# Exercise as it relates to Disease/Prevalence of anxiety and depression for team sport athletes in comparison to individual sport athlete
##### This article is a critique of; Pluhar, E., McCracken, C., Griffith, K., Christino, M., Sugimoto, D., Meehan, W. Team Sport Athletes May be Less Likely to Suffer Anxiety or Depression than Individual Sport Athletes.  Journal of Sports Science & Medicine [Internet]. 2019 Sept 1 [2022 Sept 10}. 18(3): 490-496. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683619/
## What is the background to this research?

Exercise’s effects on mental health has been studied extensively and shown to have positive effects on not only physical but mental wellbeing. For example, a 2011 meta-analysis showed significant improvements for adolescents who engaged in physical activity to experience less depressed and anxious feelings,. This study went an approach further and analysed if playing individually or playing in a team had an effect on depression and anxiety prevalence in a youth population. This study is importance as depression and anxiety in young people in Australia is increasing. In 2014, 1 in 5 people aged 11-17 had either high or very high levels of psychological distress,. Therefore, these findings are relevant and highlight the importance of the type of exercise especially in youth populations for their mental wellbeing.

## Where is the research from?

This study was conducted using 756 athletes at the Micheli Sports Injury and Prevention centre from 2013-2018 in Boston,. The data was analysed under the Oregon State University. The full list of authors and their credentials were provided in the article. The article was published in the Journal of Sports Science and Medicine in 2019. This is an easily accessible and credible publishing agency with many other reputable and peer reviewed sources.

## What kind of research was this?

This study was conducted as a cross sectional study; meaning that the data was observed and taken at one single point in time. The data was only taken from participants aged 18years and younger. P-values of <0.05 or a 95% confidence interval that did not cross 1 were defined as statistically significant,. As 756 athletes were sampled the large population group used means reliable information can be concluded. There was only a slightly higher rate of females in the population at 56% so differences seen among gender can be considered. The method of this article was unclear in how the data was specifically taken and if any bias was present. They defined their selection of individual athletes as; athletes that did not require another person to compete with (not including opponent),. Team sport athletes were defined as any athlete that competed in any team sports throughout any season,. Anxiety and depression had to be clinically diagnosed, but also self-reported by the individual,. This therefore eliminated any self-diagnosis factors that would lead to non-valid results.

## What did the research involve?

The method for this cross-sectional study was limited in their requirements for participants and how they specially gathered their research, The participants had to be at the sports injury centre and from the ages of 11-18. They were asked to document their reason for playing, time spent training, use of alcohol and intensity of exercise. The researches also recorded each athlete’s body mass index (BMI), gender and age. The athlete then self-reported any clinically diagnosed depression and anxiety. The article does not mention if they had to provide medical proof of this mental health status but it is assumed as it is mentioned repeatedly, they had to be diagnosed by a medical professional. This is reliable to ensure that those reported with mental health disorders are correct but there is also a limitation that some individuals suffering with anxiety and/or depression have not been diagnosed and for potentially many different reasons unable to access the required help. The research also went from 2013-2018, this had both positives and negatives to the final outcome. A negative effect of this is that over this 5-year period some of the athletes may have developed these mental health issues as they got older as the mean age was 13.5 years and pre-pubescent children just starting puberty would undergo many more emotional changes,. A positive however, is that the 5 year long collection period of data ensured a very large sample to compare reliable data.

## What were the basic results?

The 756 participants had a mean age of 13.5 ± 2.5years and 56% were females with 44% males.
Table 1 shows the percentages of athletes suffering from anxiety or depression. Individual at 13% (p<0.01) and for team 7% (p<0.01).
Table 1 :
| Type | Anxiety/Depression | |
| Individual | 13% | p<0.01 |
| Team | 7% | p<0.01 |
Table 2 shows other risk factors potentially related to the higher depression and anxiety rates seen in graph 1. This helps highlight other potential preventative issues relating to poor mental health in young adults. More team sport athletes drank alcohol at 9% compared to individual sport athletes at 7%. It was also more likely for team athletes to be engaging in sport for fun (79%) then for goal orientated reason (21%). Individual athletes were lower at 70% for fun reasons and 30% for goal orientated reason.
Table 2; Other factors analysed effecting mental health :
| Type | Alcohol | Goal Orientated Reason | Fun Reason |
| Individual | 7% | 30% | 70% |
| Team | 9% | 21% | 79% |

## What conclusions can we take from this research?

Current research and this study suggest that youth who engage in physical activity through team sports have lower levels of self-reported and clinically diagnosed anxiety and depression,. Although this particular study lack specificity in their method, the goal and research conclusions were strong and related to the introduction and extensively measured anxiety, depression and risk factors over the large population sample. The introduction and discussion of the article highlighted the importance of this study and provided similar literature that showed the positive effects of sport on mental health. It also suggested reasons as to why individual sport holds higher levels of mental health problems. The increased accountability and shame or guilt after loses in induvial athletes would b a contributing factor. The lack of social activity and relationship building also has been shown to be a limitation for playing sport individually,.
Other factors analysed were the reasons for playing their chosen sport, a slightly higher proportion of individual athletes had goal-related reasons. This can suggest more pressure is put onto themselves and their schedule may be less balanced with other social and academic activities.

## Practical advice

Therefore, some research including this article has shown that playing a team sport can be better for adolescent’s wellbeing due to factors linked to higher social and psychological behaviours. There is an added relationship and factor of belonging when engaged in team sports, although this is also reliant on positive relationships with teammates and coaches. However, exercise and sport in general as an adolescent will decrease the risk of developing depression and anxiety. This is proven in many studies and even this sample of young athletes used in this article as overall 8% of the adolescences reported suffering from anxiety or depression,. This is lower than the U.S average at the time in 2019,.

## Further information/resources

For more information and support please review:
Anxiety and Depression Support; https://www.beyondblue.org.au/
Guide and Reference for Adolescence Physical Activity; https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-children-and-young-people-5-to-17-years

## References

* 1 2 3 4 5 6 7 8 9 10 Pluhar, E., McCracken, C., Griffith, K., Christino, M., Sugimoto, D., Meehan, W. Team Sport Athletes May be Less Likely to Suffer Anxiety or Depression than Individual Sport Athletes. Journal of Sports Science & Medicine [Internet]. 2019 Sept 1 [2022 Sept 10}. 18(3): 490-496. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683619/
* 1 2 1)  2- Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., Apostolopoulos, V. Exercise and Mental Health. Elsevier ScienceDirect Journal [Internet]. 2017 Dec [2022 Sept 10]. 106: 48-56. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0378512217308563
* 1 2 3 4 J. Panza, M., Graupensperger, S., Agans, J., Dore, I., Vella, S., Evans, M. Adolescent Sport Participation and Symptoms of Anxiety and Depression: A Systematic Review and Meta-Analysis. Journal of Sport and Exercise Psychology. [Internet]. 2020 May 21 [2022 Sept 10]. 42(3): 201-218. Available from: https://journals.humankinetics.com/configurable/content/journals$002fjsep$002f42$002f3$002farticle-p201.xml?t%3Aac=journals%24002fjsep%24002f42%24002f3%24002farticle-p201.xml&content=fulltext
* ↑ Australian Government. Australia’s Youth; Mental Illness. Australian Institute of Health and Welfare. [Internet]. 2021 Jun 25 [2022 Sept 10]. Available from: https://www.aihw.gov.au/reports/children-youth/mental-illness
* ↑ Singh, M. Methodology Series Module 3: Cross-sectional Studies. PubMed Central [Internet]. 2016 May {2022 Sept 10]. 61(3): 261-264. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885177/
* ↑ Raising Children Network Australia. Social and Emotional Changes in pre-teens and teenagers. Health on the Net Foundation. [Internet]. 2022 [2022 Sept 10]. Available from: https://raisingchildren.net.au/pre-teens/development/social-emotional-development/social-emotional-changes-9-15-years
* ↑ Victorian Government. Strong Relationships, Strong Health. Better Health Channel [Internet]. 2021 [2022 Sept 10]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/Strong-relationships-strong-health
* ↑ Beyond Blue. Anxiety Depression and Suicide Prevention. Australian Charities. 2022 [2022 Sept 10]. Available from https://www.beyondblue.org.au
* ↑ Australian Government. Physical Activity and Exercise Guidelines. Australian Department of Health. 2022[10 Sept 2022]. Available from: https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians