Tell us more about yourself and the author team
A strength of the author team of this editorial is that the team represents several research disciplines (medicine, psychiatry, sports psychology, and clinical psychology) that target mental health issues in sports.
Carolina Lundqvist, Associate Professor in Psychology, Associate Professor in Sports Sciences and Licensed Clinical Psychotherapist. Researcher at the Athletics Research Center, Linköping University. She has extensive experience working with sports psychology and clinically as a psychotherapist with elite athletes. She has participated in several European and World Championships as well as Olympic Games. She worked, for example, for almost ten years as a sports psychology consultant for the Swedish Olympic Committee and is presently part of the Medical Commission at Swedish Athletics.
Moa Jederström is a PhD student at Athletics Research Center (Linköping University, Sweden), a former figure skater with a big interest in children’s mental health and has previously worked as a Junior Doctor at the Department of Child and Adolescent Psychiatry at Linköping University Hospital.
Laura Korhonen is a Child and Adolescent Psychiatry professor and senior consultant physician at Linköping university and Region Östergötland, Sweden. She is also the Director of Barnafrid, the National Competence Center on Violence Against Children.
Toomas Timpka is a Professor of Social Medicine and an Associate Professor of Medical Informatics at Linköping University, Sweden. He also holds an appointment as a senior consultant physician at Region Östergötland. Toomas is the Director of the Athletics Research Center, an international scientific partnership involving researchers from three continents. He has been the Principal Investigator in several research programs at World Athletics Championships and is the Head of the Medical Commission at Swedish Athletics.
What is the story behind your study?
For some time, we have noted and discussed that there are challenges with the conceptualization of mental health constructs in the sports medicine literature. We completely agree with recent opinion pieces in sports science and medicine journals that mental health is an important topic that needs more attention. In this editorial, we want to challenge mental health researchers to strive towards a deeper understanding of the topic and carefully consider methodological and contextual factors that might influence the interpretation of results.
In your own words, what did you find?
An athlete’s ability to cope with aspects of sports and life is complex and depends on several factors. An athlete is exposed to several stressors in sports and exercise settings, and mood variations are expected. A challenge in the sports context with a multitude of stressors is to separate normal (or expected) mental health and mood variations from symptoms that reflect mental illness and mental disorders. In this editorial, we provide examples of issues we think researchers should address to reduce the risk of misinterpreting the prevalence and incidence of mental disorders in sports, such as severity cut-off levels and functional impairment. We also want to highlight that the mere presence of symptoms does not justify a clinical diagnosis and that some symptoms also may reflect healthy reactions to stress or specific life events in and outside a sports setting. Milder and non-clinical mental health issues are important to consider but might be related to other support needs than psychiatric care.
What was the main challenge you faced in your study?
A general challenge is that no internationally agreed-upon standardized clinical processes are available to establish a psychiatric diagnosis, and procedures to establish a psychiatric diagnosis in clinical research and practice can vary. A diagnosis is established based on diagnostic criteria found in the DSM-5 or the ICD system. Although these criteria provide guidance, a great amount of clinical judgment, skills, and experience is needed from the mental health specialist during the diagnostic process.
If there is one take-home message from your study, what would that be?
Athletes’ mental illness symptoms should be contextually interpreted in the environment where they appear. Coping ability and impairment in daily life are also essential to consider. We also argue that there is a need for more interdisciplinary work and that psychiatric expertise should be consulted to ensure quality in mental health research. In sum, our take-home message is that researchers on mental health in sports and exercise medicine should pay careful attention to nuances in key constructs regarding mental health and psychiatric disorders.