Exercise and sport, collectively, represent the most popular leisure activity for the adolescent age group (Gerber, Holsboer-Trachsler et al. 2011). As a result, there are many benefits, including increased social contact with peers, development of self-esteem and confidence, the opportunity to improve leadership qualities and the promotion of optimal health and fitness. Exercise and sport have been shown to have an association with positive adolescent mental and physical well-being (Gerber, Holsboer-Trachsler et al. 2011). Further, exercise and sport may foster psychological coping resources such as autonomy, self-efficacy, optimism and social support. Prior research suggests that exercise and sport are able to buffer stress-related psychopathological symptoms within this age group (Gerber, Holsboer-Trachsler et al. 2011).
Despite the many benefits of sport and exercise, there are numerous negative consequences which occur as a result of sport during adolescence. Young athletes are required to participate in extensive training schedules as well as in large numbers of competitive events. At this age, there are many causes of stress, adult dominance and drop-out or attrition problems. The drive to win and attain selection at the elite level can be the cause of great psychological and physical stress (DiFiori, Benjamin et al. 2014).
In order to reach the elite level, athletes are required to invest much time and energy to the sport. There may be additional psychological strain due to pressures originating from parents, coaches, peers or the athlete themselves. Not all adolescents are able to cope with these demands and external expectations, which may make it difficult to reduce participation or quit the sport. This may place some adolescents at risk of developing long-term psychosomatic symptoms (Gerber, Holsboer-Trachsler et al. 2011). This article will discuss the many forms of stress that adolescent athletes encounter and provide some firm recommendations from a bio-psycho-social perspective.
Having strong academic performance is an important goal for adolescent athletes. In order to provide athletes with an opportunity to combine elite sport and schooling, many countries have proactively established special sport schools and sport classes. Given that stress is a key factor in the cause of psychopathological disorders among adolescents, attempts to facilitate the fusion of school and elite sport seem relevant, especially as adults tend to underestimate the level of stress perceived by adolescents themselves (Gerber, Holsboer-Trachsler et al. 2011).
Young adolescent athletes face many pressures and demands. One of these demands is the pressure for to specialise early in any given sport (DiFiori, Benjamin et al. 2014). With the exception of young age sports such as gymnastics and the martial arts, early sport specialisation can lead to staleness and burnout (DiFiori, Benjamin et al. 2014). Further, large numbers of children do not limit their sports to a given ‘season’ and are involved throughout the calendar year. Diversified sports training during early and middle adolescence may be more effective than early sport specialisation in developing elite-level skills in the primary sport due to skill transfer (DiFiori, Benjamin et al. 2014).
Growth and development:
Readiness for sports depends on a child’s level of growth and development (motor, sensory, cognitive, social, and emotional) and the tasks/demands of the individual’s competitive sport. If a young athlete is expected to learn too many skills, beyond their ability, there will be little motivation to learn new skills. Mastering tasks and developing a feeling of competence may sustain a child’s interest and motivate him or her to learn new skills (DiFiori, Benjamin et al. 2014).
Careful monitoring of training workload during the adolescent growth spurt is recommended as there is greater injury risk during this phase. This relates to diminished size-adjusted bone mineral density, asynchronous growth patterns, relative weakness of growth cartilage and physeal vascular susceptibility (DiFiori, Benjamin et al. 2014).
External pressure (parents, coaches and peers):
Parents and coaches are often guilty of placing unrealistic expectations on adolescent athletes. This may result in feelings of insecurity and displeasure in their achieved progress in their sport, comparing themselves to their chronological peers. As a consequence, children may lose self-esteem and withdraw from the sport. Readiness is assessed by determining what requisite antecedent skills will provide the basis for mastering the new activity. For example, a young athlete requires good eye tracking prior to hitting a pitched ball effectively (DiFiori, Benjamin et al. 2014).
Coping with stress in sport is a pivotal self-regulatory factor that promotes optimal levels of sporting achievement (Nicolas, Gaudreau et al. 2011). Individual-related factors (personality, motivation, cognitive evaluation) are key predictors of sport-related coping. Task-oriented coping represents the strategy to directly manage the stressful situation (that is, problem-focused) and its resulting cognitive and affective activation (approach emotion focused). This is also called approach or engagement coping and includes strategies such as effort expenditure, thought control, relaxation, logical analysis, mental imagery, and support seeking. Indicators of task-oriented coping have been associated with objective and subjective indicators of achievement (Nicolas, Gaudreau et al. 2011).
Disengagement-oriented coping, represents the strategies that enable the person to withdraw from the process of striving for the fulfilment of desired outcomes. This dimension has been negatively associated with the indicators of achievement and includes behavioural disengagement and venting of unpleasant emotions (Nicolas, Gaudreau et al. 2011).
Coach related factors in athlete coping:
Effective coaching requires not only the establishment of a satisfactory relationship but also adequate physical, technical, mental and tactical preparation of the athletes. Supportive coaching is used to refer to a broad and multi-faceted coaching style that incorporates distinct yet interrelated emotional/relational and structural/instrumental components of effective coaching. Supportive coaching can play a positive role in providing guidance in the goal striving process and nurturing of athletic and mental skills. It can be seen as a resource likely to make athletes more capable of problem solving and preparing them to cope with the stress inherent to sport competitions. Task-involving motivational climate are positively correlated with task-oriented coping (TOC) in the sporting domain (Nicolas, Gaudreau et al. 2011).
An environment which includes an ego-motivated coaching culture may provide athletes with an unsupportive coaching style. As a result of an unsupportive environment, athletes experience excessive pressure from coaches, favouritism, and greater time spent with the best athletes are important risk factors for impaired self-regulation. This is shown by associations between ego-involving motivation climate and the use of disengagement-oriented coping (DOC) in the sport domain (Nicolas, Gaudreau et al. 2011).
Holistically young aspiring athletes are at risk of developing burnout , as they face not only high physical demands but also psychological pressure to reach the elite level (Gustafsson and Skoog 2012). Burnout appears to be linked to chronic emotional and interpersonal stressors in a person’s relationship with their work (Gerber, Holsboer-Trachsler et al. 2011). In athletes, burnout is associated with negative outcomes such as performance impairment, reduced enjoyment, depressed mood and, potentially sport termination (Gustafsson and Skoog 2012). Optimists perceive their life as less stressful than pessimists, which may be why they are less likely to burnout (Gustafsson and Skoog 2012). Exhaustion is a central component to burnout and is related to stress associated with intense training and competition demands. Reduced sense of athletic accomplishment is manifested in a perception of low ability with regard to performance and skill level. Sport devaluation manifests itself in a loss of motivation, with the athlete ceasing to care about his or her previously beloved sport (DiFiori, Benjamin et al. 2014).
To date, no evidence has been found to suggest that elite sport participation protects against depressive and anxious symptoms originating from poor sleep, or that sport participation interacts with stress and sleep. This is in contrast to models that state stress to precipitate the onset of and exacerbates the impairments resulting from disturbed sleep (Gerber, Holsboer-Trachsler et al. 2011).
Literature supports beneficial health effects of leisure exercise and sport participation among youths (Gerber, Holsboer-Trachsler et al. 2011). In a recent paper, athletes reported less stress, better sleep and decreased depressive and anxious symptoms. Delayed sleep onset and a need of more than 9 hours for adolescents clash with social constraints such as family life and school schedules. As a result sleep debt increases and sleep quality becomes worse, which are factors associated with cognitive and emotional impairment (Gerber, Holsboer-Trachsler et al. 2011).
There are five main reasons as to why addressing poor sleep in adolescent athletes is important in buffering stress. First, sleep complaints in adolescents are related to both mental and physical ill-health. Second, cognitive models of insomnia suggest that stress precipitates the occurrence of sleep complaints. Third, exercise and sport may be associated with better sleep among young people. Fourth, good sleep is an important factor for elite athletes since rest has a restorative function and aids recovery from strenuous training schedules (Kellmann and Kallus 2001, Samuels 2008). Fifth, the adolescent brain undergoes dramatic changes (Fietze, Strauch et al. 2009): quantitatively, from the age of 10 to 18 years, the amount of white matter increases as compared to gray matter, whereas the brain volume remains unchanged. Importantly, changes and peaks in gray matter volume do vary between different brain regions (for example, peak of frontal gray matter: 10-12 years; peak of temporal gray matter: 16-18 years) (Gerber, Holsboer-Trachsler et al. 2011).
Qualitatively, change in the stability of stressor-sensitive regions such as the dopamine systems is considered key for adolescents’ brain response to reward (Gerber, Holsboer-Trachsler et al. 2011). With regard to sleep, a wealth of research provides evidence that adolescents still need a minimum of nine hours of sleep per night during the changes mentioned (Mercer, Merritt et al. 1998). At the same time, puberty changes the circadian rhythm such that preferred sleep onset time is after 10pm. As described above, there is good evidence that adolescence is accompanied by substantial brain changes in brain structures and sleep (Gerber, Holsboer-Trachsler et al. 2011). Therefore, positive sleep hygiene is particularly important in this age group.
Protective behavioural traits:
Optimism can be regarded as generalised outcome expectancy or as a sense of confidence that a goal can be attained (or a lack of doubt as to the goal’s attainability). Optimism is associated with a sense of control and confidence, making optimists more likely to adopt active and proactive coping as well as less avoidance coping and therefore prevent negative consequences of stress such as ill-health (Gustafsson and Skoog 2012).
Optimists are better at developing social relationships than pessimists and this is known to have positive effects on health and well-being. Not spending time with significant others has been related to burnout in athletes (Kjormo and Halvari 2002). Optimists react less reactively to stressors and therefore as less stressful. Optimists also are more prone to acceptance in uncontrollable situations whereas pessimists tend towards denial (Gustafsson and Skoog 2012).
A recent study has shown a significant negative association between optimism and both stress and burnout (Gustafsson and Skoog 2012). Optimistic athletes displayed lower levels of emotional/physical exhaustion and sport devaluation and less of a reduced sense of accomplishment. Therefore, it appears optimism is associated with lower perceptions of burnout (DiFiori, Benjamin et al. 2014).
Mediation analyses showed perceived stress to fully mediate the links between optimism and two symptoms of burnout (emotional/physical exhaustion and sport devaluation) and partly mediated the link between optimism and a third symptom, reduced sense of accomplishment (Gustafsson and Skoog 2012).
High levels of self-efficacy, perceived control and a focus on approach goals underpin a challenge state, whereas low levels of self-efficacy, perceived control and a focus on avoidance goals underpin a threat state (Turner, Jones et al. 2013). A challenge states displays improved decision making, effective and maintained cognitive function, decreased likelihood of reinvestment, efficient self-regulation and increased aerobic power, all likely to lead to successful competitive performance (Meijen, Jones et al. 2013).
Physiology of Protective Traits:
In terms of cardiovascular reactivity: a challenge state is accompanied by increased catecholamine (epinephrine and norepinephrine), indicating sympathetic adreno-medullary activity, which is reflected in increased heart rate (HR) and cardiac output (CO), attenuated pre-ejection period (PEP) and decreased total peripheral resistance (TPR). This challenge CV reactivity pattern represents an efficient physiological response to stressors, where the energy needed for successful performance (e.g. glucose) is released into the blood and can reach the brain and muscles efficiently due to decreased vascular resistance and enhanced blood flow (Turner, Jones et al. 2013).
A threat state, similar to a challenge state, is also marked by increased sympathetic adreno-medullary activity, but is accompanied by increased pituitary adrenal-cortical activity, which stimulates cortisol release (Turner, Jones et al. 2013). Thus, increased HR and attenuated PEP occurs, but with an increase or stabilisation of TPR, and a small increase, decrease or stabilisation in CO. In this pattern, pituitary-adreno-cortical activity is thought to temper sympathetic adreno-medullary activity. Therefore, compared with a challenge CV activity pattern, efficient energy delivery to the brain and muscles does not occur (Turner, Jones et al. 2013)
A threat state is proposed to lead to ineffective decision making and cognitive function, increased likelihood of reinvestment, inefficient self-regulation, and decreased aerobic power and decreased anaerobic power (compared with a challenge state); all likely to lead to unsuccessful competitive performance (Meijen, Jones et al. 2013, Turner, Jones et al. 2013).
Adolescent faith in their coping abilities decreases during adolescence. Mental toughness is important in adolescents as finishing high school and transitioning into full time work or university may form hot spots for the onset or offset of psychopathology. During developmental transitions, vulnerabilities and opportunities may change, which may alter the course of adolescent development (Gerber, Kalak et al. 2013). Therefore, it has been suggested that athletes foster their mental toughness through addressing four components: challenge mindset, commitment, control and confidence (Gerber, Kalak et al. 2013).
There is a great deal of overlap between mental toughness and the concept of ‘hardiness’. Hardiness represents a trait like characteristic that influences the way people perceive situations and react in stressful circumstances. Hardy individuals are more effective in coping with stress and that hardiness protects against stress-induced health symptoms (Maddison and Prapavessis 2005).
The three components of hardiness overlap with those for mental toughness, outlined above. These include: control, commitment and challenge. Control is defined as ‘feeling and acting as if one is influential in the face of the varied contingencies of life’. Commitment is defined as ‘becoming involved in experiences rather than experiencing alienation from whatever one encounters’. Challenge is defined as ‘a belief that change, rather than stability, is normal in life and that the anticipation of changes is an interesting incentive to growth rather than a threat to security’ (Gerber, Kalak et al. 2013).
Control helps individuals to make appropriate decisions about how to cope with stressful situations. Commitment helps people to remain proactive instead of passively accepting a given situation. Challenge supports personal development and growth, rather than safeguarding what the person already has. Confidence describes how individuals feel valuable and competent in overcoming general and interpersonal problems (Gerber, Kalak et al. 2013). A person who perceives high levels of control, remains committed despite difficulties, perceives problems as challenges and feels generally valuable is less likely to exhibit depressive symptoms, especially under high perceived stress (Gustafsson, Kenttä et al. 2011).
Mentally tough individuals are characterised by a strong tendency to view their personal environment as controllable, to perceive themselves as capable and influential, to stay committed even under adverse circumstances and to consider problems as natural challenges, which allow personal growth (Gerber, Kalak et al. 2013).
Research shows that cricketers with elevated mental toughness were associated with more developmental assets (including support, empowerment, boundaries and expectations, commitment to learning, positive values, social competencies and positive identity) and lower levels of negative emotional states (Turner, Jones et al. 2013). Further, mental toughness can be viewed not only from the traditional view of optimal performance but also from a resilience perspective outside of sport (Gerber, Kalak et al. 2013).
Stress, if not managed effectively, can have a substantial impact on athlete welfare, affecting an athlete’s mental and physical readiness to perform (Main and Grove 2009). Therefore, is it important that player wellness, including stress is monitored on a regular basis. Self-analysis tools, such as the “Hooper Index” may provide an easy and valuable measure of how an athlete is coping with the demands of training (Hooper, Mackinnon et al. 1995). This index rates factors such as perceived exertion, muscles soreness, sleep quality and mood states and have application in the monitoring and management of overtraining; however, these still lack formal validation (Hooper and Mackinnon 1995).
Promoting optimistic attitudes may be a potential way of intervening to prevent stress and burnout in athletes. Coping skills can help to supplement psychological resilience and can include both reactive and proactive strategies. Macro-level coping, or ‘cognitive avoidance’ may be another method of managing stress. Averting attention from stress-related information may reduce feelings of distress and negative consequences of an encounter (Gustafsson and Skoog 2012). Social support can help facilitate influence on sporting performance, and appropriate training to the family and friends of athletes can help to optimise its effect as an assistive strategy (Gustafsson, Kenttä et al. 2011).
There are two methods that have been shown to increase an athlete’s challenge state over that of a threat state. The first presents a challenge imagery script that emphasises the athlete’s resources to meet the demands of any given situation and helps to develop higher confidence (self-efficacy), demonstrate competence (higher perceived control) and foster approach goal setting. This method has led athletes to identify their emotional response as more helpful for performance, become more confident and appraise their situation as less threatening (Turner, Jones et al. 2013). The second method focuses on the physiological response to stress for the given athletes through cardiovascular reactivity. When provided with this information and interpretation of this information, a given athlete is more able to understand their responses to pressure, and more likely to seek assistance and guidance in further strategies to enhance their ability to deal with pressure (Turner, Jones et al. 2013).
Cognitive behavioural therapy (CBT) has been shown as an effective tool to manage stress and also foster positive behavioural traits, such as optimism (Gustafsson and Skoog 2012). Therapy focuses on changing specific thoughts and distorted thinking. CBT can make an individual more aware of pessimistic thinking, to challenge such thinking and use positive reframing to deal with pessimistic beliefs, reduce stress and potentially reduce the risk of burnout (Gustafsson and Skoog 2012).
Stress inoculation strategies function to assess the effects of stress on athletes by repeatedly exposing them to pressure situations and recording CV reactivity before their performance. Prior task exposure and stress inoculation programs integrating visualisation, self-talk and relaxation strategies can diminish the effects of sympathetic adreno-medullary activity of the heart, which may help athletes to be more relaxed under competition pressure (Turner, Jones et al. 2013).
The development of a mindset of mental toughness may represent a target intervention for resilient adaptation programmes (Gerber, Kalak et al. 2013). Controlled exposure to relevant negative stimuli (Rutter 1993), question whether mental toughness can be improved by controlled exposure to challenges or by means of specific coping training programmes (Gerber, Holsboer-Trachsler et al. 2011)
Stress management interventions typically focus on changing an individual’s psychological reactions to stressors (Rumbold 2012). Instead of viewing stress as a solely personal issue, sport organisations should acknowledge the full impact of their own processes and procedures in addressing these types of stress in sport performers. Maslach and Leiter (1997) suggest a model of matching the individual with 6 work domains: workload, control, reward, community, fairness, and values. Effective matching on these domains can be translated to the less risk of burnout (DiFiori, Benjamin et al. 2014).
An effective, proactive and preventive organisational approach to stress management seeks to make changes in the macro environment (organisation culture), the micro environment (task redesign), or in the worker’s perceptions of control (for example, enhanced decision making opportunities). Organisations are recommended to proactively address the underlying causes of the stressors, establish effective mechanisms to recognise and respond to stressor warning signs, properly identify the perspectives of stakeholders, and to implement systematic organisational learning and un-learning (Arnold and Fletcher 2012). Further environmental interventions should focus on moderating external pressures for the athlete and to monitoring and modify their training demands (Gustafsson and Skoog 2012).
Stress in adolescent athletes is a key issue that needs to be explored and managed in order to optimise performance and prevent burnout. This article has examined the various causes of stress, and interventions from a bio-psycho-social perspective. The physiology of stress has been explained through cardiovascular reactivity and the behavioural genesis of stress has been outlined through specific behavioural traits of challenge-threat response, mental toughness, hardiness, and strategies of coping. The effect that coaches, parents and peers have on creating additional pressure for athletes has been discussed as well as the landscape that many adolescent athletes need to deal with in terms of academic demands and in maintaining good sleep hygiene. Overall, stress in adolescent athletes needs to be monitored appropriately and adequate education and preventive strategies employed from an early age.
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About Tim Lathlean
PhD Candidate, Monash Injury Research Institute: Training loads, fatigue, sleep health and injury risk #AFL