Abuse in Youth Sport Tied to Poor Mental Health in Adults

Liam Davenport

April 04, 2017

FLORENCE, Italy — Children who suffer severe physical, sexual, or psychological violence when taking part in youth sport are more likely to experience mental health problems as adults, researchers warn.

A study of more than 4000 adults showed that experiencing severe interpersonal violence during youth sport increased the risk for depression, anxiety, and somatic problems. It also affected overall mental health.

"Experiencing interpersonal violence against in youth sport is associated with mental health problems in adulthood," the researchers, led by Tine Vertommen, PhD, criminologist, Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Belgium, said in a release.

"This is an important finding to consider, both from a clinical as well as a sport policy point of view."

The study was presented here at the European Psychiatric Association (EPA) 2017 Congress.

Long-term Effects

Recent research by the same group indicated that 9.1% of child athletes in the Netherlands and Belgium had experienced severe psychological violence; 8.1% had experienced severe physical violence, and 5.5% had experienced severe sexual violence.

Although several studies have shown that violence in childhood is associated with later mental health problems, this long-term relationship had not been examined in athletes.

The researchers studied the same sample of 4043 of Dutch and Belgian individuals from their previous study who had participated in youth sport. Participants were aged 18 to 50 years.

Of these, 55% were women, 51% were Belgian, 41% were highly educated, 61% were married or cohabiting, 8% were lesbian/gay/bisexual/transsexual (LGBT), 8% were from an ethnic minority, and 5% took part in disabled sport.

The Brief Symptom Inventory was used to assess psychological symptoms. The researchers focused on the global severity index (total score) and the somatization, depression, and anxiety subscales.

In a generalized linear model that took into account demographics, recent life events, and family history of psychological problems, the team found that severe sexual, physical, and psychological violence were all related to ongoing psychological problems in adulthood.

The overall effects sizes were small. The greatest impact on somatization was seen for severe sexual violence; physical and sexual violence had the greatest impact on depression. All three types of violence were equally predictive of anxiety problems.

Overall, the factor that had the greatest impact on current mental health was recent life events. Having relatives with psychological problems also had a negative impact on mental health.

The team also found that more mental health problems were reported in individuals from ethnic minorities, LGBT individuals, disabled people, and participants with a lower educational level. Being married or cohabiting appeared to have a protective effect on mental health, aside from anxiety.

Abuse in Sport "Normalized"

For Dr Vertommen, the situation in sport differs from other types of abusive situations because of the view that violence and physical contact are often considered part of the sport and are therefore "normalized."

However, she emphasized that not all physical contact is wrong, and there are lots of positive types of touching, including congratulating children when they have done something well.

"It's a vague line, and if we, as adults, don't know exactly what is good and what is maybe dangerous, how should a child know?" she said. "That's the problem. They often don't realize that this doesn't belong to normal sport participation. When I talk to victims, they often say: 'It's only after 10, 12 years that I realized that what he did back then was not normal and that wasn't a normal part of sport.' "

Dr Vertommen noted that only recently have rigorous studies of interpersonal violence in sport been conducted, and there has been a tendency to believe it is thing of the past.

However, she believes that the issue is now higher on the agenda of agencies such as the International Olympic Committee (IOC) and European institutions. "For example, the IOC published a first consensus statement in 2007 and now a new one in 2016," she said. "They started by focusing only on sexual harassment and abuse, and now they've broadened it into other types of nonaccidental harm of athletes."

Nevertheless, she is concerned that the message has not reached the grass roots level.

"If we're lucky, we have good codes of conducts and policy frameworks, but as long as the athletes on the playing field and the local coaches are unaware of these [policies], it doesn't help that much.

"That's why we have a big challenge, and we have to make another step to make these tools available to everybody and support them and stimulate them to use them in daily practice," she said.

Timely Research

Commenting on the findings for Medscape Medical News, Julian Beezhold, MD, FRCPsych, consultant in emergency psychiatry, Hellesdon Hospital, Norwich, United Kingdom, and secretary general of the European Psychiatric Association, said the research "comes at a time when there is growing public concern regarding the prevalence of abuse of children in sporting settings.

"It has found that this abuse is not only traumatic at the time but can have consequences extending far longer and into adulthood. Mental health problems following abuse in youth sport can be prevented by eliminating the abuse."

Until recently, interpersonal violence in youth sport was not taken particularly seriously, said Dr Vertommen.

"We have known for a long time already from outside sport that child abuse can have devastating effects on some people...but nobody was taking care of the specific risk factors that are available in sport and make it a conducive climate for all kinds of behaviors that are 'boundary transgressive.' "

No funding or relevant financial relationships have been disclosed.

European Psychiatric Association (EPA) 2017 Congress. Poster EV1058, presented April 2, 2017.


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