Man Up! – Sport, Masculinity, Mental Health & Help-Seeking

Introduction

• Study: “Man Up!” – Exploring intersections of sport participation, masculinity, psychological distress, and help-seeking attitudes/intentions (Ramaeker & Petrie, 2019)
• Context
  • Growing interest in how socialised masculine ideologies affect men’s physical & psychological health
  • Sport theorised as a hyper-masculine environment reinforcing competitiveness, pain-indifference, self-reliance
  • Gap: Few quantitative comparisons of masculine norms/roles between athletes vs. non-athletes and links to mental-health variables
• Core aims
  • Compare conformity to masculine norms (CMN) & gender-role conflict (GRC) in collegiate male athletes vs. non-athletes
  • Relate masculinity variables to depression & substance (alcohol) use
  • Test whether self-stigma mediates masculinity → help-seeking attitudes → intentions

Key Constructs & Definitions

• Masculinity research frameworks
  • Conformity to Masculine Norms (CMN)
  • Behavioural/cognitive adherence to culturally dominant norms
  • CMNI-46 subscales: Emotional Control, Winning, Playboy, Violence, Self-Reliance, Risk-Taking, Power over Women, Primacy of Work, Heterosexual Self-Presentation
  • Gender-Role Conflict (GRC)
  • "Psychological state in which socialised gender roles have negative consequences" (O’Neil, 2008)
  • Dimensions:
    • Restricted Emotionality (RE)
    • Restricted Affectionate Behaviour Between Men (RABBM)
    • Success, Power, Competition (SPC)
    • Conflict Between Work & Family Relations (CBWFR)
• Help-seeking model variables
  • Self-Stigma of Seeking Help: internalisation of negative stereotypes
  • Attitudes Toward Seeking Professional Psychological Help (ATSPPH-SF)
  • Intentions to Seek Counseling Inventory (ISCI)
• Mental-health outcomes
  • Depression: CESD-R (20 items)
  • Alcohol Use: AUDIT (10 items)

Study Purpose & Hypotheses

• Hypothesis 1: Athletes > non-athletes on CMN (Winning, Self-Reliance, Emotional Control) & GRC (SPC, RE, RABBM)
• Hypothesis 2: Higher CMN & GRC → higher depressive symptoms & alcohol use for both groups
• Hypothesis 3: Self-stigma mediates masculinity → negative help-seeking attitudes/intentions (stronger mediation for athletes)

Method

• Design: Cross-sectional survey; multivariate & mediational analyses
• Participants
  • Athletes: n = 220 male NCAA Division I, \text{M}_{\text{age}} = 20.03\,(SD = 1.38)
  • Sports: Football 34.1 %, Track 20.9 %, Baseball 10.9 %, Soccer 8.6 %, Swimming 7.7 %
  • Race: White 54.5 %, African-American 35.9 %, Other 4.1 %; Hispanic 10.1 %
  • Scholarship: Full 43.6 %, Partial 35.5 %, None 20.5 %
  • Non-athletes: n = 203 male undergraduates, \text{M}_{\text{age}} = 21.40\,(SD = 3.89)
  • Race: White 61 %, African-American 13.2 %, Other 11.2 %; Hispanic 26.9 %
• Instruments (reliabilities \alpha in current study)
  • CMNI-46: \alpha = .72.. .88 (subscales)
  • GRCS: \alpha = .82.. .92
  • CESD-R: \alpha = .93
  • AUDIT: \alpha = .81
  • Self-Stigma: \alpha = .84
  • ATSPPH-SF: \alpha = .81
  • ISCI: \alpha = .93
• Procedure
  • Athletes: paper surveys in team/small-group sessions (coaches absent), \$10 incentive
  • Non-athletes: online survey for course credit
  • Anonymous responses; ~20 min completion
• Data handling
  • Missing values < 3.8\%, mean substitution; CESD-R & AUDIT log-transformed for normality
  • Analyses: 2 MANOVAs, multiple regressions, path analyses (Mplus 6, ML estimation). Fit indices: \text{CFI} > .95; \text{RMSEA} < .06; \text{SRMR} < .08

Results

Sport Participation & Masculinity (Hyp 1)

• MANOVA – CMN factors: F(9, 413) = 31.24, p < .001, \eta_p^{2} = .41
  • Athletes significantly ↑ on: Winning (\eta_p^{2} = .32), Heterosexual Self-Presentation (.19), Power over Women (.17), Primacy of Work (.03), CMN Total (.19)
• MANOVA – GRC factors: F(4, 418) = 18.17, p < .001, \eta_p^{2} = .15
  • Athletes ↑ on: SPC (.11), RABBM (.05), GRC Total (.05)
  • No group differences: Emotional Control, Self-Reliance, RE, CBWFR

Masculinity → Depression (Hyp 2)

• Non-athletes regression: Adj\,R^{2} = .234
  • Significant predictors: CBWFR (\beta = .37), Self-Reliance (\beta = .25)
• Athletes regression: Adj\,R^{2} = .135
  • Only CBWFR significant (\beta = .37***)

Masculinity → Alcohol Use (Hyp 2)

• Non-athletes regression: Adj\,R^{2} = .206
  • Playboy norm \beta = .42*** (Risk-Taking ns after controls)
• Athletes regression: Adj\,R^{2} = .072
  • Risk-Taking \beta = .20; Violence \beta = .19

Mediation: Masculinity → Stigma → Attitudes → Intentions (Hyp 3)

• Non-athletes model: \chi^{2}(4) = 10.32, p = .035; CFI = .95; RMSEA = .088; SRMR = .037
  • CMN → Stigma \beta = .43*** (GRC ns)
  • Stigma \beta = -.36 & CMN \beta = -.27 → Attitudes (negative direction)
  • Attitudes \beta = .24*** → Intentions (5 % variance)
  • Significant indirects: CMN → Stigma → Attitudes (CI [ - .12, - .01 ]); Stigma → Attitudes → Intentions
• Athletes model: \chi^{2}(4) = 7.32, p = .11; CFI = .98; RMSEA = .063; SRMR = .031
  • CMN → Stigma \beta = .36*** (GRC ns)
  • Stigma \beta = -.43 & CMN \beta = -.31 → Attitudes (38 % variance)
  • Attitudes \beta = .29*** → Intentions (8 % variance)
  • Indirects mirror non-athletes; mediation strength comparable (contrary to Hyp 3 expectation)

Discussion & Interpretation

• Sport environment amplifies specific masculine norms:
  • Winning, heterosexual presentation, dominance over women, work centrality, affectionate restriction between men
• Universal masculine socialisation (emotional control, self-reliance) similar across athletes & non-athletes
• Work–family conflict (CBWFR) is a common predictor of depressive symptoms; self-reliance enhances risk for non-athletes
• Alcohol use patterns diverge:
  • Non-athletes: linked to sexual promiscuity norm (Playboy)
  • Athletes: linked to risk-taking & pro-violence norms; sport-specific bonding contexts may reinforce
• Help-seeking barriers driven by CMN and self-stigma, not by GRC; mediation chain consistent across groups
  • Conforming to masculine norms → view help as weakness → negative attitudes → lower intentions

Practical / Clinical Implications

• Public campaigns & athlete role-models (e.g., NBA’s Kevin Love) can destigmatise mental-health help-seeking
• Clinicians working with men (athletes & non-athletes):
  • Explore work–life balance, self-care, and flexible masculinity expression
  • Address self-stigma explicitly; validate courage to seek help
  • Use men-only groups to reshape norms about vulnerability & support
• Sport organisations: develop internal mental-health supports, easy service access, and promote open discussion of distress

Limitations

• Cross-sectional, self-report → cannot infer causality; possible social-desirability bias (athletes surveyed in groups)
• Sample restricted to two Division I universities; limited generalisability to other levels, regions, or age cohorts
• Masculinity variables explained modest variance in outcomes; other factors (sport-specific stressors, social support, chronic pain) should be examined

Future Research Directions

• Longitudinal tracking of masculinity, mental health, and help-seeking across college career
• Inclusion of sport-specific stressors & drinking motives, injury status, social-support measures, and intersectional identities (race, sexuality)
• Experimental interventions targeting CMN flexibility & stigma reduction, evaluated for impact on real help-seeking behaviour

Ethical & Societal Considerations

• Balancing cultural messages of toughness with promotion of vulnerability can reduce stigma and barriers to care
• Encouraging supportive environments (teams, families, employers) lowers retribution/fear for men expressing distress
• Reducing conformity pressure may decrease harmful behaviours (excessive drinking, violence) and improve mental health