The Male And Female Athlete Triad Are Associated With Anxiety In Collegiate Athletes

PURPOSE: To determine the relationship between components of the Male and Female Triad and anxiety in NCAA (DI, DII, and DIII) collegiate varsity athletes. We hypothesized that 1) athletes who have higher disordered eating scores will have higher anxiety, 2) there will be an association between reproductive dysfunction and higher anxiety, and 3) higher division level athletes will have higher prevalence of anxiety and disordered eating. METHODS: Varsity athletes (National Collegiate Athletic Association, NCAA; n = 157) from a variety of colleges and universities within the United States completed online questionnaires that assessed disordered eating (Disordered Eating Screen for Athletes, DESA; and the Eating Disorder Examination Questionnaire Short, EDES) and anxiety (Generalized Anxiety Disorder-7). Additionally, the Hypogonadism Impact of Symptoms Questionnaire Short Form (HIS-Q) and the Low Energy Availability in Females Questionnaire (LEAF-Q) were used to assess reproductive dysfunction in males and females, respectively. RESULTS: The athletes were 19.6 ± 0.12 years of age including women (n = 115) and men (n = 38). Disclosing gender identity was optional (n = 5, did not disclose gender). Average body mass index was 23.7 ± 0.24 kg/m2. Fifty-six percent of the athletes demonstrated no/mild anxiety, while 44% of the athletes displayed moderate/severe anxiety. Anxiety was associated with measures of disordered eating (EDES, p < 0.001; DESA, p < 0.001) and reproductive dysfunction in female (LEAF-Q, p < 0.001) and male (HIS-Q, p = 0.020) athletes. Chi-square tests demonstrated that a higher proportion of moderate/severe anxiety scores was present in DI athletes (58%; p = 0.049) compared to DII (49%) or DIII (30%) NCAA athletes. Twenty-eight percent of the athletes demonstrated disordered eating (DESA score > = 3) and a higher proportion of disordered eating was also present in DI athletes (53 %; p = 0.031) compared to DII (23%) or DIII (28%) NCAA athletes. CONCLUSION: The current study reports an association between anxiety and the Athlete Triad. NCAA Division I athletes report a higher level of anxiety and the Athlete Triad vs DII and DIII athletes. Further research is needed to explore the type of sport in relation to anxiety, resources available to student-athletes, as well as potential interventions.