Psychological resilience and the athlete mental health continuum: serial indirect associations through emotion regulation and sport anxiety

BMC Sports Science Medicine and Rehabilitation, 2026

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.1186/s13102-026-02157-y
Data confidence 70 medium
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Abstract

Abstract Background Psychological resilience has been consistently associated with athletes’ mental health and psychological well-being. However, the emotional and anxiety-related processes involved in the association between psychological resilience and the Athlete Mental Health Continuum remain insufficiently understood. Emotion regulation and sport anxiety may represent interrelated psychological variables associated with this relationship in competitive sport settings. Objective This study aimed to examine the associations among psychological resilience, emotion regulation, sport anxiety, and the Athlete Mental Health Continuum and to evaluate a theory-informed serial indirect-association model involving emotion regulation and sport anxiety. Methods A cross-sectional research design was employed. The study included 850 athletes actively engaged in individual and team sports in Türkiye. Data were collected using the Psychological Resilience Scale, Emotion Regulation Scale, Sport Anxiety Scale, and Athlete Mental Health Continuum Scale. A serial mediation analysis was conducted using the PROCESS Macro Model 6 with 5,000 bootstrap resamples. Because the data were cross-sectional, the model was interpreted as a theory-informed pattern of direct and indirect associations rather than evidence of temporal or causal relationships. Results Psychological resilience was positively associated with emotion regulation (r = .118, p < .001) and the Athlete Mental Health Continuum (r = .134, p < .001), and negatively associated with sport anxiety (r = -.147, p < .001). Within the regression-based serial mediation model, psychological resilience was positively associated with emotion regulation (B = .46, p < .001) and negatively associated with sport anxiety (B = -.31, p < .001). Emotion regulation was positively associated with athlete mental health continuum (B = .18, p < .001), whereas sport anxiety was negatively associated with athlete mental health continuum (B = -.51, p < .001). Bootstrap analyses indicated statistically significant indirect associations through emotion regulation (B = .08, 95% CI [.03, .16]), sport anxiety (B = .16, 95% CI [.06, .28]), and the theory-specified serial pathway involving emotion regulation and sport anxiety (B = .020, 95% CI [.006, .042]). Conclusions Psychological resilience, emotion regulation, and sport anxiety showed significant direct and indirect associations with the Athlete Mental Health Continuum. By distinguishing a general psychological resource, a self-regulatory process, and a sport-specific emotional response, the model provides an integrated framework for understanding athlete mental health beyond separate bivariate associations. The findings were statistically consistent with the theory-informed ordering examined in the study; however, the cross-sectional design does not establish temporal sequence or causality. Longitudinal and experimental research is needed to determine whether the observed associations reflect temporal or causal processes.