Fall... 2025
Embrace Change: Welcome to the Fall Edition of Sapience!
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As autumn arrives, it brings with it a season of reflection, renewal, and transformation. The air is crisp, the colors are vivid, and ideas are taking new shape. This edition celebrates the evolution of thought: how curiosity matures into innovation and innovation into impact.
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From groundbreaking studies to collaborative ventures, fall reminds us that progress often comes from change. Whether you’re refining a long-term project or planting the seeds of a new idea, this is the time to embrace transition with purpose and imagination.
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Congratulations to our featured researchers who embody this spirit of growth and reinvention. Here’s to a season of thoughtful exploration, meaningful progress, and inspired discovery.
Dietary Shifts and Diabetes Risk: A Study of Somali Immigrants in western Societies
Ikra Ibrahim
United States of America
Introduction
Diabetes is a growing health concern in many Western countries, the majority of the
growth partially stemming from immigrant and minority populations. Amongst those communities lie the Somali community. “The prevalence of type 2 diabetes mellitus among Somali immigrants is not known, but a study of 72 Somali psychiatric patients showed an increased prevalence of diabetes (24%) among this group compared with non-Somali controls”(Kinzie). These risks could stem from changes in diet and lifestyle after migration, genetic predispositions and barriers to accessing culturally appropriate healthcare.
The immigration process caused Somali immigrants to adapt to radically different lifestyles and diets, with processed foods being commonly consumed by many Western countries. However, Somali immigrants also brought their traditional health practices rooted in their culture and religion, such as fasting for 30 days of the month for Ramadan and communal health support systems, which would offer opportunities for diabetes prevention.
I wrote this paper to create a better understanding of how diabetes varies through communities by exploring cultural, social and healthcare-related factors that influence diabetes prevention in the Somali community.
The main focus of this paper is understanding how cultural beliefs, diabetes practices and community support impact the prevention and management of diabetes among Somali immigrants, with factors like how Somali culture can both affect and prevent risks of diabetes in the Somali community. This research will contribute to a better understanding of the unique health needs of Somali immigrants and highlight effective strategies for promoting diabetes prevention.
Cultural and Dietary Factors
Your food intake has the power to determine the lower or increased risk of developing diabetes, especially type 2 diabetes. To prevent and manage diabetes, it's recommended to eat non-starchy fruits and vegetables such as melons, berries, plums, spinach, cucumbers and broccoli. The consumption of complex carbohydrates over simple carbohydrates is preferred because they allow your body to get a slow release of glucose into your bloodstream, allowing your blood sugar to increase slowly. In Somali nutrition, injera (flatbread) is commonly consumed and often made from wheat or sorghum. Both are high in carbohydrates, which, when consumed in large portions, can cause a rise in blood sugar. Post-meal normal blood sugar levels are 70–99 mg/dL and two hours after a meal, it should be less than 140 mg/dL. However, the consumption of high carbohydrates would cause glucose to enter your bloodstream, resulting in a high rise in sugar levels. Rice and pasta are also common in Somali meals; they have refined carbohydrates, which, if not balanced with fiber and protein, could lead to rapid blood sugar spikes. Protein sources such as goat, lamb and beef are prevalent in Somali meals. Meat is a good source of protein, but if there is excessive consumption, it could lead to insulin resistance over time. Fish is also common and provides healthy omega-3 fatty acids, which have been shown to improve insulin sensitivity. Traditional beverages such as tea (Shaah) are made with Somali spices like cardamom pods and cloves. While it does improve insulin sensitivity, Somali tea commonly has high amounts of sugar, which negates any benefits and leads to blood sugar spikes. Typical Somali dinners are eaten in large portions and late at night. A meal high in carbohydrates can cause an imbalance in blood sugar. A smaller, well-balanced meal throughout the day would help balance blood sugar levels. Key points to manage diabetes in Somali nutrition are glycemic control. Managing high glycemic foods, such as white rice, white bread and certain fruits, by replacing them with whole grains, beans and vegetables, is important. A balanced diet, switching your intake to include more lean proteins, healthy fats, whole grains and fiber-rich vegetables, would help stabilize your blood sugar. Cutting down on animal fats and using healthy fats like olive oil and avocados are also important. Finally, portion control: Somali meals are usually shared and large portions often lead to overeating. Smaller portions of carb-heavy meals are better for managing diabetes, allowing for a balanced meal.
Interviews were conducted with two Somali individuals, one with diabetes and one without. Questions about their beliefs and knowledge regarding how food impacts health and diabetes were asked to gain individual insight into their personal experiences and cultural views on food and diabetes.
Interview of the participant without diabetes
Q1: Do you believe you are at risk for developing diabetes? Why or why not?
A1: No, I don't think I would get diabetes due to my diet. I reduced my intake of foods like pasta, packaged foods and powders. Instead I filled my diet with foods like vegetables and nuts.
Q2: Do you avoid any foods you think might increase your risk of diabetes?
A2: Yes, foods that have a lot of sugar, pasta and flour.
Q3: Do you think the Somali community is aware of how diet impacts diabetes risk, or is there a lack of knowledge?
A3: I believe most Somalis know the risks of how diet could impact diabetes but choose not to care, they consume foods that have a lot of sugar while knowing the risks.
Q4: How do you balance traditional Somali meals with modern dietary advice (like reducing sugar or eating more vegetables)?
A4: I still eat somali food but make them healthier by choosing wheat bread, using less sugar in my tea and cooking more vegetables.
Q5: What advice would you give to someone with diabetes regarding diet and lifestyle?
A5: I would tell a person with diabetes to stop consuming sugar, pasta, oil and flour, instead eat foods with wheat and vegetables. And go for short walks every day if they can't go to the gym.
Interview of the participant with diabetes.
Q1: When did you first learn you had diabetes and what was your initial reaction?
A1: I learned I had diabetes in 2014 and was surprised by the information.
Q2: What kind of changes have you made to your diet since being diagnosed with diabetes?
A2: I changed my whole diet to wheat and cut things out of it.
Q3: Do you feel your diet (or specific foods) contributed to the development of diabetes?
A3: yes I do feel my diet has contributed to my diabetes, my blood sugar doesn't spike as usual and I feel more energized in the morning.
Q4: How do you manage your blood sugar levels through diet?
A4: My blood sugar doesn't spike because I don't eat a lot and my diet also helps.
Q5: Do you feel there is enough awareness or education about managing diabetes through diet in the Somali community?
A5: There is not a lot of knowledge in the Somali community about how your diet can affect managing diabetes.
Health Beliefs and Practices
To know how Somali health beliefs influence the prevention and management of diabetes in the community, it's important to explore both conventional and traditional medicine. The traditional medicine practiced by Somalis today came from the influence of “Asian countries, like the Arabs, Indians and Persians, from which they imported healing systems”(Ahmed 240). And the arrival of Islam. Before many Somalis immigrated to Western countries it was normal practice to refer your health problems to traditional healers due to more than half of the Somali population living in rural areas. But even in areas where both traditional and conventional medicine coexisted people preferred traditional medicine because of beliefs and satisfaction. The beliefs of the Somali people shaped their explanations for causes and curing of diseases, “evil eye, envy, sin or a mistake against someone in the society, or supernatural causes such as spirits or jinni”( 240). After immigration, Somalis brought those beliefs and the practice of traditional medicine with them. More than 99% of Somalis are Muslim following the practice of fasting once a month each year, with different types of diabetes there are both good and bad effects to fasting. Those with type 1 diabetes are at greater risk compared to those with type 2 diabetes, people with type 2 diabetes take insulin meaning while fasting their insulin intake needs to be adjusted. They could be at risk of hypoglycemia if they cut back on insulin too much or if they cut back too little. With the right adjustment to your insulin fasting would minimize the risk of hypoglycemia, lower glycaemic variability, improve fat metabolism in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), increase insulin sensitivity, lower body weight and improve body composition. For individuals at high risk of developing T2DM and are overweight Fasting could enhance insulin sensitivity and glucose tolerance. The practice of fasting during Ramadan could either help or hinder diabetes management. Fasting can improve your blood sugar regulation if done with proper planning. However, mismanagement of overeating and sugar intake during fasting periods could cause instability.
Healthcare Access and Education
The Somali community lacks awareness of diabetes prevention. Families with diabetic members often don't change their diet in fear of getting diabetes. A participant mentians, “There is not a lot of knowledge in the Somali community about how your diet can affect managing diabetes.” While Somali cuisines are rich in flavor, they pose a challenge in diabetes prevention due to high carbohydrate foods and large food portions. Staple foods like injera, rice and pasta are made from refined carbohydrates that can cause a rapid increase in blood sugar levels, especially when consumed in large portions. Many of the elders in the Somali community who have immigrated to western countries such as The United States, Canada and United Kingdom being the top three. Are not very educated due to the effects caused by the war. The Somali education system was quite similar to that of the United States, the curriculums were even more advanced. “Children started school around the age of five or six and attended four years of elementary school, four years of middle school and four years of high school”(Lewis). Both public and private education was available to many. After the war only private schools were available, meaning only those that had the funds for this could get an education. But even before the war education was more likely for the boys then the girls, boys were seen as the breadwinners and the leaders while the girls were subjected by societal norms to stay home. Many of those that were affected in the war immigrated to western countries with one or zero educational background. Further building opens the lack of awareness of one's health.
Access to healthcare is another reason for the lack of awareness of diabetes prevention in the Somali community. Even with the immigration status many Western countries have universal healthcare systems. The United States has a mixture of both public and private healthcare that is seen as the most expensive healthcare system in the world. Even with the given access to private healthcare insurance to immigrants, there are still significant disparities in the system. In Canada, they allow permanent residents provincial and territorial health insurance. The difference between Canada and the United States healthcare system is that Canada has public funding that provides universal access to medical necessities while the United States is made up of both public and private, meaning that it will cost more and be difficult to access. Europe is especially different from North America. They created a health union with different branches focusing on different aspects of their healthcare system. Europe must offer equal healthcare to legal immigrants under the same conditions given to citizens. Even with the equal access given to Somali immigrants there are still: language barriers, financial aspects, complex enrollment process and cultural differences. Thankfully as of 2025, some accommodations can be made such as interpreters who are usually Somalis helping with: cultural differences, difficulty enrolling and the language barrier. As for the financial aspect, government assistance programs are eligible for immigrants.
Community Programs
There are diabetes prevention programs in many of the areas that the Somali community is located. Europe has a very large Somali community allowing for there to be two prevention programs made in the United Kingdom and Finland. The United Kingdom has a partnership with “the African Caribbean Diabetes Health Foundation, as part of a project with Diabetes UK”(know diabete). The website offers videos and articles in Somali to raise awareness for Somali speakers. The diabetes prevention program in Finland is a paper on a 12-week intervention: “Culturally sensitive lifestyle intervention to prevent type 2 diabetes among Somalis in Finland”(Wikstrom et al). The paper discusses how the Somali population is one of the largest minority groups that are contributing to the rising number of people with diabetes. They conduct group discussions “to map out the experiences and wishes of the Somali community in terms of the intervention and its execution”(81). They found four factors. Facilitator: A way to create an understanding to the participant and give a successful health promotion. Language: Allowing the participants to feel comfortable by holding a dissection in a language that is very fit for them. Setting: Giving the participants a familiar setting, such as a community center or a place of worship. Message: Adjusting the way the message is delivered so it can be understood and using cultural beliefs and values to resonate with the target audience. This highlights the findings and effective strategies identified through participant collaboration to prevent diabetes. The third diabete prevention was conducted in Seattle university. The program is similar to the one conducted in Finland, both papers revolve around data collected from participants. But this one focuses on T2D and how to self-manage and reduce long-term complications. All of these approaches can succeed in reaching the Somali communities. They are all culturally relevant, incorporating delivery methods that can reach a broader segment of the Somali community, including videos in Somali and translations. All of the programs educate the participants and their views on the importance of diet, physical activity and diabete management.
Comparative Analysis
Minorities are generally at a higher risk for diabetes compared to non-minority individuals, with various ethnic groups facing unique challenges. As shown in the pie chart, minority populations in the United states such as American Indians/Alaska Natives, Hispanics and non-Hispanic Blacks experience disproportionately higher rates of diabetes. Similarly, the Somali community faces significant factors that limit awareness, language barriers and risks caused by the traditional diet.
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Fig 1:“while 13% of the general adult population has diabetes, disproportionately high rates of diabetes are found among American Indians/Alaska Natives (14.7%), Hispanics (12.5%), and non-Hispanic Blacks (NHB) (11.7%) while lower rates are seen among non-Hispanic Asians (9.2%) and non-Hispanic Whites (NHW) (7.5%)” (Haw).
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Both hispanics and non-hispanic black people are at greater risk of developing T2DM due to neighborhood disorder which “[minimizes] opportunities for both physical and social engagement”(Yu). But non-hispanic white people are less likely due to the comparison of each neighborhood. The poverty that is ensured in the hispanic and non-hisponic black neighborhood makes it harder to receive a diagnosis resulting in an increased risk of developing complications. Similarly to the Somali community, hispanics and non-hispanic blacks face challenges such as mistrust in the healthcare system and limited access to culturally competent health education programs.
T2DM is prevalent among both American Indians/Alaska Natives and non-Hispanic Asians, but American Indians/Alaska Natives have a significantly higher rate, with a 9.9% difference. In most ethnic groups, the diagnosis of T2DM has either increased slightly or remained stable, but for American Indians/Alaska Natives, it “increased rapidly over the study period”(Golden). One recognized cause of diabetes is obesity, which impairs the pancreas's ability to produce insulin. This is similar to the Somali community’s lack of awareness regarding how unhealthy lifestyle choices can contribute to diabetes.
Non-Hispanic Asian Americans, including those of East Asian, South Asian, Southeast Asian and Pacific Islander ancestry, are at a lower genetic risk for T2DM compared to non-Hispanic Whites. However, among this group, South Asians are at a higher risk of developing T2DM. Research has shown that urban middle-class Indians were more insulin resistant than those living in rural areas or urban slums. This resistance is linked to beta cell dysfunction, which is the impaired ability of the pancreas to produce and secrete insulin. Additionally, diet plays a role in T2DM, with vegetarianism being common in many Asian cultures. Without proper attention to nutrition, deficiencies like vitamin B12 deficiency can also contribute to the risk of T2DM. Similar factors, such as lack of exercise and imbalanced diets, can also be seen in the Somali community. In all race/ethnic groups, there are shared causes of T2DM, including poor diet, lack of physical activity and genetic predispositions like insulin resistance. These factors highlight the importance of addressing lifestyle choices, as making changes can significantly impact diabetes risk across diverse backgrounds, as can be seen above.
Conclusion
Over the change in diet and lifestyle after migration, the cultural influence of healthcare and genetic ties to diabetes. The Somali community has many factors that set it apart from other minority groups that are also affected by diabetes—the cultural norm of food intake and the way it's made. Starchy foods are nothing new to the Somali cuisines but that does not mean it doesn't have effects on a body that is pre-diabetic. That followed by the lack of awareness in the community can lead to generations of pre-diabetic and diabetic people in families. Understanding the roots of the problem and exploring alternatives without erasing the culture the Somali people have been practicing can make the shift to a healthier lifestyle easier and more accepted. I found that there are simple changes that can be made such as putting less sugar in shaah, eating dinner earlier than it's traditionally done and eating fewer portions. Therefore, It's important for educators and community leaders within the Somali community to raise awareness even if that means informing the younger generation of healthy eating habits.
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Work Cited
Njeru, Jane, et al. “Diabetes Health Literacy Among Somali Patients With Diabetes Mellitus in a US Primary Care Setting.” PubMed Central, May 28, 2015.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4901386/.
Levi, Ronli. “Food Insecurity and Diabetes: Overview of Intersections and Potential Dual Solutions.” PubMed Central, Jun 24, 2023.
Ahmed, Abdullahi Mohamed. “Somali Traditional Healers: Role and Status.” Somali Studies International Association, 1995.
Hertz, Daniel, et al. “Efficacy of Fasting in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review.” PubMed Central, Aug 10, 2023.
Said, Adam Sheikh, and Dmitry Ivanovich Kicha. “Implementing Health System and the New Federalism in Somalia: Challenges and Opportunities.” PubMed Central, Feb 1, 2024.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10867962/.
Cassanelli, Lee, and Farah Sheikh Abdikadir. “Somali: Education in Transition.” Bildhaan: An International Journal Of Somali Studies, 2006.
Lewis, Toby. “Somali.” EthnoMed, Mar, 2009.
https://ethnomed.org/culture/somali/#education.
Mladovsky, Philipa, et al. “Good practices in migrant health: the European experience.” PubMed Central, Jun 12, 2012.
Know diabetes, 2025.
https://www.knowdiabetes.org.uk/get-involved/languages/somali/
Wikstrom, Katji, etal. “Culturally sensitive lifestyle intervention to prevent type 2 diabetes among Somalis in Finland.” Istituto Superiore di Sanità, Jan 13, 2021.
https://www.iss.it/documents/20126/0/ANN_21_01_13.pdf.
Abdi, Hamdi. “Group-Based Diabetes Self-Management Education for Somali population with Type II Diabetes Mellitus .” Seattle University, 2022.
https://scholarworks.seattleu.edu/cgi/viewcontent.cgi?article=1034&context=dnp-projects&utm.
Yu, Min Ying, et al. “Perceived neighborhood disorder and type 2 diabetes disparities in Hispanic, Black, and White Americans.” Frontiers, 2024.
https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1258348/full#ref11
Golden, Sherita Hill, et al. “Racial/ethnic differences in the burden of type 2 diabetes over the life course: a focus on the USA and India.” PubMed Central, Oct 1, 2020.
The Effect of Stress and Pressure on Athletes
Tyler Wang
United States of America
Introduction
Stress and pressure are common factors contributing to an athlete's performance on and off the field. No matter the age or skill level, from amateur to professional, the factors of stress and pressure have been known to significantly impact athletes mentally and physiologically. Understanding how stress and pressure can affect an athlete is crucial, not just to the athlete but also to their coaches and parents. This literature review will analyze how pressure and stress affect the performances of athletes by synthesizing existing research. This paper will shed light on the negative effects of stress and pressure on athletes, along with the positives, which may not be immediately obvious to some. It will discuss the limitations of the current research body and suggest avenues for future research.
While the specific origins of stress and pressure vary depending on the athlete, high expectations, whether from supporters, coaches, guardians, or even the players themselves, represent a common root source of stress and pressure. Stress is particularly prevalent among athletes inside the 15-21 age range (Jeong & Li, 2024) These athletes face various competing stressors, including schoolwork, social factors, and the difficulty keeping up with the demanding strength and conditioning needed for their respective sport (Malina, n.d.,). The pressure to consistently satisfy elevated expectations negatively impacts a portion of these young athletes. Young athletes may perform worse in their respective sports due to these stressors, leading to decreased success for the athlete and the program they are competing for. As a result, funding for these programs, whether they’re a school or an outside program, can get cut or reduced significantly (Coleman, 2022).
What is stress and pressure in athletics?
Stress can manifest both physically and mentally. Some people may experience physical symptoms including increased heart rate, fatigue, and headaches (Ward et al., 2023). On the other hand, individuals may also experience mental symptoms, such as panic and anxiety ("Coping With," 2024). Stress is a body’s natural response to challenges or demanding tasks. Often referred to as the body’s “fight-or-flight response (ChoukeÌ€r, 2020, p.), the brain sends hormones throughout the body as a reaction to these stressful situations. Two of the major hormones the brain releases are cortisol and adrenaline ("Chronic Stress," n.d.). Cortisol is the primary stress hormone, and its job is to enhance the brain’s use of glucose, or sugar. This allows the brain to stay on high alert, and works hand in hand with adrenaline ("Chronic Stress," n.d.). Adrenaline allows the heart to pump faster, thus causing blood pressure to increase. Ultimately, this gives the person more energy and heightens their alertness. It may seem beneficial to have your brain release cortisol and adrenaline hormones; however, this is only partially true. While these hormones can provide a short-term boost of energy, extended periods of exposure to cortisol can weaken the immune system, increase the risk of type 2 diabetes, and increase anxiety ("Cortisol," 2021).
Athletes often experience high symptoms of stress. (Ward et al., 2023) surveyed approximately 200 high school student-athletes and reported large percentages of athletes linking stress to sweating, increased heart rate, and a sense of panic. A smaller percentage of athletes linked stress and pressure to more severe symptoms, such as diarrhea and constipation.
Stress can be categorized into two main types: acute stress and chronic stress. Acute stress, often referred to as short-term stress, can suddenly overwhelm an athlete (Kelly, n.d.). This type of stress arises from immediate, high-pressure situations, such as the intensity of a final shot. While acute stress can enhance an athlete's performance by boosting focus and alertness ("Unleashing the Strength," n.d.), it can also be detrimental if it occurs too frequently or is too intense, leading to severe overload of an athlete's mental space (Ward et al., 2023). This is often known as “choking”, with studies indicating that around 77% of athletes have been impacted by stress leading to choking in the past year (Mesagno et al., 2024). This was examined during an online survey conducted by Mesagno et al., (2024), where, interestingly, 39.4% of athletes in this sample did not go on to play in more elite divisions due to choking. Alarmingly, 7.1% of athletes within this sample reported suicidal thoughts due to the effects of choking (Mesagno et al., 2024). On the other hand, chronic stress is a result of long-term, preexisting pressures, which may include high expectations from fans, coaches, or parents before a game (Hatteburg, 2020). Chronic pressure can have a much more devastating and lasting effect on an athlete, as it can lead to physical exhaustion and a decline in mental health over time ("WA Sports," n.d.).
Pressure in the context of athletics can be separated into two categories: external or internal. Internal pressure refers to the high expectations an athlete may place on themselves. It can motivate an athlete by pushing them to train harder to reach a goal they’ve set for themselves. However, internal pressure can cause self-induced stress within an athlete and create anxiety (Mansell, 2024). In contrast, external pressure comes from outside influences. External pressures can produce a fear of failure from within the athlete and can decrease their confidence on and off the field (Molenaar et al., 2021).
Sources of Stress and Pressure
In their career, athletes will face numerous sources of stress and pressure. The main kind of pressure they will face is competition. With sports being naturally competitive and intense, these strains are most responsible for an athlete facing stress (3 Types, n.d.). Competitive stressors are the challenges and demands an athlete will face during competitive events and games. There are many types of competitive stressors, including injuries, opposition, pressure, and issues regarding technique (Wood, n.d.). Current soccer player Michail Antonio reflected upon these issues, claiming, “There is a massive stress in the game when you have to constantly be your best” (3 Types, n.d.). His reflection goes to show the constant pressure athletes, even at the highest level of competition, have to face (3 Types, n.d.). These athletes can face pressure from coaches, teammates, and fans to rush rehabilitation from an injury, which can cause reinjury (Ward, n.d.). An athlete's reinjury rate can be as high as 44%, depending on the injury itself (Ward, n.d.).
Coaches, parents, fans, and sometimes even the media can place high expectations on an athlete. ​The effects of parental pressure and coach pressure can differ by age, as younger athletes may experience greater impacts from parental pressure (Dunn et al., 2022). In comparison, older athletes may be more influenced by coach pressure as they seek to please authority figures (Dunn et al., 2022). A study conducted by Dunn et al. (2022). investigated whether or not adolescent and adult athletes perceive interpersonal performance pressures from parents and coaches differently based on their age. This study examined 1544 youth athletes (average age of 15.44 years) along with 1706 older sports athletes (average age of 20.80 years). The results highlighted how different age groups can experience different forms of pressure from different sources, as older athletes reported higher levels of pressure from their coaches compared to younger athletes, who displayed the opposite trend (Dunn et al., 2022). It’s interesting how an athlete’s primary source of pressure shifts as they grow older, as it can show an athlete’s relationships with those around them evolve and mature as parental influence fades and coaching influence gets stronger and more centralized.
What’s the effect of Stress and Pressure on Athletic Performance?
To build upon the impacts of stress and pressure on athletic performance, specific studies have used brain scans to examine the neurological effects of competitive stress. One study conducted by (Cho et al., 2018) found that while under chronic stress and fear of injury, football players displayed increased activity in the amygdala, a region of the brain that processes emotion and plays a key role in the body’s stress response. This study was conducted using the Profile of Mood States (POMS), a psychological rating scale. The study showed that players with a higher score on the POMS scale had a higher fear of concussion, despite half of these players never experiencing a concussion before. As a result, players with a higher score tended to be more depressed and anxious (Cho et al., 2018). Along with this, the effect of pressure and anxiety can differ depending on the athlete. For example, female athletes tend to show higher levels of anxiety than male athletes when facing competitive stressors. It has been found that female athletes can face psychological disorders and mental health issues at roughly double the rate of their male counterparts (H. et al., 2021)
Stress and pressure can also take on an indirect role in forming bad habits for athletes in the short term and long term. An online survey conducted by (Knettel et al.) studied 188 college athletes competing at various levels (NCAA; Division 1, Division 2, and Division 3) and found that a large majority of the students (86.1%) they interviewed had drunk alcohol in the past week, with 27.8% reporting binge drinking monthly. Over 20% of participants reported using marijuana over the past year. This can perhaps be linked to stress, as 99% of participants reported feeling at least a little stressed, with 87% experiencing moderate to severe stress levels from attending college (Knettel et al., 2021). These results were similar to a study conducted by (Tanguy et al.), who studied 63 young males enlisted in the military and their responses to a challenging sporting running event. Through a questionnaire and physiological testing, researchers were able to separate participants into two groups, either exhibiting low or high anxiety levels. The physiological tests consisted of a heart rate monitor that measured the participants’ heart rates the night before the event, and a watch that tracked their time asleep and sleep efficiency the night before the event. The findings of the study showed that the participants who had higher anxiety levels had lower self-esteem, less effective sleep, and unhealthier ways of coping with stress (Tanguy et al., 2018).
Coping Mechanisms and Strategies to Fight Against Stress and Pressure
Despite stress and pressure having a major impact on an athlete’s performance on and off the field, many athletes have found ways to battle these stressors. Elite athletes have sometimes reported purposely putting themselves in stressful situations, to react better when faced with competitive stress. (Low et al.) conducted a study to explore how to create pressure training, and how pressure training can improve your performance in competition. This study took eight sports psychologists and eight elite athletes who participated in major international competitions like a world championship or the Olympics. The psychologists conducted one-on-one interviews with the athletes and examined their experiences during an online meeting that lasted less than an hour. Through these interviews, they found out that athletes can improve their ability to handle stress through pressure training, with some athletes even being able to enjoy the stressful and high-pressure situations once they had the proper training and preparation (Low et al., 2022). Similar to the findings in the study conducted by (Low et al.), another study monitored a teenage tennis player, testing their performance under pressure with and without mental training. This study, conducted by (Pineda-Hernández,) found that mental training can reduce common stress responses, such as heart rate and increased brainwave activity. To test this, (Pineda-Hernández,) used electroencephalogram (EEG) technology to track beta and gamma waves, typically associated with stress and pressure, inside the brain. Researchers then used pressure imagery, a mental training technique where athletes imagine themselves in high pressure situations in order to replicate the emotions they would feel in an actual high-stakes situation, to prepare the athlete for real-life competition (Pineda-Hernández, 2022).
Some other coping strategies elite athletes use include self-distraction, use of substances, instrumental support, positive reframing, and religion (Makarowski et al., 2022). In a study conducted by (Makarowski et al., 2022), researchers examined how athletes from Poland, Slovakia, and Romania coped with the stress of the COVID-19 pandemic. This study examined coping strategies by collecting data through surveying a diverse group of athletes. After analyzing the results of the survey, researchers found that emotional coping methods, including dysfunctional coping methods, were heavily relied on by these athletes. Some examples of emotional coping methods were self-distraction, which diverted attention away from these stressors, and positive reframing, where athletes attempted to view the difficult situation in a more positive light. Some dysfunctional coping methods included the use of substances and denial, where the athletes completely ignored the stressors in hopes the problems would go away on their own (Makarowski et al., 2022). Interestingly, these coping methods varied in effectiveness, with some having more short-term effects, such as substance use, while others helped the athletes in the long run, such as positive reframing.
Concerns and Limitations
While these studies can provide valuable insights into the effects of stress and pressure on various athletes, there are some concerns and limitations to consider. For example, the generalizability of the findings may be limited, as the samples used in many of these studies were relatively small and specific to certain populations or sports. In studies such as the one conducted by (Knettel et al., 2021), a correlation can be shown between an athlete’s substance use and their stress levels. However, no cause or effect can be established based on this data alone, suggesting a need for further research using longitudinal methods and larger, more diverse samples to better understand the relationship between stress, coping mechanisms, and performance outcomes across different athletic populations. Additionally, the research on coping mechanisms has primarily focused on surveys and self-reported data from athletes, which may be subject to biases known or unknown to the athlete. These studies primarily use limited methods to test for stress and pressure, and these methods are usually not able to fully capture the complex and dynamic nature of stress and pressure in athletic competition. For example, a survey may not be able to capture the neurological responses and changes that an athlete may experience, while a heartbeat monitor wouldn’t be able to test for the emotional effects that pressure and stress can have on an athlete. While some studies do collect physiological data, more multi-method studies are needed to inform whether, for instance, survey data is supported by physiological data. Behavioral tasks replicating real-life stressful situations may provide more nuanced and accurate data. Many of the studies in this paper have been cross-sectional and didn’t study an athlete over longer periods. Additionally, many of the surveys were retrospective, as many of the athletes may not have remembered entirely how they felt at the time of the situation.
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Conclusion
This literature review highlights the impact of stress and pressure on athletic performance, along with the coping methods commonly used to manage these stress factors. The review outlines the effects of stress and pressure, with effects ranging from short-term boosts, such as small boosts of energy, to long-term detriments, such as anxiety, depression, and suicidal thoughts. While acute stress can be positive for an athlete by sharpening focus, chronic stress often results in a decline of performance and psychological distress.
Stress and pressure can manifest in different ways, including coaching, fans, parents, media, or even within the athlete themselves. These pressures can change over time, with younger athletes being more influenced by the expectations of their parents, to older athletes being more influenced by their coaches. The most significant stressor of them all, however, is competition. When athletes face challenges like injuries or skilled opponents, their stress levels have been reported to be significantly higher.
Coping methods can vary when it comes to stress and pressure. Many pro athletes have used pressure-training as an effective method, while other elite athletes have turned to less beneficial methods such as substance use. This review underlines the fact that more research is needed to fully understand how athletes can cope with stress and pressure more positively.
Despite these insights, there are several questions that remain unanswered when referring to current research. Studies have not thoroughly examined some aspects of stress and pressure. For example, what coaching style benefits athletes the best: an authoritarian approach? Or a more supportive, encouraging approach? Current research also doesn’t expand on how an athlete’s personality traits clash with different coaching styles to impact stress.
It is important for coaches, parents, and sports psychologists to support these athletes in overcoming stress and pressure. Coaches can be proactive in understanding how their coaching style may help or harm an athlete. Coaches can adopt approaches that encourage confidence within an athlete, without adding unnecessary pressure. Along with this, parents can be encouraging and provide emotional support for athletes, especially during high periods of stress. Sports psychologists can play a key role in supporting athletes with stress management tools and activities.
By addressing these unanswered questions, researchers can promote healthier approaches in managing stress and pressure, so that the athlete can thrive not just on the field, but off the field as well.
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A huge thank you to everyone who submitted their work, and heartfelt congratulations to those whose pieces were selected for publication! Your brilliance lights up these pages. We can’t wait to see what you’ll bring to the table next month—keep the creativity and curiosity flowing!
