Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698058660657.pdf (Liberia)
BSc in Psychology Department of Psychology Prevalence of Post-Olympic blues, in relation to satisfaction of performance, retirement, psychological support, and coping strategies among Icelandic Olympians: A population-based study.

June, 2021 Student: Eygló Ósk Gústafsdóttir ID number: 010295-2389 2 Foreword Submitted in partial fulfillment of the requirements of the BSc Psychology degree, Reykjavik University, this thesis is presented in the style of an article for submission to a peer-reviewed journal.
This thesis was completed in the Spring of 2021 and may therefore have been significantly impacted by the COVID-19 pandemic.

The thesis and its findings should be viewed in light of that.

3 Abstract The Olympics is the biggest stage athletes can compete at and the Post-Olympic period can be challenging for athletes because they are often faced with life-changing decisions.

Athletes that experienced Post-Olympic blues (POB) describe feeling unmotivated, isolated, and lonely.
The aim of this study was to estimate the prevalence of POB among Icelandic Olympians, and whether it differed based on the athlete’s performance satisfaction, if it differed based on retirement following participation at the Olympic games, and if it differed based on if the athlete sought psychological support both before and after the Olympic games.

Additionally, it was explored if there was any association between athletes’ coping strategies and experiencing POB.
Participants in this study were Icelandic Olympians that participated in individual sports (N = 36).

The prevalence of POB among all participants was 56%.

The prevalence of POB was higher for athletes that were unsatisfied with their performance than those that were satisfied, and the POB prevalence was higher for the participants that did not retire after the Olympic games.

Seeking psychological support in preparation for the Olympics was more common than after the Olympics finished.
There was no relationship between coping strategies and POB.

This study indicates that POB is prevalent, and that psychological support would be helpful for athletes after the Olympics.

Keywords: Post-Olympic blues, Icelandic Olympians, Coping strategies Útdráttur Ólympíuleikarnir er stærsta keppni sem íþróttafólk geta tekið þátt í og tímabilið eftir Ólympíuleikana getur verið erfitt þar sem íþróttafólk stendur oft frammi fyrir stórum ákvörðunum.
Íþróttafólk sem upplifir niðursveiflu í líðan eftir Ólympíuleikana (POB) lýsa því að finna fyrir minnkun á hvatningu, einmannaleika og tómleika.
Markmið þessara rannsóknar var að skoða algengi POB hjá íslenskum Ólympíuförum, skoða hvernig algengi POB var í tengslum við ánægju við frammistöðu á leikunum, í tengslum við hvort íþróttamanneskjan hætti í íþróttinni eftir leikana og einnig í tengslum við hvort íþróttamanneskjan sótti sér sálfræðiaðstoð í undirbúning fyrir leikana og einnig eftir að leikunum lauk.

Að lokum var skoðað hvort munur væri á bjargráðum eftir því hvort þau upplifðu niðursveiflu í líðan eða ekki.
Þátttakendur í rannsókninni voru Íslenskir Ólympíufarar sem kepptu í einstaklingsíþróttum (N = 36).

Algengi POB meðal allra þátttakenda var 56%.

Algengi POB var hærra hjá íþróttafólki sem voru óánægð með frammistöðu sína á leikunum og POB var algengara hjá þeim þátttakendum sem hættu ekki í íþróttinni sinni eftir að leikunum lauk.

Algengara var að sækja sér sálfræðiaðstoð fyrir Ólympíuleikana heldur en eftir að þeim lauk.

Það fannst ekkert samband á milli bjargráða og POB.
Þessi rannsókn bendir til þess að POB sé algengt og að sálfræðiaðstoð væri hjálpleg eftir að Ólympíuleikum lýkur.

Lykilorð: Post-Olympic blues, Íslenskir Ólympíufarar, Bjargráð 4 Prevalence of Post-Olympic Blues, In Relation to Satisfaction of Performance, Retirement, Psychological Support, and Coping Strategies Among Icelandic Olympians: A Population-Based Study.

Mental health issues are a common problem in the world of sport and have not been studied enough (Reardon et al., 2019).
Prevalence of mental health issues among athletes can vary between sports and some athletes are more vulnerable to mental health issues than others.

Icelandic individual sports athletes are more prone to experience depression- and anxiety symptoms than athletes that participate in team sports (Tahtinen & Kristjansdottir, 2019).

Exercise is found to be very effective when treating many physical and psychological health issues (Hughes & Leavey, 2012).
However, excessive exercise can become unhealthy and can negatively affect physical and psychological health.

Elite athletes can experience injury, overtraining, cardio and immunological health issues and many other problems because of their training load.

Psychological problems could also occur for elite athletes because of the amount of time and commitment it takes to become the best in their field.
The high-pressure environment that elite athletes deal can have a negative impact on their mental health, however coping tactics have been shown to decrease the impact of negative emotions (Brown et al., 2005; Howells & Fletcher, 2015).

Coping is what an individual does to reduce negative impacts from stressful situations (Coulacoglou & Saklofske, 2017; Johnston & Johnston, 1998; Pearlin & Schooler, 1978).
Coping strategies have been shown to have high stability over time and research shows that people can cope with stressful situations with either adaptive coping or maladaptive coping (Kirchner et al., 2010; Nielsen & Knardahl, 2014; Thompson et al., 2010).. Adaptive coping involves taking active steps to remove stressors or prevent the effects from those stressors and maladaptive coping strategies can include substance abuse, self-injury, social isolation, and avoidance behavior (Carver et 5 al., 1989; Spirito & Donaldson, 1998).
Athletes that use adaptive coping strategies experience more positive emotions than those who use maladaptive coping strategies (Gaudreau & Blondin, 2002; González-García et al., 2020).

The Olympics is the biggest stage athletes can compete at and many athletes dream to just qualify at least once in their lives (Jackson et al., 1998).

Winning an Olympic gold is recognized to be the greatest achievement in sports, and it is an honor that can never be taken away from the champions.
The reason for the importance of the Olympic games is that the athletes only get a chance to compete at the Olympic games every four years, and for some athletes they only get one shot in their life to qualify (Gould & Maynard, 2009; Jackson et al., 1998).

The post-Olympic period can be challenging for Olympic athletes because they are often faced with life-changing decisions.
After athletes finish their competition at the Olympics and arrive home many go through difficult times and experience a sense of emptiness after having to realize that they are back to mundane life.

While some athletes spoke about being excited to go home and get back to normality and feeling a sense of relief because the pressure is off them, others felt like they struggled (Bennie et al., 2019).
Getting back to normality can be hard for some athletes after experiencing one of the most exciting and important period of their lives.

Many athletes face the decision of either going back to training or retiring from their sport.

The athletes describe feeling unmotivated, isolated, lonely, overwhelmed and feeling like they must start over again at square one (Bennie et al., 2019; Samuel et al., 2016).
Olympians also face issues with their identity, only looking at themselves as an athlete and lacking other outside interests can result in psychological distress and in some cases major depression (Bennie et al., 2019; Hughes & Leavey, 2012; Torregrosa et al., 2015).
Research has shown that athletes experience Post-Olympic blues (POB) for different reasons but a study on four Olympians that participated at the Rio 2016 Olympics showed 6 that their POB experience could be divided into two different periods, the experience of the Olympic games itself and then their experience after coming home from the games (Howells & Lucassen, 2018).
The study also showed that the reason for athletes experiencing depressive symptoms after the Olympics is the overall experience of the games and the celebrity status that follows their participation without taking into consideration if they were satisfied with their results.

Their celebrity status is developed over the course of the competition and peaks after they get home where they are interviewed by media and praised by their community.
When the excitement surrounding the Olympics fades the media loses interest in the athletes, making the athletes experience negative emotions and loss of identity without having a clear goal for themselves.

Olympians can experience POB for varying lengths of time as some athletes move forward to either another period of training or retirement (Howells & Lucassen, 2018).

Some athletes express that their POB is so intense and lasts for so long that they thought they were dealing with depression.
Therefore, social support is essential for the athlete’s mental health after returning home from the Olympics and that includes contact with family and friends along with support from a sport psychologist.

Athletes also expressed that normalizing the post-Olympic emotional and psychological challenge helped them cope with their circumstances (Bennie et al., 2019; Howells & Lucassen, 2018; McArdle et al., 2014; Wylleman et al., 2012).
Also, knowing that they are not the only ones experiencing that difficult period along with having other plans and goals outside of their sport to look forward to.

According to Samuel et.al (2016), the athletes reported that availability of professional support was high before and during their competition at the Olympic games, but the availability decreased after coming home.

Athletes’ have expressed that post-Olympic sport psychology support would be beneficial for them (Bennie et al., 2019).
7 As far as the author knows there have only been qualitative studies about POB and there is a gap in the literature about the prevalence and the contributing factors of POB.
Therefore, the aim of this study was (i) to estimate POB prevalence for athletes that participated in individual sports for Iceland at the Olympic games, (ii) examine the relationship between experiencing POB and satisfaction with a performance at the Olympic games, post-Olympic plans about retiring and psychological support pre and post the Olympics, and (iii) examine the relationship between experiencing POB and adaptive- or maladaptive coping strategies.
This study will add knowledge about POB in Iceland.

Also, it includes valuable information for the National Olympic and Sports association of Iceland concerning the need for psychological support for the athletes after the Olympic games have finished.

8 Participants Method Participants in this study were (N=36) Icelandic Olympians.

There were 22 (61.1%) women and 14 (38.9%) men in the study.
Each Icelandic Olympian that took part in the summer and winter Olympics in an individual sport from the year 2000-2018 were asked to take part in the study (N = 48) and 36 (75%) participated.

Participants did not get paid for the study.

Measures Post-Olympic Blues Questionnaire.

Researchers made a questionnaire to evaluate POB.
Questions were based on definitions of POB (Bennie et al., 2019; Samuel et al., 2016) and the questions were as follows: “After the Olympic games finished I experienced Post-Olympic blues”, “After the Olympic games finished I felt emptiness”, “After the Olympic games finished I felt loneliness”, “After the Olympic games finished I felt unmotivated in daily life”, and “After the Olympic games finished I felt unmotivated at practise and competition in my sport”.
Participants responded on a five-point Likert scale, 1 indicating “strongly disagree” and 5 indicating “strongly agree”.

For the data analysis, authors combined 1 and 2 to make “disagree” = 1, 3 made “neither/nor” = 2, and combined 4 and 5 to make “agree” = 3.

Participants answered the questions concerning POB for each Olympic games they competed at.

The Cronbach’s Alpha for the POB questionnaire in this study was .90.

Coping Skills.
Coping Skills.

The Brief COPE questionnaire (Carver, 1997; Carver et al., 1989) was used to measure coping strategies.

Participants answered an Icelandic version of the questionnaire.

There are 14 sub-scales: Active Coping, Planning, Positive Reframing, Acceptance, Humor, Religion, Using Emotional Support, Using Instrumental Support, Self-Distraction, Denial, Venting, 9 Substance, Behavioral Disengagement, and Self-Blame.

Each sub-scale included 2 items.


The first eight sub-scales can be referred to as adaptive coping strategies and the last six as maladaptive coping strategies (Meyer, 2001).

The participants answered how well a statement (e.g., “I try to get advice from someone about what to do”) applied to them when they were under a lot of stress.

Participants responded on a four-point ordinal scale, 1 indicating “not at all” to 4 indicating “a lot”.
Psychometric properties of the scale have been proven good (Carver, 1997).

For this study, the Cronbach’s Alpha for the Brief COPE scale was .71.

Background Questions.

The participants were asked what gender they identified as, the choices were “female”, “male”, “non-binary”, “other” or “don’t want to answer”.

They were asked what Olympic games they participated at in years 2000 to 2018.
For each Olympic games in which they participated, they were asked whether they were satisfied with their performance on a five- point Likert scale from “very unsatisfied” = 1 to “very satisfied” = 5, and whether they had retired in their sport afterwards, where they responded either “yes” or “no”.
Lastly, they were asked if they sought out psychological support before the Olympic games and if they sought psychological support after the games, these questions were also asked for each Olympics they participated at with a “yes” or “no” answer.

Procedure Researchers received a list of names from the National Olympic and Sports association of Iceland of athletes that participated in an individual sport at the summer or winter Olympics in the years 2000-2018.
The researchers sent an announcement to a closed Facebook group including most Icelandic Olympians requesting for participants that met the criteria for the study.

A link to the questionnaire was included in the announcement.

Later that same day the researchers contacted each athlete from the list of names given and asked for their participation.

The questionnaire was set up via the program Question Pro.
Before the questionnaire started there was a letter of informed consent that the participants had to accept 10 to be able to participate.

Data Analysis The SPSS statistical system was used to analyze the data of the study.

The statistical method for the analysis was ANOVA to determine whether there was any significant difference between the means of three groups in POB in relation to both adaptive- and maladaptive coping strategies.

Descriptive statistics were calculated for all factors in the study.
Measurements for this study were independent.

A Kolmogorov-Smirnov test indicated that scores on adaptive coping strategies were not significantly different from normal distribution because the p value was higher than .05, but the p value was .02 for scores on maladaptive coping strategies so they do not follow a normal distribution.
The distribution of both coping strategies means were not significantly different between three groups in POB, because the p- value in the Levene’s test was always higher than .05.

Some participants took part in more than one Olympic game, so they answered the POB questionnaire for each of their Post-Olympic experience.

Total number of Olympic experiences were 53.

The highest value for POB and the following symptoms was used for each participant.
Results Table 1 presents the descriptive statistics of POB, emptiness, loneliness, being unmotivated in daily life, and being unmotivated in the sport for all Olympic experiences and for all participants.

Table 1 also shows the outcome of a cross-table between POB and following symptoms, with satisfaction of the athlete’s performance at the Olympic games, if the athletes retired from their sport after the games finished, and if the participants sought psychological support both before and after the games.
11 Table 1 Descriptive outcome of POB and following symptoms for all Olympic experiences and all participants.
Outcome of cross-table between POB and following symptoms, with satisfaction of the athlete’s performance at the Olympic games, if the athletes retired from their sport after the games finished, and if the participants sought psychological support both before and after the games All Olympic Experiences All Participants % (N) % (N) Performance at the OG Unsatisfied Neither/nor Satisfied % (N) Yes % (N) % (N) % (N) Retiring from their sport Psychological support pre OG Psychological support post OG No % (N) Yes % (N) No % (N) Yes % (N) No % (N) Post-Olympic blues Disagree Neither/nor Agree Symptoms Emptiness Disagree Neither/nor Agree Loneliness Disagree Neither/nor Agree Unmotivated in daily life Disagree Neither/nor Agree Unmotivated for the sport Disagree Neither/nor Agree 36 (19) 15 (8) 47 (25) 31 (11) 11 (4) 56 (20) 8 (4) 6 (3) 25 (13) 49 (26) 11 (6) 38 (20) 70 (37) 6 (3) 25 (13) 42 (15) 11 (4) 44 (16) 67 (24) 6 (2) 28 (10) 17 (9) 6 (3) 15 (8) 25 (13) 2 (1) 13 (7) 66 (35) 23 (12) 11 (6) 58 (21) 28 (10) 14 (5) 25 (13) 9 (5) 6 (3) 51 (27) 11 (6) 38 (20) 39 (14) 8 (3) 53 (19) 21 (11) 4 (2) 15 (8) 0 (0) 2 (1) 4 (2) 2 (1) 0 (0) 4 (2) 2 (1) 0 (0) 4 (2) 2 (1) 2 (1) 2 (1) 2 (1) 0 (0) 4 (2) 29 (15) 8 (4) 19 (10) 2 (1) 2 (1) 19 (10) 35 (18) 14 (7) 29 (15) 15 (8) 10 (5) 23 (12) 21 (11) 6 (3) 25 (13) 10 (5) 4 (2) 10 (5) 27 (14) 12 (6) 39 (20) 31 (16) 6 (3) 19 (10) 43 (37) 4 (2) 8 (13) 2 (1) 3 (2) 17 (9) 9 (5) 2 (1) 11 (6) 48 (25) 8 (4) 21 (11) 60 (32) 4 (2) 13 (7) 19 (10) 6 (3) 23 (12) 31 (16) 6 (3) 15 (8) 26 (14) 6 (3) 17 (9) 43 (23) 0 (0) 8 (4) 10 (5) 4 (2) 10 (5) 13 (7) 4 (2) 8 (4) 40 (21) 8 (4) 29 (15) 57 (30) 2 (1) 17 (9) 40 (21) 11 (6) 4 (2) 9 (5) 9 (5) 4 (2) 57 (30) 13 (7) 8 (4) 26 (14) 15 (8) 8 (4) 40 (21) 8 (4) 4 (2) 13 (7) 6 (3) 6 (3) 53 (28) 17 (9) 6 (3) 28 (15) 8 (4) 19 (10) 0 (0) 6 (3) 17 (9) 51 (27) 6 (3) 21 (11) 23 (12) 9 (5) 17 (9) 28 (15) 2 (1) 21 (11) 11 (6) 4 (2) 10 (5) 40 (21) 8 (4) 28 (15) Prevalence of POB was 47% for all Olympic experiences, however the prevalence for all participants was 56%.
Emptiness and being unmotivated for training and competing had the highest prevalence of the symptoms for all participants.

More than half of the participants felt unmotivated for their sport after finishing their participation at the Olympics.

Unmotivated in daily life had the lowest prevalence amongst participants and loneliness did not have a high prevalence.
The prevalence for POB was higher when the athletes were unsatisfied with their results at the Olympics (25%) compared to those who were satisfied (19%).

The prevalence of experiencing POB was higher for athletes that did not retire from their sport after participating at the Olympics than for those who did retire.

Seeking psychological support in 12 the preparation for the Olympics was more common (49%) than after the Olympics finished (25%).
The prevalence of POB was higher for participants that did not seek psychological support after the Olympic games finished than for those who did seek support.

Chi-square test was not performed to investigate further the relationship between POB and variables displayed in table 1 since the Chi-square expected values assumption was violated.

Table 2 shows results from one-way ANOVA test between POB groups and scores from adaptive coping strategies and maladaptive coping strategies.
Results from ANOVA showed that scores from adaptive coping were not significantly different between POB groups.

Additionally, results from ANOVA also showed that scores from maladaptive coping were not significantly different between POB groups.
Table 2 Results from ANOVA test between POB for all participants and scores from adaptive coping and maladaptive coping Post-Olympic blues Disagree Neither/nor Agree Adaptive M 41.1 SD 4.7 M 41.0 Maladaptive 20.8 Note: M = mean; SD = standard deviation 5.2 22.8 SD 3.4 3.9 M 41.7 23.9 SD 6.7 5.5 F .04 1.14 p .96 .34 Discussion The aim of the study was to estimate POB prevalence for Icelandic Olympians participating in individual sports, to identify the relationship between experiencing POB and satisfaction with a performance at the Olympic games, plans about retiring after the games and psychological support in preparation for the games and after they finished.
Furthermore, to identify a relationship between experiencing POB and adaptive- and maladaptive coping strategies.

13 More than half of the participants of this study experienced POB.
There was not any information in the literature regarding POB prevalence, but previous studies have shown that athletes can experience POB and that after the Olympic games finished athletes’ described feeling unmotivated, isolated, lonely, overwhelmed and feeling like they must start over again (Bennie et al., 2019; Samuel et al., 2016).

Results from this study are therefore in line with previous studies, however the symptoms described in the literature were not all as common in this study.
Emptiness and unmotivated for training and competing were the most common symptoms and unmotivated for daily life had the lowest prevalence, but loneliness was also not common among participants.

Results from this study showed that prevalence for POB was higher for the athletes in this study that were not satisfied with their results than those who were satisfied.
The literature shows that one of the reasons for POB could be the rise of celebrity during the Olympics, without taking into consideration if they were satisfied with their results and that celebrity status fades away after they have arrived back home and continued in their normal life (Howells & Lucassen, 2018).

That shows that athletes can experience POB even though they were satisfied with their results.
That is in line with results from this study because participants that were satisfied with their result experienced POB even though those who were not satisfied had higher prevalence.

When it came to retirement, the results from this study were not in line with previous studies.

This study showed that the participants who did not retire had a higher prevalence of POB than those who did retire.
However, previous studies showed that athletes expressed difficulties with their identity outside of the sport and not having any interest outside of their sport (Bennie et al., 2019; Hughes & Leavey, 2012; Torregrosa et al., 2015).

Having other plans and goals outside of their sport to look forward to was a protective factor when coping with the emotional challenge athletes face after the Olympics (Bennie et al., 2019; Howells & Lucassen, 2018; McArdle et al., 2014; Wylleman 14 et al., 2012).
That could explain why participants were less likely to experience POB when retiring than for those that continued their sports career.

Previous studies showed that athletes reported that the availability for psychological support was higher before than after the Olympics and it was also more common to seek psychological support before the Olympics than after they finished in this study (Samuel et al., 2016).
The POB prevalence was higher for the participants that did not seek psychological support after the Olympic games finished than for those who did seek support.

This indicates that psychological support would benefit the athletes after the Olympic games, and that it should be more accessible so the athletes could seek out more support.
There was no relationship found in this study between coping strategies and POB which is not in line with previous studies that showed that adaptive coping strategies result in higher positive emotions for athletes and prevents effects from stressors (Carver et al., 1989; Gaudreau & Blondin, 2002; González-García et al., 2020).
These results could be because the participants had to recall their experience from up to 20 years ago so their coping strategies could have changed over time, which could have impacted the results.

However, coping strategies have been shown to have high stability over time (Kirchner et al., 2010; Nielsen & Knardahl, 2014).
Strengths and Limitations The strengths of this study were that the response rate was high and the majority of Icelandic Olympians from 2000 to present day took part in the study, making the results from this study very descriptive for the population of Icelandic Olympians in individual sports.

This study is also the first that examines POB prevalence systematically as far as the author knows, bringing crucial information for the literature.
Limitations of this study were that in some cases the participants had to recall their feelings from 20 years ago so people cannot be expected to fully remember their experience 15 so far in the past.

Also, validated questionaries to evaluate POB do not exist, so authors did have to use their own questions.

Even though internal reliability for the authors’ POB scale was good, little is known about how valid and reliable the questions were.
Even though 75% of the study populations participated in the study, the study’s statistical power is low, which means that the generalizability of the results is somewhat limited, at least outside Iceland.

Conclusions and Future Studies This study shows that POB is a real problem because more than half of the participants experienced it at least once in their Olympic career.
It must be researched better to be able to assess the reasons for POB, what symptoms POB includes, and how to support the athletes that experience POB in the best way.

For the participants of this study, it was most common to experience POB if they were not satisfied with their results, if they did not retire from their sport after the Olympic games finished, and if they did not seek psychological support after the games.
Adaptive coping strategies have been shown in previous studies to lower negative emotions in relations to stressful events, however this study did not show any relationship between POB and different coping strategies (Gaudreau & Blondin, 2002; González-García et al., 2020).

Research on this topic is needed to give a better idea of how common the problem is within the world of sports so that support can be provided for Olympic athletes.
For example, the National Olympic and Sports association of Iceland could use this information to assess their support for the athletes after the Olympic games have finished.

Better mental health for Olympic athletes could lead to improved results in their careers in the future.

For future studies, there are numerous possibilities on POB.

It would be interesting to follow the next group of Olympians from Iceland to record their psychological support before, during and after the games.
Also, it would be interesting to monitor their mental health after the games to be able to assess what the reason could be for the POB.

It is 16 furthermore important to develop a POB questionnaire that is valid and reliable to be able to further assess the prevalence of POB.

The next step would be to take the research abroad to get more information about the prevalence and compare POB between nations with their psychological support in mind.
Getting more participants all over the world could also provide more information about the reason for POB and what strategies work best when dealing with POB.

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