The Impact of COVID-19 Restrictions on Youth Athlete Mental Health: A Narrative Review

PURPOSE OF REVIEW

We discuss current research on the mental health effects of COVID-19 sports restrictions on youth athletes, highlighting the largest problems, as well as how organizations can help youth athletes by preparing for and responding to these problems.

RECENT FINDINGS

Millions of children and adolescents worldwide participate in organized sports, which has significant physical and mental health benefits. In 2020, the COVID-19 pandemic triggered large-scale, public restrictions that forced the closure and cancelation of organized youth sports across the world. Sports cancelations not only removed these protective benefits, but also worsened the mental health of youth athletes who were no longer able to participate in their sports. Youth athletes are even more vulnerable than adults to the negative mental health effects of sports restrictions. The unexpected loss of sports from COVID-19 restrictions disrupted these youths' athletic identities and worsened youth athlete depression, anxiety, anger, sleep, and quality of life. Restrictions particularly affected certain high-risk subpopulations of youth athletes including females, high school upperclassmen, those from low socioeconomic backgrounds, and those from team sports. Sports organizations could limit the negative mental health impacts of future sports cancelations by implementing at-home training opportunities, remote check-ins with teammates, discussions about athletic identity with coaches and sports psychology professionals, and mindfulness skill-building.

Effects of oxytocin administration on fear-potentiated acoustic startle in co-occurring PTSD and alcohol use disorder: A randomized clinical trial

Co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common and particularly associated with elevation of hyperarousal compared to PTSD alone. Treatment options are limited. Oxytocin regulates physiological stress response. Intranasal oxytocin administration has demonstrated potential in reducing symptoms of both PTSD and AUD. This study addresses a gap in the literature by investigating effects of intranasal oxytocin on startle reactivity, an important potential marker of both PTSD and AUD symptomatology. This is a randomized, double-blind, placebo-controlled, within- and between-participant, crossover, dose-ranging study examining the effects of a single administration of oxytocin 20 IU versus 40 IU versus placebo on psychophysiological responses to a common laboratory fear-potentiated acoustic startle paradigm in participants with PTSD-AUD (n = 47) and controls (n = 37) under three different levels of threat. Contrary to our hypothesis, for the PTSD-AUD group, oxytocin 20 IU had no effect on startle reactivity, while oxytocin 40 IU increased measures of startle reactivity. Additionally, for PTSD-AUD only, ambiguous versus low threat was associated with an elevated skin conductance response. For controls only, oxytocin 20 IU versus placebo was associated with reduced startle reactivity.

Automatic Imitation in Comorbid PTSD & Alcohol Use Disorder and Controls: an RCT of Intranasal Oxytocin

INTRODUCTION

Mimicking movements of others makes both the imitating and imitated partners feel closer. Oxytocin may increase focus on others and has been shown to increase automatic imitation in healthy controls (HC). However, this has not been replicated, and oxytocin's effects on automatic imitation have not been demonstrated in clinical populations. This study attempts to replicate effects on HC and examine effects on people with comorbid posttraumatic stress disorder and alcohol use disorder (PTSD-AUD).

METHODS

Fifty-four males with PTSD-AUD and 43 male HC received three intranasal treatment conditions (placebo, oxytocin 20 International Units (IU), and oxytocin 40 IU) in a randomized order, across three separate testing days, as part of a double-blind, crossover parent study. At 135 min post-administration, each performed the imitation-inhibition task, which quantifies automatic imitation as the congruency effect (CE). After exclusions, the final analyzed data set included 49 participants with PTSD-AUD and 38 HC.

RESULTS

In HC, oxytocin 20 IU demonstrated a statistically significant increase in CE, and 40 IU showed a trend-level increase. In PTSD-AUD, oxytocin did not significantly increase CE. Post-hoc analysis showed the PTSD-AUD group had higher CE than HC on placebo visits.

DISCUSSION

Our data suggest PTSD-AUD is associated with higher automatic imitation than HC in the absence of oxytocin administration. We successfully replicated findings that oxytocin increases automatic imitation in HC. This demonstrates an unconscious motor effect induced by oxytocin, likely relevant to more complex forms of imitative movements, which have the potential to improve social connection. We did not find a significant effect of oxytocin on automatic imitation in PTSD-AUD. Future research should examine imitation in both sexes, at peak oxytocin levels, and on increasingly complex forms of imitation.

The host complement system and arbovirus pathogenesis

Arthropod-borne viruses (arboviruses) are a significant cause of human diseases worldwide. Interactions between these viruses and the innate immune system play a major role in determining the outcome of disease. The complement system is particularly important in this process as activation of complement can contribute to both host defense as well as injury to host tissues. This review focuses on the increasing evidence that the complement system plays key roles in both protective and pathologic outcomes of arbovirus infection.

Inhibition of IFN-gamma signaling by an Epstein-Barr virus immediate-early protein

Viruses have evolved elaborate mechanisms to target many aspects of the host's immune response. The cytokine IFN-gamma plays a central role in resistance of the host to infection via direct antiviral effects as well as modulation of the immune response. In this study, we demonstrate that the Epstein-Barr virus (EBV) immediate-early protein, BZLF1, inhibits the IFN-gamma signaling pathway. BZLF1 decreases the ability of IFN-gamma to activate a variety of important downstream target genes, such as IRF-1, p48, and CIITA, and prevents IFN-gamma-induced class II MHC surface expression. Additionally, BZLF1 inhibits IFN-gamma-induced STAT1 tyrosine phosphorylation and nuclear translocation. Finally, we demonstrate that BZLF1 decreases expression of the IFN-gamma receptor, suggesting a mechanism by which EBV may escape antiviral immune responses during primary infection.