Competitive and High Performance Endurance Athletes' Experiences and Management of Exercise-Induced Pain, Mental Performance, Mental Health, and Mental Illness Symptoms

Competitive and High Performance Endurance Athletes' Experiences and Management of Exercise-Induced Pain, Mental Performance, Mental Health, and Mental Illness Symptoms PDF Author: Jonathan Lasnier
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Book Description
The overall aim of this doctoral research was to study competitive and high performance endurance athletes' experiences and management of exercise-induced pain (EIP), mental performance (i.e., self-regulation, mindfulness), mental health, and mental illness symptoms. A mixed methods experimental design guided by the pragmatic stance was employed across three studies to (a) investigate how elite endurance athletes experience and manage EIP (Study 1), (b) compare the effectiveness of an online self-regulation and mindfulness intervention in improving EIP catastrophizing, mental performance (i.e., self-regulation, mindfulness), mental health, and mental illness symptoms in middle-distance runners (Study 2), and (c) qualitatively examine the impact of the online intervention focusing on self-regulation or mindfulness and designed to help endurance athletes improve EIP management, mental performance (i.e., self-regulation and mindfulness), and mental health (Study 3). Study 1. With a paucity of research investigating EIP management in elite endurance sports, the purpose of Study 1 was to examine how elite endurance athletes experience and manage EIP, using an applied self-regulation lens to help inform the work of Mental Performance Consultants (MPCs). Individual semi-structured interviews were conducted with 12 female and 3 male athletes (Mage = 23.73, SD = 2.31) competing in track and field (i.e., 600-1500 m; n = 5), swimming (i.e., 200-400 m; n = 5), and canoe kayak (i.e., 500-1000 m; n = 5). Given the centrality of self-regulation and the necessity to effectively manage internal states (e.g., EIP) in elite sport, the social cognitive model of self-regulation was employed to guide Study 1. The codebook thematic analysis generated two themes and six subthemes (i.e., sensations [burning, tightness, heaviness], beliefs [detrimental, mental, progressive]) related to the experience of EIP as well as three themes and 17 subthemes (i.e., preparation [accept and commit to EIP, recall sources of self-efficacy, develop a segmented performance plan, be accountable to training partners or coach, expose yourself to EIP when training, expose yourself to EIP when warming up, use imagery, implement typical pre-performance routine; execution [direct attention away from EIP, use instructional/motivational self-talk, implement a segmented performance plan, regulate breathing and relax, accelerate pace, self-monitor]; evaluation [reflect using a training journal, identify possible explanations, talk with a coach]) related to the management of EIP. Findings suggest that the experience of EIP is highly cognitive and generally perceived as detrimental to performance if not effectively managed. Athletes used several psychological strategies to prepare to experience EIP, reduce the aversive effects of EIP while performing, and learn from their EIP management strategies to improve their coping capacity. In terms of the number of reported psychological strategies, findings suggest that those used to prepare to experience EIP seem to be a priority. In general, the most popular strategies pertained to accepting and committing to experiencing EIP and directing attention away from EIP. Novel strategies not typically reported in the literature included exposing oneself to EIP when warming up, being accountable to training partners or coaches, using imagery to rehearse reactions to EIP, and accelerating one's pace. Importantly, combining self-regulation and mindfulness strategies appears to be key to effectively manage EIP. Study 2. No research has compared the impact of online sport psychology interventions on various outcomes affecting endurance athletes while employing an active control group. The purpose of Study 2 was therefore to compare the effectiveness of an online self-regulation and mindfulness intervention in improving EIP catastrophizing, mental performance (i.e., self-regulation, mindfulness), mental health, and mental illness symptoms in middle-distance runners. Using a pre-post experimental design, 61 middle-distance runners competing at provincial to international levels were allocated to either a self-regulation, mindfulness, or active control group using stratified randomization. They completed a pre-intervention survey measuring EIP catastrophizing, mental performance (i.e., self-regulation capacity, dispositional mindfulness), mental health, and mental illness symptoms (i.e., anxiety, depression, and eating disorder). A final sample of 52 participants (i.e., 17 self-regulation, 19 mindfulness, and 16 active control) completed the interventions and a post-intervention survey measuring the same outcomes addressed in the pre-intervention survey. Contrary to hypotheses, results from multiple mixed ANOVAs indicated that while mean scores trended in the positive direction between Time 1 and Time 2, the self-regulation and mindfulness interventions did not significantly differ from the active control intervention on the targeted outcomes. Interestingly, when excluding athletes who screened positive for mental illness symptoms (i.e., anxiety, depression, and/or eating disorder), the active control intervention was more effective in reducing anxiety symptoms than the mindfulness intervention. Overall, the self-regulation and mindfulness interventions were not any more effective than the active control intervention in improving the selected outcomes. Study 3. The purpose of this study was to qualitatively examine the impact of the online sport psychology intervention from Study 2, which focused on either self-regulation or mindfulness and was designed to help endurance athletes improve EIP management, mental performance (i.e., self-regulation, mindfulness), and mental health. A sample of 16 middle-distance runners (i.e., 11 women and 5 men) aged between 18 to 25 years old (Mage = 21.31, SD = 2.18) who participated in the eight-module SI or MI were purposefully selected based on their high, moderate, and low pre-post evolution scores. The codebook thematic analysis generated three themes and 13 subthemes (i.e., EIP management [reframing, understanding, self-talk, segmented performance plan]; mental performance [attention regulation, motivation, self-monitoring, self-efficacy, acceptance, defusion]; mental health [self-compassion, autonomy, support]) related to the participants' perceived changes as well as three themes and seven subthemes (i.e., delivery format [asynchronous, synchronous], content [applicability, audio and video files, examples, metaphors], timing [alignment with competitive season]) related to participants' recommendations. Findings suggest that both the self-regulation and mindfulness intervention positively impacted EIP management, mental performance, and mental health. Self-regulation and mindfulness should therefore be seen as complementary rather than conflicting or incompatible approaches. Furthermore, athletes reported that their EIP literacy and EIP management skills were limited at the onset of the intervention. Consequently, an educational component should continue to be integrated in future interventions to provide an overview of EIP and relevant mental performance skills to manage it. Given the prevalence of stressors and mental health challenges in competitive and high performance sport, screening for both positive mental health and mental illness symptoms at the onset of interventions is recommended so that athletes partaking in applied sport psychology studies can obtain appropriate mental health care and support as needed. Lastly, a hybrid delivery format incorporating both asynchronous and synchronous options may be the most effective when providing online sport psychology interventions. Overall, the findings of the current doctoral research suggest that both self-regulation and mindfulness strategies positively impact EIP management, mental performance, and mental health in endurance athletes. This inquiry is also the first to quantitatively and qualitatively compare the effectiveness of an online asynchronous self-regulation and mindfulness intervention in improving key outcomes affecting endurance athletes. With increased applied research and mental performance consulting occurring virtually due to the COVID-19 pandemic, it is vital to continue examining the quality and impact of online interventions on athletes.

Competitive and High Performance Endurance Athletes' Experiences and Management of Exercise-Induced Pain, Mental Performance, Mental Health, and Mental Illness Symptoms

Competitive and High Performance Endurance Athletes' Experiences and Management of Exercise-Induced Pain, Mental Performance, Mental Health, and Mental Illness Symptoms PDF Author: Jonathan Lasnier
Publisher:
ISBN:
Category :
Languages : en
Pages :

Get Book Here

Book Description
The overall aim of this doctoral research was to study competitive and high performance endurance athletes' experiences and management of exercise-induced pain (EIP), mental performance (i.e., self-regulation, mindfulness), mental health, and mental illness symptoms. A mixed methods experimental design guided by the pragmatic stance was employed across three studies to (a) investigate how elite endurance athletes experience and manage EIP (Study 1), (b) compare the effectiveness of an online self-regulation and mindfulness intervention in improving EIP catastrophizing, mental performance (i.e., self-regulation, mindfulness), mental health, and mental illness symptoms in middle-distance runners (Study 2), and (c) qualitatively examine the impact of the online intervention focusing on self-regulation or mindfulness and designed to help endurance athletes improve EIP management, mental performance (i.e., self-regulation and mindfulness), and mental health (Study 3). Study 1. With a paucity of research investigating EIP management in elite endurance sports, the purpose of Study 1 was to examine how elite endurance athletes experience and manage EIP, using an applied self-regulation lens to help inform the work of Mental Performance Consultants (MPCs). Individual semi-structured interviews were conducted with 12 female and 3 male athletes (Mage = 23.73, SD = 2.31) competing in track and field (i.e., 600-1500 m; n = 5), swimming (i.e., 200-400 m; n = 5), and canoe kayak (i.e., 500-1000 m; n = 5). Given the centrality of self-regulation and the necessity to effectively manage internal states (e.g., EIP) in elite sport, the social cognitive model of self-regulation was employed to guide Study 1. The codebook thematic analysis generated two themes and six subthemes (i.e., sensations [burning, tightness, heaviness], beliefs [detrimental, mental, progressive]) related to the experience of EIP as well as three themes and 17 subthemes (i.e., preparation [accept and commit to EIP, recall sources of self-efficacy, develop a segmented performance plan, be accountable to training partners or coach, expose yourself to EIP when training, expose yourself to EIP when warming up, use imagery, implement typical pre-performance routine; execution [direct attention away from EIP, use instructional/motivational self-talk, implement a segmented performance plan, regulate breathing and relax, accelerate pace, self-monitor]; evaluation [reflect using a training journal, identify possible explanations, talk with a coach]) related to the management of EIP. Findings suggest that the experience of EIP is highly cognitive and generally perceived as detrimental to performance if not effectively managed. Athletes used several psychological strategies to prepare to experience EIP, reduce the aversive effects of EIP while performing, and learn from their EIP management strategies to improve their coping capacity. In terms of the number of reported psychological strategies, findings suggest that those used to prepare to experience EIP seem to be a priority. In general, the most popular strategies pertained to accepting and committing to experiencing EIP and directing attention away from EIP. Novel strategies not typically reported in the literature included exposing oneself to EIP when warming up, being accountable to training partners or coaches, using imagery to rehearse reactions to EIP, and accelerating one's pace. Importantly, combining self-regulation and mindfulness strategies appears to be key to effectively manage EIP. Study 2. No research has compared the impact of online sport psychology interventions on various outcomes affecting endurance athletes while employing an active control group. The purpose of Study 2 was therefore to compare the effectiveness of an online self-regulation and mindfulness intervention in improving EIP catastrophizing, mental performance (i.e., self-regulation, mindfulness), mental health, and mental illness symptoms in middle-distance runners. Using a pre-post experimental design, 61 middle-distance runners competing at provincial to international levels were allocated to either a self-regulation, mindfulness, or active control group using stratified randomization. They completed a pre-intervention survey measuring EIP catastrophizing, mental performance (i.e., self-regulation capacity, dispositional mindfulness), mental health, and mental illness symptoms (i.e., anxiety, depression, and eating disorder). A final sample of 52 participants (i.e., 17 self-regulation, 19 mindfulness, and 16 active control) completed the interventions and a post-intervention survey measuring the same outcomes addressed in the pre-intervention survey. Contrary to hypotheses, results from multiple mixed ANOVAs indicated that while mean scores trended in the positive direction between Time 1 and Time 2, the self-regulation and mindfulness interventions did not significantly differ from the active control intervention on the targeted outcomes. Interestingly, when excluding athletes who screened positive for mental illness symptoms (i.e., anxiety, depression, and/or eating disorder), the active control intervention was more effective in reducing anxiety symptoms than the mindfulness intervention. Overall, the self-regulation and mindfulness interventions were not any more effective than the active control intervention in improving the selected outcomes. Study 3. The purpose of this study was to qualitatively examine the impact of the online sport psychology intervention from Study 2, which focused on either self-regulation or mindfulness and was designed to help endurance athletes improve EIP management, mental performance (i.e., self-regulation, mindfulness), and mental health. A sample of 16 middle-distance runners (i.e., 11 women and 5 men) aged between 18 to 25 years old (Mage = 21.31, SD = 2.18) who participated in the eight-module SI or MI were purposefully selected based on their high, moderate, and low pre-post evolution scores. The codebook thematic analysis generated three themes and 13 subthemes (i.e., EIP management [reframing, understanding, self-talk, segmented performance plan]; mental performance [attention regulation, motivation, self-monitoring, self-efficacy, acceptance, defusion]; mental health [self-compassion, autonomy, support]) related to the participants' perceived changes as well as three themes and seven subthemes (i.e., delivery format [asynchronous, synchronous], content [applicability, audio and video files, examples, metaphors], timing [alignment with competitive season]) related to participants' recommendations. Findings suggest that both the self-regulation and mindfulness intervention positively impacted EIP management, mental performance, and mental health. Self-regulation and mindfulness should therefore be seen as complementary rather than conflicting or incompatible approaches. Furthermore, athletes reported that their EIP literacy and EIP management skills were limited at the onset of the intervention. Consequently, an educational component should continue to be integrated in future interventions to provide an overview of EIP and relevant mental performance skills to manage it. Given the prevalence of stressors and mental health challenges in competitive and high performance sport, screening for both positive mental health and mental illness symptoms at the onset of interventions is recommended so that athletes partaking in applied sport psychology studies can obtain appropriate mental health care and support as needed. Lastly, a hybrid delivery format incorporating both asynchronous and synchronous options may be the most effective when providing online sport psychology interventions. Overall, the findings of the current doctoral research suggest that both self-regulation and mindfulness strategies positively impact EIP management, mental performance, and mental health in endurance athletes. This inquiry is also the first to quantitatively and qualitatively compare the effectiveness of an online asynchronous self-regulation and mindfulness intervention in improving key outcomes affecting endurance athletes. With increased applied research and mental performance consulting occurring virtually due to the COVID-19 pandemic, it is vital to continue examining the quality and impact of online interventions on athletes.

Mental Health in the Athlete

Mental Health in the Athlete PDF Author: Eugene Hong
Publisher: Springer Nature
ISBN: 3030447545
Category : Medical
Languages : en
Pages : 299

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Book Description
This unique book provides a practical framework for and coverage of a broad range of mental health concerns applicable to the care of athletes, including depression, suicide, mood disorders, substance abuse and risk-taking behaviors. To this end, it presents content relevant to the care of athletes, including doping and the use of performance-enhancing drugs, the mental health impact of concussion, bullying and hazing, the impact of social media and exercise addiction, among other pertinent topics. Current basic and translational research on behavioral health and the relationship of brain to behavior are reviewed, and current treatment approaches, both pharmacological and non-pharmacological (including mindfulness training), are considered. This practical resource targets the stigma of mental in athletes in order to overcome barriers to care by presenting a definitive perspective of current concepts in the mental health care of athletes, provided by experts in the field and targeting sports medicine providers, mental health providers and primary care physicians involved in the direct care of recreational and competitive athletes at all levels.

Sport Psychiatry: Maximizing Performance, An Issue of Psychiatric Clinics of North America, E-Book

Sport Psychiatry: Maximizing Performance, An Issue of Psychiatric Clinics of North America, E-Book PDF Author: Silvana Riggio
Publisher: Elsevier Health Sciences
ISBN: 0323835937
Category : Medical
Languages : en
Pages : 193

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Book Description
In this issue of Psychiatric Clinics, Guest Editors Silvana Riggio and Andy Jagoda bring their considerable expertise to the topic of Sport Psychiatry: Maximizing Performance. Top experts in the field cover key topics such as defining the role of the sport psychiatrist, achieving peak performance, the pathophysiology of brain injury and behavior, and more. Provides in-depth, clinical reviews on maximizing performance from a Sports Psychiatry perspective, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 13 relevant, practice-oriented topics including motivation and burnout in sports; nutrition, eating disorders, and behavior; sleep disturbances; selection and interview criteria for drafting players; and more.

Endurance Performance in Sport

Endurance Performance in Sport PDF Author: Carla Meijen
Publisher: Routledge
ISBN: 1351682601
Category : Psychology
Languages : en
Pages : 434

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Book Description
Athletes participating at all levels of endurance performance can relate to the impact of psychological factors. Whether it is motivation, self-belief, feeling nervous before a race, exercise-induced pain, sticking to a pacing strategy, or thoughts around what to focus on, there are a vast number of psychological factors which can affect endurance performance. Bringing together experts in the field from around the world, this is the first text to provide a detailed overview of the psychology of endurance performance where there is a research and an applied focus looking at both main theoretical models as well as how interventions can support an athlete’s efficacy and well-being. The authors look at regulatory processes around pain, decision-making, self-belief, emotions, and meta-cognition, before examining a range of cognitive strategies, including the use of imagery, goals, self-talk, and mindfulness techniques. With a final section of the book outlining issues related to mental health that are relevant to endurance performance, the book shows that the future of research and application of psychological theory in endurance performance in sport is bright and thriving. Aimed at researchers, students, coaches, and athletes themselves, this is essential reading for anyone wishing to better understand how our minds experience endurance in performance arenas, and what psychological techniques can be used to make us more efficient.

Sports Psychiatry

Sports Psychiatry PDF Author: David R. McDuff
Publisher: American Psychiatric Pub
ISBN: 1585629669
Category : Medical
Languages : en
Pages : 290

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Book Description
Although psychiatrists and other mental health clinicians interested in sports practice already have the necessary general skills to help competitive athletes deal with adversity and the multitude of emotions that sports can elicit, most typically they lack the sports-specific knowledge necessary to truly help these patients and clients. In Sports Psychiatry: Strategies for Life Balance and Peak Performance, the long-time team psychiatrist for the Baltimore Orioles and the Baltimore Ravens intends to remedy this knowledge gap by sharing his unique perspective and rare expertise in cultivating athletes' peak performance while promoting team unity, sound judgement, personal growth, pride, and a lasting sense of accomplishment. The book: Explains sports culture and team structure and function, vividly describing the environment in which elite competition takes place Focuses on the shifting nature and intensity of athletes' emotions -- the highs that come with success and the lows that accompany poor performance -- and describes the situations that magnify them, including injury and pain, media scrutiny, the availability of performance-enhancing drugs, and the fear of both failure and success Addresses critical topics, such as regulating energy, recognizing and controlling stress, preparing mentally for performance, and treating mental disorders common to athletes Draws on the author's length of experience and clinical observations, the evidence base of sports psychiatry, and fascinating stories of athletes at all levels to inform, teach, encourage, and inspire. Although written for mental health professionals, the book will also be of great interest to primary care and sports medicine physicians, athletic trainers, team owners and managers -- and of course -- the athletes themselves. Engaging and insightful, Sports Psychiatry is the go-to book for those in need of practical strategies for supporting and attaining peak performance.

Mental Health Challenges in Elite Sport: Balancing Risk with Reward

Mental Health Challenges in Elite Sport: Balancing Risk with Reward PDF Author: Tadhg Eoghan MacIntyre
Publisher: Frontiers Media SA
ISBN: 2889453839
Category :
Languages : en
Pages : 132

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Book Description
Elite sport typically provides obvious rewards in terms of recognition, finance and acclaim for athletic performance. Increasingly, we are becoming aware of the risks that elite athletes, their entourage, including families, sport-science support team and coaches are exposed to. Twelve original articles, seven commentaries and a corrigendum, are structured in a five chapter format. Chapter 1, comprising the Editorial, is titled “An Overview of Mental Health in Elite Sport: Changing the Play Book” to reflect the advocacy role of this article. Chapter 2 (“Finding the Sweet Spot”) amplifies the voice of key stakeholders across three qualitative studies with three additional commentaries. Quantitative evidence is presented in Chapter 3 which has the sub-title the “State of Play.” Chapter 4, entitled the “Field of Play”, includes three original publications which present contrasting conceptual approaches to guide researchers in hypothesis generation, formulation and implementation science. Finally, in Chapter 5, “Seeing the Ball Early”, prospective perspectives are provided in three publications reinforced by two commentaries. The future thinking ideas includes the use of virtual reality training, a broadening of the concept of mental health literacy, tackling stigma and focusing on the potential positive effect of the natural environment on well-being and recovery. To date the research topic has generated widespread in the field. For example, several articles have generated an Altmetric score above 40 with one publication meriting an Altmetric score of 102. We envisage that the impact of this e-book will not simply be measured in citations, views, downloads nor social media impact, but in the discourse that emerges from this collection of contributions from a combined total of 53 authors from across three continents. It is our hope that this e-book, providing a snapshot of global challenges for elite athletes mental health and well-being, becomes a touchstone for researchers and practitioners in the field.

Mind Body and Sport

Mind Body and Sport PDF Author: NCAA
Publisher:
ISBN: 9781495131752
Category :
Languages : en
Pages :

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Book Description


Exploring the Experiences of High Performance Canadian Athletes With Mood And/or Anxiety Disorders

Exploring the Experiences of High Performance Canadian Athletes With Mood And/or Anxiety Disorders PDF Author: Lauren Dickler
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
Until recently, it was assumed that mental illnesses were not problems for high performance athletes (e.g., Dean & Rowan, 2013; Reardon & Factor, 2010). As athletes publicly share their struggles with mental illness, this assumption has been brought into question. The purpose of this research was to explore the experiences of Canadian high performance athletes with mood/anxiety disorders. Athletes were recruited via purposeful sampling and currently or recently competed for places on Canadian national sports teams. Participants described dealing with stigma, and ultimately, required a break from sport in order to effectively manage their illness. A need for education regarding mood/anxiety disorders and greater access to psychologists were expressed. Findings are discussed within the context of existing research on high performance sport and mental illness. Suggestions include the development of programs to decrease stigma, coupled with increases in funding for resources in the sport community and changes to sport policy.

Educating the Student Body

Educating the Student Body PDF Author: Committee on Physical Activity and Physical Education in the School Environment
Publisher: National Academies Press
ISBN: 0309283140
Category : Medical
Languages : en
Pages : 503

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Book Description
Physical inactivity is a key determinant of health across the lifespan. A lack of activity increases the risk of heart disease, colon and breast cancer, diabetes mellitus, hypertension, osteoporosis, anxiety and depression and others diseases. Emerging literature has suggested that in terms of mortality, the global population health burden of physical inactivity approaches that of cigarette smoking. The prevalence and substantial disease risk associated with physical inactivity has been described as a pandemic. The prevalence, health impact, and evidence of changeability all have resulted in calls for action to increase physical activity across the lifespan. In response to the need to find ways to make physical activity a health priority for youth, the Institute of Medicine's Committee on Physical Activity and Physical Education in the School Environment was formed. Its purpose was to review the current status of physical activity and physical education in the school environment, including before, during, and after school, and examine the influences of physical activity and physical education on the short and long term physical, cognitive and brain, and psychosocial health and development of children and adolescents. Educating the Student Body makes recommendations about approaches for strengthening and improving programs and policies for physical activity and physical education in the school environment. This report lays out a set of guiding principles to guide its work on these tasks. These included: recognizing the benefits of instilling life-long physical activity habits in children; the value of using systems thinking in improving physical activity and physical education in the school environment; the recognition of current disparities in opportunities and the need to achieve equity in physical activity and physical education; the importance of considering all types of school environments; the need to take into consideration the diversity of students as recommendations are developed. This report will be of interest to local and national policymakers, school officials, teachers, and the education community, researchers, professional organizations, and parents interested in physical activity, physical education, and health for school-aged children and adolescents.

Clinical Sports Psychiatry

Clinical Sports Psychiatry PDF Author: David A. Baron
Publisher: John Wiley & Sons
ISBN: 1118404939
Category : Medical
Languages : en
Pages : 250

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Book Description
This book has it all - written by national and international experts and edited by world authorities, it is the first book on sport psychiatry in over a decade. Dealing with psychopathology, mental health problems and clinical management, it differs markedly from sports psychology books that focus on performance issues. Eating disorders, exercise addiction, drug abuse are all problems that are seen in 'everyday' athletes, not just elite performers. This book shows how to help. This text covers the most important topics in contemporary sports psychiatry/psychology from an international perspective. Chapter authors are experts in the field and global leaders in the related professional organizations, including current and past Presidents/Chairs of the International Society for Sports Psychiatry and of the World Psychiatric Association Section on Exercise and Sports Psychiatry. Authors are mainly psychiatrists: the rest are PhD sport psychologists. The book comprises representative chapter authors from around the world, to an extent unprecedented in this topic. The authors and editors are well-informed in global perspectives, e.g., having served as consultants to numerous Olympic teams, in addition to service on the International Society for Sports Psychiatry's Board of Directors. Specifically, this book covers four main categories of topics: 1) mental health challenges faced by athletes (including substance use disorders, exercise addiction, eating disorders, depression, suicide, and concussion), 2) treatment approaches and therapeutic issues with athletes (including different types of psychotherapy for psychiatric disorders, psychotherapeutic performance enhancement approaches, transference and countertransference issues, achievement by proxy, psychotherapeutic issues as applied to a couple of sports that are played around the world, and use of psychiatric medications in athletes), 3) psychosocial issues affecting athletes (including sexual harassment and abuse, cultural issues, and ethics issues), and 4) the field of sports psychiatry (including work within one common sports psychiatry practice setting, and current status of and challenges in the field of sports psychiatry). There is a growing need for this book. Performance-enhancing drugs, use of psychotropics in impaired athletes, head trauma, sexual abuse, eating disorders, ethics, and depression and suicide in athletes, are just a few of the timely subjects addressed in this text. This is the only comprehensive reference available for those working in the field (or merely interested in it) to consult for current information on these topics. The existing sports psychology texts all focus on performance issues, with little, if any, attention paid to these areas of clinical significance. The book addresses the core differences between sports psychiatry and sports psychology, as well as the areas of overlap. Emphasis is placed on how the disciplines should work together in diagnosing and treating athletes dealing with emotional stress and psychopathology. Chapters include case examples and specific goals listed at the beginning, along with tables and graphs to highlight key concepts.