This article was downloaded by: [JAMES COOK UNIVERSITY] On: 16 March 2015, At: 02:59 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of American College Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vach20
The Health of University Athletes: Attitudes, Behaviors, and Stressors a
a
Rosemary Selby PhD , Harvey M. Weinstein MD & Tracy Stewart Bird BA a
a
University in Stanford , California, USA
b
Department of Athletics , Stanford, USA Published online: 09 Jul 2010.
To cite this article: Rosemary Selby PhD , Harvey M. Weinstein MD & Tracy Stewart Bird BA (1990) The Health of University Athletes: Attitudes, Behaviors, and Stressors, Journal of American College Health, 39:1, 11-18, DOI: 10.1080/07448481.1990.9936208 To link to this article: http://dx.doi.org/10.1080/07448481.1990.9936208
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
The Health of University Athletes: Attitudes, Behaviors, and stressors
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
ROSEMARY SELBY, PhD, HARVEY M. WEINSTEIN,
This study examined several aspects of the health of university athletes. Five areas of concern were targeted for investigation: general health background, use of drugs and alcohol, weight and eating behaviors, stress, and use of helping resources. The authors developed a questionnaire and used it to survey 27 varsity athletic teams at a major private university. The incidence of injuries was high; one third of the 247 student athletes surveyed reported sport-related injuries. Alcohol was much more frequently used than other drugs, and use tended to decrease during the competitive season. Significant differences between men and women athletes were found in off-season alcohol and marijuana use. Anabolic steroid abuse did not appear to be a major problem for this athlete population. Issues of diet, weight, and body image were found to be significantly different for women than for men. Although the incidence of bulimia and anorexia was low for both female and male athletes, it was clear that female athletes brought to their sport heightened concern for body image. The authors discuss the psychological and interpersonal implications that these findings have for the adjustment of female athletes. Injury and academics were perceived as the most stressful factors for both men and women, whereas weight and diet issues were a major stress factor for one third of the women. Given these data, specific recommendations are made for health professionals who work with college athletes.
Several questions about the health needs of university athletes underlie this study. Does varsity competition produce medical problems that are unique to athletes? Do athletes require medical care different from that offered to other students? Do male and female athletes differ in their medical and psychological needs?
Rosemary Selby is a clinical sport psychologist with Cowell Student Health Center at Stanford University in Stanford, California, of which Harvey M. Weinstein is director. Tracy Stewart Bird is an intern with Cowell Center and the Department of Athletics at Stanford.
VOL 39, IUW 7990
MD,and TRACY STEWART BIRD,
BA
The use of drugs among athletes has been an increasing concern in this country.’,‘ Reports of cocaine overdoses and marijuana and amphetamine use make the front pages of the sports sections of our daily newspapers. Use of anabolic steroids or other performanceenhancing drugs first found in Olympic and professional competition has filtered into the locker rooms of major university teams. In addition, there is concern that intensive athletic training and competition in some sports may be related to an increased frequency of eating disorders such as anorexia nervosa and Student athletes usually face the question of optimal weight and body competition. Issues of nutrition, percentage of body fat and its relation to peak performance, and the concern that an athlete’s diet may result in physiological imbalances such as anemia all suggest the significance of the role food plays in the life of a varsity athlete. Because of evidence that women have more concern about diet and weight control, it was hypothesized that women athletes would be more concerned about diet, weight, and body image.+” The association of exercise with physiological change has been well documented. Reports in the literature describe delayed, irregular, or absent menstrual cycles in women athletes,”-16 iron deficiency with or without anemia,”-” and other physiological indicators of body responses to exercise and, most specifically, to intensive training. Another concern for athletes is the trauma of injury and its ever-present risk. A number of studies have reported a relationship between stress, injury, and subsequent rehabilitati~n.’~~~ It appears that psychological stress both predisposes an athlete to injury and results from injury to a degree that warrants concern for the athlete’s we1I-being. University students who participate in intercollegiate athletics must deal with all of the usual pressures of college life in addition to training and competition. The
77
COL1EC;E HEALTH pressures of representing one's institution, the importance of the coach in motivating performance, and the athlete's own drive to win add increased stress to the life of the How college athletes perceive their stressors, what symptoms of stress they show, and to whom they turn in order to alleviate these pressures are critical questions that are addressed in this study. The specific objectives of this study were to identify (1) the sources of stress for student athletes and (2) sex differences among athletes with respect to health-related behaviors and attitudes.
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
METHOD We distributed a questionnaire to the members of 27 out of 28 varsity athletic teams at a major private university in March 1985 (the men's golf team was not available to respond to the survey). The teams surveyed included such diverse sports as football, baseball, basketbalI, swimming, tennis, gymnastics, wrestling, and diving. The 439 questionnaires were handed out to more than 70% of the varsity athletes; 267 forms were returned, a response rate of 61'10. The instrument used was the Athlete's Health Questionnaire, a 52-question survey instrument designed by the authors to elicit information on the following topics: demographic characteristics, general health information, alcohol and drug use, stress factors, diet, weight, body image, and knowledge and use of health resources. The questionnaires were accompanied by a letter that explained the goals of the study and assured the respondents' anonymity.
injured athletes reported either no change in training (29%) or that they modified their training somewhat (56%). Very few of the athletes reported a chronic illness. Those specified were allergies, diabetes, chondromalacia, and back problems. Because of the concern about the effects on menstruation of diet and extreme levels of exercise, we asked women about the regularity of their menstrual periods. Sixty-nine percent indicated regular periods in the last 6 months, and 56% reported no other history of cessation of menses. Because of the greater physical demands and time requirements that athletes experience from training and competition, they were also asked about health practices such as use of vitamins and nutritional supplements, relaxation, and sleep. About a quarter of the athletes used vitamins daily both in season (26%) and off season (22%). Almost half were taking vitamins on an infrequent basis, ie, two or fewer times per month, both in season (43%) and off season (46%). There were no significant differences between the sexes in vitamin use. There was, however, a significant difference in the = 17.67, df in-season use of nutritional supplements = 3, p < .001); 23% of the men and only 7% of the women used nutritional supplements one or more times per week during their competitive season. Fewer than half of the athletes, both in season (37%) and off season (46%), took time to relax on a daily basis. Only about a quarter of the athletes got sufficient sleep on a daily basis in season (22%) or off season (28%). Most athletes (ie, 68% in season; 67% off season) reported they got sufficient sleep two or fewer times a week.
(x'
RESULTS Demographics The mean age of the athletes in the sample was 19.8 years. (3those who responded, 56% were men and 44% were women. The response was fairly evenly distributed between classes: freshmen, 27.8%; sophomores, 28.2%; juniors, 25.9%; seniors and coterminal seniors i(seniors pursuing a master's degree in a fifth year), 18%. The majority of the respondents were Caucasian (86.4%); others in the sample were black (7.5%), native American (6.4%), Chicano (1.9"/0), and Asian-American (1.So/,).
General Health Background Athletes were asked about current injuries, illnesses, and, for women, menstrual patterns. Thirty-five percent of the athletes reported a current physical injury. N o sig:iificant difference was found in frequency of injury between men and women. The most commonly reported injuries were back and knee, tendonitis, ankle sprains, and pulled muscles. Most athletes reported they continued to train even though injured; only 6% of injured athletes said that they stopped training. Most
72
Alcohol and Drug Use A significant sex difference in alcohol use was found during the off season only, As the data in Table 1 show, 60% of the male and 41% of the female athletes used alcohol at least once a week during their off season. During the competitive season, alcohol use decreased to 42% of the men and 26% of the women. With respect to marijuana use, men and women did not differ significantly in their in-season use, but they did differ significantly in their off-season use; 8% of the men and 2% of the women reported at least weekly use (Table 1). We found no significant differences in cocaine use between men and women, either in season or off season. With regard to the use of performance-enhancing drugs, no women and only 1% of the males reported some use of steroids during the competitive season; 2% of the men reported off-season steroid use. In addition, we found no significant sex difference in the use of analgesics (eg, aspirin). Painkillers were, however, more frequently used in season by all the athletes as a group = 21.43, df = 3, p < .01). Five percent of the
(x'
)ACH
HEALTH athletes were daily in-season users of analgesics, primarily aspirin. During the season, 26% of the athletes reported using painkillers at least once a week. When asked about other drug use, approximately 10% reported using “other drugs” both in season and off season one or more times a week. Sudafed is an example of a commonly dispensed drug from the training room that was given as an example on the questionnaire.
TABLE 1 Student Athletes’ Use of Alcohol and Drug
Substance used Alcohol In Seawn Men Women Off season Men Women Marijuana In season Men Women Off season Men Women Cocaine In season Men Women Off season
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
Did, Weight, and Body Image This population of student athletes fell primarily within the normal weight ranges for their heights. Sixtyseven percent of the men and 84% of the women were within acceptable weights according to the standards developed at the NIH National Consensus Conference of the Fogarty Cente~.~’ Thirty-two percent of the men versus 8% of the women were in the high-weight range, presumably because of the weight and muscle requirements of their sports. The reported incidence of eating disorders was low in this study. Two percent of the women reported a history of bulimia and 470 of anorexia nervosa. Comparable figures for men were 1% for each. A marked sex difference existed, however, with respect to dieting, weight, feelings about weight, and the relationship of weight to athletic performance. Significantly more women were preoccupied with these concerns, and they reported many more negative feelings associated with these issues. More women (22%) than men (13%) felt that weight was critical to performance 10.92, df 4, p < .05),although more men (21%) than women (16%) felt that what an athlete eats is critical to performance (f = 9.38, df = 4, p < .05). Although few men or women had a weight requirement for competition, 43% of the women but only 18Y0 of the men had been told by their coaches to modify their weight Cx‘ = 9.46, df = 1, p < .001). It is significant that more women than men reported that they had difficulty in attaining their own ideal competition weight Cx‘ = 23.59, df 3, p < .001) as well as the ideal weight their coaches suggested (f 8.73, df 3, p < .05). The sex difference emerged once again over the issue of weight maintenance; the women athletes reported considerably more difficulty in maintaining their ideal (x2 = 23.59, df = 3, p < .001) or their coach-suggested weight (f = 9.24, df = 3, p < .05). Women experienced more negative emotional responses to concerns about weight and competition (see Table 2). Anger, anxiety, and depression were the expression of the frustration associated with weight control for women. Questions related to body image revealed striking differences in the men’s and women’s views of themselves. Apparent distortions in self-perception and in perception of how others see them characterized these women (see Table 3). A majority (63%) of the women
-
-
-
-
VOL 39, )UlY 7990
-
OF UNlVERSlTY ATHLETES
Men Women
Number of times No 2 or fewer 1 or more use per month perweek % % %
15 19
43
55
x’
df
42 26
4.76 2
60
9.17* 2
11
29
16
42
78 86
22
70 82
21
87 92
13 8
1.31
1
83 90
17
2.44
1
41
3.31
14 16
1
7.85* 2
2
10
Note: Some percentages do not add up to 100 because of mu nding. *Sex differences significant at p < .05. I
TABLE 2 Percentage of Students Who Expressed Various Levels of Emotion When Unable to Reach or Maintain Ideal Weight
I
Emotion
I
None 1
Level of reaction Great deal 2 2 3 4 5 (df-4)
I
I
II
Anxiety Men Women Depression Men Women Anger Men Women
66 18
16 17
10 21
6 25
19
70 16
18 18
8 24
3 29
13
64 23
14
13
20
23
7 23
11
67.88* 83.86* 45.41*
*Sex differences significant at p < .001.
athletes saw themselves as overweight, and one third of them believed that their coaches also saw them as overweight. Only 14% of the men thought of themselves as overweight. If the Fogarty scales, which were standardized on a general population, are used, 32X of the men would be categorized as outside an accep
13
COLLEGE HEALTH TABLE 3 Student Athletes' Perceptions of Their Weight Acceptability
Remonses About Underweight right Overweight % % %
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
Question How do you see yourself? Men Women How does your coach see you? Men Women How do your peers see you! Men Women How do your parents see you? Men Women Sex differences significant at * p
< .05;
14
-
2)
18 1
68 36
14 63
73.45** *
21 5
70 62
9 33
24.33***
13 5
80 81
14
9
84 74
7 21
5 **p < .01; "'p
table range. The women reported that both their parents and peers viewed the weight of these student athletes as about right. The women athletes, however, tended1 to be self-critical about how much they weighed and also attributed to their coaches negative evaluations of their weight. Given this concern about excessive weight, it is not surprising that the women athletes were actively involved in weight-reduction programs. Although they were asked about use of diuretics, self-induced vomiting, laxatives, and fasting, they reported little use of these weightcontrol methods. The only significant sex difference was found in dieting behavior-43% of the women dieted on a weekly-to-daily basis, as opposed to 26% of the men (x' = 42.33, df = 4, p < .001). Sixty-four percent of the women and 11% of the men reported that they had been on weight-loss diets since they entered the university. This is not directly related to varsity athletics because 80% of the women indicated that they had dieted before entering the university. The student athletes were asked about binge eating, which was defined as "rapid eating of an abnormally large amount of food in less than two hours." Although 38% of the women and 27% of the men reported binge eating during the past year, there was no significant difference between men and women in this eating behavior. An examination of the frequency of binge eating again revealed no significant differences, with 79% of the men and 88% of the women binge eating no more than one to two times a month. The emotional responses associated with binge eating indicated that, for women, negative feelings were associated with binging, eg, anger, depression, and being "down on oneself." For men, positive feelings, such as contentment, satisfaction, and relaxation, were
xZ (df
7
7.39* 12.49**
< .001.
associated with binging. In addition, 29% of the women felt that their eating binges were abnormal, but only 2% of the men felt this way (see Table 4). For these women athletes, distorted body image and weight preoccupation were associated with negative emotional reactions in a way that was not seen in the men. Stress Factors
When asked how stressful they found different aspects of their lives at Stanford, male and female athletes responded in the same way with respect to a major stressor-physical injury. As shown by the data in Table 5, about two thirds of both groups felt stressed or highly stressed about an injury that interfered with training or competing. Academics were of major concern for both men and women, although significantly more women (72%) than men (5S0/,)found academic work stressful. In addition, more female athletes found sport competition and having an athletic scholarship stressful. On other stressors related to athletic involvement, ie, injury, time demands of sport, and coach expectations, we found no statistical differences between men and women. Although only 25% of the men ranked general health as stressful, this was significantly greater than the percentage of women (19%) who identified this as a stressor. In fact, general health was cited as stressful by fewer women than any other factor. The most dramatic differences between men's and women's stressors were in the area of weight and eating behaviors. Weight was stressful for only 6% and eating behavior for 5% of the men, but one third of the women responded that both factors were stressful.
IACH
HEALTH OF UNlVERStN ATHLETES Another source of stress specifically examined was whether a traumatic event had occurred for the student since arrival at the university. Twenty-five percent of the men and 37% of the women answered in the affirmative, a difference that achieved statistical significance Cx2 = 3.95, df = 1 , p < .05).
Knowledge and Use of Health Resources Overall, men and women showed similar patterns of talking with helping resources when something traumatic happened to them. Family members, friends, and
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
TABLE 4 Student Athletes' Feelings About Eating Binges Men
Women
OIo
Of0
Question How do you usually feel after an eating binge? Content Satisfied Relaxed Down on myself Angry Depressed What do you think about your eating binges?* Normal Not normal Not sure
-
*Sex differences Significant at a level of p
df
22 16 12 9 3 5
5 1 30 21 17
71 2 27
42 29 29
7
< .OOl ($
2).
-
13.64,
teammates were most often turned to, followed by intimate partners and coaches (see Table 6). No significant differences were found between men and women. When asked if they knew about the psychological services of the student health center, fewer than half responded affirmatively. More women knew about the service than men (49%for women, 33% for men; $ = 5.73, df = 1, p
Journal of American College Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/vach20
The Health of University Athletes: Attitudes, Behaviors, and Stressors a
a
Rosemary Selby PhD , Harvey M. Weinstein MD & Tracy Stewart Bird BA a
a
University in Stanford , California, USA
b
Department of Athletics , Stanford, USA Published online: 09 Jul 2010.
To cite this article: Rosemary Selby PhD , Harvey M. Weinstein MD & Tracy Stewart Bird BA (1990) The Health of University Athletes: Attitudes, Behaviors, and Stressors, Journal of American College Health, 39:1, 11-18, DOI: 10.1080/07448481.1990.9936208 To link to this article: http://dx.doi.org/10.1080/07448481.1990.9936208
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
The Health of University Athletes: Attitudes, Behaviors, and stressors
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
ROSEMARY SELBY, PhD, HARVEY M. WEINSTEIN,
This study examined several aspects of the health of university athletes. Five areas of concern were targeted for investigation: general health background, use of drugs and alcohol, weight and eating behaviors, stress, and use of helping resources. The authors developed a questionnaire and used it to survey 27 varsity athletic teams at a major private university. The incidence of injuries was high; one third of the 247 student athletes surveyed reported sport-related injuries. Alcohol was much more frequently used than other drugs, and use tended to decrease during the competitive season. Significant differences between men and women athletes were found in off-season alcohol and marijuana use. Anabolic steroid abuse did not appear to be a major problem for this athlete population. Issues of diet, weight, and body image were found to be significantly different for women than for men. Although the incidence of bulimia and anorexia was low for both female and male athletes, it was clear that female athletes brought to their sport heightened concern for body image. The authors discuss the psychological and interpersonal implications that these findings have for the adjustment of female athletes. Injury and academics were perceived as the most stressful factors for both men and women, whereas weight and diet issues were a major stress factor for one third of the women. Given these data, specific recommendations are made for health professionals who work with college athletes.
Several questions about the health needs of university athletes underlie this study. Does varsity competition produce medical problems that are unique to athletes? Do athletes require medical care different from that offered to other students? Do male and female athletes differ in their medical and psychological needs?
Rosemary Selby is a clinical sport psychologist with Cowell Student Health Center at Stanford University in Stanford, California, of which Harvey M. Weinstein is director. Tracy Stewart Bird is an intern with Cowell Center and the Department of Athletics at Stanford.
VOL 39, IUW 7990
MD,and TRACY STEWART BIRD,
BA
The use of drugs among athletes has been an increasing concern in this country.’,‘ Reports of cocaine overdoses and marijuana and amphetamine use make the front pages of the sports sections of our daily newspapers. Use of anabolic steroids or other performanceenhancing drugs first found in Olympic and professional competition has filtered into the locker rooms of major university teams. In addition, there is concern that intensive athletic training and competition in some sports may be related to an increased frequency of eating disorders such as anorexia nervosa and Student athletes usually face the question of optimal weight and body competition. Issues of nutrition, percentage of body fat and its relation to peak performance, and the concern that an athlete’s diet may result in physiological imbalances such as anemia all suggest the significance of the role food plays in the life of a varsity athlete. Because of evidence that women have more concern about diet and weight control, it was hypothesized that women athletes would be more concerned about diet, weight, and body image.+” The association of exercise with physiological change has been well documented. Reports in the literature describe delayed, irregular, or absent menstrual cycles in women athletes,”-16 iron deficiency with or without anemia,”-” and other physiological indicators of body responses to exercise and, most specifically, to intensive training. Another concern for athletes is the trauma of injury and its ever-present risk. A number of studies have reported a relationship between stress, injury, and subsequent rehabilitati~n.’~~~ It appears that psychological stress both predisposes an athlete to injury and results from injury to a degree that warrants concern for the athlete’s we1I-being. University students who participate in intercollegiate athletics must deal with all of the usual pressures of college life in addition to training and competition. The
77
COL1EC;E HEALTH pressures of representing one's institution, the importance of the coach in motivating performance, and the athlete's own drive to win add increased stress to the life of the How college athletes perceive their stressors, what symptoms of stress they show, and to whom they turn in order to alleviate these pressures are critical questions that are addressed in this study. The specific objectives of this study were to identify (1) the sources of stress for student athletes and (2) sex differences among athletes with respect to health-related behaviors and attitudes.
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
METHOD We distributed a questionnaire to the members of 27 out of 28 varsity athletic teams at a major private university in March 1985 (the men's golf team was not available to respond to the survey). The teams surveyed included such diverse sports as football, baseball, basketbalI, swimming, tennis, gymnastics, wrestling, and diving. The 439 questionnaires were handed out to more than 70% of the varsity athletes; 267 forms were returned, a response rate of 61'10. The instrument used was the Athlete's Health Questionnaire, a 52-question survey instrument designed by the authors to elicit information on the following topics: demographic characteristics, general health information, alcohol and drug use, stress factors, diet, weight, body image, and knowledge and use of health resources. The questionnaires were accompanied by a letter that explained the goals of the study and assured the respondents' anonymity.
injured athletes reported either no change in training (29%) or that they modified their training somewhat (56%). Very few of the athletes reported a chronic illness. Those specified were allergies, diabetes, chondromalacia, and back problems. Because of the concern about the effects on menstruation of diet and extreme levels of exercise, we asked women about the regularity of their menstrual periods. Sixty-nine percent indicated regular periods in the last 6 months, and 56% reported no other history of cessation of menses. Because of the greater physical demands and time requirements that athletes experience from training and competition, they were also asked about health practices such as use of vitamins and nutritional supplements, relaxation, and sleep. About a quarter of the athletes used vitamins daily both in season (26%) and off season (22%). Almost half were taking vitamins on an infrequent basis, ie, two or fewer times per month, both in season (43%) and off season (46%). There were no significant differences between the sexes in vitamin use. There was, however, a significant difference in the = 17.67, df in-season use of nutritional supplements = 3, p < .001); 23% of the men and only 7% of the women used nutritional supplements one or more times per week during their competitive season. Fewer than half of the athletes, both in season (37%) and off season (46%), took time to relax on a daily basis. Only about a quarter of the athletes got sufficient sleep on a daily basis in season (22%) or off season (28%). Most athletes (ie, 68% in season; 67% off season) reported they got sufficient sleep two or fewer times a week.
(x'
RESULTS Demographics The mean age of the athletes in the sample was 19.8 years. (3those who responded, 56% were men and 44% were women. The response was fairly evenly distributed between classes: freshmen, 27.8%; sophomores, 28.2%; juniors, 25.9%; seniors and coterminal seniors i(seniors pursuing a master's degree in a fifth year), 18%. The majority of the respondents were Caucasian (86.4%); others in the sample were black (7.5%), native American (6.4%), Chicano (1.9"/0), and Asian-American (1.So/,).
General Health Background Athletes were asked about current injuries, illnesses, and, for women, menstrual patterns. Thirty-five percent of the athletes reported a current physical injury. N o sig:iificant difference was found in frequency of injury between men and women. The most commonly reported injuries were back and knee, tendonitis, ankle sprains, and pulled muscles. Most athletes reported they continued to train even though injured; only 6% of injured athletes said that they stopped training. Most
72
Alcohol and Drug Use A significant sex difference in alcohol use was found during the off season only, As the data in Table 1 show, 60% of the male and 41% of the female athletes used alcohol at least once a week during their off season. During the competitive season, alcohol use decreased to 42% of the men and 26% of the women. With respect to marijuana use, men and women did not differ significantly in their in-season use, but they did differ significantly in their off-season use; 8% of the men and 2% of the women reported at least weekly use (Table 1). We found no significant differences in cocaine use between men and women, either in season or off season. With regard to the use of performance-enhancing drugs, no women and only 1% of the males reported some use of steroids during the competitive season; 2% of the men reported off-season steroid use. In addition, we found no significant sex difference in the use of analgesics (eg, aspirin). Painkillers were, however, more frequently used in season by all the athletes as a group = 21.43, df = 3, p < .01). Five percent of the
(x'
)ACH
HEALTH athletes were daily in-season users of analgesics, primarily aspirin. During the season, 26% of the athletes reported using painkillers at least once a week. When asked about other drug use, approximately 10% reported using “other drugs” both in season and off season one or more times a week. Sudafed is an example of a commonly dispensed drug from the training room that was given as an example on the questionnaire.
TABLE 1 Student Athletes’ Use of Alcohol and Drug
Substance used Alcohol In Seawn Men Women Off season Men Women Marijuana In season Men Women Off season Men Women Cocaine In season Men Women Off season
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
Did, Weight, and Body Image This population of student athletes fell primarily within the normal weight ranges for their heights. Sixtyseven percent of the men and 84% of the women were within acceptable weights according to the standards developed at the NIH National Consensus Conference of the Fogarty Cente~.~’ Thirty-two percent of the men versus 8% of the women were in the high-weight range, presumably because of the weight and muscle requirements of their sports. The reported incidence of eating disorders was low in this study. Two percent of the women reported a history of bulimia and 470 of anorexia nervosa. Comparable figures for men were 1% for each. A marked sex difference existed, however, with respect to dieting, weight, feelings about weight, and the relationship of weight to athletic performance. Significantly more women were preoccupied with these concerns, and they reported many more negative feelings associated with these issues. More women (22%) than men (13%) felt that weight was critical to performance 10.92, df 4, p < .05),although more men (21%) than women (16%) felt that what an athlete eats is critical to performance (f = 9.38, df = 4, p < .05). Although few men or women had a weight requirement for competition, 43% of the women but only 18Y0 of the men had been told by their coaches to modify their weight Cx‘ = 9.46, df = 1, p < .001). It is significant that more women than men reported that they had difficulty in attaining their own ideal competition weight Cx‘ = 23.59, df 3, p < .001) as well as the ideal weight their coaches suggested (f 8.73, df 3, p < .05). The sex difference emerged once again over the issue of weight maintenance; the women athletes reported considerably more difficulty in maintaining their ideal (x2 = 23.59, df = 3, p < .001) or their coach-suggested weight (f = 9.24, df = 3, p < .05). Women experienced more negative emotional responses to concerns about weight and competition (see Table 2). Anger, anxiety, and depression were the expression of the frustration associated with weight control for women. Questions related to body image revealed striking differences in the men’s and women’s views of themselves. Apparent distortions in self-perception and in perception of how others see them characterized these women (see Table 3). A majority (63%) of the women
-
-
-
-
VOL 39, )UlY 7990
-
OF UNlVERSlTY ATHLETES
Men Women
Number of times No 2 or fewer 1 or more use per month perweek % % %
15 19
43
55
x’
df
42 26
4.76 2
60
9.17* 2
11
29
16
42
78 86
22
70 82
21
87 92
13 8
1.31
1
83 90
17
2.44
1
41
3.31
14 16
1
7.85* 2
2
10
Note: Some percentages do not add up to 100 because of mu nding. *Sex differences significant at p < .05. I
TABLE 2 Percentage of Students Who Expressed Various Levels of Emotion When Unable to Reach or Maintain Ideal Weight
I
Emotion
I
None 1
Level of reaction Great deal 2 2 3 4 5 (df-4)
I
I
II
Anxiety Men Women Depression Men Women Anger Men Women
66 18
16 17
10 21
6 25
19
70 16
18 18
8 24
3 29
13
64 23
14
13
20
23
7 23
11
67.88* 83.86* 45.41*
*Sex differences significant at p < .001.
athletes saw themselves as overweight, and one third of them believed that their coaches also saw them as overweight. Only 14% of the men thought of themselves as overweight. If the Fogarty scales, which were standardized on a general population, are used, 32X of the men would be categorized as outside an accep
13
COLLEGE HEALTH TABLE 3 Student Athletes' Perceptions of Their Weight Acceptability
Remonses About Underweight right Overweight % % %
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
Question How do you see yourself? Men Women How does your coach see you? Men Women How do your peers see you! Men Women How do your parents see you? Men Women Sex differences significant at * p
< .05;
14
-
2)
18 1
68 36
14 63
73.45** *
21 5
70 62
9 33
24.33***
13 5
80 81
14
9
84 74
7 21
5 **p < .01; "'p
table range. The women reported that both their parents and peers viewed the weight of these student athletes as about right. The women athletes, however, tended1 to be self-critical about how much they weighed and also attributed to their coaches negative evaluations of their weight. Given this concern about excessive weight, it is not surprising that the women athletes were actively involved in weight-reduction programs. Although they were asked about use of diuretics, self-induced vomiting, laxatives, and fasting, they reported little use of these weightcontrol methods. The only significant sex difference was found in dieting behavior-43% of the women dieted on a weekly-to-daily basis, as opposed to 26% of the men (x' = 42.33, df = 4, p < .001). Sixty-four percent of the women and 11% of the men reported that they had been on weight-loss diets since they entered the university. This is not directly related to varsity athletics because 80% of the women indicated that they had dieted before entering the university. The student athletes were asked about binge eating, which was defined as "rapid eating of an abnormally large amount of food in less than two hours." Although 38% of the women and 27% of the men reported binge eating during the past year, there was no significant difference between men and women in this eating behavior. An examination of the frequency of binge eating again revealed no significant differences, with 79% of the men and 88% of the women binge eating no more than one to two times a month. The emotional responses associated with binge eating indicated that, for women, negative feelings were associated with binging, eg, anger, depression, and being "down on oneself." For men, positive feelings, such as contentment, satisfaction, and relaxation, were
xZ (df
7
7.39* 12.49**
< .001.
associated with binging. In addition, 29% of the women felt that their eating binges were abnormal, but only 2% of the men felt this way (see Table 4). For these women athletes, distorted body image and weight preoccupation were associated with negative emotional reactions in a way that was not seen in the men. Stress Factors
When asked how stressful they found different aspects of their lives at Stanford, male and female athletes responded in the same way with respect to a major stressor-physical injury. As shown by the data in Table 5, about two thirds of both groups felt stressed or highly stressed about an injury that interfered with training or competing. Academics were of major concern for both men and women, although significantly more women (72%) than men (5S0/,)found academic work stressful. In addition, more female athletes found sport competition and having an athletic scholarship stressful. On other stressors related to athletic involvement, ie, injury, time demands of sport, and coach expectations, we found no statistical differences between men and women. Although only 25% of the men ranked general health as stressful, this was significantly greater than the percentage of women (19%) who identified this as a stressor. In fact, general health was cited as stressful by fewer women than any other factor. The most dramatic differences between men's and women's stressors were in the area of weight and eating behaviors. Weight was stressful for only 6% and eating behavior for 5% of the men, but one third of the women responded that both factors were stressful.
IACH
HEALTH OF UNlVERStN ATHLETES Another source of stress specifically examined was whether a traumatic event had occurred for the student since arrival at the university. Twenty-five percent of the men and 37% of the women answered in the affirmative, a difference that achieved statistical significance Cx2 = 3.95, df = 1 , p < .05).
Knowledge and Use of Health Resources Overall, men and women showed similar patterns of talking with helping resources when something traumatic happened to them. Family members, friends, and
Downloaded by [JAMES COOK UNIVERSITY] at 02:59 16 March 2015
TABLE 4 Student Athletes' Feelings About Eating Binges Men
Women
OIo
Of0
Question How do you usually feel after an eating binge? Content Satisfied Relaxed Down on myself Angry Depressed What do you think about your eating binges?* Normal Not normal Not sure
-
*Sex differences Significant at a level of p
df
22 16 12 9 3 5
5 1 30 21 17
71 2 27
42 29 29
7
< .OOl ($
2).
-
13.64,
teammates were most often turned to, followed by intimate partners and coaches (see Table 6). No significant differences were found between men and women. When asked if they knew about the psychological services of the student health center, fewer than half responded affirmatively. More women knew about the service than men (49%for women, 33% for men; $ = 5.73, df = 1, p
