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      Elite lean athletes at sports high schools face multiple risks for mental health concerns and are in need of psychosocial support

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          Abstract

          The combined demands on an adolescence in an elite sports high school can negatively affect mental health (eg, stress, burnout, depression, anxiety). Late adolescence is also when elite-striving athletes typically transition from junior-to-senior level programs. In addition, adolescent elite lean sports athletes have an increased risk of suffering from abnormal eating pathology. The purpose of this study was to investigate the perceived psychosocial needs that young, elite-striving lean sports athletes in sports high schools find essential for their sports careers and transition from junior-to-senior level sports. Eight Swedish elite-striving lean sports athletes (2 men and 6 women; median age 17.0 years, range: 16–18 years) participated in this study and sports represented were athletics (n = 1), gymnastics (n = 3), and wrestling (n = 4). Semi-structured interviews were performed, and data was analyzed by thematic analysis. Results showed integration, both in the present situation and for the future, as an overarching theme perceived as essential for a successful elite sports career over time. Three additional themes were also identified: (a) Psychosocial stress (combined performance demands, diminished social life, sports-related body weight demands, taboo talking about eating disorders, injuries), (b) Protective psychosocial factors (social support and psychological safety, communication and coordination school and sports, self-care/health behaviors), and (c) support needs junior-to-senior transition (career advice and mentorship, individualized support). As a result, elite-striving, lean sports athletes attending sports high schools need additional support to excel in their academic and athletic endeavors. Sports developmental programs continue to provide inadequate support before and during the junior-to-senior level transition. Similarly, despite the continued calls for reducing the stigma of mental health, athletes in sports schools still encounter barriers from coaches and peers, making the subject taboo, particularly surrounding eating pathologies.

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          Most cited references56

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          Using thematic analysis in psychology

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            Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

            Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              Reflecting on reflexive thematic analysis

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – original draft
                Role: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Investigation
                Role: ConceptualizationRole: Formal analysisRole: Investigation
                Role: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                21 April 2023
                2023
                : 18
                : 4
                : e0284725
                Affiliations
                [1 ] Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
                [2 ] Athletics Research Center, Linköping University, Linköping, Sweden
                [3 ] Department of Physical Education, Sport and Human Performance, Winthrop University, Rock Hill, SC, United States of America
                [4 ] Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
                University of Valencia, SPAIN
                Author notes

                Competing Interests: The authors have declared that no competing interests exists.

                Author information
                https://orcid.org/0000-0001-6570-5480
                https://orcid.org/0000-0002-6360-9599
                Article
                PONE-D-22-35217
                10.1371/journal.pone.0284725
                10121048
                37083747
                67e4b55e-c12b-49ed-aa81-4132351ae3b0
                © 2023 Lundqvist et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 23 December 2022
                : 5 April 2023
                Page count
                Figures: 1, Tables: 1, Pages: 18
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Biology and Life Sciences
                Psychology
                Behavior
                Recreation
                Sports
                Social Sciences
                Psychology
                Behavior
                Recreation
                Sports
                Biology and Life Sciences
                Sports Science
                Sports
                Social Sciences
                Sociology
                Education
                Schools
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Medicine and Health Sciences
                Health Care
                Psychological and Psychosocial Issues
                Social Sciences
                Economics
                Labor Economics
                Employment
                Careers
                Custom metadata
                Due to the qualitative nature of this research and that sharing transcripts publicly is not permitted by the ethical approval and would violate the agreement to which the participant consented, sharing of data publicly is not possible. Excerpts from the transcripts are included in the article in the results section. Data is available on reasonable request by contacting registrator@ 123456ibl.liu.se [DNR IBL-2023-00087].

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                Uncategorized

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