Cyclic patterns of high-risk behaviours within ballet culture.

Background: To determine whether a sample of pre-professionally trained, professional, and retired ballet dancers experienced body dysmorphia, eating disorders (EDs), perfectionism, Obsessive-Compulsive Disorder (OCD), anxiety, depression, substance use, sexual abuse, and injuries within ballet culture.

Methods: A total of 10 female ballet dancers aged 18-25 years of age participated in a structured interview either in-person or online via Zoom. Interview questions were open-ended to capture the richness of participant responses. The Exercise Science Thematic Analysis Model was utilized to analyze the participant responses. This study used a semantic focus and what has been described as a 'top-up' or deductive approach. The purpose of the study was to determine whether body dysmorphia, EDs, perfectionism, OCD, anxiety, depression, substance use, sexual abuse, and injuries were described in the participant narrative.

Results: Participant responses were organized into the following categories: the overarching theme, themes, sub-themes, level one emerging themes (emergent in > or = 5 participant responses), and level two emerging themes (emergent in < 5 participant responses). The overarching theme was cyclic trauma with two themes: lack of control/inconsistency/instability and perfectionism. Subthemes included body dysmorphia and EDs, mental health, injuries, sexual violence and substance use. The majority of the participants (60%) expressed feeling a of lack of control, instability, and/or inconsistency in the ballet world. Eight out of ten (80%) participants provided responses consistent with perfectionism. All participants stated that the subthemes body dysmorphia/EDs, mental health, and sexual violence were problematic in ballet culture. Injuries emerged as a subtheme in 70% of interviews and substance use was mentioned by 30% of participants although no participants had first-hand experience with substance use in the context of ballet. Complex-Post Traumatic Stress Disorder (C-PTSD) emerged as a theme which was unexpected and thus, requires further exploration in future research with ballet dancers.

Conclusions: The findings of this study indicate that ballet environments expose dancers to several health risk factors. Steps should be taken to reduce the risk of harm associated with these health risk factors.