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Team Sports, Adverse Childhood Experiences, and Mental Health

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A story published by National Public Radio (NPR) in May caught our attention. Here’s the headline:

“Playing Teen Sports May Protect From Some Damages of Childhood Trauma”

Like many things we see in the media that intersect with our specialty – helping adolescents struggling with mental health and/or substance use disorders – we thought to ourselves:

“Hmmm. Interesting – if true.”

It turns out that this interesting piece of news is as true as it can be, all things being equal. Three things make it as true as it can be:

  1. It’s based on peer-reviewed data.
  2. It’s based on a longitudinal study that included almost 10,000 participants.
  3. It really was longitudinal: researchers began the study in 1995 and concluded in 2008.

Those three factors are important, because often headlines about mental health are based on studies that: a) are not peer-reviewed, b) include very few participants, and c) don’t follow participants for a significant period of time.

This study does all three – that’s why we’re sharing it with you.

But first, let’s talk briefly about childhood trauma and define Adverse Childhood Experiences.

What are Adverse Childhood Experiences?

In 1998, the Centers for Disease Control and Kaiser Permanente Health Systems partnered to launch an ambitious study on the effect of adverse childhood experiences on an individual’s long-term physical, mental, social and emotional health. Known today as the ACE Study, it is widely recognized that the publication of this paper marked the beginning of an approach to mental and emotional healthcare practices now commonly called “trauma-informed care.”

The ACE Study and several follow-up studies identified exposure to the following indicators as “Adverse Childhood Experiences:”

  • Physical, emotional or sexual abuse
  • Physical or emotional neglect
  • Domestic violence
  • Living with an individual struggling with substance abuse, an individual diagnosed as mentally ill or an individual who was incarcerated or sentenced to be incarcerated
  • Experiencing racism and/or bullying
  • Living in foster homes
  • Living in an unsafe neighborhood
  • Witnessing violence

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), individuals who experience ACEs are at increased risk of the following:

  • Early alcohol use
  • Illicit drug use
  • Prescription drug misuse
  • Alcohol use disorders
  • Substance use disorders
  • Suicide attempts
  • Depression
  • Risky sexual behavior
  • Adolescent pregnancy
  • Lowered IQ
  • Impaired cognitive function
  • Diabetes
  • Heart Attack

Now, let’s get back to that study. In a nutshell, it claimed participation in team sports as a teenager can help protect an individual against some of the long-term consequences of experiencing early trauma.

Let’s have a look at the data.

Team Sports as a Teen, Trauma, and Adult Mental Health

This study – “Association of Team Sports Participation With Long-term Mental Health Outcomes Among Individuals Exposed to Adverse Childhood Experiences” – happened in three phases. First, researchers collected data from high school seniors in the 1994-1995 school year. Next, they collected another set of data from the same students in 2008. Finally, they subjected the data to rigorous statistical analysis between 2017 and 2019.

Participants included 4,470 males and 5,198 females, with an average age of 15 years old when first interviewed and an average age of 29 at follow-up. Of the 9,668 participants:

  • 49.3% initially reported at least one ACE
  • 21.3% reported two or more ACEs

Of those who reported ACEs, those who participated in team sports as teenagers showed lower odds of receiving a diagnosis of:

  • Depression:
    • 16.8% for teens who played team sports
    • 220% for teens who did not play team sports
  • Anxiety:
    • 11.8% for teens who played team sports
    • 16. 8% for teens who did not play team sports

The data also showed a difference in participants who reported current depressive symptoms at follow-up:

  • Depressive symptoms:
    • 21.9% for teens who played team sports
    • 27.5% for teens who did not play team sports

The researchers themselves summarize the data perfectly:

“Among individuals affected by ACEs, team sports participation in adolescence was associated with better adult mental health.”

It’s Never Been About Winning

Here’s a quick digression: while a very small percentage of high school athletes go on to participate in collegiate athletics, and an even smaller percentage of those go on to play sports professionally, the rest of the team wasn’t there with an eye on a scholarship and a big-time contract.

They were there for all the other benefits:

  • A sense of belonging
  • A sense of accomplishment
  • Deeper peer relationships
  • Coach-student relationships, as opposed to teacher-student relationships
  • Life lessons:
    • Hard work
    • Dedication
    • Learning to lose gracefully
    • Leaning to win gracefully
  • Fun
  • Getting/staying/learning how to be in good shape

High school team sports, in fact, are about everything but winning. We won’t tell that to the Friday Night Lights crowd, though – they won’t believe us. High school team sports are about becoming a better person, being a part of the community, and participating in something that’s healthy and fun.

Winning is great – yes, that’s true.

Going to a tournament with your team, making the playoffs, maybe even winning a championship?

Yes, all fantastic.

But what this study shows us is what most of us have known all along: high school sports are about more than the score on the scoreboard. We’ve all known about the non-athletic benefits we just listed, and now we know one more thing about high school team sports: they can help kids who’ve experienced early trauma.

That’s huge.

I think we can all agree it’s far more important than winning a game.

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