Date of Award

Spring 2019

Document Type

Thesis Restricted

Degree Name

Master of Science (MS)


Athletic Training – Post Professional Concentration

Committee Chairperson

Lindsey Keenan, PhD, LAT, ATC

Committee Member

Rachel Daltry, PsyD

Committee Member

Emily Duckett, MS, LAT, ATC


Context: The purpose of this study was to provide the optimal cut-off score for a depression screening tool in the collegiate student-athlete population, and to determine the prevalence of depression symptoms in the sample. Methods: A total of 882 participants at two NCAA Division II universities (mean age 19.68 ± 1.41 years; 48.5% male, 51.5% female) completed a depression screening tool, the Patient Health Questionnaire-9 (PHQ-9), during their pre-participation exam (PPE). Based on a random stratified sampling technique, 290 student-athletes completed asemi-structured neuropsychiatric interviewwithin two weeks of their PPE. The interview served as a reference standard for meeting diagnostic criteria for major depressive disorder. The receiver operating characteristic (ROC) curve was used to identify the area under the curve (AUC) and sensitivity and specificity of individual cut-off scores. Descriptive statistics were used to determine the prevalence of depressive symptoms. Results: The mean PHQ-9 score was 2.14 ± 3.14. The area under the ROC curve was 0.811 (95% CI = .707, .915). A cut-off score of 6 was found to maximize diagnostic accuracy, with a sensitivity of 0.78 and a specificity of 0.75. Using this cut-off score, the prevalence of clinically relevant depression symptoms in this sample was 13.4% (n = 118), compared to 4.0% (n = 35) when using the cut-off score of 10, which is the established score for the general population. Conclusions: The results of this study suggest the optimal cut-off score in student-athletes is lower than the recommended cut-off score in the general population.