{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T03:10:25Z","timestamp":1773976225346,"version":"3.50.1"},"reference-count":51,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2021,9,27]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The escalated competitive pressure and professionalisation of esports players could predispose them to mental health symptoms. We aimed to develop a model to explore the association between distress and anxiety\/depression symptoms and potential associations between adaptive or maladaptive coping strategies, sleeping disturbance, alcohol consumption and eating habits in electronic football players.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The present exploratory cross-sectional study includes the Distress Screener, General Health Questionnaire, Brief Cope, Sleep Disturbance Domain of the Patient-Reported Outcomes Measurement Information System, Alcohol Use Disorders Identification Test Consumption and a set of questions regarding eating habits. A two-step robust maximum likelihood method of the Structural Equation Modelling approach was used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Both measurement model (\u03c7<jats:sup>2<\/jats:sup>\/df=1065.04 (637), p&lt;0.001; Tucker-Lewis Index (TLI)=0.91, Comparative Fit Index (CFI)=0.92, standardised root mean residual (SRMR)=0.07 and root mean square error of approximation (RMSEA)=0.05; 95% CI 0.043 to 0.053) and hypothesised structural model (\u03c7<jats:sup>2<\/jats:sup>\/df=1131.98 (648); p&lt;0.001; TLI=0.90, CFI=0.91, SRMR=0.07 and RMSEA=0.05; 95%\u2009CI 0.054 to 0.06) showed an adequate fit to the data. Stress was positively related with depression and anxiety symptoms. Only anxiety symptoms were linked with coping strategies. Maladaptive coping strategies were related to sleep disturbance, alcohol consumption and poor eating habits, whereas adaptive coping strategies were associated with less sleep disturbance, reduced alcohol consumption and better eating habits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>An integrative approach to help electronic football players when early signs of distress are present might help avoid other mental health symptoms that interfere with players\u2019 well-being and overall health. Additionally, adequate coping strategies to manage anxiety symptoms due to distress may help counteract potential negative consequences for lifestyle habits in electronic football players.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsem-2021-001149","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T14:44:30Z","timestamp":1633963470000},"page":"e001149","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Mental health symptoms in electronic football players"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0495-9230","authenticated-orcid":false,"given":"Ana Monteiro","family":"Pereira","sequence":"first","affiliation":[{"name":"Portugal Football School, Portuguese Football Federation, Oeiras, Portugal"},{"name":"Research Center in Sports Sciences, Health Sciences and Human Development, University of Maia, ISMAI, CIDESD, Maia, Portugal"}]},{"given":"Pedro","family":"Teques","sequence":"additional","affiliation":[{"name":"Portugal Football School, Portuguese Football Federation, Oeiras, Portugal"},{"name":"N2i, Polytechnic Institute of Maia, Maia, Porto, Portugal"},{"name":"CIPER, Interdisciplinary Center for the Study of Human Performance, University of Lisbon, Faculty of Human Kinetics, Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9227-8234","authenticated-orcid":false,"given":"Evert","family":"Verhagen","sequence":"additional","affiliation":[{"name":"Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers \u2013 Vrije Universiteit Amsterdam, Amsterdam, Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0126-4177","authenticated-orcid":false,"given":"Vincent","family":"Gouttebarge","sequence":"additional","affiliation":[{"name":"Section of Sports Medicine, University of Pretoria, Pretoria, South Africa"},{"name":"Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Netherlands"},{"name":"Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, Netherlands"}]},{"given":"Pedro","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Portugal Football School, Portuguese Football Federation, Oeiras, Portugal"},{"name":"Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Portugal"},{"name":"CIDEFES, Universidade Lus\u00f3fona, Lisboa, Portugal"}]},{"given":"Jo\u00e3o","family":"Brito","sequence":"additional","affiliation":[{"name":"Portugal Football School, Portuguese Football Federation, Oeiras, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"2025083110423990000_7.4.e001149.1","unstructured":"NewZoo . 2020 games market report | April update. 2020."},{"key":"2025083110423990000_7.4.e001149.2","unstructured":"NewZoo . 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