Running Head: STUDENT-ATHLETE MENTAL HEALTH Establishing foundational data on the mental health functioning, stress, mood, self-regulation capacity, and perceptions of coaching climate of Canadian Interuniversity Sport (CIS) student-athletes Krista Van Slingerland University of Ottawa MASTER’S THESIS Thesis submitted to the University of Ottawa in partial fulfillment of the requirements for the degree of Masters of Arts in Human Kinetics Ottawa, Ontario, Canada November 14, 2016 © Krista Van Slingerland, Ottawa, Canada, 2016 STUDENT-ATHLETE MENTAL HEALTH II Acknowledgements I would like to take this opportunity to acknowledge some individuals who made a significant impact on this project in their own ways. Firstly, thank you to all of the student- athletes who took the time to participate in the study, especially those 110 who participated twice, thanks for helping us break ground on an issue near to my heart. Second, to Dr. Natalie Durand-Bush, who took me in and provided me an avenue to pursue my passion and who has taught me much about academia and life. Nat, you have been an outstanding mentor; you’ve inspired me to dream bigger than I thought was possible and I am so looking forward to continuing our journey together. Next, to Scott Rathwell, thank you for lending me your expertise, time and most of all for your patience and understanding. I am also grateful to Drs. Bradley Young and Jennifer Brunet for sitting on my committee and providing valuable feedback that was fundamental to the project’s success. Thanks to Brad for your unwavering enthusiasm as a teacher, I’m glad I learned the ropes from you; and to Jen for improving the strength of the project by pushing me to go far beyond my comfort zone. Lastly, I am appreciative of the support I’ve received from my family, loved ones and friends as well. Devin, thank you for being the hero behind the scenes and supporting me throughout the thesis process. Finally, to the women and coaches of the University of Ottawa’s women’s basketball team, thanks for being my family away from home and for the past two years of unforgettable memories. STUDENT-ATHLETE MENTAL HEALTH III Table of Contents Chapter 1 – Introduction…..……………………...………...……………………………….. 1 Background – Definition and Prevalence of Mental Health and Illness……………………. 1 Chapter 2 - Literature Review……………………………...……………………………….. 4 Well-being and Mental Illness: Not the Same, but not Mutually Exclusive……………. 4 Mental Health Landscape of University-Aged Populations…..………………………… 5 Demography of Poor Mental Health: Stress and Individual Differences……………….. 8 Student-Athlete Mental Health………………………………………………………….. 10 Mood…………………………………………………………………………………….. 13 Self-Regulation………...……………………………….……………………………….. 15 Coaching Climate……………………………………………..….……………………... 19 Summary..… …………………………...…………….…………………......................... 21 Research Purpose and Questions.…………………………………………………………… 23 Chapter 3 - Methods……………………………………………..………………………….. 27 Participants………………………………………………………………......................... 27 Procedures……………………………………………………………………………….. 28 Measures………………………………………………………………………………… 29 Data Analysis. ……………………………………………………………………………… 34 Chapter 4 - Results………………………………………….………………………………. 3 7 Article 1: Levels and Prevalence of Mental Health Functioning in Canadian Interuniversity Sport (CIS) Student-Athletes..………………................................................ 38 Introduction. ………………………………………………………………………………... 40 Mental Health and Illness……..………………………………………………………… 40 Mental Health in University Students..…………………….............................................. 42 University Student-Athletes.………………………………………………………... 44 Methods. ……………………………………………………………….…………………… 48 Participants………………………………………………………………………………. 48 Instruments………………………………………………………………………………. 48 Procedures.………………………………………………………………………………. 50 Data Analysis and Results………………………………………………............................... 50 Discussion. …………………………………………………………………………………. 54 Limitations………………………………………………………………............................... 59 Conclusion and Practical Implications..…………………………………………………….. 60 References…………………………………………………………………………………... 62 Article 2: Investigating university student-athletes’ mental health functioning in relation to their stress, mood, self-regulation capacity, and perceptions of coaching climate................. 75 STUDENT-ATHLETE MENTAL HEALTH IV Introduction…………………………………………………………………………………. 77 Mental Health and Mental Illness ………………………………………......................... 77 Stress. …………………………………………………………………………………… 78 Mood. …………………………………………………………………………………… 79 Self-Regulation………………………………………………………….......................... 79 Coaching Climate……………………………………………...……..…………………. 80 Purpose of the Study and Hypotheses. ……………………………………………………... 81 Methods.……………………………………………………………................................ 82 Participant Recruitment.………………………………………………………………… 82 Instruments……………………………………………………………………………… 84 Data Analysis and Results. …………………………………………………………………. 86 Model Fit..……………………………………………………………………………… 88 Stress. ……………………………………………………………………………….. 89 Mood States……………………………….………………………………………… 89 Self-Regulation Capacity..……………………………………………….................... 89 Perceived Coaching Climate.………………………………………………………… 90 Discussion. ………………………………………………………………............................. 90 Stress…………………………………………………………………………………… 91 Mood…………………………………………………………………………………… 92 Self-Regulation Capacity………………………………….…………………………… 93 Perceived Coaching Climate…………………………………………………………… 94 Mental Health Functioning and Athletic Performance………………………………… 94 Limitations……………………………………………………………….............................. 95 Concluding Remarks………………………………………………………………………... 96 References. …………………………………………………………………………………. 99 Chapter 5 - General Discussion....................……………………………............................... 114 Towards a Preliminary Mental Health Profile of Canadian Student-Athletes………..…. 115 The “big picture”……………………………………………………………………... 116 Future Directions and Recommendations…………………………………………………... 118 Chapter 6 - Conclusion……………….…………………………………...………………… 122 Chapter 7 – Statement of Contributions……………………………..…………………….... 1 24 References and Appendices…………………………………………………………………. 125 Appendix A: Table 1: Summary of Sample Demographics………………………………… 130 Appendix B: Recruitment text provided to Athletic Directors……………………………… 132 Appendix C: CIS endorsement letter….…………………………………………………….. 134 Appendix D: Recruitment Text: SAMHI website………………………............................... 135 Appendix E: Recruitment Text: SAMHI social media platforms…………………………... 136 Appendix F: Consent form: Time 1 (November, 2015, EN/FR)…………………..……….. 137 Appendix G: Invitation to Participate at Time 2 – Link to Questionnaire and Consent (EN/FR)………………………….………………………………………….......................... 147 STUDENT-ATHLETE MENTAL HEALTH V Appendix H: Demographic Questionnaire (EN/FR)….…………………..………………… 148 Appendix I: Adult Mental Health Continuum-Short Form (EN/FR)……..………………… 156 Appendix J: Student-Life Stress Inventory (EN/FR)……………………..………………… 158 Appendix K: Profile of Mood States – Short Form (EN/FR)……………..………………… 162 Appendix L: Adolescent Self-Regulation Inventory (EN/FR)……………………………… 164 Appendix M: Sport Climate Questionnaire (EN/FR)……………………………………….. 167 List of Figures Article 2 Figure 1. Significant Standardized Beta Weights for Path Analysis……………..…………. 1 13 General Discussion Figure 2. CIS Student-Athletes’ Mood Profile Compared to Norms and NCAA Football Players………………………………………………………………………………………. 117 List of Tables Article 1 Table 1. Summary of Sample Demographics……………………………………………….. 6 9 Table 2. Internal Consistency Coefficients Grouped by Time and Questionnaire Language…………………………………………………………………………………..... 71 Table 3. Level and Prevalence of MHF Across Time………………………………………. 72 Table 4. Level and Prevalence of MHF Based on Student-Athletes With and Without a Previous Mental Illness Diagnosis………………………………………………………….. 73 Table 5. Summary of Main and Interaction Effects of Gender, Alcohol Use, Living Situation, Year of Study and Type of Sport on MHF for Five Separate RM-MANOVAs … 74 Article 2 Table 1. Internal Consistency Coefficients Grouped by Time and Questionnaire Language……………………………………………………………………………………. 108 Table 2. Time 2 Correlations Between Scale Scores and Descriptive Statistics …………… 109 Table 3. Beta Coefficients and Significance Testing for Initial Path Model……………….. 111 STUDENT-ATHLETE MENTAL HEALTH VI Abstract Mental health has become increasingly important on post-secondary campuses across Canada, as the majority of university students represent the cohort of the Canadian populace that is most vulnerable to mental illness, substance abuse, and suicide. Evidence suggests that student-athletes, a visible and diverse sub-population of university students, are at equal risk of experiencing a mental illness (Reardon & Factor, 2010), but could be even more vulnerable to mental health challenges than their non-athlete peers (Neal et al., 2013; Watson & Kissinger, 2007), given the additional demands and pressures that they face. Problematic though, is that the culture of athletics and prevailing stigma surrounding mental illness can lead student-athletes to overreport their well-being and deny distress (Steiner, Denny, & Stemmle, 2010), as well as underutilize the mental health services available to them on campus (Lopez & Levy, 2013). Although researchers have investigated the mental health of American college students (e.g., Eklund, Dowdy, Jones, & Furlong, 2011) and attempted to understand the vulnerability