reports "Physical Activity Assessment and Counseling in Pediatric Clinical Settings" and "Sports Specialization and Intensive Training in Young Athletes" by reviewing relevant literature on healthy organized sports for youth and providing guidance on organized sport readiness and entry. The report also provides guidance for pediatricians on counseling parents and advocating for healthy organized sports participation.

Depression and suicidal ideation in high-performance athletes suffering from low back pain: The role of stress and pain-related thought suppression

BACKGROUND

Depression and suicidal ideation are important health problems in athletes suffering from pain. Dysfunctional pain cognitions, that is, pain-related thought suppression (PTS), may play an important role in their aetiology. Thought suppression was shown to increase depressive mood, particularly in highly stressed individuals. This cross-sectional study examines the relationship between PTS and stress on depression and suicidal ideation in athletes with pain.

METHODS

A total of 159 athletes with non-specific low back pain completed a set of questionnaires to measure PTS, depression and stress. Participants were split into groups with high and low stress, and high and low PTS. Two-way ANOVA calculated main effects for PTS, stress and a PTS*stress interaction, with depressive symptoms as dependent. Subsequently, distribution tests were calculated, investigating if the presence of clinically relevant depression and suicidal ideation is dependent of conditions of high/low PTS and stress.

RESULTS

A main effect of stress demonstrated higher depression scores in highly stressed athletes. Further, a significant PTS*stress interaction showed elevated depression scores in athletes with high PTS and high stress. Distribution analysis revealed positive associations between PTS, stress and depression, with depression being most frequent among athletes with high PTS and high stress. Suicidal ideation was not significantly associated with PTS and only weakly correlated with stress.

CONCLUSIONS

Our findings show that PTS is the most common pain response in athletes with pain. The results indicate a higher prevalence of depression and elevated depressive symptoms in athletes experiencing high stress, seemingly more pronounced when highly engaging in PTS.

SIGNIFICANCE

This study contributes to the understanding of depression in athletes with pain, suggesting stress and pain-related thought suppression to increase symptoms and prevalence of depression. As athletes often experience acute or chronic pain, understanding the impact of pain cognitions on health outcomes is an important step in the optimization of treatments.

Exercise participation and shared decision-making in patients with inherited channelopathies and cardiomyopathies

Sports eligibility and disqualification of patients with cardiac diseases are important considerations for adult and pediatric cardiologists. The 2005 guidelines that addressed this issue have recently been revised and updated, and the new guidelines advocate for a shared decision-making approach in which the well-informed athlete and family participate in the discussion. In this review, we focus on the benefits of sports participation and review the revised guidelines related to sports participation in patients with channelopathies and cardiomyopathies.

Extracurricular Activities are Associated with Lower Suicidality through Decreased Thwarted Belongingness in Young Adults

Research has shown a negative association between extracurricular activities (ECAs) and suicidality. This study builds upon past research by using the interpersonal psychological theory of suicide to better understand the mechanisms involved in the relationship between ECAs and suicide risk. A total of 121 community and online-recruited adults ages 18 to 24-years-old participated. Self-report measures of suicidality, thwarted belongingness, and perceived burdensomeness were collected. Duration and breadth of participation in ECAs were assessed. ECA involvement was negatively associated with thwarted belongingness and perceived burdensomeness. An indirect effect of ECAs on suicidality through thwarted belongingness was statistically significant, but not for perceived burdensomeness. ECA involvement was associated with decreased suicidality through lower levels of thwarted belongingness. Interventions utilizing ECAs may be a low-cost, high-access option for decreasing suicide risk.

Sports-related concussions - media, science and policy

Although growing awareness about the potential long-term deleterious effects of sport-related concussion has led to increased attention to the risks of collision sports, calls to ban these sports, such as American football, might be premature. Collision sports have a relatively high incidence of concussions, but participation in these sports also confers a host of benefits. In addition, the associated risks of participation, including concussion, have not been definitively shown to outweigh the benefits they provide, and the risk-benefit ratio might vary among individuals. The risks of concussion and repetitive concussions associated with collision sports are unknown in the general population and not well characterized even in elite athlete populations. In this article, we discuss current knowledge on sports-related concussion, its neurological consequences, and implications for regulation of the practice of collision sports.

"When it's just me at home, it hits me that I'm completely alone": an online survey of adolescents in self-care

The present study examined adolescents' experiences of loneliness and solitude in their responses to an online survey on self-care. Both quantitative (n = 272) and qualitative (n = 150) responses were coded for these feelings when home alone. Results indicate that adolescents experience the duality of aloneness, including both positive solitude and negative loneliness. Adolescents' responses range from embraced solitude and self-care to feelings of loneliness and rejection of time by themselves. Adolescents reporting loneliness were significantly less likely to enjoy being home alone during the day and at night (p < or = .001). Also, gender, age, and emotions such as fear, boredom, and separation anxiety are associated with loneliness among adolescents in self-care. Interventions to increase connectedness and combat loneliness during out-of-school hours are recommended.

Relationships between physical activity and depressive symptoms among middle and older adolescents: a review of the research literature

PURPOSE

The purpose of the review was to describe current knowledge regarding relationships between physical activity (PA) and depressive symptoms among adolescents.

CONCLUSIONS

Inverse relationships were found between PA, particularly sports participation, and depressive symptoms. Limitations of the current research are discussed, including measurement issues. A major gap exists regarding research with youth at high risk for depressive symptoms and low levels of PA, including older, low-income, minority females. Future research should focus on high-risk populations such as youth attending alternative high schools.

PRACTICE IMPLICATIONS

Nurses should consider promoting PA among middle and older adolescents as a way to prevent depressive symptoms and consider integrating PA into care plans for those experiencing depressive symptoms.

Sport participation during adolescence and suicide ideation and attempts

BACKGROUND

Most research regarding sport participation and suicide risk found protective relationships. However, all studies in this area were based on cross-sectional designs.

OBJECTIVE

To fill a gap in research by exploring associations between sport involvement and suicide ideation and attempts (suicidality) based on a 5-year longitudinal, population-based study.

STUDY GROUP

Participants (n = 739) completed surveys in middle school and high school.

METHODS

Logistic regression analysis compared suicidality during high school across four groups: youth who participated in sport in both middle and high school, youth who participated only in middle school or only in high school, and youth who did not participate in sport during adolescence.

RESULTS

Compared to non-participants, youth involved in sport in both middle and high school had lower odds of suicidal ideation during high school. Youth who discontinued sport after middle school had higher odds of attempting suicide during high school than non-participants.

CONCLUSIONS

Remaining involved in sport throughout adolescence can offer mental health benefits. Future research should identify mechanisms that account for protective relationships between involvement in sport throughout adolescence and suicidality, and identify factors that explain deleterious relationships for youth who discontinue sport early in adolescence.

Potential mediating pathways through which sports participation relates to reduced risk of suicidal ideation

Suicide ranks as the third leading cause of death for American youth. Researchers examining sport participation and suicidal behavior have regularly found inverse relationships. This study represents the first effort to test a model depicting potential mechanisms through which sport participation relates to reduced risk of suicidal ideation. The participants were 450 undergraduate students. Measures assessed participants' involvement in university-run sports and other activities; frequency of physical activity; and perceived social support, self-esteem, depression, hopelessness, loneliness, and suicidal ideation. Regression analyses confirmed a path model and tested for mediation effects. Vigorous activity mediated relationships between sport participation and self-esteem and depression; and self-esteem and depression mediated the relationship between vigorous activity and suicidal ideation. Social support mediated relationships between sport participation and depression, hopelessness, and loneliness; and each of these risk factors partially mediated the relationship between social support and suicidal ideation. However no variable fully mediated the relationship between sport participation and suicidal ideation. This study provides a foundation for research designed to examine pathways through which sport participation relates to reduced risk of suicidal behavior.

Familism, parent-adolescent conflict, self-esteem, internalizing behaviors and suicide attempts among adolescent Latinas

Adolescent Latinas continue to report higher levels of suicide attempts than their African-American and White peers. The phenomenon is still not understood and is theorized to be the result of the confluence of many cultural, familial, and individual level factors. In Latino cultures, belief in the importance of the family, the value known as familism, appears to protect youth's emotional and behavioral health, but parent-adolescent conflict has been found to be a risk factor for suicide attempts. The role of familism in relation to parent-adolescent conflict, self-esteem, internalizing behaviors, and suicide attempts has not been studied extensively. To address this question, we interviewed 226 adolescent Latinas, 50% of whom had histories of suicide attempts. Using path analysis, familism as a cultural asset was associated with lower levels of parent-adolescent conflict, but higher levels of internalizing behaviors, while self-esteem and internalizing behaviors mediated the relationship between parent-adolescent conflict and suicide attempts. Our findings point to the importance of family involvement in culturally competent suicide prevention and intervention programs. Reducing parent-daughter conflict and fostering closer family ties has the added effect of improving self-esteem and shrinking the likelihood of suicide attempts.

Can sports events affect suicidal behavior? A review of the literature and implications for prevention

BACKGROUND

Engagement in sports and physical activity, either actively as an athlete or in a passive way as a spectator, impacts interpersonal behavior and physical and mental health.

AIMS

The study reviews literature on the relationship between sports spectatorship and suicidal behavior to ascertain whether sports spectatorship has an impact on suicidal behavior, either increasing the risk or being a protective factor.

METHODS

The literature was searched via PubMed/MEDLINE and PsycINFO. Nine studies published between 1986 and 2006 were identified.

RESULTS

The reviewed studies focused on the impact of sports events on the societal level, and analyzed data regarding national or local suicide rates. Their results indicate that sports events can have an impact on suicide mortality and morbidity, but this relationship seems to be mediated by age, gender, marital status, and alcohol consumption, as well as the process and outcome of the game (e.g., victory vs. defeat of the favored team).

CONCLUSIONS

There is some evidence that sports events can reduce the rates of suicide on the societal level; however, there is a lack of studies exploring how sports spectatorship might influence levels of suicide risk in individuals and how mediating variables might operate on the individual level.

Athletic participation and seatbelt omission among u.s. High school students

Although seatbelts save lives, adolescents may be disproportionately likely to omit their use. Using data from the 1997 Youth Risk Behavior Survey, a national survey of more than 16,000 U.S. public and private high school students, the authors employed a series of logistic regression analyses to examine cross-sectional associations between past year athletic participation and regular seatbelt omission. Controlling for the effects of gender, age, race, parental education, and school urbanicity, student athletes were significantly less likely than nonathletes to report seatbelt omission. Separate gender-specific analyses showed that this effect was significant for girls but only marginally significant for boys; in addition, the effect was strongest for adolescents who participated on three or more school or community sports teams. Possible explanations for the relationship between athletic participation and seatbelt omission, including Jessor's problem behavior syndrome, prosocial sport subcultures, and sensation seeking, are considered.

Long-run labour market and health effects of individual sports activities

This microeconometric study analyzes the effects of individual leisure sports participation on long-term labour market variables, health and subjective well-being indicators for West Germany based on individual data from the German Socio-Economic Panel study (GSOEP) 1984-2006. Econometric problems due to individuals choosing their own level of sports activities are tackled by combining informative data and flexible semiparametric estimation methods with a specific way to use the panel dimension of the data. The paper shows that sports activities have sizeable positive long-term labour market effects in terms of earnings and wages, as well as positive effects on health and subjective well-being.

Mental Well-Being and Sport-Related Identities in College Students

Past research has linked physical activity and sports participation with improved mental and social well-being, including reduced risk of depression and suicidality. In this study we examined relationships among several dimensions of athletic involvement (team sport participation, individual sport participation, athlete identity, and jock identity), gender, and depression and suicidal behavior in a sample of 791 undergraduate students. Both participation in a team sport and athlete identity were associated with lower depression scores. Athlete identity was also associated with lower odds of a past-year suicide attempt, whereas jock identity was associated with elevated odds of a suicide attempt. The findings are discussed in light of the relationship between mental well-being and a larger constellation of health-risk behaviors linked to a "toxic jock" identity.

High school youth and suicide risk: exploring protection afforded through physical activity and sport participation

BACKGROUND

Suicide ranks as the third leading cause of death for adolescents. Recent data from the Centers for Disease Control and Prevention (CDC) indicate that the adolescent suicide rate increased 18% between 2003 and 2004. Sport may represent a promising protective factor against adolescent suicide. This study examined the relative risk of hopelessness and suicidality associated with physical activity and sport participation.

METHODS

Data from the CDC's 2005 Youth Risk Behavior Survey were analyzed. Logistic regression modeling was used to compare the odds of hopelessness and suicidality in students who engaged in various levels of physical activity to inactive students. Similar analyses were performed comparing risks of athletes to nonathletes, and the risks of highly involved athletes to nonathletes.

RESULTS

Findings showed that frequent, vigorous activity reduced the risk of hopelessness and suicidality among male adolescents. However, low levels of activity actually increased the risk of feeling hopeless among young females. Yet, for both males and females, sport participation protected against hopelessness and suicidality.

CONCLUSION

These findings indicate that involvement in sport confers unique psychosocial benefits that protect adolescents against suicidality. Findings suggest that mechanisms other than physical activity contribute to the protective association between sport and reduced suicidality. Social support and integration may account for some of the differences found in suicidality between athletes and nonathletes.

Psychologic stress related to injury and impact on sport performance

Injury rates are high among children and adolescent athletes. Psychosocial stressors, such as personality, history of stressors, and life event stress can influence injury occurrence. After injury, those same factors plus athletic identity, self-esteem, and significant others-such as parents, coaches, and teammates-can affect injury response, recovery and subsequent sport performance. Goal setting, positive self-talk, attribution theory, and relaxation or mental imagery are psychologic interventions that can help injured athletes cope with psychosocial stressors. Medical professionals should be aware of the potential influence that psychosocial stressors and psychologic interventions can have on injury occurrence, injury recovery, and sport performance.