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Sleep disturbance is the strongest bridge symptom linking athlete burnout, depression, and anxiety in collegiate athletes.

In a network analysis of 1,226 Chinese collegiate athletes, sleep disturbance (PHQ-3) emerged as the strongest bridge symptom (bEI = 0.47) connecting the three clusters of burnout, depression, and anxiety. The most central nodes were depressed mood (PHQ-2; EI = 1.22), physical exhaustion (ABQ-E8; EI = 1.11), and uncontrollable worry (GAD-2; EI = 1.07).

Last updated: Jul 25, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Exploring the interrelationships between athlete burnout, depression, and anxiety: a network analysis approach.

observational

Fu Y, Song YG, Liang R, Wang J, Zhao J, Shangguan Y, Zhuang T · Frontiers in psychology (2026)

Participants: N/A
Duration: N/A
Intervention: Not applicable (observational network analysis; no intervention tested)
Outcome: Centrality (expected influence) and bridge centrality (bridge expected influence) of symptoms across athlete burnout, depression, and anxiety
Effect Size: N/A
Population: 1,226 Chinese collegiate athletes (637 male, 589 female; mean age 18.11 years, SD = 1.39)

Result:

PubMed: 42482729DOI: 10.3389/fpsyg.2026.1845637

Mechanism Graph

Sleep disturbance (PHQ-3) shows the highest bridge expected influence (bEI = 0.47) among all symptoms
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This symptom connects the burnout, depression, and anxiety symptom clusters
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Targeting sleep disturbance may interrupt transdiagnostic symptom-transmission pathways
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Result: Sleep disturbance is a key intervention target for reducing comorbidity

Limitations

  • ⚠Cross-sectional design prevents causal inference about the direction of relationships between symptoms
  • ⚠Sample limited to Chinese collegiate athletes, which may not generalize to other athlete populations or cultures

Frequently Asked Questions

What is the strongest bridge symptom linking burnout, depression, and anxiety in athletes?▼

Sleep disturbance (PHQ-3) was identified as the strongest bridge symptom with a bridge expected influence of 0.47, meaning it most strongly connects the three symptom clusters.

Which symptoms were most central in the network analysis?▼

Depressed mood (PHQ-2; EI = 1.22), physical exhaustion (ABQ-E8; EI = 1.11), and uncontrollable worry (GAD-2; EI = 1.07) were the most central nodes.

What does bridge expected influence (bEI) measure?▼

Bridge expected influence quantifies how strongly a symptom connects different symptom clusters (e.g., burnout, depression, and anxiety), indicating its role in comorbidity.

How many athletes were included in this study?▼

The study included 1,226 Chinese collegiate athletes (637 male, 589 female) with a mean age of 18.11 years.

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References

  1. 1.Fu Y, Song YG, Liang R, Wang J, Zhao J, Shangguan Y, Zhuang T. "Exploring the interrelationships between athlete burnout, depression, and anxiety: a network analysis approach.." Frontiers in psychology, 2026. PMID: 42482729 DOI: 10.3389/fpsyg.2026.1845637
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.