To Flourish or Languish, that is the question: Exploring the mental health profiles of Danish elite athletes
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“…focused on early identi fi cation (yellow) at the athlete level can include regular screening for well-being and mental health issues such as depression, anxiety, and eating disorders (Kuettel, Pedersen, and Larsen 2021; Rice et al. 2020), and teaching coaches to notice athletes ’ energy levels.”
InfluentialA Review of Mental Health Issues in High-Performance and Elite-Level Cycling
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“Kuettel et al. [7] advance this discourse by categorizing distinct mental health profiles among elite athletes, illuminating this population ’ s varied psychological experiences and support requirements.”
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“In addition, women exhibit higher levels of depression and therefore are more likely to gain health benefits from regular exercises (17, 32).”
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InfluentialMental health in athletes: Does authentic leadership matter?
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Mental health literacy and psychological outcomes in dual-career athletes
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“…of depression, factors such as sport satisfaction, support from inside and outside of sport, a starting status, and help-seeking intentions have been found to predict lower depression scores in elite athletes (Kuettel & Larsen, 2019; Kuettel et al., 2021; Perry et al., 2022; Tahtinen et al., 2021).”
BackgroundMethodInfluentialMental ill-health in semi-elite women’s soccer in England: a mixed-methods approach
Bramley, O., Healy, L. C., & Sarkar, M. (2024) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2024.2311752 · Cited by 9 · see citing works
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“In a recent quantitative study among Danish elite athletes, three distinctive mental health pro fi les (i.e., fl ourishing, moderate mental health, and languishing) were discovered (15).”
Wellbeing in high-performance swimming: A grounded theory study
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Self-Compassionate Motivation and Athlete Well-Being: The Critical Role of Distress Tolerance
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“In the recent study by Kuettel et al. (2021), 6.5% of their sample were categorized as languishing; considerably more than the 1.4% here.”
InfluentialSzabadics, A., Morgan, P. B. C., Sarkar, M., McEwan, D., & McCormack, F. (2024) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2024.2361691 · Cited by 8 · see citing works
Lishman, T., Shannon, S., McDevitt‐Petrovic, O., Breslin, G., & Brick, N. (2024) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2024.2389218 · Cited by 8 · see citing works
“…69.6% of MOs were classed as “flourishing”, 27.7% as “moderately healthy” and 2.8% “languishing”, figures comparable with those reported within Danish elite athletes by Kuettel et al. (2021), with 64% classed as “flour-ishing”, 29% as “moderately healthy”, and 7% as “languishing” in that study.”
InfluentialGrimson, S., Brickley, G., Smeeton, N. J., Abbott, W., & Brett, A. (2022) · European Journal of Sport Science · doi:10.1080/17461391.2022.2125834 · Cited by 8 · see citing works
The Prevalence of Emotional Exhaustion in Professional and Semiprofessional Coaches
Lundkvist, E., Gustafsson, H., Madigan, D., Hjälm, S., & Kalén, A. (2023) · Journal of Clinical Sport Psychology · doi:10.1123/jcsp.2021-0039 · Cited by 7 · see citing works
“…and our findings combined with similar findings from other studies both in coaching and for athletes (Apostolidis, 2012; Gerber et al., 2018; Küttel et al., 2021; Pastore & Judd, 1993; Reardon et al., 2019; Vealey et al., 1992) at least to some extent underline that how we research burnout…”
Stornæs, A. V., Sundgot-Borgen, J. K., Pettersen, G., Rosenvinge, J. H., & Nordin‐Bates, S. M. (2023) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2023.102474 · Cited by 7 · see citing works
Colangelo, J., Smith, A. J., Buadze, A., & Liebrenz, M. (2023) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2023.1270957 · Cited by 7 · see citing works
Measures to protect and promote elite athletes’ mental health in Swiss sports
Röthlin, P., Horvath, S., & Birrer, D. (2023) · Sports Psychiatry · doi:10.1024/2674-0052/a000061 · Cited by 6 · see citing works
Örencik, M., Schmid, M. J., Schmid, J., Schmid, J., & Conzelmann, A. (2024) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2024.102606 · Cited by 6 · see citing works
A Survey of the Mental Health of UK Olympic and Paralympic Sport Athletes
Leyland, S., Currie, A., Elizabeth Board, Mistry, A., Jaques, R., & Ranson, C. (2022) · Journal of Athlete Development and Experience · doi:10.25035/jade.04.02.03 · Cited by 6 · see citing works
“, 2017), Denmark (Kuettel et al., 2021), and Sweden (Åkesdotter, 2020).”
BackgroundResultInfluentialWaffo, B. T., & Hauw, D. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152519 · Cited by 7 · see citing works
Ford, M., Rothmann, S., & van Zyl, L. E. (2025) · BMC Psychology · doi:10.1186/s40359-025-02922-7 · Cited by 4 · see citing works
“Previous studies have found different flourishing profiles and linked these profiles to levels of social support structures, stress, job satisfaction and organizational citizenship behavior, showing significant differences between the profiles in relation to these aspects [67, 68].”
The Impact of Sexual Orientation on College Athlete Sport-Related Belonging and Well-Being
Fallon-Korb, A., Leibovitz, A., Meir, G., & Stanley, C. T. (2025) · The Sport Psychologist · doi:10.1123/tsp.2024-0083 · Cited by 4 · see citing works
2Steps4Health project: Promotion of mental health in junior professional sports
Kaiser, J., Walter, N., Oppitz, L., Braun, B., & Schmitz, J. (2023) · Sports Psychiatry · doi:10.1024/2674-0052/a000066 · Cited by 5 · see citing works
Type of sport-and gender-related personality features in the case of injured martial arts athletes
Patenteu, I., Predoiu, R., Bitang, A., Predoiu, A., Nica, S. A., & AM, 1. (2023) · Journal of Educational Sciences & Psychology · doi:10.51865/jesp.2023.2.20 · Cited by 4 · see citing works
The Influence of Climate on Flourishing and Motivational Outcomes for U.S. Masters Swimmers
Fry, M. D., Wineinger, T. O., Long, H., Guivernau, M. R., Gano‐Overway, L. A., & Iwasaki, S. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20031990 · Cited by 4 · see citing works
What is this thing called “Post-Olympic Blues”? An Exploratory Study Among Danish Olympic Athletes
Diment, G. M., Stagis, N. D., & Küttel, A. (2023) · Scandinavian Journal of Sport and Exercise Psychology · doi:10.7146/sjsep.v5i.134527 · Cited by 4 · see citing works
Stable or Fluid? An Investigation Into Female Student Athlete Basketball Players’ Well-Being
Columbus, A., Mack, D., Wilson, P., & Chimera, N. J. (2023) · Case Studies in Sport and Exercise Psychology · doi:10.1123/cssep.2022-0023 · Cited by 4 · see citing works
Skating on thin ice? Mental health and well-being in women’s ice hockey
Johansson, H., Malmborg, J. S., Ekengren, J., Lind, J. C., & Ivarsson, A. (2023) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2023-001746 · Cited by 4 · see citing works
“This can, in turn, be valuable, considering that sport is a powerful Open access platform for promoting MH and gender equality, especially within high-level sports where such work can serve as a model for society at large.”
BackgroundKüttel, A., Melin, A., Larsen, C. H., & Lichtenstein, M. B. (2022) · Scandinavian Journal of Sport and Exercise Psychology · doi:10.7146/sjsep.v4i1.128360 · Cited by 4 · see citing works
“…for the CES-D, most studies with athletes have used the conventional cut-off point >16 to classify athletes according to their symptomatology (e.g., Beable et al., 2017, Gulliver et al., 2015, Kuettel et al., 2020), whereas other studies have used a cut-off point >22 (e.g., Nixdorf et al., 2013).”
BackgroundInfluentialSelf-citationFeatures of successful high-performance sport environments: Stakeholder insights
Schlawe, A., Christiansen, A. V., & Henriksen, K. (2026) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2026.2683956 · Cited by 3 · see citing works
Risk and protective factors for safeguarding and abuse prevention in dance: a scoping review
Dwarika, M. S., Jordan-Dewhurst, T., Tidmarsh, G., Kolitsida, M., Sanchez, E., Quinton, M. L., & Cumming, J. (2026) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2025.2611828 · Cited by 2 · see citing works
Morela, E., Kouli, O., Lykou, A., Bebetsos, E., Antoniou, P., & Lykou, X. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104375 · Cited by 3 · see citing works
Examining the Field of Applied Sport Psychology in Denmark
Feddersen, N. B., & Ryom, K. (2022) · Journal of Sport Psychology in Action · doi:10.1080/21520704.2022.2129890 · Cited by 2 · see citing works
Exploring Work Stress and Coping Strategies in the Hotel Industry: A Preliminary Study
Yusriani, S., Patiro, S. P. S., Prambudi, I. S., & Effendy, A. J. (2023) · Proceedings International Conference on Business Economics & Management · doi:10.47747/icbem.v1i1.1332 · Cited by 2 · see citing works
MALAYSIAN ELITE DISABLED ATHLETES: THE QUALITY OF LIFE AND SATISFACTION WITH LIFE
Lee, C. A., Hussein, K. H., & Goh, S. L. (2023) · Journal of Health and Translational Medicine · doi:10.22452/jummec.vol26no2.1 · Cited by 1 · see citing works
Psychiatric Disorders in Elite Athletes
Rungstrøm, K., Frisk, C. H., Hulgaard, D. R., & Lichtenstein, M. B. (2024) · Scandinavian Journal of Sport and Exercise Psychology · doi:10.7146/sjsep.v6i.140705 · Cited by 2 · see citing works
Geiger, S., Aufderlandwehr, J., Esser, A. J., Reinemann, E., Muehlbauer, T., Viehweger, S., Skoda, E., Teufel, M., & Bäuerle, A. (2025) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2024.0496 · Cited by 1 · see citing works
“30 Given these considerations, a tailored approach has been specifically recommended for addressing elite athletes ’ mental health 31 and that mental health interventions for athletes should be easily accessible.”
Nogueira, M. J., & Teixeira, D. (2025) · Healthcare · doi:10.3390/healthcare13111257 · Cited by 1 · see citing works
“For qualitative interpretation, PMHQ scores are categorized into three levels–Languishing (39–78), Intermediate (79–117), and Flourishing (118–156)—with higher scores reflecting more favorable mental health status [26].”
Valverde, S., Joncheray, H., Stambulova, N. B., & Ruffault, A. (2025) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2025.2590492 · Cited by 1 · see citing works
Sports competition related anxiety: Is it modifiable among athletes in urban schools in Sri Lanka?
Rajasinghe, S. V., & Arambepola, C. (2021) · Asian Journal of Interdisciplinary Research · doi:10.54392/ajir2145 · Cited by 1 · see citing works
A wellness application: use of imagery for athletes’ stress reduction and relaxation
Alicea, S. K., Sackett, S. C., & Winter, A. (2024) · Journal of Imagery Research in Sport and Physical Activity · doi:10.1515/jirspa-2023-0036 · Cited by 2 · see citing works
Making the cut: Investigating body image and well-being among female powerlifters
Tremonte, I. L., Mack, D. E., Wilson, P. M., & Sabiston, C. M. (2025) · Performance Enhancement & Health · doi:10.1016/j.peh.2025.100333 · Cited by 1 · see citing works
The Killing of a Sacred Veneer: Depressive Symptoms in Athletes
Tahtinen, R. E. (2021) · Liverpool John Moores University · doi:10.24377/ljmu.t.00014387 · Cited by 1 · see citing works
Wester, C. T., Küttel, A., Mathorne, O. W., & Henriksen, K. (2021) · Scandinavian Journal of Sport and Exercise Psychology · doi:10.7146/sjsep.v3i.126144
Kiens, K., Kask, K., & Jõgi, A. (2023) · International Sport Coaching Journal · doi:10.1123/iscj.2022-0065
Differences in the Level of Burnout between Recreational Boxers and Non-athletes
Zboncak, Ľ., Kraček, S., Kukurová, K., Gregor, T., & Mancovič, M. (2023) · International journal of human movement and sports sciences · doi:10.13189/saj.2023.110404
The female athlete’s mind: mental health experiences and support in women’s cricket academies
Brooker, R. S., Ogden, D. J., Plateau, C. R., & Barker, J. B. (2025) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2025.2474036
“Female athletes report higher levels of mental illness symptoms and lower levels of mental health compared to male athletes (Kuettel et al., 2021).”
MENTAL HEALTH AND DISORDERS IN ELITE SPORTS COACHES
Colagrai, A. C., Augusto, J. B., & Fernandes, P. T. (2025) · Corpoconsciência · doi:10.51283/rc.29.e18644
Additional file 2 of The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Frost, J., Walton, C. C., Purcell, R., Fisher, K., Gwyther, K., Kocherginsky, M., & Rice, S. M. (2024) · Figshare · doi:10.6084/m9.figshare.25203736
Additional file 4 of The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Frost, J., Walton, C. C., Purcell, R., Fisher, K., Gwyther, K., Kocherginsky, M., & Rice, S. M. (2024) · Figshare · doi:10.6084/m9.figshare.26679632
Additional file 6 of The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Frost, J., Walton, C. C., Purcell, R., Fisher, K., Gwyther, K., Kocherginsky, M., & Rice, S. M. (2024) · Figshare · doi:10.6084/m9.figshare.26679638
Additional file 1 of The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Frost, J., Walton, C. C., Purcell, R., Fisher, K., Gwyther, K., Kocherginsky, M., & Rice, S. M. (2024) · Figshare · doi:10.6084/m9.figshare.25203625
Additional file 3 of The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Frost, J., Walton, C. C., Purcell, R., Fisher, K., Gwyther, K., Kocherginsky, M., & Rice, S. M. (2024) · Figshare · doi:10.6084/m9.figshare.26679629
Additional file 5 of The Mental Health of Elite-Level Coaches: A Systematic Scoping Review
Frost, J., Walton, C. C., Purcell, R., Fisher, K., Gwyther, K., Kocherginsky, M., & Rice, S. M. (2024) · Figshare · doi:10.6084/m9.figshare.26679635
Suardika, I. K., Haryanto, A. I., Tarigan, S. F. N., Parengkuan, M., Kaawoan, A. Z. I. S., Afriani, S. D., & Purnomo, E. (2025) · Balneo and PRM Research Journal · doi:10.12680/balneo.2025.899
Henderson, S., Bloom, G. A., & Alexander-Urquhart, D. (2026) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2026.2638369
McCluskey, T., Stevens, M. R., Murray, K., Cruwys, T., & Robertson, A. M. (2026) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2026.2666094
Mental health in tennis: a cross-organisational hybrid summit-Delphi consensus process
Kroshus, E., Capel-Davies, J., Ellenbecker, T. S., Gouttebarge, V., Martin, K., Miller, S., Mountjoy, M. L., Reardon, C. L., Stroia, K. A., & Hainline, B. W. (2026) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-111479
Gorczynski, P. F., Bilgoe, S. C., Gouttebarge, V., Hitchcock, M., & Currie, A. (2026) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-111429
Neméti-Fehér, Z., Ionel, M. S., Gherghișan, A., Iliescu, D., & Ion, A. (2026) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2026.2687387
Pomerleau-Fontaine, L., Boudreault, V., Labossière, S., Durand‐Bush, N., Maurin, J., Brassard, S., Parent, S., Dion, J., & Soulard, A. D. (2026) · Journal of Sport and Exercise Psychology · doi:10.1123/jsep.2025-0255
NAIDOO, D., Chantler, J., Gouttebarge, V., van Rensburg, D. J., & MacMillan, C. (2026) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2026.07.018
Hainline, B. W., Gouttebarge, V., Kroshus, E., & Reardon, C. L. (2026) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-111464
ADİLOĞULLARI, G. E., Adiloğulları, İ., & Şenel, E. (2026) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2026.2740797
Trait mindfulness and competitive-race flow in swimmers: the mediating role of attentional control
Luo, L., & Xu, B. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1938433
“…elite athletes are not defined solely by a performance dimension; they present diverse profiles between psychological flourishing and languishing (Kuettel et al., 2021), and their athletic identity and performance pressure continually shape their psychological experience (Edison et al., 2021).”
Spolverato, L., Devoto-Araya, M., Wylleman, P., Brandt, K. D., Bertran-Gracia, L., Jordana, A., Kenttä, G., Papathomas, A., Ruffault, A., Blijlevens, S., et al. (2026) · International Journal of Sports Science & Coaching · doi:10.1177/17479541261499703
- Authors
- Kuettel, A., Pedersen, A. K., & Larsen, C. H.
- Affiliations
- University of Southern Denmark (DK)
- Venue
- Psychology of Sport and Exercise
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 52
- Pages
- 101837
- ISSN
- 1469-0292 (ISSN-L)
- OpenAlex
- W3097628858
- Cited by
- 89
- References
- 67
- Citations by year
- 2026: 13 · 2025: 13 · 2024: 22 · 2023: 21 · 2022: 11 · 2021: 9
- FWCI
- 15.48
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Psychology of sport and exercise (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by-nc-nd)
- Funders
- Team Denmark (2018-5)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Sport Psychology and Performance
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- elite athletes, athlete mental health, anxiety symptoms, depressive symptoms, psychological well-being, eudaimonia, languishing, sex differences, social support, sports environment, stress, protective factors, risk factors
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