Mental Health State Endorsements In College Athletics: Examining The Role Of Sex And Sex-matched Sports In Collegiate Athletes

Recent evidence indicates an increase in mental health conditions among collegiate athletes, with female athletes reporting higher anxiety and depression symptoms. Little is known if sex-related differences in mental health are influenced by sport type (e.g., collision vs non-contact sports). Sport type may be influential regarding mental health as they may introduce different types of stressors to athletes unique to the sport. PURPOSE: Examine Generalized Anxiety Disorder-7 (GAD7) and Patient Health Questionaire-8 (PHQ8) scores by (i) sex, and (ii) within sex-matched sports among collegiate athletes. METHODS: NCAA Division I athletes (N = 566; age = 19.5 ± 1.5 years) from 2 institutions completed GAD7 and PHQ8 scales and demographic and health history information (e.g., concussion, depression, and anxiety). Anxiety and depression symptoms were assessed using the GAD7 (range: 0-21) and PHQ8 (range: 0-24), with higher scores indicating greater severity. To control for sport type, we also investigated sex-matched sports. Sex-matched sports were defined as those where the same sport is available and structured similarly for both male and female athletes (basketball, soccer, cross country, ice hockey, tennis, skiing, and track and field). Mann Whitney U tests were used to examine GAD7 and PHQ8 scores between sexes (female vs. male), and within sex-matched sports while controlling for a diagnosed concussion and mental health condition history. Medians and Interquartile ranges were reported for GAD7 and PHQ8 scores. RESULTS: 301 athletes [70.4% female (n = 212); 29.6% males (n = 89)] were included in the analyses. Female athletes had higher GAD7 (med = 1.0, IQR = 0.0-3.0) and PHQ8 (2.0, 1.0-4.0) scores than male athletes (GAD7: 0.0, 0.0-1.0; PHQ8: 1.0, 0.0-2.0; p’s < 0.01). When examining within sex-matched sports (n = 72), female athletes (n = 29) endorsed higher GAD7 scores (1.0, 0.0-3.0) than male athletes (n = 43; 0.0, 0.0-1.0; p < .01), however, there were no differences on PHQ8 (p > 0.05). CONCLUSIONS: Female athletes endorsed greater severity of anxiety than male athletes, even after controlling for mental health and concussion history, and sport type. Clinically, these findings suggest that female athletes may uniquely need targeted mental health screening and support, especially for anxiety management. Supported by: This study was funded by New Hampshire's IDeA Networks of Biomedical Research Excellence (NH-INBRE; PI: Kelshaw)