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.
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