The Influence Of Sex On Sports Specialization And Quality Of Life In Adolescent Athletes

PURPOSE: To examine if there was an association between level of sport specialization and sex on the presence of depression, anxiety, and fatigue in healthy adolescent athletes. METHODS: We obtained data from uninjured adolescent athletes who were completing pre-participation physical examinations (PPE). Participants completed surveys for sport specialization level (Jayanthi scale) and Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global questionnaire domains of depressive symptoms, anxiety, and fatigue. Athletes were grouped according to sex (female/male) and sport specialization level (low/moderate/high). RESULTS: A total of 265 athletes completed the study: 46% (n = 121; mean age = 15.2 ± 1.83 yrs; 45% female) were low specialized, 35% (n = 93; mean age = 15.3 ± 1.23 yrs; 42% female) were moderately specialized, and 19% (n = 51, mean age = 15.6 ± 1.15 yrs; 49% female) were highly specialized. Groups were similar for demographics, age and hours per week spent in sport. For self-reported anxiety, there was an observed effect of sex (mean ± SD: female = 3.62 ± 3.56 vs. male = 1.44 ± 2.12, p = 0.001) and sport specialization level (high = 3.35 ± 3.91 vs. moderate = 1.90 ± 2.57, p = 0.01), but no interaction between sex and specialization level (p = 0.11). There was an observed effect of sex (female = 2.04 ± 3.23 vs. male = 0.79 ± 1.82, p = 0.001) on depression, but no effect of specialization (p = 0.20) or an interaction between the two (p = 0.51). Lastly, there was an observed effect of sex (female = 2.35 ± 2.81 vs. male = 1.53 ± 2.27, p = 0.01) on fatigue, but no effect of specialization level (p = 0.22) or an interaction between the two (p = 0.95). CONCLUSIONS: Female athletes, regardless of specialization level, reported higher levels of anxiety, depression, and fatigue than male athletes despite similar levels of hours per week spent in sport. Additionally, highly specialized athletes, regardless of sex, reported higher levels of anxiety than their low or moderately specialized peers. However, none of the domains revealed an interaction between sex and level of sport specialization. These findings support prior research that highly specialized athletes report increased anxiety compared to non-specialized peers and that female athletes report increased changes in quality of life compared to their male peers.