Background Elite-level athletes are vulnerable to psychological distress due to rigorous training and competitive schedules. Psychological screening is a preventative strategy to target athletes at risk for maladaptive coping and psychopathology; however, psychological screening is rarely implemented in elite sport environments.

Objective To assess psychological distress (i.e., anxiety, psychological strain, and burnout) and coping behavior in Olympic-level swimmers following a major athletic stressor: postponement of the 2020 Olympics due to COVID-19.

Design A retrospective mixed-methods design was used.

Setting An online psychological assessment and a follow-up telehealth semi-structured interview were completed.

Participants Participants (n=14) included international swimmers who: achieved a top 10 time; placed in the top 3 in their 2019 national meet; or qualified for the World Championships.

Assessment of Risk Factors Anxiety, psychological strain, and burnout were evaluated as risk factors for maladaptive coping.

Outcome Measurements Assessment included Generalized Anxiety Disorder-7 (GAD-7), Athlete Psychological Strain Questionnaire (APSQ), and Athletic Burnout Questionnaire (ABQ) scales. Coping behaviors were derived from interview content (available for 12 of the 14 participants).

Results Findings (mean ± SD) indicated mild anxiety (6.29 ± 4.87) and severe psychological strain (22.71 ± 4.83). Higher psychological strain associated with higher emotional and physical exhaustion—a subscale of the ABQ (r = 0.791; p = 0.001). A subset of athletes (n=5) reported moderate-to-severe anxiety. Most athletes (n = 9) practiced maladaptive coping (75%) (e.g., behavioral and mental disengagement); however, maladaptive coping was more frequent in athletes with greater psychological distress.

Conclusions Several athletes reported levels of anxiety and psychological strain that, according to APSQ and GAD-7 guidelines, necessitated clinical evaluation. Higher psychological distress coincided with more frequent maladaptive coping. Findings urge implementation of psychological screening in elite athletics to better support athletes’ mental health and prevent development of maladaptive coping and psychopathology.