Studies investigating psychological safety in sports and non-sports contexts have mostly utilized the universal Team Psychological Safety Scale (TPSS) aimed for performance development in professional teams. The Sport Psychological Safety Inventory (SPSI) has recently been introduced for psychological safety measurement specifically in sports. The aim of this study was to compare the psychometric properties of the TPSS and the SPSI within an elite sport context. A cross-sectional survey was used to collect data for assessment of the internal consistency, factorial validity, construct validity and measurement invariance of the TPSS and the SPSI. Complete data sets were provided by 371 elite Athletics athletes (track and field) and orienteers. Both the TPSS (ω = 0.72) and the SPSI subscales (range: ω = 0.81-0.88) showed acceptable internal consistency. Confirmatory factor analyses indicated a mediocre to good model fit for the TPSS and the SPSI three-factor correlated structure. The TPSS and the SPSI subscale ‘mentally healthy environment’ showed a moderate correlation. Measurement invariance tests suggested the TPSS to be fully invariant across genders, while the SPSI was found non-invariant. The study shows that the TPSS appears sound for assessing psychological safety in elite sports, while caution is needed when using the SPSI.

I sin debattartikel i Läkartidningen (7 jan 2025) argumenterar Anna Melin och Lykke Tamm för att relativ energibrist inom idrott (REDs) är ett allvarligt och vanligt problem som bör tas på allvar.

Vi instämmer i att nutrition är en av flera grundläggande förutsättningar för idrottslig utveckling, prestation samt fysisk och psykisk hälsa. Det är självklart att träningsbelastning och energiintag måste anpassas och balanseras på alla nivåer av idrottsutövande. Däremot ifrågasätter vi författarnas framställande av REDs som ett väletablerat »syndrom«, särskilt i Läkartidningen, som riktar sig till den svenska hälso- och sjukvården.

Background Figure skaters typically jump in only one direction, landing on the same leg. Current prevention programs in figure skating lack knowledge about the importance of jumping direction in injury etiology.Objective To describe lateralisation (handedness, footedness, jumping direction) in female competitive figure skaters and its association with injury risk.Design One-year retrospective cohort study.Setting All licensed competitive figure skaters (n=400) in the southeastern region of Sweden.Participants 137 female figure skaters (mean age 12.9 (SD 3.0) years). Assessment of Risk Factors Lateralisation data and significant sports injury episodes for one year were reported by skaters. Associations were analyzed between handedness and jump-landing leg and between lateralization (right-sided/left-sided/mixed) and injury-sidedness (right/left/bilateral).Main Outcome Measurements Significant sports injury episode with time loss from sports >21 days. Results Most skaters reported right-side handedness (93%), footedness (87%) and landing leg (85%). The jumping direction (landing leg) was associated with handedness/footedness (p=0.035). Forty-two skaters (31%) had suffered a significant sports injury episode. Fifty-nine injuries (64% overuse/36% traumatic) were reported; 48 (83%) were located to the lower extremities; 35% of the lower extremity injuries involved only the landing leg. No association between left-sidedness and overuse injury episode (p=0.463) or traumatic injury (p=0.760) incidence during the study period was observed. Neither was any association found between lateralisation and distribution of injury to sides (p=0.328).Abstract 863 Figure 1 DAGitty on theoretically potential pathways between lateralisation, asymmetrical loading and injury aetiology. In figure skating, you specialise very early in jumping/spining in only one direction(thus all jumps on the sme leg). Accumulated load (skating level, years as a figure skater, training hours) may contribute to a component of exhaustion and more asymmertical loading enhancing lateralisation. The degree of laterlisation may affect balance, coordination and injury location. Athletes prone to left-wise dexterity skate with their “creative” brain and may be more prone to injury when exhaused, as well as having worse mental health in terms of body image, anxiety and depressin indicators. Blue node = outcome and ancestors of the outcome.Green node = exposure. Light grey node = unobserved (latent). Green arrow = casual path.View this table:Abstract 863 Table 1 Localization of injuries sustained in the last 12 months (n=59) with regard to lateralization injuries categorized into overuse and traumatic injuries, respectively.Conclusions Right-side handedness, footedness, and jump landing leg dominated in female competitive figure skaters. No association was found between the side that injury was sustained and the skater’s jumping direction. The relatively small size of the study implies that the risk of type 1 error must be considered. The results can be used to inform injury prevention programs for figure skaters. More research is needed on the contribution of laterality and asymmetric loading.

Background Elite athletes are role models for young sportspersons regarding social media use. Self-objectification, including self-sexualizing, contributes to body dissatisfaction and body shame, especially in young females. For efficient prevention of self-objectification, knowledge is needed about elite athletes’ self-presentation on social media.

Objective To compare social media postings indicative of self-objectification among female elite athletes in an aesthetic and a non-aesthetic individual sport and by age.

Design Cross-sectional quantitative visual content analysis study.

Setting Instagram on October 1st, 2021.

Participants All Swedish elite female athletes aged 16 years or older with open Instagram accounts in figure skaters (n=26) and athletics (track and field) athletes (n=40).

Assessment of Risk Factors The 30 most recently posted images were identified from each athlete’s Instagram account (Figure). Following exclusion of non-topical images, a panel (4 women/4 men) individually scored factors indicative of self-objectification in the remaining images. The scores were analyzed quantitatively by sport (figure skating/athletics) and age group (age-cut at 21 years).

Main Outcome Measurements Proportion of sexually suggestive images in Instagram postings.

Results In total, 1,869 images were analyzed; 669 posted by figure skaters and 1200 by athletics athletes. Seventy-four images (4%) were classified as containing sexually suggestive content. Figure skaters posted more images with sexually suggestive content (p=0.032) than athletics athletes (especially images with sexual posing (p=0.005) and sexualized body parts in focus (chest (p=0.049); hip-region (p=0.001)). Younger athletes published more images interpreted to contain sexual suggestion than older athletes (p<0.001) (especially images focusing on the chest (p=0.008)). 

Conclusions Prevention of self-objectification in young female sportspersons should include moderation of self-presentation practices on social media among female elite athletes in aesthetic sports and young elite athletes in their upper teens. Further research on the role of social media in the etiology of mental unhealth in sportspersons is warranted. 

Epidemiological studies suggest that psychiatric disorders are as prevalent amongst high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sport organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sport performance ethos with a discourse on mental health. This narrative cornerstone review examines challenges related to definitions and classifications of athlete mental health in high-performance sports and how these influence assessments and the implementation of interventions. We discuss challenges with concept creep and psychiatrisation and outline their consequences for sport healthcare professionals. Based on this, we present a framework that aligns different categories of athlete mental health conditions (from the reduction of wellbeing to psychiatric disorders) with intervention types (from the provision of supporting environments to pharmacotherapy). We conclude that researchers and sport practitioners need to carefully consider conceptual creep and the risk of pathologising normal and healthy, albeit emotionally aversive, reactions to athlete lifeworld events when assessing athlete mental health. A clear separation of terminology denoting the athlete's resources to handle the lifeworld (including salutogenic factors) and terms describing psychiatric conditions and their management is necessary to avoid misguidance in intervention planning.

Enabling athletes to achieve peak performances while also maintaining high levels of health is contextually complex. We aim to describe what a health system is and apply the essential functions of stewardship, financing, provision of services and resource generation to an Australian high-performance sport context. We introduce a fifth function that health systems should not detract from athletes ability to achieve their sports goals. We describe how these functions aim to achieve four overall outcomes of safeguarding the health of the athletes, responding to expectations, providing financial and social protection against the costs of ill health, and efficient use of resources. Lastly, we conclude with key challenges and potential solutions for developing an integrated health system within the overall performance system in high-performance sport.

Objectives To examine whether universal prevention via a digital health platform can reduce the injury incidence in athletics athletes aged 12-15 years and if club size had an influence on the effect of the intervention. Methods This was a cluster randomised trial where young athletics athletes were randomised through their club following stratification by club size into intervention (11 clubs; 56 athletes) and control (10 clubs; 79 athletes) groups. The primary endpoint was time from baseline to the first self-reported injury. Intervention group parents and coaches were given access to a website with health information adapted to adolescent athletes and were encouraged to log in and explore its content during 16 weeks. The control group continued training as normal. Training exposure and injury data were self-reported by youths/parents every second week, that is, eight times. The primary endpoint data were analysed using the log-rank test. Cox proportional hazards regression was used to analyse the second study aim with intervention status and club size included in the explanatory models. Results The proportion of completed training reports was 85% (n=382) in the intervention group and 86% (n=545) in the control group. The injury incidence was significantly lower (HR=0.62; chi(2)=3.865; p=0.049) in the intervention group. The median time to first injury was 16 weeks in the intervention group and 8 weeks in the control group. An interaction effect between the intervention and stratification factor was observed with a difference in injury risk between athletes in the large clubs in the intervention group versus their peers in the control group (HR 0.491 (95% CI 0.242 to 0.998); p=0.049). Conclusions A protective effect against injury through universal access to health information adapted for adolescent athletes was observed in youth athletics athletes. The efficacy of the intervention was stronger in large clubs.

The present cross-sectional study examined the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviours during the first wave of the COVID-19 pandemic in 2020. A total of 290 pregnant women and their husbands (N = 580) were randomly selected from a list of pregnant women in the Iranian Integrated Health System and were invited to respond to psychometric scales assessing fear of COVID-19, depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. The findings demonstrated significant dyadic relationships between husbands and their pregnant wives fear of COVID-19, mental health, and preventive behaviours. Pregnant wives actor effect of fear of COVID-19 was significantly associated with depression, suicidal intention, mental quality of life, and COVID-19 preventive behaviours but not anxiety. Moreover, a husband actor effect of fear of COVID-19 was significantly associated with depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. Additionally, there were significant partner effects observed for both the pregnant wives and their husbands concerning all outcomes. The present study used a cross-sectional design and so is unable to determine the mechanism or causal ordering of the effects. Also, the data are mainly based on self-reported measures which have some limitations due to its potential for social desirability and recall biases. Based on the findings, couples may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women and the foetus.