Analyze another student’s initial post. Examine their applic

REVIEW published: 08 May 2020

doi: 10.3389/fspor.2020.00042

Frontiers in Sports and Active Living | www.frontiersin.org 1 May 2020 | Volume 2 | Article 42

Edited by:

Sophia Nimphius,

Edith Cowan University, Australia

Reviewed by:

Chris John Bishop,

Middlesex University, United Kingdom

Claudia Reardon,

University of Wisconsin-Madison,

United States

*Correspondence:

J. Bryan Mann

[email protected]

Specialty section:

This article was submitted to

Elite Sports and Performance

Enhancement,

a section of the journal

Frontiers in Sports and Active Living

Received: 05 October 2019

Accepted: 30 March 2020

Published: 08 May 2020

Citation:

Lopes Dos Santos M, Uftring M,

Stahl CA, Lockie RG, Alvar B,

Mann JB and Dawes JJ (2020) Stress

in Academic and Athletic Performance

in Collegiate Athletes: A Narrative

Review of Sources and Monitoring

Strategies.

Front. Sports Act. Living 2:42.

doi: 10.3389/fspor.2020.00042

Stress in Academic and Athletic Performance in Collegiate Athletes: A Narrative Review of Sources and Monitoring Strategies

Marcel Lopes Dos Santos 1, Melissa Uftring 1, Cody A. Stahl 1, Robert G. Lockie 2,

Brent Alvar 3, J. Bryan Mann 4* and J. Jay Dawes 1

1 School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK, United States, 2Department of Kinesiology, California State University, Fullerton, CA, United States, 3Department of Kinesiology, Point Loma

Nazarene University, San Diego, CA, United States, 4Department of Kinesiology and Sport Sciences, University of Miami,

Miami, FL, United States

College students are required to manage a variety of stressors related to academic,

social, and financial commitments. In addition to the burdens facing most college

students, collegiate athletes must devote a substantial amount of time to improving

their sporting abilities. The strength and conditioning professional sees the athlete on

nearly a daily basis and is able to recognize the changes in performance and behavior an

athlete may exhibit as a result of these stressors. As such, the strength and conditioning

professional may serve an integral role in the monitoring of these stressors and may be

able to alter training programs to improve both performance andwellness. The purpose of

this paper is to discuss stressors experienced by collegiate athletes, developing an early

detection system through monitoring techniques that identify the detrimental effects of

stress, and discuss appropriate stress management strategies for this population.

Keywords: stress, load management, academic stress, stress management, injury

INTRODUCTION

The college years are a period of time when young adults experience a significant amount of change and a variety of novel challenges. Academic performance, social demands, adjusting to life away from home, and financial challenges are just a few of the burdens college students must confront (Humphrey et al., 2000; Paule and Gilson, 2010; Aquilina, 2013). In addition to these stressors, collegiate athletes are required to spend a substantial amount of time participating in activities related to their sport, such as attending practices and training sessions, team meetings, travel, and competitions (Humphrey et al., 2000; López de Subijana et al., 2015; Davis et al., 2019; Hyatt and Kavazis, 2019). These commitments, in addition to the normal stress associated with college life, may increase a collegiate-athlete’s risk of experiencing both physical and mental issues (Li et al., 2017; Moreland et al., 2018) that may affect their overall health and wellness. For these reasons, it is essential that coaches understand the types of stressors collegiate athletes face in order to help them manage the potentially deleterious effects stress may have on athletic and academic performance.

Strength and conditioning coaches are allied health care professionals whose primary job is to enhance fitness of individuals for the purpose of improving athletic performance (Massey et al., 2002, 2004, 2009). As such, many universities and colleges hire strength

Lopes Dos Santos et al. Stress in College Athletes

and conditioning coaches as part of their athletic staff to help athletes maximize their physical potential (Massey et al., 2002, 2004, 2009). Strength and conditioning coaches strive to increase athletic performance by the systematic application of physical stress to the body via resistance training, and other forms of exercise, to yield a positive adaptation response (Massey et al., 2002, 2004, 2009). For this reason, they need to understand and to learn how to manage athletes’ stress. Additionally, based on the cumulative nature of stress, it is important that both mental and emotional stressors are also considered in programming. It is imperative that strength and conditioning coaches are aware of the multitude of stressors collegiate athletes encounter, in order to incorporate illness and injury risk management education into their training programs (Radcliffe et al., 2015; Ivarsson et al., 2017).

Based on the large number of contact hours strength and conditioning coaches spend with their athletes, they are in an optimal position to assist athletes with developing effective coping strategies to manage stress. By doing so, strength and conditioning coaches may be able to help reach the overarching goal of improving the health, wellness, fitness, and performance of the athletes they coach. The purpose of this review article is to provide the strength and conditioning professional with a foundational understanding of the types of stressors collegiate athletes may experience, and how these stressors may impact mental health and athletic performance. Suggestions for assisting athletes with developing effective coping strategies to reduce potential physiological and psychological impacts of stress will also be provided.

Stress and the Stress Response In its most simplistic definition, stress can be described as a state of physical and psychological activation in response to external demands that exceed one’s ability to cope and requires a person to adapt or change behavior. As such, both cognitive or environmental events that trigger stress are called stressors (Statler and DuBois, 2016). Stressors can be acute or chronic based on the duration of activation. Acute stressors may be defined as a stressful situation that occurs suddenly and results in physiological arousal (e.g., increase in hormonal levels, blood flow, cardiac output, blood sugar levels, pupil and airway dilation, etc.) (Selye, 1976). Once the situation is normalized, a cascade of hormonal reactions occurs to help the body return to a resting state (i.e., homeostasis). However, when acute stressors become chronic in nature, they may increase an individual’s risk of developing anxiety, depression, or metabolic disorders (Selye, 1976). Moreover, the literature has shown that cumulative stress is correlated with an increased susceptibility to illness and injury (Szivak and Kraemer, 2015; Mann et al., 2016; Hamlin et al., 2019). The impact of stress is individualistic and subjective by nature (Williams and Andersen, 1998; Ivarsson et al., 2017). Additionally, the manner in which athletes respond to a situational or environmental stressor is often determined by their individual perception of the event (Gould and Udry, 1994; Williams and Andersen, 1998; Ivarsson et al., 2017). In this regard, the athlete’s perception can either be positive (eustress) or negative (distress). Even though they both cause physiological

arousal, eustress also generates positive mental energy whereas distress generates anxiety (Statler and DuBois, 2016). Therefore, it is essential that an athlete has the tools and ability to cope with these stressors in order to have the capacity to manage both acute and chronic stress. As such, it is important to understand the types of stressors collegiate athletes are confronted with and how these stressors impact an athlete’s performance, both athletically and academically.

METHODS

Literature Search/Data Collection The articles included in this review were identified via online databases PubMed, MEDLINE, and ISI Web of Knowledge from October 15th 2019 through January 15th 2020. The search strategy combined the keywords “academic stress,” “athletic stress,” “stress,” “stressor,” “college athletes,” “student athletes,” “collegiate athletes,” “injury,” “training,” “monitoring.” Duplicated articles were then removed. After reading the titles and abstracts, all articles that met the inclusion criteria were considered eligible for inclusion in the review. Subsequently, all eligible articles were read in their entirety and were either included or removed from the present review.

Inclusion Criteria The studies included met all the following criteria: (i) published in English-language journals; (ii) targeted college athletes; (iii) publication was either an original research paper or a literature review; (iv) allowed the extraction of data for analysis.

Data Analysis Relevant data regarding participant characteristics (i.e., gender, academic status, sports) and study characteristics were extracted. Articles were analyzed and divided into two separate sections based on their specific topics: Academic Stress and Athletic Stress. Then, strategies for monitoring and workload management are discussed in the final section.

ACADEMIC STRESS

Fundamentally, collegiate athletes have two major roles they must balance as part of their commitment to a university: being a college student and an athlete. Academic performance is a significant source of stress for most college students (Aquilina, 2013; López de Subijana et al., 2015; de Brandt et al., 2018; Davis et al., 2019). This stress may be further compounded among collegiate athletes based on their need to be successful in the classroom, while simultaneously excelling in their respective sport (Aquilina, 2013; López de Subijana et al., 2015; Huml et al., 2016; Hamlin et al., 2019). Davis et al. (2019) conducted surveys on 173 elite junior alpine skiers and reported significant moderate to strong correlations between perceived stress and several variables including depressed mood (r = 0.591), sleep disturbance (r = 0.459), fatigue (r = 0.457), performance demands (r = 0.523), and goals and development (r = 0.544). Academic requirements were the highest scoring source of stress of all variables and was most strongly correlated with perceived

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stress (r = 0.467). Interestingly, it was not academic rigor that was viewed by the athletes as the largest source of direct stress; rather, the athletes surveyed reported time management as being their biggest challenge related to academic performance (Davis et al., 2019). This further corroborates the findings of Hamlin et al. (2019). The investigators reported that during periods of the academic year in which levels of perceived academic stress were at their highest, students had trouble managing sport practices and studying. These stressors were also associated with a decrease in energy levels and overall sleep quality. These factors may significantly increase the collegiate athlete’s susceptibility to illness and injury (Hamlin et al., 2019). For this reason, coaches should be aware of and sensitive to the stressors athletes experience as part of the cyclical nature of the academic year and attempt to help athletes find solutions to balancing athletic and academic demands.

According to Aquilina (2013), collegiate athletes tend to be more committed to sports development and may view their academic career as a contingency plan to their athletic career, rather than a source of personal development. As a result, collegiate athletes often, but certainly not always, prioritize athletic participation over their academic responsibilities (Miller and Kerr, 2002; Cosh and Tully, 2014, 2015). Nonetheless, scholarships are usually predicated on both athletic and academic performance. For instance, the National Collegiate Athletic Association (NCAA) requires collegiate athletes to achieve and maintain a certain grade point average (GPA). Furthermore, they are also often required to also uphold a certain GPA to maintain an athletic scholarship. The pressure to maintain both high levels of academic and athletic performancemay increase the likelihood of triggeringmental health issues (i.e., anxiety and depression) (Li et al., 2017; Moreland et al., 2018).

Mental health issues are a significant concern among college students. There has been an increased emphasis placed on the mental health of collegiate athletes in recent years (Petrie et al., 2014; Li et al., 2017, 2019; Reardon et al., 2019). Based on the 2019 National College Health Assessment survey from the American College Health Association (ACHA) consisting of 67,972 participants, 27.8% of college students reported anxiety, and 20.2% reported experiencing depression which negatively affected their academic performance (American College Health Association American College Health Association-National College Health Assessment II, 2019). Approximately 65.7% (50.7% males and 71.8% females) reported feeling overwhelming anxiety in the past 12months, and 45.1% (37.1%males and 47.6% females) reported feeling so depressed that it was difficult for them to function. However, only 24.3% (13% males and 28.4% females) reported being diagnosed and treated by a professional in the past 12 months. Collegiate athletes are not immune to these types of issues. According to information presented by the NCAA, many certified athletic trainers anecdotally state that anxiety is an issue affecting the collegiate-athlete population (NCAA, 2014). However, despite the fact that collegiate athletes are exposed to numerous stressors, they are less likely to seek help at a university counseling center than non-athletes (NCAA, 2014), which could be related to stigmas that surround mental health services (NCAA, 2014; Kaier et al., 2015; Egan,

2019). This not only has significant implications related to their psychological well-being, but also their physiological health, and consequently their performance. For instance, in a study by Li et al. (2017) it was found that NCAA Division I athletes who reported preseason anxiety symptoms had a 2.3 times greater injury incidence rate compared to athletes who did not report. This same study discovered that male athletes who reported preseason anxiety and depression had a 2.1 times greater injury incidence, compared to male athletes who did not report symptoms of anxiety and depression. (Lavallée and Flint, 1996) also reported a correlation between anxiety and both injury frequency and severity among college football players (r = 0.43 and r = 0.44, respectively). In their study, athletes reporting high tension/anxiety had a higher rate of injury. It has been suggested that the occurrence of stress and anxiety may cause physiological responses, such as an increase in muscle tension, physical fatigue, and a decrease in neurocognitive and perception processes that can lead to physical injuries (Ivarsson et al., 2017). For this reason, it is reasonable to consider that academic stressors may potentiate effects of stress and result in injury and illness in collegiate athletes.

Periods of more intense academic stress increase the susceptibility to illness or injury (Mann et al., 2016; Hamlin et al., 2019; Li et al., 2019). For example, Hamlin et al. (2019) investigated levels of perceived stress, training loads, injury, and illness incidence in 182 collegiate athletes for the period of one academic year. The highest levels of stress and incidence of illness arise during the examination weeks occurring within the competitive season. In addition, the authors also reported the odds ratio, which is the occurrence of the outcome of interest (i.e., injury), based off the given exposure to the variables of interest (i.e., perceived mood, sleep duration, increased academic stress, and energy levels). Based on a logistic regression, they found that each of the four variables (i.e., mood, energy, sleep duration, and academic stress) was related to the collegiate athletes’ likelihood to incur injuries. In summary, decreased levels of perceived mood (odds ratio of 0.89, 0.85–0.0.94 CI) and sleep duration (odds ratio of 0.94, 0.91–0.97 CI), and increased academic stress (odds ratio of 0.91, 0.88–0.94 CI) and energy levels (odds ratio of 1.07, 1.01–1.14 CI), were able to predict injury in these athletes. This corroborates Mann et al. (2016) who foundNCAADivision I football athletes at a Bowl Championship Subdivision university were more likely to become ill or injured during an academically stressful period (i.e., midterm exams or other common test weeks) than during a non-testing week (odds ratio of 1.78 for high academic stress). The athletes were also less likely to get injured during training camp (odds ratio of 3.65 for training camp). Freshmen collegiate athletes may be especially more susceptible to mental health issues than older students. Their transition includes not only the academic environment with its requirements and expectations, but also the adaptation to working with a new coach and teammates. In this regard, Yang et al. (2007) found an increase in the likelihood of depression that freshmen athletes experienced, as these freshmen were 3.27 times more likely to experience depression than their older teammates. While some stressors are recurrent and inherent in academic life (e.g., attending

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classes, homework, etc.), others are more situational (e.g., exams, midterms, projects) and may be anticipated by the strength and conditioning coach.

ATHLETIC STRESS

The domain of athletics can expose collegiate athletes to additional stressors that are specific to their cohort (e.g., sport- specific, team vs. individual sport) (Aquilina, 2013). Time spent training (e.g., physical conditioning and sports practice), competition schedules (e.g., travel time, missing class), dealing with injuries (e.g., physical therapy/rehabilitation, etc.), sport- specific social support (e.g., teammates, coaches) and playing status (e.g., starting, non-starter, being benched, etc.) are just a few of the additional challenges collegiate athletes must confront relative to their dual role of being a student and an athlete (Maloney and McCormick, 1993; Scott et al., 2008; Etzel, 2009; Fogaca, 2019). Collegiate athletes who view the demands of stressors from academics and sports as a positive challenge (i.e., an individual’s self-confidence or belief in oneself to accomplish the task outweighs any anxiety or emotional worry that is felt) may potentially increase learning capacity and competency (NCAA, 2014). However, when these demands are perceived as exceeding the athlete’s capacity, this stress can be detrimental to the student’s mental and physical health as well as to sport performance (Ivarsson et al., 2017; Li et al., 2017).

As previously stated, time management has been shown to be a challenge to collegiate athletes. The NCAA rules state that collegiate athletes may only engage in required athletic activities for 4 h per day and 20 h/week during in-season and 8 h/week during off-season throughout the academic year. Although these rules have been clearly outlined, the most recent NCAA GOALS (2016) study reported alarming numbers regarding time commitment to athletic-related activities. Data from over 21,000 collegiate athletes from 600 schools across Divisions I, II, and III were included in this study. Although a breakdown of time commitments was not provided, collegiate athletes reported dedicating up to 34 h per week to athletics (e.g., practices, weight training, meetings with coaches, tactical training, competitions, etc.), in addition to spending between 38.5 and 40 h per week working on academic-related tasks. This report also showed a notable trend related to athletes spending an increase of ∼2 more athletics-related hours per week compared to the 2010 GOALS study, along with a decrease of 2 h of personal time (from 19.5 h per week in 2010 to 17.1 in 2015). Furthermore, ∼66% of Division I and II and 50% of Division III athletes reported spending as much or more time in their practices during the off-season as during the competitive season (DTHOMAS, 2013). These numbers show how important it is for collegiate athletes to develop time management skills to be successful in both academics and athletics. Overall, most collegiate athletes have expressed a need to find time to enjoy their college experience outside of athletic obligations (Paule and Gilson, 2010). Despite that, because of the increasing demand for excellence in academics and athletics, collegiate athletes’ free time with family and friends is often scarce (Paule and Gilson, 2010).

Consequently, trainers, coaches, and teammates will likely be the primary source of their weekly social interactivity.

Social interactions within their sport have also been found to relate to factors that may impact an athlete’s perceived stress. Interactions with coaches and trainers can be effective or deleterious to an athlete. Effective coaching includes a coaching style that allows for a boost of the athlete’s motivation, self- esteem, and efficacy in addition to mitigating the effects of anxiety. On the other hand, poor coaching (i.e., the opposite of effective coaching) can have detrimental psychological effects on an athlete (Gearity and Murray, 2011). In a closer examination of the concept of poor coaching practices, Gearity and Murray (2011) interviewed athletes about their experiences of receiving poor coaching. Following analysis of the interviews, the authors identified the main themes of the “coach being uncaring and unfair,” “practicing poor teaching inhibiting athlete’s mental skills,” and “athlete coping.” They stated that inhibition of an athlete’s mental skills and coping are associated with the psychological well-being of an athlete. Also, poor coaching may result in mental skills inhibition, distraction, insecurity, and ultimately team division (Gearity and Murray, 2011). This combination of factors may compound the negative impacts of stress in athletes and might be especially important for in injured athletes.

Injured athletes have previously been reported to have elevated stress as a result of heightened worry about returning to pre-competition status (Crossman, 1997), isolation from teammates if the injury is over a long period of time (Podlog and Eklund, 2007) and/or reduced mood or depressive symptoms (Daly et al., 1995). In addition, athletes who experience prolonged negative thoughts may be more likely to have decreased rehabilitation attendance or adherence, worse functional outcomes from rehabilitation (e.g., on measures of proprioception, muscular endurance, and agility), and worse post-injury performance (Brewer, 2012).

MONITORING CONSIDERATIONS

In addition to poor coaching, insufficient workload management can hinder an athlete’s ability to recover and adapt to training, leading to fatigue accumulation (Gabbett et al., 2017). Excessive fatigue can impair decision-making ability, coordination and neuromuscular control, and ultimately result in overtraining and injury (Soligard et al., 2016). For instance, central fatigue was found to be a direct contributor to anterior cruciate ligament injuries in soccer players (Mclean and Samorezov, 2009). Introducing monitoring tools may serve as a means to reduce the detrimental effects of stress in collegiate athletes. Recent research on relationships between athlete workloads, injury, and performance has highlighted the benefits of athlete monitoring (Drew and Finch, 2016; Jaspers et al., 2017).

Athlete monitoring is often assessed with the measuring and management of workload associated with a combination of sport- related and non-sport-related stressors (Soligard et al., 2016). An effective workload management program should aim to detect excessive fatigue, identify its causes, and constantly adapt rest,

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