Psychological interventions for competitive anxiety and emotional regulation in athletes: a quality-appraised, mechanism-oriented systematic review

Abstract

This systematic review adheres to the PRISMA 2020 framework to synthesize psychological interventions for competitive anxiety in athletes, addressing the fragmented nature of prior research. Following a search of Scopus for English literature covering anxiety, emotion regulation, mindfulness, relaxation, breathing, imagery, and self-talk across 865 initial records, studies were screened and evaluated using FICO criteria. Ultimately, 50 studies published between 2021 and 2026 met all quality standards for final analysis. The findings reveal that mindfulness-based interventions—particularly programs like Mindful Sport Performance Enhancement—deliver the most stable and consistent effects in alleviating both cognitive worries and physical tension. Additionally, multi-week imagery and relaxation techniques yield reliable improvements, while multi-module comprehensive programs further enhance psychological resilience and self-confidence under pressure. These insights provide coaches and sports psychologists with evidence-based foundations for pre-competition preparation, while future research should prioritize large-scale randomized controlled trials, standardized anxiety measurement tools, and extended long-term follow-up monitoring.

Keywords
  • Competitive anxiety
  • Emotion regulation
  • Mindfulness
  • Mental skills training
  • Athletes
References
  1. Alkasasbeh, W.J., Grivas, G.V., & Amawi, A.T. (2026). Integrative psychological interventions for stress regulation in sport: a mini-review. Frontiers in Sports and Active Living, 8. https://doi.org/10.3389/fspor.2026.1798062
  2. Aouani, H., Selmi, W., Hammami, A., Ceylan H.İ., Hammami, R., Bayrakdaroğlu, S., Bayrakdaroğlu, Y., Uluç, E.A., Raul-Ioan, M., Uluç, S., & Valentina, S. (2024). Meditative pathways to emotional intelligence in athletes: narrative review study. Journal of Men's Health, 20(9), 25–31. https://doi.org/10.22514/jomh.2024.145
  3. Aulia, P., Puspasari, D., Maharani, P., Safitri, S.N., Yulitri, S., Rahmah, J.H., Hazizah, I.Z., & Dani, F.R. (2025). The effectiveness of self-talk to increase self-confidence, emotional regulation and motivation in athletes. Retos, 65, 285–292. https://doi.org/10.47197/retos.v65.112325
  4. Battaglini, M.P., Pessôa Filho, D.M., Calais, S.L., Miyazaki M.C.O.S., Neiva, C.M., Espada, M.C., de Moraes, M.G., & Verardi C.E.L. (2022). Analysis of Progressive Muscle Relaxation on Psychophysiological Variables in Basketball Athletes. International Journal of Environmental Research and Public Health, 19(24). https://doi.org/10.3390/ijerph192417065
  5. Beenen, K.T., Vosters, J.A., & Patel, D.R. (2025). Sport-related performance anxiety in young athletes: a clinical practice review. Translational Pediatrics, 14(1), 127–138. https://doi.org/10.21037/tp-24-258
  6. Chang, Y.-K., Gill, D.L., Creswell, J.D., Chen, D.-T., Lin, C.-Y., Chu, C.-H., & Nien, J.-T. (2023). Effect of mindfulness-based intervention on endurance performance under pressure and performance-relevant mental attributes an interdisciplinary perspective: Protocol for a mindfulness-based peak performance (MBPP) trial. Contemporary Clinical Trials, 129. https://doi.org/10.1016/j.cct.2023.107175
  7. Dana, A., Shahir, V.A., & Ghorbani, S. (2022). The impact of Mindfulness and Mental Skills Protocols on Athletes' Competitive Anxiety. Biomedical Human Kinetics, 14(1), 135–142. https://doi.org/10.2478/bhk-2022-0017
  8. Desai, V., Stambulic, T., Grounds, R., Lea, J., & Westerberg, B.D. (2025). A Scoping Review of Mental Practice in Athletes: How can Surgeons Learn?. Journal of Surgical Education, 82(1). https://doi.org/10.1016/j.jsurg.2024.103336
  9. Di Corrado, D., Tortella, P., Coco, M., Messina, G., Campoli, F., & Parisi, M.C. (2026). Effects of Personalized Mental Imagery Training on Anger Expression and Resilience in Adolescent Rugby Players: A Controlled Study. Children, 13(2). https://doi.org/10.3390/children13020249
  10. Dugas, J., Ernst, N., & Nield, L.S. (2025). Self-Administered Relaxation Techniques Improving Postconcussive Mood Symptoms in an Appalachian Population. Southern Medical Journal, 118(9), 602–605. https://doi.org/10.14423/SMJ.0000000000001874
  11. Edmizal, E., Donie, Barlian, E., Welis, W., Sin, T.H., Umar, Padli, Ahmed, M., Haryanto, J., & Bhatnagar, P. (2025). Effect of psychological skills training on reaction time and strategic thinking in competitive badminton - a systematic review. Retos, 62, 439–453. https://doi.org/10.47197/retos.v62.110746
  12. Fekih, S., Zguira, M.S., Koubaa, A., Bettaieb, A., Hajji, J., Bragazzi, N.L., & Jarraya, M. (2021). Effects of Mental Training Through Imagery on the Competitive Anxiety of Adolescent Tennis Players Fasting During Ramadan: A Randomized, Controlled Experimental Study. Frontiers in Nutrition, 8. https://doi.org/10.3389/fnut.2021.713296
  13. Fernández-Barradas, E.Y., Reynoso-Sánchez, L.F., Herrera-Meza, S., López-Walle, J.M., & Martínez-Moreno, A.G. (2026). Slow paced breathing and power posing: a pre-competitive ritual during an American football season. Frontiers in Sports and Active Living, 8. https://doi.org/10.3389/fspor.2026.1800382
  14. Gao, Y., Shi, L., Fu, N., Yang, N., Weeks-Gariepy, T., & Mao, Y. (2024). Mobile-Delivered Mindfulness Intervention on Anxiety Level Among College Athletes: Randomized Controlled Trial. Journal of Medical Internet Research, 26(1). https://doi.org/10.2196/40406
  15. Garg, S., Uriegas, N.A., Winkelmann, Z.K., Adams, M., & Fraley, A.L. (2024). Effect of Mindful Sport Performance Enhancement in College Athletes for Reducing Sports-Caused Anxiety and Improving Self-Awareness: A Critically Appraised Topic. International Journal of Athletic Therapy and Training, 29(5), 235–239. https://doi.org/10.1123/ijatt.2023-0054
  16. Gómez-Landero, L.A., Santos-Rosa, F.J., Reguera-López-de-la-Osa, X., & Cervelló, E. (2026). Do Different Interdependencies within a Sport Affect the Perceived Motivational Climate, Use of Spontaneous Self-Talk, Positivity or Precompetitive Anxiety?. Journal of Human Kinetics, 102, 227–240. https://doi.org/10.5114/jhk/204776
  17. Goumni, C., Tannoubi, A., Hawani, A., Khalifa, R., Srem-Sai, M., Hagan, J.E., & Geantă, V.A. (2026). Effects of an 8-week Mindfulness–Acceptance–Commitment intervention on competitive anxiety, mindfulness, and 200-m sprint performance in junior female sprinters: a quasi-experimental study. Sport Sciences for Health, 22(3). https://doi.org/10.1007/s11332-026-01931-2
  18. Grilli Cadieux, E., Gemme, C., & Dupuis, G. (2021). Effects of Yoga Interventions on Psychological Health and Performance of Competitive Athletes: A Systematic Review. Journal of Science in Sport and Exercise, 3(2), 158–166. https://doi.org/10.1007/s42978-020-00104-y
  19. Kelemen, B., Tóth, R., Benczenleitner, O., & Tóth, L. (2025). Effects of group mindfulness intervention on high-level distance runners: a quasi-experimental study. Frontiers in Sports and Active Living, 7. https://doi.org/10.3389/fspor.2025.1556404
  20. Khaleghi, B., Sheykhzadeh, G.R., Derakhshan, S., & Eyni, S. (2025). Mental toughness and competitive state anxiety in Iranian adolescent athletes: the mediating role of emotional self-efficacy and mindfulness. Sport Sciences for Health, 21(3), 1837–1846. https://doi.org/10.1007/s11332-025-01411-z
  21. Konstantinou, G.N., Kloiber, S., & Blumberger, D.M. (2025). The Mental Game of Tennis: A Scoping Review and the Introduction of the Resilience Racket Model. Sports, 13(5). https://doi.org/10.3390/sports13050130
  22. Kumenap, E.E., Makadada, F.A., Perdana, G.S., Geantă, V.A., & Ilham (2025). Validation and reliability of a visualization and relaxation exercise program for enhancing speed climbing performance. Retos, 63, 1045–1053. https://doi.org/10.47197/retos.v63.111162
  23. Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
  24. Li, L., Wang, J., Li, Q., & Fu, Q. (2026). The Effect of Different Psychological Interventions on Athletes' Competitive Anxiety: A Systematic Review and Bayesian Network Meta-Analysis. Sports Medicine – Open, 12(1). https://doi.org/10.1186/s40798-026-01007-y
  25. Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., Gøtzsche, P.C., Ioannidis, J.P.A., Clarke, M., Devereaux, P.J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Journal of Clinical Epidemiology, 62(10), e1–e34. https://doi.org/10.1016/j.jclinepi.2009.06.006
  26. Ma, Y., & Mumtaz, S. (2025). The long-term mental health benefits of exercise training for physical education students: a comprehensive review of neurobiological, psychological, and social effects. Frontiers in Psychiatry, 16. https://doi.org/10.3389/fpsyt.2025.1678367
  27. Mascarenhas D.A.M., Mathias, E.G., L, A., S, I., K G, V., Kannanayakkal, A., V, G., & K, K.P. (2026). Mapping the evidence on mindful sport performance enhancement (MSPE) and its influence on flow, performance, and mental health in athletes: A scoping review. Performance Enhancement and Health, 14(2). https://doi.org/10.1016/j.peh.2026.100419
  28. McDuff, D.R., Garvin, M., & Marsalis, R. (2025). Perspectives on performance anxiety in young athletes and dancers. Sports Psychiatry, 4(3), 159–166. https://doi.org/10.1024/2674-0052/a000114
  29. Merlin, Q., Vacher, P., Martinent, G., & Nicolas, M. (2024). Youth Athletes' Self-Esteem: The Impact of Integrated Psychological Skills Training. Pediatric Exercise Science, 36(4), 265–273. https://doi.org/10.1123/pes.2024-0005
  30. Mun Ho, C., Mohd Kassim, M.A., Kamu, A., Pang N.T.P., Volpe, U., & Orsolini, L. (2026). A five-decade bibliometric review of interventions for performance anxiety in sports: Key themes and future directions. Sports Psychiatry, 5(1), 21–29. https://doi.org/10.1024/2674-0052/a000120
  31. Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., Brennan, S.E., Chou, R., Glanville, J., Grimshaw, J.M., Hróbjartsson, A., Lalu, M.M., Li, T., Loder, E.W., Mayo-Wilson, E., McDonald, S., McGuinness, L.A., Stewart, L.A., Thomas, J., Tricco, A.C., Welch, V.A., Whiting, P., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
  32. Paley, C.A., & Johnson, M.I. (2025). Human Resilience and Pain Coping Strategies: A Review of the Literature Giving Insights from Elite Ultra-Endurance Athletes for Sports Science, Medicine and Society. Sports Medicine, 55(9), 2137–2146. https://doi.org/10.1007/s40279-025-02277-4
  33. Park, I., & Jeon, J. (2023). Psychological Skills Training for Athletes in Sports: Web of Science Bibliometric Analysis. Healthcare (Switzerland), 11(2). https://doi.org/10.3390/healthcare11020259
  34. Piepiora, P.A., Jurczyk, J.B., & Vveinhardt, J. (2024). Mental preparation of karateka for sports competition in kata. Frontiers in Sports and Active Living, 6. https://doi.org/10.3389/fspor.2024.1525853
  35. Piri, N., Ihsan, F., Makadada, F.A., & Pandeleke, T. (2026). The role of mental exercise in optimizing athlete performance: A systematic review of cognitive and psychological interventions. Sport TK, 15(7), 1–19. https://doi.org/10.6018/sportk.640081
  36. Pradani, W.H., Guspa, A., Hidayati, I., Rahayu, W.F., & Oktarisa, F. (2025). Trends and Knowledge Base of Positive Self-Talk Research in Sport over a 30-Year Publication History: A Bibliometric Analysis Study. International Journal of Human Movement and Sports Sciences, 13(4), 830–840. https://doi.org/10.13189/saj.2025.130419
  37. Qi, F., Soh, K.G., Mohd Nasirudddin, N.J., & Mai, Y. (2022). Effects of taichi on physical and psychological health of college students: A systematic review. Frontiers in Physiology, 13. https://doi.org/10.3389/fphys.2022.1008604
  38. Reklaitiene, D., & Vveinhardt, J. (2025). Mindfulness and Emotional Intelligence as Predictors of Psychological Well-Being in Athletes with Disabilities. Sports, 13(11). https://doi.org/10.3390/sports13110389
  39. Saha, S., Pahan, M.K., Karmakar, D., Kaur G.I.J., & Gurjar, R. (2025). Psycho-yogic training and its effects on the psychological well-being of underperforming female athletes. Journal of Bodywork and Movement Therapies, 45, 639–644. https://doi.org/10.1016/j.jbmt.2025.09.043
  40. Sánchez-Ruiz, R., Gil-Caselles, L., García-Naveira, A., Arbinaga, F., Ruiz-Barquín, R., & Olmedilla-Zafra, A. (2025). Competitive Anxiety, Sports Injury, and Playing Category in Youth Soccer Players. Children, 12(8). https://doi.org/10.3390/children12081094
  41. Sánchez-Sánchez, L.C., Franco, C., Amutio, A., García-Silva, J., & González-Hernández, J. (2023). Influence of Mindfulness on Levels of Impulsiveness, Moods and Pre-Competition Anxiety in Athletes of Different Sports. Healthcare (Switzerland), 11(6). https://doi.org/10.3390/healthcare11060898
  42. Schweickle, M.J., Appaneal, R.N., Jackman, P.C., Minahan, C.L., Moyle, G.M., Pickering, C., Stewart, D., Vella, S.A., & Swann, C. (2026). Performance Under Pressure in Sport: A Position Statement from Exercise and Sports Science Australia (ESSA). Sports Medicine, 56(8), 1851–1867. https://doi.org/10.1007/s40279-026-02472-x
  43. Sharma, A., & Prasad, B.K. (2023). Effect of VMBR training on psychological dimensions of anxiety and mental toughness of table tennis players. Physical Education Theory and Methodology, 23(1), 28–34. https://doi.org/10.17309/tmfv.2023.1.04
  44. Singh, D., Kalra, S., Mohammad, M., Munjal, J., Danish, M., & Ajmera, P. (2025). Effect of yoga on selected performance metrics and mental health of track and field athletes: A systematic review. Journal of Bodywork and Movement Therapies, 45, 199–205. https://doi.org/10.1016/j.jbmt.2025.08.006
  45. Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. https://doi.org/10.1186/1471-2288-8-45
  46. Timea, B.M., Carmen C.-B., Nicolae, O.M., Nicola, M., Teodor, G.V., Maria, S.A., Cornelia, P., Hervás-Gómez, C., Florina, G.E., & Dan, M. (2025). Effects of the SmartACT Intervention on Motor and Psychological Variables in Adolescent Athletes: A Controlled Trial Using BlazePod and Microgate. Children, 12(10). https://doi.org/10.3390/children12101338
  47. Tingaz, E.O. (2025). Effects of brief online mindful sport performance enhancement on athletes' mental health, emotion regulation, and performance: A mixed-methods randomized controlled trial. International Journal of Sports Medicine, 46(10), 768–779. https://doi.org/10.1055/a-2602-9082
  48. Trandafirescu E.-A., Potop, V., Mihai, I., Fleancu, J.L., Cojanu, F., & Trandafirescu, G. (2024). Dribbling emotions and anxiety in women's football: a scoping review. Pedagogy of Physical Culture and Sports, 28(6), 479–488. https://doi.org/10.15561/26649837.2024.0602
  49. Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence-informed management knowledge by means of systematic review. British Journal of Management, 14(3), 207–222. https://doi.org/10.1111/1467-8551.00375
  50. Vella-Fondacaro, D., & Romano-Smith, S. (2023). The Impact of a Psychological Skills Training and Mindfulness-Based Intervention on the Mental Toughness, Competitive Anxiety, and Coping Skills of Futsal Players - A Longitudinal Convergent Mixed-Methods Design. Sports, 11(9). https://doi.org/10.3390/sports11090162
  51. Ventaja-Cruz, J., Cuevas Rincón, J.M., Tejada-Medina, V., & Martín-Moya, R. (2025). Psychological determinants of performance in women's football: a systematic review on resilience, anxiety, motivation and cohesion. Retos, 64, 242–253. https://doi.org/10.47197/retos.v64.111614
  52. Villodres, G.C., Rodríguez-Mérida, M., Vizcaíno-Cuenca, R., & Muros, J.J. (2026). Effectiveness of Physical Education Interventions on Mental Health in Children and Adolescents: A Systematic Review of Wellbeing and Distress Across Educational Levels. Adolescent Research Review, 11(2), 385–413. https://doi.org/10.1007/s40894-025-00276-0
  53. Vinu, W., Sivachandiran, S., Ajmal, P.M., Ashif Ali, N.K., Safad, A.K., Shareef, K.K., Aravind, M.K., & Kabeer, D.A. (2025). Anxiety and mental toughness in football players: a study of the Kerala Premier League and women's Kerala Premier League. Retos, 66, 1025–1036. https://doi.org/10.47197/retos.v66.112785
  54. Warfield, E., Esposito, P., & Braun-Trocchio, R. (2023). Differences in Relaxation and Imagery among NCAA Division I Sport Types. Sports, 11(11). https://doi.org/10.3390/sports11110224
  55. Zhang, H., & Liu, M. (2026). Enhancing Taekwondo practitioners' wellness with the assessment of mental capabilities. Science and Sports, 41(4), 362–374. https://doi.org/10.1016/j.scispo.2025.12.004