{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:21:12Z","timestamp":1770351672035,"version":"3.49.0"},"reference-count":36,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"unspecified","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003965","name":"International Olympic Committee","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003965","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2025,12,21]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if paediatric athletes exhibit differences in positive screenings on the Sport Mental Health Assessment Tool (SMHAT-1) compared with adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Team USA Olympic and Paralympic paediatric athletes \u226421 years (n=589; 58.8% female; age=19.5\u00b11.7 years) completed the SMHAT-1 between January 2021 and September 2024. A comparative sample of Team USA adult athletes (n=493, 54.2% female; age=27.3\u00b14.9 years) matched for sex and sport was randomly sampled, and the percentage of athletes with a positive screening on each questionnaire was calculated. \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      analysis compared the proportion of positive screenings between paediatric and adult samples. Piecewise linear regression assessed the association between age and total questionnaire scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The proportion of positive screenings was lower for paediatric athletes for the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (1)=21.2, p&lt;0.001) and Athlete Psychological Strain Questionnaire (APSQ) (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (1)=4.47, p=0.034). Increasing age of paediatric athletes was associated with higher AUDIT-C (\u03b2=0.41, p&lt;0.001) and APSQ scores (\u03b2=0.35, p&lt;0.001); however, a negative deviation was observed in AUDIT-C (\u03b2=\u22120.44, p&lt;0.001) and APSQ scores (\u03b2=\u22120.38, p=0.002) among adults. Further, increasing age of paediatric athletes was associated with increased General Anxiety Disorder-7 (\u03b2=0.14, p=0.045) and ASSQ (\u03b2=0.12, p=0.029) scores; however, there was no significant deviation from this age trend in adults for either score (p&gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Paediatric athletes produce a similar proportion of positive screenings to adults on subcomponents of the SMHAT-1, but they show a lower proportion of positive screenings for alcohol misuse and psychological strain. The changes in SMHAT-1 subcomponent scores among paediatric athletes warrant continued exploration to determine how the interaction of psychosocial development and elite sport may impact mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsem-2025-002831","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:16:04Z","timestamp":1770300964000},"page":"e002831","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A comparative analysis of the Sport Mental Health Assessment Tool (SMHAT-1) between paediatric and adult Olympic and Paralympic athletes"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4080-6271","authenticated-orcid":false,"given":"Ashley N","family":"Triplett","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, 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G","family":"Post","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA"},{"name":"United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA"},{"name":"Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Bartley","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S","family":"Shilt","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital, Houston, Texas, USA"},{"name":"Baylor College of Medicine, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L","family":"Dugan","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital, Houston, Texas, USA"},{"name":"Baylor College of Medicine, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA"},{"name":"United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Finnoff","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA"},{"name":"United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA"},{"name":"Department of Physical Medicine and Rehabilitation, University of Utah, 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