Relationships among High School Student-Athletes’ Mental Health, Stressors, and Social Support during the COVID-19 Pandemic in Japan

  1. Kaori Yamaguchi
  2. Eriko Katagami
  3. Ryoji Shinohara
  4. Taishi Tsuji
  5. Zentaro Yamagata
  6. Hironobu Tsuchiya

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Abstract

Objectives

The impact of the spread of COVID-19 on the mental health and its mitigating factors of high school athletes is not fully understood. The aims of this study were 1) to describe the psychological distress and stressors experienced by high school athletes during the COVID-19 pandemic and to elucidate the relationships between them and 2) to determine the relationship between psychological distress and social support.

Methods

Participants of this cross-sectional study were recruited from public high schools in East Japan. We conducted either an online or paper-based questionnaire survey from July 12 to 31, 2020, and used data collected from 3017 high school student athletes (valid response rate: 88.7%) for the analyses. We evaluated psychological distress (K6 ≥10), stressors to athletes during the COVID-19 pandemic (SAC-19), and perceived social support from others. Logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for developing psychological distress.

Results

Among the participants, 764 (25.3%) experienced psychological distress. Among the five factors extracted from the SAC-19, self-restraint requests (OR = 1.03, 95% CI: 1.01– 1.04), pressure from the surrounding environment (OR = 1.15, 95% CI: 1.12–1.18), and difficulties in maintaining athletic activities (OR = 1.16, 95% CI: 1.12–1.21) increased the risk of psychological distress. On the other hand, participants who were satisfied with the support from family members (OR = 0.77, 95% CI: 0.67–0.90), teammates (the same grade) (OR = 0.81, 95% CI: 0.67–0.98), and coaches and instructors (OR = 0.77, 95% CI: 0.65–0.91) showed lower psychological distress.

Conclusions

During the COVID-19 pandemic, high school athletes experienced more psychological distress than usual. Stressors such as self-restraint requests, pressure from the surrounding environment, and difficulties in maintaining athletic activities increased the risk. On the other hand, social support from family members, teammates (the same grade), and coaches and instructors can help alleviate these stressors.

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  1. ScreenIT

    SciScore for 10.1101/2021.11.25.21266885: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The present study was approved by the ethics committee of the university with which the last author of this study is affiliated (Approval No. 20-10). 2.2. Measures: (1) Demographic information: Data on sex, school grade, type of sport played (racket sports, ball games, budo and martial arts, individual sports [e.g., track and field], or dance), and competitive level (regional, prefecture [entry], or prefecture [winners] or higher) were collected. (2) Psychological distress: K6, a scale that measures the degree of mental health problems, was originally developed in English by Kessler et al.6, and translated into Japanese by Furukawa et al.7 K6 is often used as a screening test for distress experienced in various contexts.
    Sex as a biological variableHigh school students enrolled in the extracurricular activity club who provided consented complete the questionnaires (n = 3400; male = 1798; female = 1293).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Stata/MP 16.1 (StataCorp, College Station, TX, USA) was used to calculate descriptive statistics and performing multivariable regression analyses, with P <.
    StataCorp
    suggested: (Stata, RRID:SCR_012763)
    SAS 9.4 software (SAS Institute Inc., Cary, NC, USA) was used for the exploratory factor analysis.
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: The strength of the current study was the use of data from a large-scale survey of high school athletes during the COVID-19 pandemic. This is not only the first survey in Japan, but also provide valuable data that are applicable worldwide. However, this study has several limitations. First, generalizability is not sufficiently high. The survey was conducted in a relatively limited area in Japan, and since the infection status and behavioral restrictions differed depending on the period, the results possibly differed depending on the survey conditions. Furthermore, restrictions on activities may differ depending on the school, and the extent to which the activities were restricted is unknown. Second, the cross-sectional study design does not allow for a discussion of causal relationships. Third, the criterion-related validity of the SAC-19 against the gold standard items were not confirmed in advance because emphasis was placed on conducting a rapid investigation. However, the internal consistency was acceptable, and the results that were in line with our hypotheses were confirmed in the current study; therefore, this might not be a major limitation.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2021.11.25.21266885v1 on medRxiv