From Passion to Abyss: The Mental Health of Athletes during COVID-19 Lockdown

Round 1

Reviewer 1 Report

Pathological stress levels and sleep disorders can affect athletes' performance and increase the risk of sports injuries on return to competition. These facts are not quite well confirmed.

Author Response

Thank you for taking the time to review and for giving us the opportunity to review our paper.

We believe that we improved all sections and  we hope that the review will meet your expectations.

Thank you very much!!!

Reviewer 2 Report

European Journal of Investigation in Health, Psychology and Education

Article ID: ejihpe-2120639

Title: From Passion to Abyss: The Mental Health of Athletes during COVID-19 Lockdown

Dear Authors,

General comments

Thank you for giving me the opportunity to review this paper.

This study aims: (i) to characterize the psychological health of athletes during the COVID -19 lockdown by analyzing stress, happiness, and sleep activity; (ii) to perform a comparative analysis of the psychological health of athletes by reference to remuneration status and cuts; and (iii) to study the mediating role of sleep disorders on stress and happy relationship.

Specific comments

Introduction

The introduction can be improved (it is suggested to adjust the introduction), making the whole framework (followed) and presenting (1) in the penultimate paragraph, the general objective of the work (“This study aims: (i) to characterize the psychological health of athletes during the COVID -19 lockdown by analyzing stress, happiness, and sleep activity; (ii) to perform a comparative analysis of the psychological health of athletes by reference to remuneration status and cuts; and (iii) to study the mediating role of sleep disorders on stress and happy relationship."), and (2) in the last paragraph, the study hypotheses (all).

Material and Methods

Date of application of the questionnaire? (2.2.)

The statistical analysis section is missing (2.3.).

Results

The first paragraph can be deleted (L153-157).

This section can (should) be simplified (more synthetic and not repeating the results presented in the tables).

Discussion

These sections can be improved (e.g.: some references are missing; some paragraphs can be simplified).

Conclusions

OR Final considerations

In my opinion, authors present some final considerations in this section (the conclusions themselves were presented in the discussion)

References

This section needs to be completely revised.

Author Response

Thank you for taking the time to review and for giving us the opportunity to review our paper.

We appreciate your comments, and we think they can contribute to improving the quality of our paper. We hope that the review will meet your expectations.

The response to your comments is attached.

Author Response File: Author Response.pdf

Reviewer 3 Report

Major Comments – Abstract

1.          Pg. 1 Lines 15−16: Use the same terminology to refer to major examined factors throughout the manuscript. For example, “subjective happiness” instead of “low in mood”.

Major Comments – Introduction

2.          Pg. 1 Lines 24−25: Cite the source of this piece of information on when and where the outbreak started.

3.          Pg. 1 Lines 25−26: Provide the reference for this extent (i.e., whole world) of the spread. For example, there are 195 countries in the world, but the WHO had records of confirmed cases in only 114 countries.

4.          Pg. 1 Line 33: Clarify “breaks”. Also for Pg. 5 Line 216.

5.          Pg. 1 Lines 43−44: Does this limitation stem from the imposition of lockdown measures or does it refer to athletes’ self-reporting of low activity levels? Without contextual elaboration, “usual daily activity” is vague and does not seem to be relevant to the highlighted problems.

6.          Pg. 2 Line 52: How was “complete” qualitatively assessed? For example, was uncertainty level determined to be complete, rather than high or low, from a summary of surveys on athletes’ responses to relevant questions?

7.          Pg. 2 Line 55: Do you mean “cancellation of the qualification process” rather than “qualification process and cancellation”?

8.          Pg. 2 Line 62: By itself, “COVID-19” is a general term. Hence, it is unclear if “COVID-19 experience” refers to experiences of falling ill from contracting the associated virus, experiences of containment lockdown, etc.

9.          Pg. 2 Lines 74−75: Has the main study objective been presented? Is the “focus on the impact of sports interruption on the mental and psychological health of athletes” the secondary objective? The term “sports interruption” does not provide contextual specificity. For example, does it refer to event disruption during a sport training session or competition?

10.       Pg. 2 Line 81: See previous comment regarding the need to contextualize “sports interruption”.

11.       Pg. 3 Lines 107−108: Clarify “these levels”. 

Major Comments – Materials and Methods

12.       Pg. 3 Line 121: With participants as young as 13 years of age, it is more appropriate to use the term “females”.

13.       Pg. 3 Lines 126−127: What are the mean and standard deviation ages of participants in these two expertise levels?

14.       Pg. 3 Line 132: “52.2%” is not synonymous with “most”.

15.       Pg. 3 Line 134: What is the overall Cronbach’s alpha coefficient for this questionnaire? Does it indicate a sufficiently high reliability to justify combining sociodemographic and sports-related questions as well as several other scales into one questionnaire without biasing participants’ responses?

16.       Pg. 3 Line 144: The adapted SHS should not be referred to as the SHS, but with indication of the adaptation for all instances of its use throughout the manuscript. “SHS” should only be used to refer to the original version of the SHS. What is the new Cronbach’s alpha coefficient after adding the item to the SHS?

17.       Pg. 4 Line 152: Do the Sleep Disorders Scale and the Sleep Problems Scale refer to the same scale in this study?

18.       Data check (e.g., normality of distribution) and analysis (e.g., t-test, ANOVA, correlation) methods as well as guidelines for interpreting results should also be described in a subsection within the Materials and Methods section. For example, what are the ranges of numerical values indicating low versus high levels of association between any two factors?

Major Comments – Results

19.       Pg. 4 Lines 159−161: The Results section should be focused on reporting statistical values, without the need to mention study objectives/goals/hypotheses/predictions. Specifications of analysis methods and software programs should be presented in the data analysis subsection within the Materials and Methods section.

20.       Pg. 4 Line 165: Again, the reporting of results should focus on reporting summary statistics, statistical values, and findings of statistical significance (or not). The use of qualitative statements such as “remarkably high”, “adverse reaction”, “exceptionally high”, and “too high” is appropriate. New terms (e.g., involuntary interruption, competition interruption) should not be introduced within the Results section so as to prevent conceptual ambiguity.

21.       Pg. 4 Line 166: Do you mean “H1”?

22.       Pg. 4 Lines 166−175: It is unclear whether the statistical approach of “a test of means comparison” entailed the authors obtaining the scores of the participants in the cited study for comparison with the scores of the participants in this study? If so, how were potential confounding factors due to unequal sample sizes addressed? Provide the summary statistics (e.g., mean and standard deviation values) for all, female, and male participants.

23.       Pg. 4 Lines 177−178: With participants averaging 20 years of age, it is more appropriate to use the terms “females” and “males”.

24.       Pg. 4 Line 186: Do these national reference values refer to SDS scores? Clarify the relationship between levels of sleep disorders as measured by the SDS and health risk.

25.       Pg. 4 Line 195 to Pg. 5 Line 198: For each of the two expertise levels, what percentages belong to low, moderate, and high health risk?

26.       Pg. 5 Lines 206−207: These comparisons are invalid because a different version of the SHS (after adding one additional scale item) was administered to participants in this study.

27.       Pg. 5 Line 225 and Pg. 6 Line 236: Do not use “sleep disturbance” interchangeably with “sleep disorders” without clarifying their conceptual relationship in the Introduction section.

28.       Pg. 5 Lines 229−233: Provide the p-values and confidence intervals for these correlation coefficients.

29.       Pg. 5 Line 234: Does this use of “significant” correspond with statistical significance?

30.       Pg. 6 Line 240: Why were tests of homogeneity not carried out?

31.       Pg. 6 Lines 244−264: Provide the test statistics, p values and effect sizes (or confidence intervals) for these statistical comparisons to enable the interpretation of statistical significance.

32.       Pg. 6 Lines 264−266: Two contradictory points were presented in this sentence. Clarify “the truth”.

33.       Pg. 6 Line 271: What is the conceptual relationship between “dynamics” and mediation analysis?

34.       Pg. 6 Line 274: What is the 95% confidence interval for this beta coefficient? 

Major Comments – Discussion

35.       Pg. 7 Lines 310−311: The terminology used for these three factors should remain the same throughout the manuscript so as not to introduce conceptual ambiguity. For example, “sleep disorders” and “sleep activity” are different constructs.

36.       Pg. 7 Line 317: Specify the time point because “before” is vague.

37.       Pg. 7 Line 325 to Pg. 8 Line 328: Provide the references for these observations.

38.       Pg. 8 Lines 329−330: Proper rest and recovery during sleep were not measured in this study.

39.       Pg. 8 Lines 337−338: The previous sentence does not substantiate this mediating relationship because there no research evidence was provided to support physical development, emotional regulation, cognitive performance, and quality of life as proxies of stress perception and subjective happiness.

40.       Pg. 8 Lines 339−342: Cite the sources of reference for these observations

41.       Pg. 8 Lines 345−350: Since these were not the findings of this study, the references should be cited accordingly.

42.       Pg. 8 Line 358: Provide the reference for this association between happiness and resilience.

43.       Pg. 8 Line 378: Clarify “level”.

44.       Pg. 9 Lines 387−388: Perceived abandonment was neither measured nor its relationship with stress examined in this study to have findings in support of this statement.

45.       Pg. 9 Lines 388−390: This statement also cannot be supported by the findings of this study. Discussion points should be focused on the interpretation of your results, and not include postulations beyond the scope of this study’s research questions.

46.       Pg. 9 Lines 402−403: How was “wholly changed” quantified? Source of identity and passion were not examined in this study to have findings to support this statement.

Major Comments – Conclusion

47.       Pg. 9 Line 430: Cite the reference for this observation.

48.       Pg. 9 Lines 430−432: Conclusion points should not extend generalizations beyond the findings of this study.

Minor Comments

49.       Throughout manuscript: Use “,” instead of “.” as the thousands separator.

50.       Throughout manuscript: Add “the” before “WHO”.

51.       Pg. 1 Lines 30 and 34: Add “home” before “confinement”, or replace “confinement” with “lockdown”.

52.       Pg. 1 Line 37: Add a comma after “health”.

53.       Pg. 1 Line 40: Consider adding “there is research evidence indicating that”, or similar, before “athletes”.

54.       Pg. 2 Line 51: Were these changes “routine” (i.e., occurring regularly) or do they refer to “changes in routine”?

55.       Pg. 2 Line 60: Consider adding “participation” after “sport”.

56.       Pg. 2 Line 75: Delete “further” because this is the first instance of introducing any hypothesis.

57.       Pg. 2 Line 83: Replace “decreasing” with “decrease” to maintain consistency of verb usage in a list.

58.       Pg. 2 Line 84: Replace “By” with “According to the”, or similar. Add “of” before “financial”.

59.       Pg. 2 Line 86: Use “(in)security” instead of “security/insecurity”.

60.       Pg. 2 Lines 88−89: Rephrase as “Financial insecurity represented in this study as monetary cuts can…”.

61.       Pg. 2 Line 91: “COVID-19”

62.       Pg. 2 Lines 92−93: H5 should not be expressed as a list item due to its separation from the other four hypotheses by one paragraph; it should be expressed as a standalone sentence.

63.       Pg. 2 Line 96 and Pg. 3 Line 100: Check grammatical usage.

64.       Pg. 2 Line 98: The use of “more” is inappropriate for describing these four uncountable nouns.

65.       Pg. 3 Line 103: See comment regarding how to express a standalone hypothesis (not in a list). Does this hypothesis apply to all stress levels? That is, it is predicted that even very low stress levels would negatively influence happiness levels?

66.       Pg. 3 Line 109: Consider replacing “some” with “several”, “showed” with “have shown”, and “influence” with “influences”.

67.       Pg. 3 Line 111: Delete the comma.

68.       Pg. 3 Lines 112 and 113: “ with”

69.       Pg. 3 Lines 115−116: Check sentence expression.

70.       Pg. 3 Lines 117−118: See comments on H5 and H6 regarding how to express standalone hypotheses.

71.       Pg. 3 Lines 126−127: Delete “Additionally” and replace “groups” with “skill levels”.

72.       Pg. 3 Line 128: Replace “last” with “latter” and “activity” with “participation”.

73.       Pg. 3 Line 134: Use “A” instead of “The”.

74.       Pg. 3 Line 140: Delete “The”.

75.       Pg. 3 Lines 148−149: Consider rephrasing to “…independent item that evaluates happiness change…”.

76.       Pg. 4 Line 153: Replace “small” with “subscale” and add “the” before “COPSOQII”.

77.       Pg. 4 Lines 154−155: Check grammatical expression.

78.       Pg. 4 Line 168: “this scale” should not be used before specifying the scale (i.e., PSS).

79.       Pg. 4 Line 178: Replace “training class” with “training level group” and “competition class” with “competition level group”.

80.       Pg. 5 Line 225: Rephrase to “…levels of stress, sleep disorders, and…”.

81.       Pg. 6 Line 239: Add “subjective”, “perceived”, or “self-reported” before “happiness” throughout the manuscript.

82.       Pg. 6 Line 258: Maintain consistency in relating these cuts to wage, pay, or salary throughout the manuscript (in-text and table descriptions).

83.       Pg. 6 Line 280 to Pg. 7 Line 289: Move these descriptions to the Data Analysis subsection within the Materials and Methods section.

84.       Pg. 7 Line 313: “happy”?

85.       Pg. 7 Lines 323−324: Check grammatical usage.

86.       Pg. 8 Line 369: It is inappropriate to use “enhance” with “negative”.

87.       Pg. 8 Line 380 to Pg. 9 Line 382: Check sentence expression.

88.       Pg. 9 Lines 399−400: Check grammatical usage and spelling.

89.       Pg. 9 Line 401: Conclusive remarks should be presented in the Conclusion section.

90.       Pg. 9 Line 432: Replace “confinement” with “isolation”.

Author Response

Dear Reviewer

 Thank you for taking the time to review and for giving us the opportunity to review our paper.

We appreciate your comments, and we think they can contribute to improving the quality of our paper. We hope that the review will meet your expectations.

The response to your comments is attached.

Thank you very much!!!

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Dear authors,

In general, the article has some improvements. In its current form it appears to be acceptable (i.e., appears to meet the minimum requirements to be accepted for publication).

Congratulations

Author Response

Thank you for taking the time to review and for allowing us to review our paper.
We appreciate your comments, and they can contribute to improving the quality of our paper. This last revision improved the article, and we hope they meet your expectations.
Again, thank you so much for the review.

Reviewer 3 Report

Major Comments – Abstract 

1. Pg. 1 Lines 15−16: Use the same terminology to refer to major examined factors throughout the manuscript. For example, “subjective happiness” instead of “low in mood”. 

Major Comments – Introduction 

2. Pg. 2 Line 96 and Pg. 3 Lines 112 and 116: The term “sports interruption” does not provide contextual specificity. For example, does it refer to event disruption during a sport training session or competition? Consider rephrasing to "...during interruption to sports training and competitions:" 

Major Comments – Materials and Methods 

3. Pg. 3 Line 160: Since Cronbach’s alpha coefficient was not calculated after adding the new item to the SHS, it should be stated that the addition of the new item to the SHS has not been validated in this study. If the new item was added to the modified SHS questionnaire to be used together with the other items of the original SHS questionnaire, it cannot be considered as an independent item unless it is used separately in a single-item questionnaire, rather than administered with the other items of the original SHS questionnaire. 

4. Pg. 4 Line 178: Does "not guaranteed" mean the assumptions were not met or not checked? 

5. Pg. 4 Line 181−182: Does "guaranteed" mean the assumptions were checked? 

Major Comments – Results 

6. Pg. 5 Line 247 and Pg. 6 Lines 253 and 268: The use of qualitative statements such as “marked", "breakdown”, and “too high” is appropriate. 

7. Pg. 4 Lines 166−175: The issue of potential confounding factors due to the comparison of data from unequal sample sizes from different studies has yet to be addressed. 

8. Pg. 8 Figure 1: Use appropriate greater or less than symbols to indicate the correct p values, rather than report p values as 0. For example, p < .001. 

Major Comments – Conclusion 

9. Pg. 10 Line 457: What does "its" refer to? 

10. Pg. 10 Line 460: The time relative to the start of the lockdown was not a definite moment, but spans over a period. 

Minor Comments 

11. Pg. 1 Lines 43−44: Delete “a” or add “regimen” after “exercise”. 

12. Pg. 1 Line 44: Replace “limited” with “restricted”. 

13. Pg. 1 Line 45: Rephrase to “...activity, which is composed of only several...”. 

14. Pg. 2 Line 46: Replace “evidenced” with either “experienced” or “witnessed”. 

15. Pg. 2 Line 58: Rephrase to “...pursuit of goals by athletes, whether...”. 

16. Pg. 2 Lines 80−81: Rephrase to “...on the other, subjective happiness can act as a buffer...”. 

17. Pg. 2 Lines 89−90: “A multi-country study showed that an...”. 

18. Pg. 2 Line 92: "with”. 

19. Pg. 2 Line 95: Rephrase to “...fall asleep easily and better sleep efficiency [27]”. 

20. Pg. 3 Line 111: Rephrase to "...on the relationship between stress and subjective happiness.". 

21. Pg. 3 Line 121: "mediate" 

22. Pg. 3 Lines 132−133: Position "years" after the parentheses for each standard deviation value. 

23. Pg. 3 Line 134: "participation" 

24. Pg. 3 Line 134: Add “salaries” after “paid”. 

25. Pg. 4 Line 162: "...problems were assessed by the Sleep...". 

26. Pg. 4 Line 163: Add "the" before "COPSOQII". 

27. Pg. 4 Line 163: Replace "by" with "of". 

28. Pg. 4 Lines 170−172 and 176: Check grammar. 

29. Pg. 4 Lines 180−182: Check grammar. 

30. Pg. 5 Lines 235−240: Check grammar. 

31. Pg. 7 Line 288: Rephrase to "...show lower levels of perceived stress than...". 

32. Pg. 7 Line 313: "showed" 

33. Pg. 10 Line 459: Replace "felt" with "self-reported". 

34. Pg. 10 Line 461: What does "permit concludes" refer to? 

35. Pg. 10 Line 461: "mediation?

Author Response

Dear Reviewer

Thank you very much for the time d spent reviewing for the second time our article. We appreciate your comments, and they can improve our paper's quality. This version has been improved, and we hope it meets your expectations.

Abstract

The same terminology was adopted throughout the paper.

Introduction

The term “sports interruption” was rephrasing to "...during interruption to sports training and competitions:"  Thank you for help.

Materials and Methods

We clarified that we tested the normality of distribution and homogeneity of variances, but they were not met. Moreover, we make it clear too that the independence and multicollinearity were checked through Durbin-Watson Statistics and VIF.

Regarding Cronbach's alpha coefficient of SHS (Subjective Happiness Scale), we do not include HCI- (Happiness Change Item). Just include four items, the items of the original scale. We did not calculate the variable Subjective Happiness with five items. Subjective Happiness was measured with a mean of four original item scales. If we include more than one item (HCI), Cronbach's alpha coefficient is .73;, it's stronger than for four original items. However, if we did not use the HCI to calculate Subjective Happiness, how do we include item HCI in Cronbach's alpha coefficient calculation? Subjective Happiness and Happiness change were calculated separately.    However, if you consider it essential that the paper contains Cronbach's alpha coefficient whit five items, we can add this information.

Major Comments – Results

We fixed the figure and replaced p=.000 by p < .001.

Major Comments – Conclusion

We improve our conclusion section.

Minor Comments

We meet all the requirements.