Skip to main content

By: Bianca Mattioli - Austin FC Athletic Training Fellow

Prospective Pilot Study of Mood in Highly Specialized Youth Male Soccer Athletes

      Participating in youth sports has shown to promote healthy lifestyles, enhance social relationships, and improve self-imaging.1 Early sport specialization has become increasingly popular among youth athletes. A highly specialized athlete is one who participates in a single sport at the exclusion of other sports for at least eight months out of the year. The rise of early specialization has led to an increase in injury rates at younger age equivalent to 22 million occurrences each year in student athletes 5-22 years old.2 However, very little research on the psychological impact of early sport specialization has been conducted despite the recent prevalence of stress and anxiety among youth and adolescents.3,4 Pressure to perform consistently at the highest level is strenuous on an athlete. This can lead to burnout, injury, and isolation in young athletes if not properly managed.5-7 Stressors can be intrinsic, pressure from the players themselves to perform at a certain level, as well as extrinsic, coming from parents, coaches, and teammates. Additionally, young athletes face stressor in their lives outside of sports, including their home lives and academic obligations. Understanding how stress and anxiety affect specialized youth and adolescent athletes throughout a season is the first step for parents, coaches, and healthcare professionals to provide efficient and successful management in psychological distress among youth and elite athletes.  

      We surveyed highly specialized youth soccer players (N=14) of three different age groups (U14: n=7, U15: n=4, and U17: n=3) at preseason, midseason, and postseason, and found that overall stress (Perceived Stress Scale 4, PSS-4) scores (4.1±2.49) and anxiety (Generalized Anxiety Disorder 7-Item Scale, GAD-7) scores (2.7±3.58) were on average lower than normative scores (stress=6.91±2.898; anxiety, non-athlete=2.76 ±3.499; anxiety, athlete=6.310). Athletes scoring overall lower than their non-athletic counterparts can suggest that sports do have a positive impact on children. These measures are not diagnostic in nature, they are used as a tool to determine need for future testing. At least one athlete scored an 8 or greater in stress and/or 10 or greater for anxiety, indicating more stress and/or anxiety (PSS-4 range: 0-9; GAD-7 range: 0-15). 

      Information about win-loss records, perceived pressure, leadership, and team cohesion metrics were also collected from the players to investigate additional factors that may have altered their mood states. Average pressure perceived by the athletes from their coaches (1.82 ± 0.60) was slightly higher than what they perceived from their parents (1.36 ± 0.81), but the difference was not statistically significant (CI=-0.01-0.92, P=0.05). Athletes, on average, scored support staff better than their respective head coach when asked about each individual’s coaching/leadership style (Head Coach=103.19, Support Staff 1=109.00; Support Staff 2=116.5). These findings suggest that the relationship between the athlete and support staff may be more comfortable when compared to their relationship with their head coach, which can be influenced by result, performance, and playing time. Team cohesion was greatest among the younger age group than the older teams, which could indicate that the younger age group may be playing more for the enjoyment and have less pressure among them to perform overall and/or outperform each other for a position. Lastly, we found that athletes scored lower in stress (-0.5 ± 3.20) and anxiety (-0.82 ± 3.29) during the first half of the season when compared to the second half (stress=1.5 ± 4), anxiety=1.06 ± 4.63). Consequently, the teams had a better first half record (85% win rate) than the second half (43% win rate). These findings indicate that the increase in stress and anxiety towards the end of the season could be due to increase in loss which could be the result of increase in travel, game frequency, outside activities (school, family obligations, etc.), and/or fatigue. 

      In conclusion, stress and anxiety scores remained consistently low throughout the season when compared to normative values for the athletes age groups. Our findings do not mean that mental health should be discounted in this population. We found that some athletes individually scored higher than their teammates in stress and/or anxiety at every timepoint. Clinicians, coaches, and parents need to approach athletes in an individual and multi-disciplinary fashion. Performance; perceived expectations from parents, coaches, and teammates; and injury can affect mental health and should be taken into consideration moving forward as athletes start to specialize at earlier ages. 


Bianca Mattioli  

Athletic Training Fellow, Austin FC 




  1. Myer GD, Jayanthi N, DiFiori JP, et al. Sports Specialization, Part II: Alternative Solutions to Early Sport Specialization in Youth Athletes. Sports Health. 2016;8(1):65-73.
  2. Post EG, Biese KM, Schaefer DA, et al. Sport-Specific Associations of Specialization and Sex With Overuse Injury in Youth Athletes. Sports Health. 2020;12(1):36-42.
  3. Bhargava D, Trivedi H. A Study of Causes of Stress and Stress Management among Youth. IRA-International Journal of Management & Social Sciences (ISSN 2455-2267). 2018;11(3).
  4. McDowell CP, MacDonncha C, Herring MP. Brief report: Associations of physical activity with anxiety and depression symptoms and status among adolescents. J Adolesc. 2017;55:1-4.
  5. Jayanthi N, Pinkham C, Dugas L, Patrick B, Labella C. Sports specialization in young athletes: evidence-based recommendations. Sports Health. 2013;5(3):251-257.
  6. Jayanthi NA, LaBella CR, Fischer D, Pasulka J, Dugas LR. Sports-specialized intensive training and the risk of injury in young athletes: a clinical case-control study. Am J Sports Med. 2015;43(4):794-801.
  7. Myer GD, Jayanthi N, Difiori JP, et al. Sport Specialization, Part I: Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes? Sports Health. 2015;7(5):437-442.
  8. Warttig SL, Forshaw MJ, South J, White AK. New, normative, English-sample data for the Short Form Perceived Stress Scale (PSS-4). J Health Psychol. 2013;18(12):1617-1628.
  9. Bernd Löwe M, PhD, Oliver Decker, PhD, Stefanie Müller, MS,Elmar Brähler, PhD,, Dieter Schellberg P, Wolfgang Herzog, MD, and Philipp Yorck Herzberg, PhD. Validation and Standardization of the Generalized AnxietyDisorder Screener (GAD-7) in the General Population. Med Care. 2008;46(3):266-274. 
  1. McGuine TA, Biese KM, Petrovska L, et al. Mental Health, Physical Activity, and Quality of Life of US Adolescent Athletes During COVID-19-Related School Closures and Sport Cancellations: A Study of 13 000 Athletes. J Athl Train. 2021;56(1):11-19.