Association of Team Sports Participation With Long-term Mental Health Outcomes Among Individuals Exposed to Adverse Childhood Experiences

Overview

Journal JAMA Pediatr

Publisher American Medical Association

Date 2019 May 29

PMID 31135890

Citations 45

Authors

Molly C Easterlin

Paul J Chung

Mei Leng

Rebecca Dudovitz

Affiliations

Soon will be listed here.

Abstract

Importance: Adverse childhood experiences (ACEs) are associated with long-term poor mental health. Less is known about factors that improve long-term mental health among those with ACEs.

Objective: To evaluate, among those exposed to ACEs, whether team sports participation during adolescence is associated with better mental health in adulthood and whether the association between team sports participation and mental health varies by sex.

Design, Setting, And Participants: This study used data from 9668 individuals who participated in waves 1 (1994-1995) and 4 (2008) of the National Longitudinal Study of Adolescent to Adult Health. Individuals were included if they had complete data on exposure to ACEs (physical and sexual abuse, emotional neglect, parental alcohol misuse, parental incarceration, and living with a single parent) and a valid sample weight. Statistical analysis was performed from November 6, 2017, to January 4, 2019.

Main Outcomes And Measures: The association between team sports participation in grades 7 to 12 (wave 1) and diagnosis of depression and/or anxiety and current depressive symptoms (determined by Center for Epidemiologic Studies Depression scale-10 scores) at ages 24 to 32 years (wave 4) among individuals exposed to ACEs. Multivariable logistic regression models were weighted based on propensity scores for factors associated with team sports participation and controlled for individual, family, and school characteristics. Interaction terms tested whether associations between team sports participation and mental health varied by sex.

Results: Of 9668 individuals included in the study (4470 male [50.0%]; mean [SD] age, 15.2 [1.75] years), 4888 (49.3%) reported 1 or more ACE and 2084 (21.3%) reported 2 or more ACEs. Among those with ACEs, team sports participation during adolescence was significantly associated with lower odds of receiving a diagnosis of depression (unadjusted rate, 16.8% vs 22.0%; propensity score-weighted [PSW] adjusted odds ratio [aOR], 0.76; 95% CI, 0.59-0.97) or anxiety (11.8% vs 16.8%; PSW aOR, 0.70; 95% CI, 0.56-0.89) and having current depressive symptoms (21.9% vs 27.5%; PSW aOR, 0.85; 95% CI, 0.71-1.01). There were no significant differences in associations between team sports participation and mental health by sex. Stratified analyses showed significant associations for all outcomes among males (depression: PSW aOR, 0.67 [95% CI, 0.46-0.99]; anxiety: PSW aOR, 0.66 [95% CI, 0.45-0.96]; depressive symptoms: PSW aOR, 0.75 [95% CI 0.56-0.99]) but only 1 outcome among females (anxiety: PSW aOR, 0.73; 95% CI, 0.54-0.98).

Conclusions And Relevance: Among individuals affected by ACEs, team sports participation in adolescence was associated with better adult mental health. Team sports may be an important and scalable resilience builder.

Citing Articles

Toward a Trauma-Informed Comprehensive School Physical Activity Program: Specifying Feasible Practices Across the School Day.

Kroshus-Havril E, Hafferty K, Massey W, Whitley M, Darroch F, Shaikh M J Sch Health. 2024; 95(2):172-186.

PMID: 39528426 PMC: 11750590. DOI: 10.1111/josh.13519.

Exploring the sports participation, muscle-strengthening exercise and active commuting with comorbidity of depression and anxiety among Chinese children and adolescents: a cross-sectional study.

Feng B, Luo F, Chen Y, Zhao Y, Wang P, Bao R Front Psychol. 2024; 15:1338190.

PMID: 39257409 PMC: 11385614. DOI: 10.3389/fpsyg.2024.1338190.

Role of Sports Motivation and Basic Psychological Needs in the Relationship Between Child Maltreatment and Psychological Adaptation in Adolescents.

Rodrigue C, Bothe B, Dion J Child Maltreat. 2024; :10775595241267964.

PMID: 39079015 PMC: 11894842. DOI: 10.1177/10775595241267964.

Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents.

Choi K, Bravo L, La Charite J, Cardona E, Elliott T, James K Acad Pediatr. 2024; 24(8):1236-1245.

PMID: 39004299 PMC: 11649072. DOI: 10.1016/j.acap.2024.07.006.

Adolescent mental health interventions: a narrative review of the positive effects of physical activity and implementation strategies.

Li Z, Li J, Kong J, Li Z, Wang R, Jiang F Front Psychol. 2024; 15:1433698.

PMID: 38993342 PMC: 11236730. DOI: 10.3389/fpsyg.2024.1433698.

References

Musliner K, Singer J . Emotional support and adult depression in survivors of childhood sexual abuse. Child Abuse Negl. 2014; 38(8):1331-40. PMC: 4383236. DOI: 10.1016/j.chiabu.2014.01.016. View

Bardone A, Moffitt T, Caspi A, Dickson N, Stanton W, Silva P . Adult physical health outcomes of adolescent girls with conduct disorder, depression, and anxiety. J Am Acad Child Adolesc Psychiatry. 1998; 37(6):594-601. DOI: 10.1097/00004583-199806000-00009. View

Bruce M, Seeman T, Merrill S, Blazer D . The impact of depressive symptomatology on physical disability: MacArthur Studies of Successful Aging. Am J Public Health. 1994; 84(11):1796-9. PMC: 1615223. DOI: 10.2105/ajph.84.11.1796. View

Halfon N, Larson K, Lu M, Tullis E, Russ S . Lifecourse health development: past, present and future. Matern Child Health J. 2013; 18(2):344-65. PMC: 3890560. DOI: 10.1007/s10995-013-1346-2. View

Taliaferro L, Rienzo B, Miller M, Pigg Jr R, Dodd V . High school youth and suicide risk: exploring protection afforded through physical activity and sport participation. J Sch Health. 2008; 78(10):545-53. DOI: 10.1111/j.1746-1561.2008.00342.x. View

Szilagyi M, Halfon N . Pediatric Adverse Childhood Experiences: Implications for Life Course Health Trajectories. Acad Pediatr. 2015; 15(5):467-8. DOI: 10.1016/j.acap.2015.07.004. View

Motl R, Birnbaum A, Kubik M, Dishman R . Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosom Med. 2004; 66(3):336-42. DOI: 10.1097/01.psy.0000126205.35683.0a. View

Asztalos M, De Bourdeaudhuij I, Cardon G . The relationship between physical activity and mental health varies across activity intensity levels and dimensions of mental health among women and men. Public Health Nutr. 2009; 13(8):1207-14. DOI: 10.1017/S1368980009992825. View

Schickedanz A, Halfon N, Sastry N, Chung P . Parents' Adverse Childhood Experiences and Their Children's Behavioral Health Problems. Pediatrics. 2018; 142(2). PMC: 6317990. DOI: 10.1542/peds.2018-0023. View

10.

LeTendre M, Reed M . The Effect of Adverse Childhood Experience on Clinical Diagnosis of a Substance Use Disorder: Results of a Nationally Representative Study. Subst Use Misuse. 2017; 52(6):689-697. PMC: 5519323. DOI: 10.1080/10826084.2016.1253746. View

11.

Dugoff E, Schuler M, Stuart E . Generalizing observational study results: applying propensity score methods to complex surveys. Health Serv Res. 2013; 49(1):284-303. PMC: 3894255. DOI: 10.1111/1475-6773.12090. View

12.

Flaherty E, Thompson R, Litrownik A, Theodore A, English D, Black M . Effect of early childhood adversity on child health. Arch Pediatr Adolesc Med. 2006; 160(12):1232-8. DOI: 10.1001/archpedi.160.12.1232. View

13.

Chen E, Miller G . Stress and inflammation in exacerbations of asthma. Brain Behav Immun. 2007; 21(8):993-9. PMC: 2077080. DOI: 10.1016/j.bbi.2007.03.009. View

14.

Eyler A, Piekarz-Porter E, Serrano N . Pay to Play? State Laws Related to High School Sports Participation Fees. J Public Health Manag Pract. 2018; 25(3):E27-E35. PMC: 6416066. DOI: 10.1097/PHH.0000000000000813. View

15.

Dishman R, Hales D, Pfeiffer K, Felton G, Saunders R, Ward D . Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls. Health Psychol. 2006; 25(3):396-407. DOI: 10.1037/0278-6133.25.3.396. View

16.

Danese A, Moffitt T, Harrington H, Milne B, Polanczyk G, Pariante C . Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Arch Pediatr Adolesc Med. 2009; 163(12):1135-43. PMC: 3560401. DOI: 10.1001/archpediatrics.2009.214. View

17.

Babiss L, Gangwisch J . Sports participation as a protective factor against depression and suicidal ideation in adolescents as mediated by self-esteem and social support. J Dev Behav Pediatr. 2009; 30(5):376-84. DOI: 10.1097/DBP.0b013e3181b33659. View

18.

Johnson S, Riley A, Granger D, Riis J . The science of early life toxic stress for pediatric practice and advocacy. Pediatrics. 2013; 131(2):319-27. PMC: 4074672. DOI: 10.1542/peds.2012-0469. View

19.

Resnick M, Bearman P, Blum R, Bauman K, Harris K, Jones J . Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997; 278(10):823-32. DOI: 10.1001/jama.278.10.823. View

20.

Garner A, Shonkoff J . Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics. 2011; 129(1):e224-31. DOI: 10.1542/peds.2011-2662. View