The four-time Olympic champion Simone Biles has pulled out of Thursday’s all-around gymnastics competition as she struggles with a mental-health issue. USA Gymnastics said Biles might still take part in next week’s individual event finals. “After further medical evaluation, Simone Biles has withdrawn from the final individual all-around competition at the Tokyo Olympic Games, in order to focus on her mental health,” it said. “We wholeheartedly support Simone’s decision and applaud her bravery in prioritizing her well-being. Her courage shows, yet again, why she is a role model for so many.”

Biles sensationally pulled out of the team event on Tuesday after a faltering opening vault, leaving her teammates in a losing battle against the Russians for the gold medal, but said afterward that she was “just dealing with things internally that will get fixed in the next couple of days” and would defend the all-around title she won in Rio de Janeiro. She will be replaced on Thursday by Jade Carrey, the ninth-highest scorer in the qualifiers.