Context:

Increased attention continues to be placed on best practices for assisting studentathletes who show symptoms of a mental health illness. One of the most common mental health issues for student-athletes is feeling overwhelmed or anxious. Early recognition of these symptoms can assist the student-athlete in finding early intervention. Objective:

To elucidate specific attributes associated with increased likelihood of anxiety symptoms and treatment avoidance, to help practitioners (i.e. athletic trainers) better-identify and assist high-risk individuals. Design:

Cross-sectional study. Setting:

United States colleges and universities. Patients of Other Participants:

Varsity athletes (n=51,882) who completed the National College Health Assessment (NCHA) between 2011 and 2019. Main Outcome Measures:

Survey responses (self-report) to questions related to anxiety symptoms and disorders cross-sectioned into eight predictors: year in school, gender, sexual orientation, race/ethnicity, school type, international student, history of mental health illness anxiety of impending academic performance. Results:

Over three-fourths the of student-athletes reported an overwhelming feeling with all that they had to do in their daily activities, while only half of the student-athletes reported overwhelming anxiety as a symptom. Gender, sexual orientation, and race/ethnicity had a large effect on these two symptoms. However, of the student-athletes who reported overwhelming anxiety as a symptom only one-fourth of those student-athletes reported receiving a diagnosis for anxiety and/or received treatment for anxiety. Conclusions:

Factors like year in school and availability of mental health information appeared to have little impact. Others including gender, sexual orientation, race/ethnicity, school type, and prior mental health treatment had important effects on the experience of anxiety-related symptoms and the propensity to seek treatment. The present study provides additional evidence that the stresses Online First 2 placed on college student-athletes frequently lead to feelings of being overwhelmed and, eventually, anxiety disorder diagnoses. However, most student-athletes experiencing anxietyrelated symptoms still do not seek diagnosis/treatment.