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Åkesdotter, CeciliaORCID iD iconorcid.org/0000-0002-2952-0347
Publications (10 of 16) Show all publications
Åkesdotter, C., Kenttä, G. & Sparkes, A. C. (2024). Elite athletes seeking psychiatric treatment: Stigma, impression management strategies and the dangers of the performance narrative. Journal of Applied Sport Psychology, 36(1), 24-44
Open this publication in new window or tab >>Elite athletes seeking psychiatric treatment: Stigma, impression management strategies and the dangers of the performance narrative
2024 (English)In: Journal of Applied Sport Psychology, ISSN 1041-3200, E-ISSN 1533-1571, Vol. 36, no 1, p. 24-44Article in journal (Refereed) Published
Abstract [en]

This study explores the reasons given by five elite athletes for choosing to seek psychiatric support and treatment outside, rather than inside, their own sport environments. Life story interviews were conducted with these athletes, who were recruited from an open psychiatric clinic in Stockholm, Sweden. The interviews were then subjected to a structural and a thematic narrative analysis. The former revealed the power of the performance narrative to frame the lives of the athletes by producing a single-minded focus on performance outcomes that justifies, and even demands, the exclusion of any form of psychological weakness or vulnerability. The latter revealed the relationship between the performance narrative and the process of stigmatization associated with psychiatric disorders in elite sport and how this pressures athletes to adopt specific Goffmanesque impression management strategies to protect themselves within their own sport environments. These strategies were as follows: wearing a mask (to hide their psychological suffering), adhering to a vow of silence (making stories of psychological suffering untellable in elite sport), and finding an alibi (a way of portraying suffering in an “acceptable” form). Finally, we reflect on implications for practice, including the potential of narrative care, to help elite athletes explore alternative narratives that might be supportive rather than dangerous companions when suffering from psychiatric disorders.

Lay summary: Five elite athletes were interviewed about their experiences of living with psychiatric disorders, focusing on their choice to seek psychiatric treatment outside, rather than inside, their own sport environments. Stigma and adhering to a single-minded focus on performance forced the athletes to adopt different strategies to hide their psychological suffering.

IMPLICATIONS FOR PRACTICE

  • The performance narrative, characterized by a single-minded focus on performance that demands the exclusion of any form of psychological weakness, stigmatizes elite athletes with psychiatric disorders, making their stories untellable within elite sport.
  • To protect themselves from stigma, these athletes developed impression management strategies to hide their psychological suffering within elite sport.
  • Knowledge of these impression management strategies among different mental health providers working to support athletes, and the use of narrative care to explore alternative narratives, may facilitate elite athletes in seeking support, help, and understanding for their psychiatric disorders.
Place, publisher, year, edition, pages
Taylor & Francis, 2024
National Category
Applied Psychology Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7458 (URN)10.1080/10413200.2023.2185697 (DOI)000950176700001 ()
Note

At the time of Cecilia Åkesdotter's dissertation this article was a manuscript in revision.

Available from: 2023-01-04 Created: 2023-01-04 Last updated: 2024-01-08
Åkesdotter, C. & Kenttä, G. (2023). Balans och återhämtning i tränarrollen (2 uppl.ed.). In: Idrottens ledarskap: (pp. 119-133). Stockholm: SISU Förlag
Open this publication in new window or tab >>Balans och återhämtning i tränarrollen
2023 (Swedish)In: Idrottens ledarskap, Stockholm: SISU Förlag , 2023, 2 uppl., p. 119-133Chapter in book (Other (popular science, discussion, etc.))
Abstract [sv]

Detta kapitel handlar om hur viktigt det är att ha en balanserad totalbelastning vilket innebär att de grundläggande förutsättningarna finns på plats: äta bra, sova och ha möjlighet till psykosocial återhämtning.

Place, publisher, year, edition, pages
Stockholm: SISU Förlag, 2023 Edition: 2 uppl.
National Category
Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7568 (URN)9789177270959 (ISBN)
Available from: 2023-03-31 Created: 2023-03-31 Last updated: 2023-03-31
Kenttä, G. & Åkesdotter, C. (2023). Clinical characteristics of treatment-seeking athletes and coaches within elite sport. In: Proceedings from the 38th Annual Conference of the Association for the Applied Sport Psychology: . Paper presented at 38th Annual Conference of the Association for the Applied Sport Psychology, 2023, Orlando, Florida, USA.
Open this publication in new window or tab >>Clinical characteristics of treatment-seeking athletes and coaches within elite sport
2023 (English)In: Proceedings from the 38th Annual Conference of the Association for the Applied Sport Psychology, 2023Conference paper, Oral presentation with published abstract (Other academic)
National Category
Applied Psychology Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-8058 (URN)
Conference
38th Annual Conference of the Association for the Applied Sport Psychology, 2023, Orlando, Florida, USA
Available from: 2024-01-16 Created: 2024-01-16 Last updated: 2024-01-16
Åkesdotter, C. (2023). Psychiatric disorders in Swedish elite athletes: Prevalence, comorbidity and life stories. (Doctoral dissertation). Stockholm: Gymnastik- och idrottshögskolan, GIH
Open this publication in new window or tab >>Psychiatric disorders in Swedish elite athletes: Prevalence, comorbidity and life stories
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to explore psychiatric disorders in Swedish elite athletes.

The first study investigates a) the prevalence of symptoms of psychiatric disorders, b) the prevalence of mental health problems, defined by psychological suffering and impairment>2 weeks, c) the usefulness of sport-specific instruments in indicating clinical levels of psychiatric symptoms, and d) the life history of psychiatric disorders.

The second study describes psychiatric disorders and comorbidities in a clinical cohort of treatment-seeking elite athletes and high-performance coaches at two publicly funded outpatient psychiatric clinics in Stockholm and Malmö, Sweden.

The third study uses a narrative approach to understand the reasons why elite athletes with established psychiatric disorders choose to seek support and treatment outside – rather than within – their own sport environment.

The fourth study presents a poetic representation of one female elite athlete’s experiences of living with, and seeking treatment for, an eating disorder.

In sum, 19.5% of Swedish elite athletes had symptoms of anxiety and/or depression, and 8.1% had previously received a psychiatric diagnosis. The lifetime prevalence of mental health problems was 51.7%, with 50% of onsets between ages 17 and 21. Sport-specific instruments generally reported fair diagnostic accuracy, but without sufficient sensitivity or specificity for practical use. Among elite athletes in psychiatric treatment, anxiety disorders were the most common (69%), followed by affective disorders (51%) and eating disorders (26%). Comorbidity was generally common between disorders.

Regarding help-seeking, the performance narrative – defined as a single-minded focus on performance that justifies, and even demands, the exclusion of any form of psychological weakness – forced elite athletes to adopt various impression management strategies to hide their psychological suffering. In closing, being invited to witness the em-bodied experiences of a female elite athlete struggling with and seeking treatment for an eating disorder reminds us that behind every prevalence number there is a person.

Place, publisher, year, edition, pages
Stockholm: Gymnastik- och idrottshögskolan, GIH, 2023. p. 114
Series
Avhandlingsserie för Gymnastik- och idrottshögskolan ; 28
National Category
Applied Psychology Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7460 (URN)978-91-988127-0-1 (ISBN)
Public defence
2023-02-03, Aulan, Lidingövägen 1, Stockholm, 15:30 (English)
Opponent
Supervisors
Available from: 2023-01-04 Created: 2023-01-04 Last updated: 2023-01-13Bibliographically approved
Åkesdotter, C. (2023). Vikten av återhämtning (2 uppl.ed.). In: Idrottens träning: (pp. 215-229). Stockholm: SISU Förlag
Open this publication in new window or tab >>Vikten av återhämtning
2023 (Swedish)In: Idrottens träning, Stockholm: SISU Förlag , 2023, 2 uppl., p. 215-229Chapter in book (Other (popular science, discussion, etc.))
Abstract [sv]

Detta kapitel vänder sig till dig som är tränare för idrottare som tränar för att prestera och tävla, och där balansen mellan belastning och återhämtning blir mycket viktig både ur prestations- och hälsosynpunkt.

Place, publisher, year, edition, pages
Stockholm: SISU Förlag, 2023 Edition: 2 uppl.
National Category
Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7569 (URN)9789177270942 (ISBN)
Available from: 2023-03-31 Created: 2023-03-31 Last updated: 2023-03-31
Åkesdotter, C., Kenttä, G., Eloranta, S., Håkansson, A. & Franck, J. (2022). Prevalence and comorbidity of psychiatric disorders among treatment-seeking elite athletes and high-performance coaches. BMJ Open Sport & Exercise Medicine, 8(1), Article ID e001264.
Open this publication in new window or tab >>Prevalence and comorbidity of psychiatric disorders among treatment-seeking elite athletes and high-performance coaches
Show others...
2022 (English)In: BMJ Open Sport & Exercise Medicine, ISSN 2398-9459, Vol. 8, no 1, article id e001264Article in journal (Refereed) Published
Abstract [en]

Objectives Few studies have evaluated the prevalence of psychiatric disorders among treatment-seeking elite athletes (EA) or high-performance coaches (HPC) in psychiatric outpatient settings. Methods Descriptive overview of EA and HPC with psychiatric disorders at two publicly funded psychiatric outpatient treatment clinics in Stockholm and Malmo, Sweden. Co-occurring psychiatric disorders were illustrated using Venn diagrams for EA and HPC, and male and female EA separately, among patients from the Stockholm clinic (SC) that used standardised diagnostic interviews. Results Overall, most patients were EA (n=221) compared with HPC (n=34). The mean age was 23.5 (+/- 5.9) years for EA and 42.8 (+/- 8.8) for HPC. Anxiety disorders were most common at the SC in EA and HPC (69% vs 91%, respectively). Stress-related disorders were found in 72% of HPC compared with 25% of EA. Affective disorders were found in 51% of EA and 52% of HPC. Eating disorders were common among EA (26%), especially females (37%). Substance use disorders were found in 17% of HPC. Comorbidity was generally common between affective and anxiety disorders. Conclusion Stress and adjustment disorders were found in nearly three of the four HPC compared with one in four EA. Eating disorders were prevalent in around one in four athletes and about one in six HPC had a substance use disorder.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2022
Keywords
anxiety, depression, eating disorders, psychiatry, stress, EATING-DISORDERS, MENTAL-HEALTH, SYMPTOMS, SPORT
National Category
Psychiatry Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7032 (URN)10.1136/bmjsem-2021-001264 (DOI)000776490400001 ()35444812 (PubMedID)
Available from: 2022-04-26 Created: 2022-04-26 Last updated: 2023-01-04
Åkesdotter, C., Kenttä, G., Eloranta, S. & Franck, J. (2020). The prevalence of Mental Health Problems in elite athletes. Paper presented at Vol. 23 Issue 4, p329. Journal of Science and Medicine in Sport (4), 329-335
Open this publication in new window or tab >>The prevalence of Mental Health Problems in elite athletes
2020 (English)In: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, no 4, p. 329-335Article in journal (Refereed) Published
Abstract [en]

Objectives

The first aim was to examine mental health problems (MHP) in elite athletes addressing prevalence, sex-differences, onset, recurrent episodes, help-seeking, symptoms of specific disorders and previous psychiatric diagnoses. The second aim was to investigate if sport-specific instruments could indicate clinical levels of psychiatric symptoms.

Design

Cross-sectional survey.

Methods

Elite athletes (representing different Swedish national teams and applying for a university scholarship (n = 333) answered a web-based survey. Females represented 58.9%. Mean age was 24.6(±3.1) years and 77.2% were individual-and 22.8% team-sport athletes.

Results

Lifetime prevalence of MHP was 51.7% (females 58.2%, males 42.3%). Point prevalence was 11.7% (females 13.8%, males 8.8%). Onset of first MHP episode peaked at age 19 with 50% of onsets between ages 17–21. Recurrent episodes were common, and females sought help more than males (females 37.8%, males 16.8%). Overall 19.5% reached the clinical cut-offs for symptoms of anxiety and/or depression (females 26.0%, males 10.2%). Previous psychiatric diagnoses existed among 8.1% (females 10.7%, males 4.4%). A depressive disorder, an eating disorder or a trauma and stress related disorder (self-reported as burnout) were most common. Finally, most sport-specific instruments (80%) demonstrated a fair diagnostic accuracy compared to clinically validated instruments.

Conclusions

Lifetime prevalence of MHP was reported by more than half of the athletes. Symptoms manifested in young age and recurrent episodes were common. Sport-specific instruments indicating when symptoms reach clinical levels are potentially useful for data summary purposes on a group level, but without sufficiently high sensitivity and specificity to be recommend for applied work with athletes.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Psychiatric disorders, Help seeking, Onset, Measurement
National Category
Sport and Fitness Sciences Psychology
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-5910 (URN)10.1016/j.jsams.2019.10.022 (DOI)000521119900003 ()
Conference
Vol. 23 Issue 4, p329
Available from: 2019-11-11 Created: 2019-11-11 Last updated: 2023-01-04Bibliographically approved
Åkesdotter, C. & Kenttä, G. (2019). The prevalence and stories of Mental Health Problems in elite sport. In: Proceedings of The 15th European Congress of Sport Psychology (FEPSAC): . Paper presented at 15th European Congress of Sport Psychology (FEPSAC). 15-20 July 2019. Münster, Germany.
Open this publication in new window or tab >>The prevalence and stories of Mental Health Problems in elite sport
2019 (English)In: Proceedings of The 15th European Congress of Sport Psychology (FEPSAC), 2019Conference paper (Other academic)
National Category
Psychology
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-6014 (URN)
Conference
15th European Congress of Sport Psychology (FEPSAC). 15-20 July 2019. Münster, Germany
Available from: 2020-01-29 Created: 2020-01-29 Last updated: 2020-02-17Bibliographically approved
Åkesdotter, C. & Kenttä, G. (2018). Balans, återhämtning och utveckling i rollen som tränare. In: Idrottens ledarskap: (pp. 111-125). Stockholm: SISU idrottsböcker
Open this publication in new window or tab >>Balans, återhämtning och utveckling i rollen som tränare
2018 (Swedish)In: Idrottens ledarskap, Stockholm: SISU idrottsböcker , 2018, p. 111-125Chapter in book (Other (popular science, discussion, etc.))
Abstract [sv]

Tränare behöver precis som idrottare hitta vägar för att utvecklas, må bra och prestera över tid. [...] Detta kapitel handlar om hur viktigt det är att ha en balanserad totalbelastning vilket innebär att de grundläggande förutsättningarna finns på plats: äta bra, sova och ha möjlighet till psykosocial återhämtning.

Place, publisher, year, edition, pages
Stockholm: SISU idrottsböcker, 2018
National Category
Sport and Fitness Sciences
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-5388 (URN)9789177270201 (ISBN)
Available from: 2018-08-23 Created: 2018-08-23 Last updated: 2018-08-23
Åkesdotter, C. & Kenttä, G. (2018). Idrottens psykologi. In: Specialidrott: Tränings- och tävlingslära (pp. 109-141). Stockholm: SISU idrottsböcker
Open this publication in new window or tab >>Idrottens psykologi
2018 (Swedish)In: Specialidrott: Tränings- och tävlingslära, Stockholm: SISU idrottsböcker , 2018, p. 109-141Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: SISU idrottsböcker, 2018
National Category
Sport and Fitness Sciences Psychology
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-5449 (URN)978-91-7727-026-3 (ISBN)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2018-10-18
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2952-0347

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