Sports Medicine Research: In the Lab & In the Field: Interpersonal Difficulties as a Risk Factor for Athletes’ Eating Psychopathology (Sports Med Res)


Monday, September 30, 2013

Interpersonal Difficulties as a Risk Factor for Athletes’ Eating Psychopathology

Interpersonal difficulties as a risk factor for athletes’ eating psychopathology

Shanmugam, V., Jowett, S. and Meyer, C. Scandinavian Journal of Medicine & Science in Sports. 2013. doi: 10.1111/sms.12109

Take Home Message: An athlete’s perceived level of conflict with a coach is related to his/her risk of developing an eating psychopathology.

Eating disorders are far from uncommon within the realm of athletics and recent research has identified athletes to be at an increased risk of developing eating disorders as well as problematic eating attitudes. Eating disorders can lead to long term detrimental physiological and psychological outcomes and are the leading cause of mortality above all other mental health issues. Due to the fact that it is not understood why exactly athletes are particularly at risk for eating disorders, investigation in this subject matter is extremely important. This article delves into research about this subject and tries to determine the predictive role of interpersonal difficulties such as relationship quality and attachment styles on eating psychopathology among competitive British athletes. The study involved 122 British athletes (36 males and 86 females) with a mean age of ~21 years and ranging from collegiate to athletes at international competitive levels. Some of the athletes were involved with individual sports such as swimming, cycling and judo, while the other athletes participated in team sports such as rugby, football, and hockey. Data collection consisted of a study pack including a demographic questionnaire, Eating Disorder Examination Questionnaire, Sport-Specific Quality of Relationship Inventory, and Experiences in Close Relationships. The athletes completed the packs at baseline and at this time the authors collected their body mass index (BMI). Six months later the authors gave the same study pack to the athletes and measured the athletes’ BMI again to collect a second round of data. This study found that out of all of the possible predictors, the conflict with the coach was the only independent predictor of athletes’ eating psychopathology.

This study helps solidify the idea that those suffering from unsupportive relationships that are constantly filled with conflict, especially athletes, can be at increased risk of suffering from eating disorders or problematic eating attitudes. Although we still cannot be 100% sure why exactly athletes are at more risk for eating disorders, this study found that interpersonal relationships, especially between player and coach, play a huge role in eating psychopathology. We can hypothesize that because athletes spend countless amounts of hours in the company of their teammates and coaches due to their rigorous schedules, these relationships may not always be healthy or without conflict and can cause increased risk of unhealthy eating habits and attitudes. The findings of this study could allow for immediate education to be implemented in athletic venues in regards to training athletes and coaches about the potential issues surrounding eating habits. Education is key, but if all else fails, there could also potentially be other interventions involving sports nutritionists and even sports psychologists to work with both the athletes as well as coaching staff. This study could potentially be used in many different venues of athletics as well, such as cheerleading, ballet, rowing, gymnastics, and also wrestling, all sports that demand a large amount of practice, time, and effort, but also there is such a stigma about what these athletes should look like, which I would presume could pose a even higher risk of poor eating psychopathology.

Questions for Discussion: As a clinician, have you ever had to deal with a patient who was suffering from an eating disorder and found it was due to their interpersonal relationships? Do you feel like it should be part of the role of an athletic trainer to be trained to identify “divergent” relationships between players and coaches? How important is it for athletes to feel like they can go to their supervising clinician for a “safe haven” to discuss any possible issues regarding eating issues and/or unhealthy relationships?

Written by: Chelsea Jacoby
Reviewed by: Lisa Chinn and Jeffrey Driban

Related Posts:
Genetic Associations of Recovery from Eating Disorders

Shanmugam V, Jowett S, & Meyer C (2013). Interpersonal difficulties as a risk factor for athletes' eating psychopathology. Scandinavian Journal of Medicine & Science in Sports PMID: 23992547


Kelsey Croak said...

In my clinical experience so far, I have only had to deal with one athlete with an eating disorder. However, this particular instance was not due to negative interpersonal relationships. Even though my exposure with this particular topic is limited, I believe the relationship between a player and a coach plays a huge role in the athlete's mindset when it comes to weight management, fitness level and eating issues. Athletes tend to seek the approval of a coach as they would from a parent. If for some reason, an athlete’s performance is being criticized or if they are told they need to increase their fitness level, they might interpret this as the coach telling them they need to lose weight. This is magnified even more so, if the athlete does not have a positive relationship with the coach and understand the intentions behind the criticism. The athlete sometimes receives this criticism, though intended to be constructive, negatively.
As athletic trainers, we serve multiple roles in a addition to being a health care provider. It is extremely important that athletes feel they can talk to their supervising clinician about anything. The more comfortable the athlete feels with their supervising clinician, the more honest and upfront they will be about their concerns or issues, including eating disorders and interpersonal relationships. That being said I don’t necessarily feel like athletic trainers need to be trained to pick out these divergent relationships, I think they just need to be aware of the relationship and communication between the coach and athlete, if they are positive or negative. This skill develops with time and experience. It is also the responsibility of the clinician to be able to intervene if they notice these negative relationships.

ChelseaJacoby said...

Thank you so much for your comment. I completely agree with you on all of the aspects you touched upon. I agree with you especially on the fact that a coach’s criticism may be perceived incorrectly and may elicit further implications such as eating disorders. I also believe that it is our responsibility as clinicians to protect the athletes as much as we can, but it is important to understand as well that there is a fine line that we need to teeter when choosing whether or not to intervene. It is important that we be aware of the relationships, especially the negative ones, that surround athletes and intervene only if there becomes an issue, since we really aren’t professionally trained to pick out divergent relationships. As long as we are keeping the best interests of the athlete in minds at all times, I think we can provide adequate help if necessary. Thank you again for your post, I really appreciate the feedback!

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