Maltreatment in sport

Maltreatment, referred to as, “volitional acts that result in or have the potential to result in physical injuries and/or psychological harm,”9 can be experienced in many different ways in the athletic environment. Coaches, parents, administrators, officials and athletes all represent both potential victims and perpetrators of maltreatment. Specific forms of maltreatment in sport are illustrated in fig 1.

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Figure 1

Categorisation of maltreatment in sport.

In general, maltreatment can be roughly categorised into relational and non-relational maltreatments, depending on the nature of the relationship in which the behaviour occurs. Much maltreatment, both relational and non-relational, exists within relationships of differential power—thus, it is the critical nature of the relationship, in which the maltreatment occurs that differentiates between various forms of maltreatment in sport.

Relational maltreatment

In general, the four major recognised forms of relational maltreatment include: physical abuse, sexual abuse, emotional abuse and neglect.9 These four forms of maltreatment are referred to as “relational disorders” as they “occur within the context of a critical relationship role,” in which the relationship has significant influence over an individual’s sense of safety, trust, and fulfillment of needs.9 Examples of these relationships in sport may include, but are not limited to athletes’ relationships with parents, coaches, and teammates in a mentoring role. A summary of the different relational maltreatments can be seen in tables 1–4. To date, the experience of sexual abuse in sport has been the focus of much research, with emotional abuse receiving less attention. It is perplexing that no empirical studies have specifically examined physical abuse or neglect in sport. Each of the individual relational maltreatments will be reviewed below.

Sexual abuse

Sexual abuse is defined as, “any sexual interaction with person(s) of any age that is perpetrated against the victim’s will, without consent or in an aggressive, exploitative, manipulative or threatening manner.”10 In general, sexually abusive behaviours are divided into touching and non-touching sexual offences.11

As mentioned previously, sexual abuse has received the most research attention in sport of all four relational abuses. Investigation of 253 student-athletes and 275 coaches on perceptions of interpersonal coach–athlete relations reported that 2% of the athletes sampled had experienced sexual abuse in sport, and 3% of the coaches admitted to having been intimately involved with an athlete under the age of 18 years.12 A survey analysis of the prevalence of sexual abuse in organised competitive sport in Australia reported that of the 2118 respondents, 13% of female athletes and 6% of male athletes reported experiences of sexual abuse in the sport environment.13 Moreover, the prevalence of sexual harassment and abuse among 572 Norwegian elite female athletes was compared with a sample of 574 age-matched controls. Results revealed no overall differences between the groups, but the prevalence of sexual harassment and abuse in athletes increased with age. Female athletes had experienced abuse from both men and women, and the prevalence rate of athletes’ experiences of sexual harassment and abuse from male authority figures in sport was greater than what the controls had experienced in a workplace or educational setting.14

Along with the recent emergence of research defining the problem of sexual abuse in sport, quite a few studies have been published identifying specific risk factors for athletes’ experiences of sexual abuse. Trends of risk have been categorised into coach variables, athlete variables and sport variables.5 Other individual factors of risk identified in the literature include athletic maturation of the athlete,15 parents’ trust of the coach,16 sport type17 and the subculture of sport itself.18 Studies have also been published on the grooming process of sexual abuse in sport5 12 15 19 and the temporal development of sexually abusive coach–athlete relations.20 An extensive review of the literature on sexual abuse in sport has been previously published.21

Emotional abuse

The term “emotional abuse” has been used synonymously with the term “psychological maltreatment,” or “psychological abuse.”22 However, while these forms of maltreatment are similar, they are not necessarily the same.23 According to the American Human Association (AHA), psychological maltreatment comprises both emotional abuse and emotional neglect.24 Considering this distinction, various definitions, specifically of emotional maltreatment, have been proposed.

The AHA defined emotional maltreatment as “active, intentional, berating, disparaging or other abusive behaviour toward the child, which impacts upon the emotional well-being of the child.”24 Similarly, Glaser defined emotional abuse as a relationship between a child and care giver that is characterised by patterns of non-physical harmful interactions.25 Distinguishing emotional abuse from emotional bullying or emotional neglect in sport, in order for behaviour to be defined as emotional abuse, it must represent a pattern of deliberate non-contact behaviours within a critical relationship that has the potential to be harmful. The intent of a perpetrator to inflict harm is not required in order for a pattern of behaviour to constitute emotional abuse; nor is evidence of the eventual harm inflicted.26 Specific emotionally abusive behaviours in sport have been categorised into verbal emotional abuse and non-verbal emotional abuse, including physical emotional abuse and the denial of attention and support.26

Examinations of athletes’ experiences of emotional abuse have been limited. Preliminary exploration of the experience of other relational abuses in sport occurred in the mid-1990s alongside the investigations of sexual abuse and other non-relational maltreatments in sport. In 1994 and 1995, a satisfaction survey was administered to 110 and 103 US student-athletes respectively. Among other aspects, the survey assessed the frequency of physical, verbal and mental abuse by coaching staff. Results of the study showed that 22% of respondents reported experiencing coaching techniques that were verbally or mentally abusive.27

Research specifically on athletes’ experiences of emotional abuse in sport has not emerged until recently. Gervis and Dunn conducted a study on the prevalence of emotional abuse of elite athletes by their coaches and reported that shouting, belittling, threats, and humiliation were found to be the most common forms of emotional abuse, with more abusive behaviours reported once the athletes reached the elite level.28 Additionally, a model of the process by which athletes experience emotional abuse across the course of their career was proposed and suggested that an athlete’s experiences of emotional abuse are related to their cultural acquiescence and perception of performance.29

Physical abuse

Physical abuse has historically been the most visible form of maltreatment. Over time, several variations in the definition of physical abuse have been proposed outlining both contact and non-contact physical abuses. Perry et al defined physical abuse as the infliction of physical harm on a child by a parent or care giver.30 Similarly, Matthews referred to physical abuse as, “non-accidental trauma or physical injury,” and suggested that in many instances, physical abuse results from inappropriate or excessive physical discipline of parents or caretakers.11 Likewise, the Coalition on the Physical Punishment of Children and Youth defined physical punishment as, “an action intended to cause physical discomfort or pain to correct a child’s behaviour,” and suggested that both hitting and non-hitting physical punishments may be distinguished as physically abusive behaviours.31

Although, no empirical investigations have specifically examined physical abuse within the athletic environment, several authors have alluded to problems of physical abuse in sport. Gravely and Cochran reported that 3% of the 213 student-athletes surveyed indicated having been subjected to physically abusive coaching techniques.27 Also, David suggested that athletes can be exposed to several forms of physical abuse in competitive sport including excessive intensive training and physical violence by adults—including corporal punishment.2

Neglect

Neglect refers to a lack of reasonable care,25 and an all-round deprivation of attention.32 According to the American Human Association, neglect is defined as passive or passive/aggressive inattention to an individual’s needs, nurturing or well-being.24 Likewise, Matthews characterised neglect as omissions in care resulting in significant harm or risk of significant harm. Types of neglect are categorised into physical, educational, emotional and social neglect.

No studies have been conducted to date on athletes’ experiences of neglect in sport. However, when considering long-term health consequences resulting from intensive training or competition in sport (eg, overuse injuries/delay in maturation) as potential maltreatments,2 33 they may be best categorised as non-relational maltreatments but could be considered as neglect if a person within a critical relationship role over the athlete (eg, coach/parent) is aware of the occurrence of harm resulting from an overuse injury or delay in maturation, and recklessly disregards the athlete’s well-being by forcing them to perform activities that may enhance the problem, or by discouraging them from seeking healthcare.

Non-relational maltreatment

Other forms of maltreatment that do not occur within critical relationships are referred to as non-relational maltreatments and include, for example: harassment, bullying, corruption/exploitation, sexual exploitation/prostitution, institutional maltreatment, child labour and abuse/assault by persons not known closely or not within a critical relationship with the individual. Non-critical relationships in sport may include, for example, the relationship of an athlete with a coach, teammate, official, sport administrator or the sport organisation. This section will review the non-relational maltreatments of institutional maltreatment, child labour, harassment and bullying in sport. A summary of these non-relational maltreatments can be seen in tables 5–8.

Institutional maltreatment

Institutional maltreatment involves the abusive or neglectful experience of a child by a child-serving institution.34 Examples of institutional maltreatment include the failure of an institution to meet appropriate standards of care, or when the core practices of an organisation are abusive.

Although not explicitly defined as institutional maltreatment, researchers have criticised several aspects of organised sport for having potentially detrimental implications on athletes’ well-being. One of the greatest criticisms of organised sport has been the prevailing climate of competition. Pooley suggested that within the competitive sport model, the average or moderate athletes are discriminated against.35 It has been suggested that competitive sport can negatively affect the mental health of athletes as evident in their significant levels of reported stress.36 37 Also, competitive sport has been reported to make athletes vulnerable to other forms of abuse when the goal of winning overshadows other reasons for participating in sport.38

Other criticisms of sport, which could fall under the category of institutional maltreatment, include the literature on authorised sport-related injury and violence, and concerns for the development of elite child athletes.2 The risk of athletes’ to injury and the problems of violence in contact sports such as hockey have been well reported.39 40 Additionally, there has been an emerging concern for chronic overuse injuries among elite child athletes,33 which has called into question the practices of the respective sporting institutions on the long-term well-being of sport participants.

Child labour

According to the International Labor Organization, child labour is defined as a child who works for long hours, in dangerous or unhealthy conditions or in an environment where they are exposed to lasting physical or psychological harm.41 In 1973, the International Labor Organization passed the Minimum Age Convention (No 183) stipulating, “The minimum age for admission to employment shall not be less than the age of completion of compulsory schooling.”41 This was followed by the adoption of the Worst Forms of Child Labour Convention (No 182) in 1999, which “calls for immediate and effective measures to secure the prohibition and elimination of the worst forms of child labour which include slavery and similar practices, forced recruitment for use in armed conflict, use in prostitution and pornography, any illicit activity, as well as work which is likely to harm the health, safety and morals of children.”41

Research has criticised the intensive training and competition of children in sport, positioning young elite athletes as child athletic workers.42 It has been reported that in many sports, elite child athletes are encouraged to spend a substantial proportion of their time training and competing,3 43 and previous research has discussed the issue of trafficking child athlete in elite sports, such as the trafficking of young camel jockeys.44 Additionally, related to the issue of elite child athletes as child labourers, it is suggested that in reference to previously presented reports on the long-term health consequences of sport participation,33 if the long-term harm of an athlete was causally linked with their sport participation as a child, and that athlete was rewarded financially or otherwise as a child for their sport participation, then this could also constitute non-bonded child labour.

Harassment

Harassment refers to unwanted or coerced behaviours that are in violation of an individual’s human rights. Harassing behaviours can be directed toward an individual or a group, and are considered to be based upon an abuse of power and trust by a person in a position of authority.45 Harassing behaviours have been defined as any “comment, conduct or gesture directed toward and individual or a group of individuals, which is insulting, intimidating, humiliating, malicious, degrading or offensive.”46 Individuals can experience harassment because of their race or ethnic origin, socio-economic status, culture, age, disability, gender, sexuality or religious beliefs. Distinguishing harassment from abuse is the critical nature of the relationship in which the behaviour occurs. Forms of harassment in sport include, but are not limited to, physical harassment, sexual harassment, emotional harassment, gender harassment, racial harassment and homophobia.

One of the most well-cited investigations of sexual harassment in sport is Kirby and Greaves’s national-level study on sexual harassment and abuse among Canadian Olympians. In this study, of the 266 surveys completed, 19% of the athletes complained of experiencing upsetting sexual comments or advances. Additionally, 25% of the respondents reported being insulted, ridiculed, made to feel like a bad person, slapped, hit or beaten by these authority figures.47 Similarly, Volkwein administered a survey to 210 American female college athletes from three separate campuses representing Divisions I, II and III of the National Collegiate Athletic Association (NCAA) and reported that over 18% of respondents had experienced derogatory remarks or sexist jokes from their coach, and 2% reported verbal or physical sexual advances of their coach.48 Furthermore, harassment experiences related to sport were reported by 14% of 301 surveyed Israeli female student-athletes.49

Bullying

Bullying includes physical, verbal or psychological attacks or intimidations that are intended to cause fear, distress or harm to the victim. Like abuse and harassment, bullying is based upon an imbalance of power, with a more powerful individual oppressing the less powerful one. It includes an absence of provocation by the victim, and repeated incidents between the same individuals over a prolonged period of time.50 Discerning bullying from harassing and abusive behaviours, it is suggested that bullying occurs in non-critical peer–peer relationships. There is still often a power imbalance in these relationships, but the bully is not in an officially prescribed position of authority over the victim. Examples of bullying behaviour are categorised into physical, emotional and social bullying behaviours.

Arguably the most common form of bullying researched in sport is athletes’ experiences of hazing, defined as “any humiliating or dangerous activity expected of someone to join a group regardless of willingness to participate.”51 Hazing activities reported in sport include being yelled at, cursed at, forced to associate with specific people, acting as a personal servant, being forced to drink excessively, destruction or theft of property and simulation of sexual acts.52 In 1999, 10 000 athletes representing 224 NCAA Colleges were surveyed on their experiences of hazing in the athletic environment. Results indicated that 68% of respondents reported being involved in a humiliating or degrading sport initiation activity. Fifty-seven per cent were involved in an initiation activity involving alcohol, and 27% of the respondents partook in hazing activities that had a high chance of injury, danger or criminal implications.53 In 2005, Hinkle reported that of the 284 university student-athletes surveyed, 29% had experienced some form of hazing. Subsequent interviews suggested the experience of hazing is often downplayed, rationalised and justified by athletes, and the athletes’ commitment to their sport and identity contributed to their acceptance of their hazing experience.52 Similarly, McGlone examined the prevalence of hazing in NCAA women’s athletics. In this study, 48.5% of the athletes had reported they had been hazed, and 38.7% reported awareness of hazing occurring on other women’s teams in their athletic institution. Mental and alcohol related hazing were the most common types of hazing reported, and team-sports were found to have a significantly higher prevalence of hazing compared with non-team sports.54

Future directions

Overall, when reviewing the literature on maltreatment in sport, several recommendations are made for future research. It has been previously suggested that research aimed at advancing abuse and violence prevention initiatives should proceed through the following five stages: (1) identify the nature of the problem; (2) clarify risk and protective factors; (3) design and pilot test interventions; (4) conduct clinical trials to evaluate intervention; and (5) facilitate large-scale implementation.55 This model will be used to guide the recommendations for future research on maltreatment in sport.

Criticisms of problematic behaviours in the sport domain have been expressed by researchers for a period of time, but it is only recently that athletes’ experiences of these behaviours have been delineated as maltreatment in sport. As reviewed above, there has been a series of papers published outlining the problems of sexual abuse in sport, a few articles on emotional abuse, child labour, harassment and bullying, and no empirical papers on physical abuse, neglect or institutional maltreatment in sport. While the research published to date has contributed significantly to the sport literature by reporting the occurrence of these problems, further advancement is required in several areas including explorations of the processes through which the various maltreatments occur, and the short- and long- term implications of these maltreatments on both the personal and professional well-being of the athlete.

Attainment of prevalence data on the widespread nature of maltreatment in sport is warranted. It is the author’s supposition that even if only one athlete, coach, parent or official is maltreated in sport, it constitutes a problem. Thus, prevalence data are irrelevant for defining the importance of the problem but are required in order to assess the nature of the different maltreatments comparatively, over time, and relative to specific prevention and intervention initiatives. That being said, of the studies conducted to date on maltreatment prevalence in sport, transferability of the reported data may be limited for several reasons. The significant range in reported prevalence of sexual abuse (2–42%) and hazing (29–69%) suggests a need for standardisation in measurement. Furthermore, with the exception of Fasting et al, who reported a response rate over 80%,14 most prevalence studies on maltreatment in sport have reported much lower responses. One suggestion made by Fasting et al for their unusually high response rate was the inclusion of questions about other aspects of the athletes’ sport participation beyond their experiences of abuse.14 It is therefore suggested that future prevalence studies should consider examining athletes’ experiences of maltreatment within broader research perspectives.

The next step is to identify factors of risk and resilience to maltreatment in sport so that these variables may be addressed in future prevention programmes. Several studies have elucidated factors of risk to the sexual abuse of athletes,5 15 16 17 18 20 but risk factors to other maltreatments in sport have not been examined. Research on factors of risk should examine predisposing variables in sport, intrinsic variables to the victim(s) and perpetrator(s), and environmental factors. Among other variables, research should examine the relationship between age, gender, race, ethnicity, sexuality, disability, sport type, level of competition, stage of career and period of competitive season, with the frequency, duration and intensity of each of the maltreatments in sport. The impact of an athlete’s personal relationships with parents, teammates and coaches on their vulnerability to maltreatment would be a fruitful line of enquiry. Protective and resilience factors at all levels of the sporting spectrum (micro–marco) should be considered. Also, research on the impact of a maltreated experience as risk for another type of maltreatment, and the interrelation of risk between maltreatments is required.

The development of a prevention and intervention initiative would ideally include the inter-relation of the four components of advocacy, policy, education and research. A key component to the development and implementation of any form athlete protection initiative would be that it is empirically informed and tested. Research is required collaboratively on best methods for prevention, intervention and treatment. More specifically, it is suggested that the evaluation of developed political and educational responses should consider such aspects as content, knowledge acquisition, behavioural change and barriers to protection. Pilot testing of established interventions should occur, along with a continued empirical evaluation of interventions over time.

Conclusions

The consistency of athlete maltreatment terminology among researchers is paramount in order to ensure the transferability of data both between studies and over time. This paper reviewed the literature to date on the various maltreatments in sport and proposed a conceptual framework to be used among research practitioners. After reviewing the literature, several recommendations were posed for future research. Ultimately, once standardisation of definitions and measures of maltreatment in the athletic environment is achieved, the impact of collaborative research pursuits on the prevention of maltreatment in sport is limitless.