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Mountjoy M, Junge A, Bindra A, Blauwet C, Budgett R, Currie A, Engebretsen L, Hainline B, McDuff D, Purcell R, Putukian M, Reardon CL, Soligard T, Gouttebarge V. Surveillance of athlete mental health symptoms and disorders: a supplement to the International Olympic Committee's consensus statement on injury and illness surveillance. Br J Sports Med 2023; 57:1351-1360. [PMID: 37468210 DOI: 10.1136/bjsports-2022-106687] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/21/2023]
Abstract
In 2019, the International Olympic Committee (IOC) published a consensus statement outlining the principles for recording and reporting injury and illness in elite sport. The authors encouraged sport federations to adapt the framework to their sport-specific context. Since this publication, several sports have published extensions to the IOC consensus statement.In response to a paucity of epidemiological data on athlete mental health, the IOC mental health working group adapted the IOC consensus statement on injury and illness surveillance to improve the capturing of athlete mental health data. In addition to the members of the working group, other experts and athlete representatives joined the project team to address gaps in expertise, and to add stakeholder perspective, respectively. Following an in-person meeting, the authors worked remotely, applying the scientific literature on athlete mental health to the IOC injury and illness surveillance framework. A virtual meeting was held to reach consensus on final recommendations.Practical outcomes based on the analysis of the scientific literature are provided with respect to surveillance design, data collection and storage, data analysis and reporting of athlete mental health data. Mental health-specific report forms for athlete and health professional utilisation are included for both longitudinal and event-specific surveillance.Ultimately, this publication should encourage the standardisation of surveillance methodology for mental health symptoms and disorders among athletes, which will improve consistency in study designs, thus facilitating the pooling of data and comparison across studies. The goal is to encourage systematic surveillance of athlete mental health.
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Affiliation(s)
- Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
- Medical and Scientific Department-Games Group, International Olympic Committee, Lausanne, Switzerland
| | - Astrid Junge
- Center for Health in Performing Arts, MSH Medical School Hamburg, Hamburg, Germany
| | - Abhinav Bindra
- Olympic Champion and IOC Athletes Commission Member, Deharadun, Punjab, India
| | - C Blauwet
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Alan Currie
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Exercise, Sport and Rehabilitation Therapies, University of Sunderland, Sunderland, UK
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - David McDuff
- Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rosemary Purcell
- Elite Sport and Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Margot Putukian
- Chief Medical Officer, Major League Soccer, Princeton, New Jersey, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Vincent Gouttebarge
- Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Section Sports Medicine, University of Pretoria, Pretoria, South Africa
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, The Netherlands
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Junge A, Hauschild A. Behind the Curtain: Prevalence of Symptoms of Depression, Generalised Anxiety and Eating Disorders in 147 Professional Dancers from Six Opera Houses or State Theatres. SPORTS MEDICINE - OPEN 2023; 9:92. [PMID: 37777697 PMCID: PMC10542047 DOI: 10.1186/s40798-023-00638-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Mental health problems cover a wide spectrum. Depression and anxiety disorders are the most frequent mental health problem in the general population and in elite athletes. The aim of the present study was to assess the prevalence of symptoms of depression, generalised anxiety disorder and eating disorders in professional dancers, to compare the results between genders and to the general population and to analyse potential determinants. METHODS During a pre-season health screening, professional dancers of six German companies answered a comprehensive questionnaire on personal and dancer-specific characteristics, medical history and the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Questionnaire (GAD-7) and Eating-Disorder-Examination-Questionnaire (EDE-QS). RESULTS A total of 82 (55.8%) female and 65 (44.2%) male dancers answered the questionnaire. One in five (20.8%) dancers had at least moderate symptoms of either depression, generalised anxiety disorder or eating disorders. The prevalence of at least moderate symptoms of depression was 11.1% in female and 6.4% in male dancers, of generalised anxiety disorder 16.0% in female and 6.4% in male dancers and of eating disorders 14.8% in female and 6.1% in male dancers. Compared to the general population of the same gender and similar age, the prevalence of at least moderate symptoms of generalised anxiety disorder was significantly higher in both genders. About one in four dancers (26.9%) reported a subjective need for support from a psychotherapist at the time of the screening. The PHQ-9, GAD-7 and EDE-QS sum scores were not related to the size or type of the companies, the age or rank of the dancers, but the PHQ-9 and GAD-7 sum score were significantly related to severity of musculoskeletal pain in the past seven days and to chronic or recurrent symptoms of low mood and generalised anxiety. CONCLUSION The prevalence of symptoms of depression, generalised anxiety and eating disorders was high in professional dancers. Routine screening and low-threshold interventions to improve mental health of professional dancers are recommended.
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Affiliation(s)
- Astrid Junge
- Center for Health in Performing Arts, Medical School Hamburg (MSH), Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Anja Hauschild
- Center for Health in Performing Arts, Medical School Hamburg (MSH), Am Kaiserkai 1, 20457, Hamburg, Germany
- Center for Rehabilitation and Sports Medicine, BG Klinikum Hamburg, Hamburg, Germany
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de las Heras-Fernández R, Mendoza G, Jimenez M. Psychological stress responses to a live performance by professional flamenco dancers. PeerJ 2023; 11:e15282. [PMID: 37197580 PMCID: PMC10184656 DOI: 10.7717/peerj.15282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/03/2023] [Indexed: 05/19/2023] Open
Abstract
Dance is a high demanding discipline that involves physiological and psychological pressures. The pressure increases when dancers perform in front of an audience that, on a physiological level, can generate hormonal responses similar to those of an athlete before a competition for social status. Low levels of testosterone (T) and high levels of cortisol (C) are related to a decrease in performance and an increase in the risk of injury. Therefore, this study sets out to analyse hormone response patterns in professional flamenco dance performances depending on whether the performances are completed successfully and whether there are differences by sex and professional category. Saliva specimens (2-5 ml) were taken from the participants before and after the performance. Samples were immunoassayed by duplicate to analyze momentary fluctuations in two hormones regularly used in studies with professional athletes. The results showed significant differences in solo dancers' T responses before and after the performance (p < 0.01), suggesting that the dancing role in the show (soloist or corps the ballet) and responsibility over the performance were important modulators to the hormone responses observed.
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Affiliation(s)
| | | | - Manuel Jimenez
- Universidad Internacional de La Rioja, Logroño, La Rioja, Spain
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Soerel BF, Plaatsman LA, Kegelaers J, Stubbe JH, van Rijn RM, Oudejans RRD. An analysis of teachers' instructions and feedback at a contemporary dance university. Front Psychol 2023; 14:1133737. [PMID: 37179871 PMCID: PMC10174436 DOI: 10.3389/fpsyg.2023.1133737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/04/2023] [Indexed: 05/15/2023] Open
Abstract
Background Given the demands posed by excessive practice quantities in modern dance, physical and mental health can be compromised. Therefore, there is a need to consider how quality of practice may be improved and possibly even reduce training times. Sports literature has shown that instructions and feedback given by coaches can have an effect on the quality of training and influence self-regulation and the performance of athletes. However, currently little is known about the use of instructions and feedback by dance teachers. The aim of the current study was, therefore, to examine the type of instructions and feedback given by dance teachers during various dance classes. Methods A total of six dance teachers participated in this study. Video and audio recordings were made of six dance classes and two rehearsals at a contemporary dance university. The dance teacher's coaching behavior was analyzed using the modified Coach Analysis and Intervention System (CAIS). Additionally, feedback and instructions were also examined in terms of their corresponding focus of attention. Absolute numbers, as well as times per minute (TPM) rates were calculated for each behavior before, during, and after an exercise. Absolute numbers were also used to calculate ratios of positive-negative feedback and open-closed questions. Results Most feedback comments were given after an exercise (472 out of 986 total observed behaviors). Improvisation had the highest positive-negative feedback ratio (29) and open-closed questions ratio (1.56). Out of the focus of attention comments, internal focus of attention comments were used most frequently (572 out of 900). Discussion/conclusion The results make clear that there is a large variability in instructions and feedback over teachers and classes. Overall, there is room for improvement toward a higher positive-negative feedback ratio, a higher open-closed question ratio and producing more comments eliciting an external focus of attention.
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Affiliation(s)
- Benjamin F. Soerel
- Codarts University of the Arts, Rotterdam, Netherlands
- Breederode Hogeschool, Rotterdam, Netherlands
- *Correspondence: Benjamin F. Soerel,
| | - Larissa A. Plaatsman
- Codarts University of the Arts, Rotterdam, Netherlands
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Performing Artist and Athlete Research Lab, Codarts University of the Arts, Rotterdam, Netherlands
| | - Jolan Kegelaers
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Janine H. Stubbe
- Codarts University of the Arts, Rotterdam, Netherlands
- Performing Artist and Athlete Research Lab, Codarts University of the Arts, Rotterdam, Netherlands
- Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Rotterdam Arts and Sciences Lab, Rotterdam, Netherlands
| | - Rogier M. van Rijn
- Codarts University of the Arts, Rotterdam, Netherlands
- Performing Artist and Athlete Research Lab, Codarts University of the Arts, Rotterdam, Netherlands
| | - Raôul R. D. Oudejans
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Institute for Brain and Behavior, Amsterdam, Netherlands
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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van Winden D, van Rijn RM, Savelsbergh GJP, Oudejans RRD, Stubbe JH. The Association Between Stress and Injury: A Prospective Cohort Study Among 186 First-Year Contemporary Dance Students. Front Psychol 2021; 12:770494. [PMID: 34803856 PMCID: PMC8602075 DOI: 10.3389/fpsyg.2021.770494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (N = 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0-100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as "all injuries" (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and "substantial injuries" (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann-Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March, p < 0.05), and in 5 months for substantial injuries (September, October, November, December, April, p < 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries [F(1.87,216.49) = 3.10, p = 0.051] and substantial injuries [F(2,138) = 4.16, p = 0.018]. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.
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Affiliation(s)
- Diana van Winden
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - Rogier M van Rijn
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - Geert J P Savelsbergh
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Institute of Brain and Behavior, Amsterdam, Netherlands.,Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Raôul R D Oudejans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Institute of Brain and Behavior, Amsterdam, Netherlands.,Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Janine H Stubbe
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands.,Rotterdam Arts and Sciences Lab (RASL), Rotterdam, Netherlands.,Department of General Practice, Erasmus University Medical Center, Rotterdam, Netherlands
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Stubbe JH, Tiemens A, Keizer-Hulsebosch SC, Steemers S, van Winden D, Buiten M, Richardson A, van Rijn RM. Prevalence of Mental Health Complaints Among Performing Arts Students Is Associated With COVID-19 Preventive Measures. Front Psychol 2021; 12:676587. [PMID: 34211426 PMCID: PMC8239520 DOI: 10.3389/fpsyg.2021.676587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/19/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the effect of COVID-19 preventive measures on the mental health of performing arts students. In a prospective cohort study, performing arts students (N = 213) from Codarts Rotterdam, University of the Arts, were invited to monitor their health during one academic year (September 2019–May 2020). Every month, students completed items on mental health complaints, stress, and sleep quality. Chi-square tests and repeated-measures ANOVA with deviation contrasts were performed to investigate whether COVID-19 preventive measures were associated with changes in mental health complaints, stress scores, and sleep quality. During the COVID-19 lockdown, subjective mental health, Mental Health Inventory-5 (MHI-5), and items on loneliness were additionally completed by the respondents. A total of 98 students (46.0%) were included in the analyses. The 3-month prevalence of mental health complaints was significantly higher during the COVID-19 lockdown compared to the two pre-COVID-19 periods (p < 0.001). Mean stress scores were significantly lower for February (35.20) and March (36.41) when compared to the overall mean (40.38). Sleep quality scores (mean) were significantly higher for April (6.90), and May (6.89) when compared to overall mean (6.58). Furthermore, at least 75.5% of the participants dealt with moderate to very severe loneliness in all 3 months during the COVID-19 lockdown. During lockdown, performing arts students perceived less stress and their sleep quality increased. However, the prevalence of mental health complaints increased. Besides, 3 out 4 students dealt with moderate to very severe loneliness.
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Affiliation(s)
- Janine H Stubbe
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands.,Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands.,Rotterdam Arts and Sciences Lab (RASL), Rotterdam, Netherlands
| | - Annemiek Tiemens
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - Stephanie C Keizer-Hulsebosch
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - Suze Steemers
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands.,Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Diana van Winden
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands.,Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Maurice Buiten
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - Angelo Richardson
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
| | - Rogier M van Rijn
- Codarts Rotterdam, University of the Arts, Rotterdam, Netherlands.,PErforming Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
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