Determinants of anxiety in elite athletes: a systematic review and meta-analysis

Simon Rice, Kate Gwyther, Olga Santesteban-Echarri, David Baron, Paul Gorczynski, Vincent Gouttebarge, Claudia L. Reardon, Mary E. Hitchcock, Brian Hainline, Rosemary Purcell

Research output: Contribution to journalArticlepeer-review

266 Downloads (Pure)


Objective - To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes.

Design - Systematic review and meta-analysis.

Data sources - Five online databases (PubMed, SportDiscus, PsycINFO, Scopus, and Cochrane) were searched up to November 2018 to identify eligible citations.

Eligibility criteria for selecting studies - Articles were included if they were published in English, were quantitative studies, and measured a symptom-level anxiety outcome in competing or retired athletes at the professional (including professional youth), Olympic, or collegiate/university levels.

Results and Summary - We screened 1163 articles; 61 studies were included in the systematic review and 27 of them were suitable for meta-analysis. Overall risk of bias for included studies was low. Athletes and non-athletes had no differences in anxiety profiles (d = -0.11, p = 0.28). Pooled effect sizes, demonstrating moderate effects, were identified for; (i) career dissatisfaction (d = 0.45, higher anxiety in dissatisfied athletes), (ii) gender (d = 0.38; higher anxiety in female athletes), (iii) age (d = -0.34; higher anxiety for younger athletes), and (iv) musculoskeletal injury (d = 0.31; higher anxiety for injured athletes). A small pooled effect was found for recent adverse life events (d = 0.26)--higher anxiety in athletes who had experienced one or more recent adverse life events.

Conclusion - Determinants of anxiety in elite populations broadly reflect those experienced by the general population. Clinicians should be aware of these general and athlete-specific determinants of anxiety among elite athletes.
Original languageEnglish
Pages (from-to)722–730
JournalBritish Journal of Sports Medicine
Publication statusPublished - 16 May 2019


Dive into the research topics of 'Determinants of anxiety in elite athletes: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this