Psychometric Analysis of the International Olympic Committee’s Sport Mental Health Assessment Triage Tool Among Non-Elite Amateur Adult Athletes

Background: The International Olympic Committee developed the Sport Mental Health Assessment Tool-1, encompassing the Athlete Psychological Strain Questionnaire (APSQ) - used for initial screening of mental ill-being symptoms and risk in elite athletes. Despite preliminary psychometric evidence, the APSQ has yet to be tested in non-elite amateur athletes, who represent the majority of sporting participants. The aim of the current study was to test the factor structure, cut-off point sensitivity, nomological validity, and test-retest reliability of the APSQ in non-elite amateur athletes.
Method: Athletes (n = 605) aged 28.57 years (SD = 9.32) comprising 402 males (73.5%) completed the 10-item APSQ, alongside validated measures of anxiety, depression, and well-being. Two Confirmatory Factor Analysis models were tested, in addition to a series of receiver operating characteristics curves benchmarked against clinically relevant anxiety and depression symptoms to examine pre-defined and alternative cut-point sensitivity. Nomological validity was tested through Pearson’s correlations, and intraclass correlation coefficients were examined for test-retest reliability.
Results: A higher-order APSQ model comprising a general ‘Psychological Strain’ factor, and three subcomponents of ‘External coping’, ‘Self-Regulation’ and ‘Performance’ was selected. Convergent and divergent validity were shown, and a new revised cut-point was found to have good classification accuracy within the sample. Largely ‘fair-to-good’ test-retest reliability values were found.
Conclusion: The APSQ could be considered for initial screening of athlete mental health symptoms by sports organisations, and may enable effective triaging to follow-up mental health assessment and/or supporting guidance, potentially preventing, or mitigating, short and long-term effects of mental ill-being. Further research should be undertaken to establish if the psychometric properties found amongst the present sample are generalisable to the broader amateur sporting population.