On what motivates us: a detailed review of intrinsic v. extrinsic motivation

Self-determination, motivation and burnout among residents in Lebanon

In the highly stressful environment of graduate medical residency, residents often grapple with anxiety, depression, and burnout. Those with intrinsic motivation, self-determination (SD), effective coping skills, and mindfulness may exhibit resilience against burnout and its negative effects on well-being. Using the SD theory framework, our study aims to explore the intricate relationship between motivation, stressors, and individual traits, aiming to predict burnout and mental distress among residents in training. We collected data from multispecialty residents through standardized questionnaires assessing SD, motivation, burnout, and mental distress. Structural equation models (SEM) were employed, on subsamples of high and low SD; model fits were checked. Various forms of motivation were tested as mediators between stressors, personality, and the three dimensions of burnout. In the overall sample of 112 participants, extrinsic motivation fully mediates the relation between stressors and low sense of personal accomplishment (indirect Beta = 0.02; p = 0.04). In the introject model, motivation fully mediates the relation between maladaptive coping and depersonalization (indirect Beta = 0.10; p = 0.03). In the intrinsic motivation model, motivation fully mediates the relation between adaptive (indirect Beta = 0.13; p < 0.001), maladaptive coping (indirect Beta = - 0.15; p = 0.01) and depersonalization (indirect Beta = - 0.31; p > 0.001). Among the low SD subgroup, a full mediation effect was found for extrinsic motivation between stressors and depersonalization (indirect Beta = 0.07; p = 0.027) and for intrinsic motivation between adaptive coping and depersonalization (indirect Beta = 0.150; p = 0.014). In the high SD subgroup, mindfulness has a moderation effect on burnout dimensions, positively on the relation between maladaptive coping and depersonalization and negatively on maladaptive coping and emotional exhaustion in the intrinsic and introject models. In both the low and high SD subgroups, regardless of motivation type, emotional exhaustion correlates with anxiety and depression, while depersonalization negatively correlated with mental distress. The presence of SD moderated the effect of stressors on burnout. Mindfulness plays a crucial role in buffering the effect of maladaptive coping on the various dimensions of burnout, linked in its turn to depression and anxiety symptomatology. Mindfulness also exerts a direct inverse effect on personal exhaustion in the low SD subgroup. Further studies are suggested to confirm these findings.

Unlocking the path to quality maternity care: a qualitative study on work environment dynamics, providers' responsiveness, and professionalism in central region, Malawi

BACKGROUND

Responsiveness and professionalism are essential components of high-quality maternity care. Responsiveness involves effective communication, respectful interactions, and consideration of the emotional, physical, and cultural needs of women, while professionalism encompasses clinical competence, ethical adherence, and respectful engagement with patients and colleagues. However, various workplace factors, including managerial structures, resource constraints, and institutional culture, influence the extent to which maternity care providers uphold these principles. This study aims to explore how organizational culture, management styles, and resource availability influence responsiveness and professionalism in Malawian maternity care settings, with the goal of identifying strategies to enhance provider motivation and improve maternal healthcare delivery.

METHODS

A qualitative study was conducted in two maternity care units in Malawi. Data were collected using Twelve semi-structured interviews, two focus group discussions and sixteen observations with maternity care providers in one faith-based hospital and one government-owned hospital, sampled purposively. Transcripts were imported into NVIVO 14 software, and a reflexive thematic analysis was conducted.

FINDINGS

The study found that limited physical space, resource shortages, and heavy workloads constrained providers' ability to deliver responsive care. Rigid managerial structures, lack of professional recognition, and restricted autonomy contributed to low morale and reluctance to take initiative. Hierarchical power dynamics and inadequate institutional support further discouraged collaboration and accountability. Despite these challenges, providers highlighted the importance of teamwork, mutual support, and a positive work environment in fostering professionalism and responsiveness. Unpredictable work schedules and poor work-life balance also emerged as key concerns, impacting provider well-being and engagement.

CONCLUSION

The study provides insights into the complex interplay of systemic, managerial, and interpersonal factors affecting responsiveness and professionalism in maternity care. Addressing these challenges requires targeted interventions that can strengthen resource allocation, supportive leadership, and policies that promote provider well-being and motivation which can in turn enhance maternal and newborn outcomes.

Comparison of Clinically Meaningful Improvements After Center-Based and Home-Based Telerehabilitation in People With COPD

BACKGROUND

Response to pulmonary rehabilitation is not equal for all participants and may vary across health outcomes for any one individual. Alternative methods of pulmonary rehabilitation delivery, for example, telerehabilitation, may improve program access, but also could affect response to rehabilitation.

RESEARCH QUESTION

What is the rate of clinical response to home-based telerehabilitation compared with center-based pulmonary rehabilitation, and are any participant baseline characteristics associated with pulmonary rehabilitation response relative to the model of delivery?

STUDY DESIGN AND METHODS

In this secondary analysis of 2 randomized controlled trials, participants were categorized as responders or nonresponders according to achievement of the minimal important difference (MID) for each outcome of interest at end rehabilitation and after the 12-month follow-up (change from baseline). Outcomes of interest were functional exercise capacity (6-minute walk distance; MID, 30 m), health-related quality of life (chronic respiratory disease questionnaire: MID, 2.5, 2, 3.5, and 2 points for the dyspnea, fatigue, emotion, and mastery domains, respectively; CRQ total score MID, 10 points); and symptoms (modified Medical Research Council: MID, -1 point).

RESULTS

Two hundred sixty-six individuals with COPD were included in the analysis. The proportion of responders was not different between center-based pulmonary rehabilitation and home-based telerehabilitation at either end rehabilitation or 12-month follow-up for any outcome (range, 39%-62%). In a binary logistic regression analysis, baseline outcome values, but not participant demographic characteristics, were associated most commonly with responder status. The relative risk of program noncompletion in the center-based group was nearly 4 times greater than for telerehabilitation (center-based pulmonary rehabilitation: n = 79 [58%] vs home-based telerehabilitation: n = 116 [90%]; relative risk, 3.89; 95% CI, 2.28-6.63).

INTERPRETATION

In this study, responder status to pulmonary rehabilitation was not different between center-based and home-based telerehabilitation. The ability to identify patient characteristics that confer greater potential for rehabilitation response or better suitability for a particular model of rehabilitation remains a challenge.

Leveraging Generative Artificial Intelligence to Improve Motivation and Retrieval in Higher Education Learners

Unlabelled

Generative artificial intelligence (GenAI) presents novel approaches to enhance motivation, curriculum structure and development, and learning and retrieval processes for both learners and instructors. Though a focus for this emerging technology is academic misconduct, we sought to leverage GenAI in curriculum structure to facilitate educational outcomes. For instructors, GenAI offers new opportunities in course design and management while reducing time requirements to evaluate outcomes and personalizing learner feedback. These include innovative instructional designs such as flipped classrooms and gamification, enriching teaching methodologies with focused and interactive approaches, and team-based exercise development among others. For learners, GenAI offers unprecedented self-directed learning opportunities, improved cognitive engagement, and effective retrieval practices, leading to enhanced autonomy, motivation, and knowledge retention. Though empowering, this evolving landscape has integration challenges and ethical considerations, including accuracy, technological evolution, loss of learner's voice, and socioeconomic disparities. Our experience demonstrates that the responsible application of GenAI's in educational settings will revolutionize learning practices, making education more accessible and tailored, producing positive motivational outcomes for both learners and instructors. Thus, we argue that leveraging GenAI in educational settings will improve outcomes with implications extending from primary through higher and continuing education paradigms.

A taxonomy of athletic values and implications for clinical practice

Introduction

The current study surveyed collegiate student-athletes regarding their perceived level of importance surrounding 30 previously derived and empirically obtained athletic values to improve viability of sport psychological practices.

Methods

A total of 162 student-athletes enrolled in a private Midwestern NCAA Division 1 university within the United States of America completed tasks asking them to sort and rate utilized values based upon perceived importance surrounding athletic performance and sustained excellence.

Results

Results revealed a hierarchy of athletic values, favoring intrinsic values, useable when emphasizing the importance of value-driven behavior in applied sport psychological practices. Minimal differences were seen across gender, ethnicity, sport classification, and other comparative groups.

Discussion

Current results may help inform sport psychological practice while working within value-based frameworks.

The negative aspects of injury on motivation of sports and physical exercise practitioners

Introduction

Injury is an inherent situation in the sports and recreational environment of physical exercise practices. Additionally, injured practitioners might present different motivational drives that may impair the continuity in physical exercise. However, little is known about the motivational profile of injured physical exercise practitioners. The aim of this study is to describe and compare different dimensions of motivation among injured (IG) and non-injured (NIG) physical exercise and sport practitioners.

Methods

A total of 83 participants made part of the study (IG: 52, age: 30.8 ± 8.4 years; NIG: 31, age: 27.5 ± 8.4 years). An ad hoc on-line questionnaire was used, containing sociodemographic information and the Sport Motivation Scale (SMS-II). The SMS-II evaluates different dimensions of motivation based on the tenets of the self-determination theory and was answered by both groups to examine possible differences. The researchers contacted clubs and gyms, as well as online promotions.

Results

In the IG, there was a prevalence of 45% of give-up thoughts and 48% were competing. Also, the IG demonstrated higher median values of demotivation when compared to the NIG, with a small effect size (NIG median: 3.3; IG median: 5.8; p = 0.04, r = 0.26).

Conclusion

We conclude that almost half of the injured practitioners demonstrated give-up thoughts as well as exhibit higher levels of demotivation compared to non-injured ones. Thus, it indicates the need for a rehabilitation approach also focused on motivational issues, to improve overall heath and prevent physical activity drop out.

Improving brain health via the central executive network

Cognitive and physical stress have significant effects on brain health, particularly through their influence on the central executive network (CEN). The CEN, which includes regions such as the dorsolateral prefrontal cortex, anterior cingulate cortex and inferior parietal lobe, is central to managing the demands of cognitively challenging motor tasks. Acute stress can temporarily reduce connectivity within the CEN, leading to impaired cognitive function and emotional states. However a rebound in these states often follows, driven by motivational signals through the mesocortical and mesolimbic pathways, which help sustain inhibitory control and task execution. Chronic exposure to physical and cognitive challenges leads to long-term improvements in CEN functionality. These changes are supported by neurochemical, structural and systemic adaptations, including mechanisms of tissue crosstalk. Myokines, adipokines, anti-inflammatory cytokines and gut-derived metabolites contribute to a biochemical environment that enhances neuroplasticity, reduces neuroinflammation and supports neurotransmitters such as serotonin and dopamine. These processes strengthen CEN connectivity, improve self-regulation and enable individuals to adopt and sustain health-optimizing behaviours. Long-term physical activity not only enhances inhibitory control but also reduces the risk of age-related cognitive decline and neurodegenerative diseases. This review highlights the role of progressive physical stress through exercise as a practical approach to strengthening the CEN and promoting brain health, offering a strategy to improve cognitive resilience and emotional well-being across the lifespan.

Challenges and insights of transferring animal maze studies principles to human spatial learning research

Maze tasks, originally developed in animal research, have become a popular method for studying human cognition, particularly with the advent of virtual reality. However, these experiments frequently rely on simplified environments and tasks, which may not accurately reflect the complexity of real-world situations. Our pilot study aims to transfer a multi-alternative maze with a complex task structure, previously demonstrated to be useful in studying animal cognition, to studying human spatial cognition. The challenges to be resolved at this stage included developing a virtual maze and selecting an appropriate instruction that will elicit processes similar to those observed in animal models. A virtual maze was developed, and two types of instructions were provided to the participants: (1) to collect coins; (2) to interact with the maze in order to draw its structure after the game. The results indicate that a more structured instruction with a clear attainable goal ("collect") prompted more in-depth exploration and engagement with the key elements of the maze, eliciting processes similar to those of animals. While the maze demonstrates promise as a tool for comparative studies, it also has the potential to uncover different aspects of human cognition.

Virtual Reality High-Intensity Interval Training Exergaming Compared to Traditional High-Intensity Circuit Training Among Medical Students: Pilot Crossover Study

Background

This study evaluated the effectiveness of a virtual reality (VR) high-intensity interval training (HIIT) boxing protocol compared to traditional high-intensity circuit training (HICT) in improving exercise motivation, engagement, and physiological responses among 30 healthy medical students.

Objective

The purpose was to compare the VR HIIT protocol, which involved using an Oculus Quest 2 for a futuristic exoskeleton game experience, with a traditional 12-exercise HICT.

Methods

In total, 30 medical students engaged in both VR HIIT, using an Oculus Quest 2 for a futuristic exoskeleton game experience, and a traditional 12-exercise HICT. Metrics included heart rate (HR) and blood lactate levels before and after exercise alongside ratings of perceived exertion and the Situational Motivation Scale.

Results

VR HIIT showed significantly higher mean HR (mean 161, SD 15 vs mean 144, SD 11 bpm; d=1.5; P<.001), peak HR (mean 182, SD 15 vs mean 176, SD 11 bpm; d=0.8; P=.001), and ratings of perceived exertion (mean 16, SD 2 vs mean 15, SD 2; d=0.4; P=.03). Postexercise lactate levels were higher in HICT (mean 8.8, SD 4.5 vs mean 10.6, SD 3.0 mmol/L; d=0.6; P=.006). Intrinsic motivation and other psychological measures showed no significant differences, except for lower fatigue in HICT (d=0.5; P=.02).

Conclusions

VR HIIT significantly enhances physiological parameters while maintaining intrinsic motivation, making it a viable alternative to traditional HICT. However, the short-term nature of this study is a limitation, and future research should explore the long-term engagement and therapeutic impacts of VR exercise in diverse and clinical populations.

The effect of reward and voluntary choice on the motor learning of serial reaction time task

Objective

Reward and voluntary choice facilitate motor skill learning through motivation. However, it remains unclear how their combination influences motor skill learning. The purpose of the present study is to investigate the effects of reward and voluntary choice on motor skill learning in a serial reaction time task (SRTT).

Methods

Participants completed six parts of SRTT, including pre-test, training phase, immediate post-test, a random session, delayed post-test, and retention test on the following day. During the training phase, participants were divided into four groups (reward_choice, reward_no-choice, no-reward_choice, no-reward_no-choice). In the reward condition, participants received reward for correct and faster (than a baseline) responses while those in the no-reward groups did not. For the choice manipulation, participants in the voluntary choice groups chose the color of the target, whereas in the forced choice groups, the same color was assigned by the computer.

Results

The results showed that the four groups did not exhibit any significant differences in reaction time and error rate in the pre-test phase. Importantly, both reward and voluntary choice significantly enhanced sequence-specific learning effects, while no interaction was found. No significant effects of reward and voluntary choice were observed in the retention test.

Conclusions

These findings suggest that reward and voluntary choice enhance motor skill performance and training independently, potentially at the action-selection level, which implies different mechanisms underlying the influences of reward and voluntary choice.

Intrinsic motivations in health and fitness app engagement: A mediation model of entertainment

Objective

This study aims to investigate the intrinsic motivations driving continued usage of health and fitness apps, addressing a gap in the literature where user motivation has received limited attention. The study focuses on the role of entertainment as a mediator between intrinsic motivations and continuance intention, using the Uses and Gratifications Theory as a conceptual framework.

Methods

Data were collected through an online survey of 2869 health and fitness app users in Vietnam. Intrinsic motivations were categorized into challenge, curiosity, fantasy, and social interaction. Hypotheses were tested using SEM, and subgroup analyses were conducted to examine variations across demographic groups.

Results

The findings reveal that entertainment mediates the relationship between intrinsic motivations and continuance intention, with challenge and curiosity being the strongest predictors of sustained app usage. Challenge also demonstrated a direct effect on continuance intention, independent of entertainment. Demographic analysis indicated that males are primarily motivated by challenge and curiosity, while females and higher-income users are driven more by curiosity.

Conclusion

This study highlights the importance of intrinsic motivations in shaping user engagement with health and fitness apps. Practical implications include the need for app developers to design features that align with user motivations, such as gamified challenges, personalized content, and interactive elements. Future research should explore extrinsic motivations and validate the framework across other digital platforms to expand its applicability.

The longitudinal behavioral effects of acute exposure to galactic cosmic radiation in female C57BL/6J mice: Implications for deep space missions, female crews, and potential antioxidant countermeasures

Galactic cosmic radiation (GCR) is an unavoidable risk to astronauts that may affect mission success. Male rodents exposed to 33-beam-GCR (33-GCR) show short-term cognitive deficits but reports on female rodents and long-term assessment are lacking. We asked: What are the longitudinal behavioral effects of 33-GCR on female mice? Also, can an antioxidant/anti-inflammatory compound (CDDO-EA) mitigate the impact of 33-GCR? Mature (6-month-old) C57BL/6J female mice received CDDO-EA (400 μg/g of food) or a control diet (vehicle, Veh) for 5 days and Sham-irradiation (IRR) or whole-body 33-GCR (0.75Gy) on the 4th day. Three-months post-IRR, mice underwent two touchscreen-platform tests: (1) location discrimination reversal (tests behavior pattern separation and cognitive flexibility, abilities reliant on the dentate gyrus) and (2) stimulus-response learning/extinction. Mice then underwent arena-based behavior tests (e.g. open field, 3-chamber social interaction). At the experiment's end (14.25-month post-IRR), an index relevant to neurogenesis was quantified (doublecortin-immunoreactive [DCX+] dentate gyrus immature neurons). Female mice exposed to Veh/Sham vs. Veh/33-GCR had similar pattern separation (% correct to 1st reversal). There were two effects of diet: CDDO-EA/Sham and CDDO-EA/33-GCR mice had better pattern separation vs. their respective control groups (Veh/Sham, Veh/33-GCR), and CDDO-EA/33-GCR mice had better cognitive flexibility (reversal number) vs. Veh/33-GCR mice. One radiation effect/CDDO-EA countereffect also emerged: Veh/33-GCR mice had slower stimulus-response learning (days to completion) vs. all other groups, including CDDO-EA/33-GCR mice. In general, all mice showed normal anxiety-like behavior, exploration, and habituation to novel environments. There was also a change relevant to neurogenesis: Veh/33-GCR mice had fewer DCX+ dentate gyrus immature neurons vs. Veh/Sham mice. Our study implies space radiation is a risk to a female crew's longitudinal mission-relevant cognitive processes and CDDO-EA is a potential dietary countermeasure for space-radiation CNS risks.

Intrinsic and extrinsic control impact motivation and outcome sensitivity: the role of anhedonia, stress, and anxiety

BACKGROUND

Motivated behaviors vary widely across individuals and are controlled by a range of environmental and intrinsic factors. However, due to a lack of objective measures, the role of intrinsic v. extrinsic control of motivation in psychiatric disorders remains poorly understood.

METHODS

We developed a novel multi-factorial behavioral task that separates the distinct contributions of intrinsic v. extrinsic control, and determines their influence on motivation and outcome sensitivity in a range of contextual environments. We deployed this task in two independent cohorts (final in-person N = 181 and final online N = 258), including individuals with and without depression and anxiety disorders.

RESULTS

There was a significant interaction between group (controls, depression, anxiety) and control-condition (extrinsic, intrinsic) on motivation where participants with depression showed lower extrinsic motivation and participants with anxiety showed higher extrinsic motivation compared to controls, while intrinsic motivation was broadly similar across the groups. There was also a significant group-by-valence (rewards, losses) interaction, where participants with major depressive disorder showed lower motivation to avoid losses, but participants with anxiety showed higher motivation to avoid losses. Finally, there was a double-dissociation with anhedonic symptoms whereby anticipatory anhedonia was associated with reduced extrinsic motivation, whereas consummatory anhedonia was associated with lower sensitivity to outcomes that modulated intrinsic behavior. These findings were robustly replicated in the second independent cohort.

CONCLUSIONS

Together this work demonstrates the effects of intrinsic and extrinsic control on altering motivation and outcome sensitivity, and shows how depression, anhedonia, and anxiety may influence these biases.

Examining the link between exercise motivation and preferred exercise setting in college students

Introduction: This study examined differences in self-determined motivation between those who prefer to exercise outdoors vs indoors. These differences could foster targeted applications of Self-Determination Theory to develop intrinsic exercise motivation. Participants: n = 506 students attending a mid-size four-year university in the southeastern United States participated. Methods: This was a cross-sectional study using a modified version of the Exercise Motivations Inventory (EMI-2). Results: Using exploratory and confirmatory factor analysis, three exercise motivations were identified: intrinsic, extrinsic, and social. Using structural equation modeling, we found higher extrinsic motivation was associated with indoor exercise preference, whereas higher social motivation was associated with outdoor exercise preference. Discussion: This study revealed exercise setting as a possible contributing factor for self-determined motivation. Those who prefer to exercise indoors may be at higher risk of strengthening external regulation. Interventions that support psychological needs may help foster self-determined exercise motivation among college students.

Fake-News Attitude Evaluation in Terms of Visual Attention and Personality Traits: A Preliminary Study for Mitigating the Cognitive Warfare

Although the Internet grants access to a large amount of information, it is crucial to verify its reliability before relying on it. False information is a dangerous medium that poses a considerable threat, as it impacts individuals' perceptions and information processing, eventually shaping people's behaviors. Misinformation can be weaponized, especially in cross-border conflicts, where it can be used as a means to erode social cohesion by manipulating public opinion and exacerbate tensions between nations. Cognitive Warfare targets human cognition shaping to be a realm of warfare. It entails the synergy of activities designed to alter perceptions of reality, along with other Instruments of Power, to affect attitudes and behaviors by influencing, protecting, or disrupting cognition on an individual, group, or population level to gain an advantage over an opponent. The objective of our study was to identify behavioral patterns and profile personality traits most likely to accept fake news as true, aiming to mitigate the phenomenon and impact of misinformation and disinformation, as well as addressing the concerning effects of Cognitive Warfare. Based on the Big Five Theory model, we investigated the variation in visual attention and level of Conscientiousness, Open-Mindedness, and Emotional Stability in regard to the capability to detect fake news. In this study, we measured Implicit reaction time (IRT) and visual behavior (Eye Tracker) while participants were shown both fake and real news. The results indicated that subjects who were able to differentiate between fake news and real news tended to exhibit lower levels of Open-Mindedness and focused heavily on the visual elements of the posts.

Leadership in federally qualified health centers: examining recruitment and retention in rural Oklahoma

PURPOSE

Healthcare workforce shortages, particularly in rural areas, present a global challenge. The purpose of this study is to explore the leadership dynamics within federally qualified health centers (FQHC) in rural Oklahoma, focusing on recruitment, retention, job satisfaction and development practices.

DESIGN/METHODOLOGY/APPROACH

Eighteen managers with five or more years of tenure from Oklahoma FQHCs were interviewed. Leadership's role in influencing job satisfaction, recruitment, retention and development practices was analyzed using a multilevel ecological framework through qualitative content analysis with NVivo.

FINDINGS

The analysis includes ten key themes including the critical role of leadership in addressing recruitment and retention challenges, the importance of aligning organizational culture, rural culture, access challenges, trainings and values with workforce development initiatives, and the impact of leadership practices on job satisfaction.

ORIGINALITY/VALUE

This study uniquely examines leadership strategies in rural FQHCs, integrating ecological considerations for cultural, logistical and community-specific factors. It emphasizes the pivotal role leadership plays in shaping workforce development. As rural healthcare evolves, refining these approaches is crucial for addressing workforce challenges, improving healthcare access and ensuring that rural FQHCs remain sustainable, driving positive outcomes for healthcare professionals and communities.

The Role of Patient Satisfaction Scores in Clinical Care and Physician Wellness

Patient satisfaction scores have become an integral part of the vocabulary of medical practitioners. Patient satisfaction scores are a domain far ignored, but which have recently gained prominence as patients have demanded a fair share of their own assessments of their medical caregivers. This has created a complex interplay of meeting patients' demands and satisfying their wants and needs, which at times may not completely align with the best possible approach to management and standard of care algorithms. Here we present a commentary on patient satisfaction scores and their impact on physician well-being. We present historical aspects from both patient and provider perspectives and how they vary in private versus academic practice, and create some guidance for future refinement and implementation of these scores to serve two purposes: first, to allow for optimal doctor-patient relationships; and second, to enhance overall satisfaction for the patient as well as the physician.

Does Free Will Really Exist? The Motivational Congruence Theory's Perspective

Free will plays a critical role in human motivation. Recent advances in science and technologies have had a significant impact on free will. They have raised serious concerns regarding the threatening effects of such advancements on perceived autonomy. However, there is still a longstanding debate on the existence of free will, known as the problem of free will. Philosophers have provided contrasting views regarding the existence of free will and its relationship with causal determination and mental causation problems. These problems are related to the underlying dualistic approach between mental and physical factors. Similar to the philosophy literature, the motivation literature is concerned with the problem of free will and its influence on motivation and performance. Cognitive evaluation and self-determination theories are the most renowned theories which assert the effect of autonomy (i.e., free will) on intrinsic motivation. However, these theories have mainly focused on the effect of the need for autonomy as an underlying driver of intrinsic motivation. They have not been able to address the fundamental question about the existence of actual free will and its effect on motivation and performance. This is mainly due to their dualistic approach in the form of intrinsic/extrinsic motivation dichotomization. Motivational congruence theory addresses the problem of free will and substantiates its effect by going beyond such a dualistic approach and resolving the related problems of mental causation and causal determination. The theory does this by taking a cotextualist and dialectical approach to the interaction between intrinsic and extrinsic motivational mechanisms and context.

Relationships between depression, anxiety, and motivation in the real-world: Effects of physical activity and screentime

Background

Mood and anxiety disorders are highly prevalent and comorbid worldwide, with variability in symptom severity that fluctuates over time. Digital phenotyping, a growing field that aims to characterize clinical, cognitive and behavioral features via personal digital devices, enables continuous quantification of symptom severity in the real world, and in real-time.

Methods

In this study, N=114 individuals with a mood or anxiety disorder (MA) or healthy controls (HC) were enrolled and completed 30-days of ecological momentary assessments (EMA) of symptom severity. Novel real-world measures of anxiety, distress and depression were developed based on the established Mood and Anxiety Symptom Questionnaire (MASQ). The full MASQ was also completed in the laboratory (in-lab). Additional EMA measures related to extrinsic and intrinsic motivation, and passive activity data were also collected over the same 30-days. Mixed-effects models adjusting for time and individual tested the association between real-world symptom severity EMA and the corresponding full MASQ sub-scores. A graph theory neural network model (DEPNA) was applied to all data to estimate symptom interactions.

Results

There was overall good adherence over 30-days (MA=69.5%, HC=71.2% completion), with no group difference (t(58)=0.874, p=0.386). Real-world measures of anxiety/distress/depression were associated with their corresponding MASQ measure within the MA group (t's > 2.33, p's < 0.024). Physical activity (steps) was negatively associated with real-world distress and depression (IRRs > 0.93, p's ≤ 0.05). Both intrinsic and extrinsic motivation were negatively associated with real-world distress/depression (IRR's > 0.82, p's < 0.001). DEPNA revealed that both extrinsic and intrinsic motivation significantly influenced other symptom severity measures to a greater extent in the MA group compared to the HC group (extrinsic/intrinsic motivation: t(46) = 2.62, p < 0.02, q FDR < 0.05, Cohen's d = 0.76; t(46) = 2.69, p < 0.01, q FDR < 0.05, Cohen's d = 0.78 respectively), and that intrinsic motivation significantly influenced steps (t(46) = 3.24, p < 0.003, q FDR < 0.05, Cohen's d = 0.94).

Conclusions

Novel real-world measures of anxiety, distress and depression significantly related to their corresponding established in-lab measures of these symptom domains in individuals with mood and anxiety disorders. Novel, exploratory measures of extrinsic and intrinsic motivation also significantly related to real-world mood and anxiety symptoms and had the greatest influencing degree on patients' overall symptom profile. This suggests that measures of cognitive constructs related to drive and activity may be useful in characterizing phenotypes in the real-world.

Family Members' Explanatory Models of Cancer Anorexia-Cachexia

The experience of bearing witness to the lack of appetite and involuntary weight loss that characterizes cancer anorexia-cachexia syndrome (CACS) is reported to be stressful for family members. Research identifies that family members engage in a wide range of behaviors in response to a relative who shows minimal interest in eating and is literally 'wasting away' before their eyes. Some families, though concerned about the symptoms of CACS, do not dwell excessively on the patient's nutritional intake while others continually harass the patient to eat and petition health care providers for aggressive nutritional interventions to eat in an attempt to stave off further physical deterioration. While studies have detailed how family members respond to a terminally ill relative with CACS, empirical work explicating the explanatory models of CACS that they hold is lacking. Explanatory models (EMs) reflect the beliefs and ideas that families have about why illness and symptoms occur, the extent to which they can be controlled, how they should be treated, and how interventions should be evaluated. To address this gap in the literature, a grounded theory study guided by Kleinman's Explanatory Model questions was conducted with 25 family members of advanced cancer patients. The core category of 'Wayfaring' integrates the key categories of the model and maps onto Kleinman's questions about CACS onset, etiology, natural course, physiological processes/anatomical structures involved, treatment, and the impacts of disease on patient and family. Findings suggest that a divergence between some biomedical constructions of CACS and explanatory models held by family members may fuel the family-health care provider conflict, thereby providing direction for communication with families about care of the patient with anorexia-cachexia.

Individual work-motive values: determinants and consequences for the appraisal of specific health-related work characteristics

The objectives of the present study were to determine whether (I) work-motive values influence the appraisal of specific work characteristics of significance for health and function and (II) subject variables impact work-motive values. Two aspects of work-motive values were studied: values that assign importance to pursuing one's personal goals and interests, internally based work-motive values (IntWMVs), and values that assign importance to external factors, externally based work-motive values (ExtWMVs). These aspects of motive values, age, gender, skill level, managerial role, and specific psychosocial work characteristics were analyzed in a cross-sectional sample of 12,994 employees in 101 private and public organizations. Two-year follow-up prospective data from 6,252 employees in 69 organizations elucidated whether associations were stable over time. The results showed that IntWMV influenced reports of levels of control of decisions, empowering leadership, innovative climate, quantitative demands, feedback from work, and self-leadership. ExtWMVs were most consistently associated with role clarity. Skill level and managerial role were associated with reporting higher levels of IntWMVs and lower ExtWMVs. In conclusion, the present data support the assumption that work-motive values influence the appraisal, reporting, and consequently measurements of work characteristics. Managers differ from subordinates in work-motive values and may face challenges in ascertaining and supporting subordinates' needs.

Does an aptitude for surgery exist and can we predict it? An experimental study

BACKGROUND

The selection and allocation of surgeons with a greater potential for high surgical performance are essential aspects of improving the quality, safety, and effectiveness of surgical procedures. Objective of this trial was to determine the existence of basic skills and traits that would predict better performance in surgery, and those predictive factors that constitute a driving force in different stages of training.

MATERIALS AND METHODS

The randomized crossover training trial took place from January 2021 to December 2021 and was conducted at an educational training center for minimally invasive surgery. A total of n =87 physicians (residents and experts) from surgical disciplines and n =239 fifth-year medical students were studied. The participants underwent extensive neuropsychological testing and surgical training, which was performed with conventional as well as robot-assisted laparoscopy by way of identical brief tasks conducted six times in a randomized crossover setting. Main Outcome was the latent factor structure of 'psychomotor skills', 'personality', and 'motivation' based on structural equation modeling.

RESULTS

The training performance of both students and physicians was significantly explained by the interaction of the three factors (explained variance: 8.2% for students, 23.8% for physicians). In students, motivation (explained variance 8.4%) and personality (explained variance 4.5%) revealed the highest contribution to surgical training performance (explained variance through psychomotor skills 1.1%). In physicians, psychomotor skills (explained variance 27.4%) made the greatest contribution to surgical training performance (explained variance through motivation 2.3%; explained variance through personality 10.5%).

CONCLUSION

The study showed that surgical performance is sensitive to, and fragile in regard of nonsurgery-related general individual traits. This aligns with the notion that early selection of surgeons with prospects of high surgical performance is possible, and perhaps even necessary in order to keep up with future demands on the medical system.

Exercise motivation, physical exercise, and mental health among college students: examining the predictive power of five different types of exercise motivation

Introduction

The mental health (MH) of college students has long been a crucial concern for families, educational institutions, and society. Extensive research has demonstrated the influential role of exercise motivation in shaping MH. However, further investigation is warranted to ascertain which types of exercise motivation may have more influence on the MH of college students. The present study examined the direct effects of five distinct types of exercise motivation, namely health motivation (HM), appearance motivation (APM), fun motivation (FM), ability motivation (ABM), and social motivation (SM) on MH. Additionally, the study explored the potential mediating role of physical exercise (PE) in these relationships.

Methods

An cross-sectional study design was employed. A total of 433 Chinese college students participated in the study and completed our questionnaires, which included the Exercise motivation scale (EM scale), the Physical exercise scale (PE scale), and the Mental health scale (MH scale).

Results

The findings revealed a significant and positive relationship between all five categories of exercise motivation and the MH of college students. Specifically, FM was found to have the most pronounced impact on MH, followed by HM, ABM, SM, and APM, in descending order of influence. Furthermore, the impacts of HM, FM, ABM, and SM on MH were found to be partially mediated by PE. However, the association between APM and MH was entirely mediated by PE.

Discussion

The present study contributes to enhancing the comprehension of the underlying mechanisms behind different exercise motivations in relation to PE and MH. Additionally, it offers practical implications for developing intervention strategies for improving the MH of college students.

Exploring adolescent girls and young women's PrEP-user profiles: qualitative insights into differentiated PrEP delivery platform selection and engagement in Cape Town, South Africa

INTRODUCTION

Adolescent girls and young women (AGYW), a priority population for HIV prevention in Africa, show high interest but difficulty in sustained effective use of pre-exposure prophylaxis (PrEP). With ongoing PrEP scale-up focused on increasing access, it is important to understand what influences AGYW's choice of PrEP delivery platforms.

METHODS

The POWER implementation study in Cape Town provided PrEP between 2017 and 2020 to AGYW (16-25 years) from four differentiated delivery platforms: mobile clinic, government facility, courier delivery or community-based youth club. Healthcare providers at government and mobile clinics provided PrEP (initiation and refills) as part of comprehensive, integrated sexual and reproductive health services. Courier and youth club platforms provided light-touch PrEP refill services incorporating rapid HIV self-testing. We conducted in-depth interviews with a purposive sample of AGYW who had ≥3 months of PrEP-use and accessed ≥2 PrEP delivery platforms. The thematic analysis explored AGYW's preferences, decision-making and habits related to PrEP access to inform market segmentation.

RESULTS

We interviewed 26 AGYW (median age 20) PrEP-users between November 2020 and March 2021. AGYW PrEP-users reported accessing different services with, 24 accessing mobile clinics, 17 courier delivery, 9 government health facilities and 6 youth clubs for their PrEP refills. Qualitative findings highlighted four potential behavioural profiles. The "Social PrEP-user" preferred PrEP delivery in peer spaces, such as youth clubs or adolescent-friendly mobile clinics, seeking affirmation and social support for continued PrEP use. The "Convenient PrEP-user" favoured PrEP delivery at easily accessible locations, providing quick (courier) or integrated contraception-PrEP refill visits (mobile and government clinic). The "Independent PrEP-user" preferred PrEP delivery that offered control over delivery times that fit into their schedule, such as the courier service. The "Discreet PrEP-user" highly valued privacy regarding their PrEP use (courier delivery) and avoided delivery options where unintentional disclosure was evident (youth club). Comfort with HIV self-testing had minimal influence on PrEP delivery choice.

CONCLUSIONS

Market segmentation of AGYW characterizes different types of PrEP-users and has the potential to enhance tailored messaging and campaigns to reach specific segments, with the aim of improving sustained PrEP use and HIV prevention benefits.

Financial incentive interventions for smoking cessation among Chinese smokers: study protocol for a cluster randomised controlled trial

INTRODUCTION

There is an urgent issue to relieve the burdens caused by tobacco use through feasible and effective smoking cessation interventions, particularly in a middle-income country with less accessible smoking cessation services and high demand for quitting smoking. Financial incentives have shown effective in changing health behaviours, thus needing to test its portability to a wider implementation and effectiveness of increasing smoking cessation rates.

METHODS AND ANALYSIS

This is a three-arm cluster randomised controlled trial. 462 eligible participants will be assigned to 2 financial incentive groups-rewards or deposits, or the control group. All participants including those in the control group will receive text messages to help quitting smoking developed by the US National Cancer Institute over a 3-month intervention period. In addition to text messages, reward group participants will be rewarded with CNY200 and CNY400 (CNY100 approximately US$15) for sustained smoking abstinence at 1 month and 3 months follow-up assessments; participants in the deposit group will accumulate CNY200 and CNY600 in the deposit accounts after verified smoking abstinence at 1 month and 3 months follow-up assessments, and all the deposits will be given at once right after the 3-month follow-up visit. The primary outcome is biochemically verified smoking abstinence rate sustained for 6 months after enrolment.

ETHICS AND DISSEMINATION

This trial protocol has been approved by the Ethics Committee of Peking University Health Science Centre (date: 23 February 2023; ethical approval number: IRB00001052-22172). Results and findings of this trial will be disseminated in peer-reviewed journals and professional conferences.

TRIAL REGISTRATION NUMBER

ChiCTR-IOR-2300069631.

Navigating the complex terrain of motivated behavior: a bibliometric and neuroscientific perspective

Over several decades, motivated behavior has emerged as a crucial study area within neuroscience. Understanding the neural substrates and mechanisms driving behaviors related to reward, addiction, and other motivation forms is pivotal for novel therapeutic interventions. This review provides a bibliometric analysis of the literature, highlighting the main trends, influential authors, and the potential future direction of the field. Utilizing a dataset comprised by 3,150 publications from the Web of Science and Scopus databases ("motivated behavior as query), we delve into key metrics like publication trends, keyword prevalence, author collaborations, citation impacts, and employed an unsupervised natural language processing technique - Latent Dirichlet Allocation - for topic modeling. From early investigations focusing on basic neural mechanism and behaviors in animal models to more recent studies exploring the complex interplay of neurobiological, psychological, and social factors in humans, the field had undergone a remarkable transformation. The last century has seen a proliferation of research dedicated to uncovering the intricacies of motivation, significantly enriching our understanding of its myriad implications for human behavior and mental health. This bibliometric analysis aims to offer comprehensive insights into this dynamic research area, highlighting the field's key contributions and potential future directions, thereby serving as a valuable resource for researchers, and hopefully give a more thorough understanding of the research area.

Implementing a student-centered stroke intervention and prevention education program; evaluating motivation, cognitive load, and performance among middle school students

Background

In this study, we investigated the association between motivation, cognitive load, difficulty, and performance in a stroke education outreach program implemented for middle school students.

Methods

Various interactive instructional activities were developed to engage students throughout the program to assess cognitive and intrinsic load arising from learner implementation of various tasks in a stroke education program for middle school kids. Performance was measured using a post-test to assess knowledge gained by the 6th, 7th, and 8th-grade middle school students. A short questionnaire was also administered to collect data on students' motivation using the ARCS model to asses attention, relevance, confidence, and satisfaction. In addition, we evaluated difficulty level and cognitive load. The relationship between performance and motivation was assessed using Pearson's correlation.

Results

In our results, there was no significant difference (p > 0.05) in performance between the 6th, 7th, and 8th-grade students. The difference in performance, cognitive load (mental effort and difficulty), or motivation between the 6th, 7th, and 8 t-grade students was not significant (p > 0.05). The correlation between motivation and performance was significant (r = 0.87, p = 0.001), while the correlation between mental effort and performance was not significant (r = 0.34, p = 0.270). Also, the correlation between difficulty and performance was not significant (r = 0.38, p = 0.361). In the ARCS motivation model, attention, and confidence received the lowest mean scores (3.9), while relevance received the highest score (4.3).

Conclusion

Our findings reveal the importance of implementing novel activities to enhance students' motivation to improve performance in the implementation of stroke education outreach programs for middle school students.

Assessing motivation for treatment in eating disorders: psychometric validation of the Italian version of the Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ-ITA)

PURPOSE

Treatment resistance is a significant challenge in addressing eating disorders (EDs). The Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ) has been previously validated in ED populations to assess patients' motivation for treatment. This study aimed to validate the ACMTQ in the Italian language (ACMTQ-ITA) and evaluate its psychometric properties.

METHODS

We recruited a clinical sample of adults aged 18 or older, diagnosed with EDs, proficient in the Italian language, and providing written informed consent. Participants with psychiatric comorbidities such as schizophrenia, bipolar disorder, and substance use disorder were excluded from the study. Validity of the ACMTQ-ITA was assessed using reliability analysis with Cronbach's α and McDonald's ω estimates, and Confirmatory Factor Analysis (CFA).

RESULTS

Results from the reliability analysis confirmed the internal consistency of the Autonomous Motivation (AM) factor (α = 0.82, ω = 0.82), the Controlled Motivation (CM) factor (α = 0.76, ω = 0.77), and the ACMTQ-ITA overall score (α = 0.79). The CFA confirmed the two-factor solution (i.e., AM and CM) identified in the original validation of the ACMTQ (Comparative Fit Index = 0.92, Akaike Information Criterion = 3427.26, Bayesian Information Criterion = 3486.82; Root Mean Square Error of Approximation = 0.08, Standardized Root Mean Square Residual = 0.09).

CONCLUSION

The ACMTQ-ITA emerged as a valid and reliable tool for measuring motivation for treatment in individuals with EDs. Its implementation may facilitate the comprehension of treatment motivation, offering valuable clinical insights and implications for health management practices.

LEVEL OF EVIDENCE

Level V, descriptive studies.

The effect of reward expectation on working memory of emotional faces under different levels of cognitive load: an ERP study

Using event-related potentials (ERPs), this study examined the impact of reward expectations on working memory of emotional faces under different levels of cognitive load in a task combining the N-back paradigm and the reward expectation paradigm. The experiment involved presenting high- or low-reward cues followed by an N-back task for emotional faces with different loads. The accuracy results showed that under a high task load, both reward and emotion effects were significantly observed. However, these effects disappeared under a low task load. Analysis of the ERP data revealed that the early P2 and VPP components exhibited greater responses to fearful faces than to neutral faces. In the later stages, the P3 and LPP components showed greater reactions to high rewards than to low rewards. Additionally, the P2 component was found to be modulated by task load in relation to rewards, the EPN component demonstrated task load modulation with respect to emotions, and the N170 component showed an interaction effect between rewards and emotions. These findings imply that load regulates the reward effect and the emotional superiority effect in the process of working memory for emotional faces. In the cognitive processing of working memory, motivation and emotion jointly influence processing. Emotional factors have a greater impact in the early stage of processing, while motivation factors have a greater impact in the late stage of processing.

Incentive policy for the comprehensive development of young medical talents: an evolutionary game study

Introduction

Currently in China, there is a lack of well-defined and viable incentive mechanisms at the governmental and hospital levels to support the development of young medical talents, thereby hindering their growth Existing studies primarily investigate the current state and trajectory of incentives, yet they inadequately address the distinctive characteristics of various stakeholders involved in medical talent incentive processes, particularly the lack of research on incentive mechanisms with Chinese attributes.

Methods

This study adopts evolutionary game theory to investigate the dynamics of replication and the strategies for achieving evolutionary stability in the comprehensive development of young medical talents, considering both scenarios with and without supportive policies.

Results

In the absence of any supportive policy measures, the evolutionarily stable strategy (ESS) point is O(0,0), the unstable equilibrium point is C(1,1), and the saddle points are A(0,1), B(1,0). The initial state of the system is at the unstable equilibrium point C(1,1), which means that the young medical talents and medical institutions adopt a combination of strategies (actively seeking comprehensive development and taking incentive measures). Under the scenario with supportive policies, the ESS point is C(1,1), the unstable equilibrium point is O(0,0), and the saddle points are A(0,1), B(1,0). The initial state of the system is at the unstable equilibrium point O(0,0), which means that young medical talents and medical institutions adopt (N,N) strategy combinations (inactively seeking comprehensive development, implementing no incentive measure).

Discussion

(1) Government incentives play a crucial role in motivating young medical talents to seek comprehensive development. (2) The level of government incentive support for young medical talents should exceed the cost increment of individual efforts. Additionally, the policy support provided by the government to medical institutions should surpass the incentive support offered by these institutions to young medical talents. This will enhance the motivation and encouragement efforts of medical institutions in actively promoting comprehensive development among young medical talents. (3) With the backing of certain government incentive policies, medical institutions implementing incentive measures and young medical talents actively seeking comprehensive development will establish a virtuous cycle of mutual promotion.

The Emotional State of Second-Language Learners in a Research Writing Course: Do Academic Orientation and Major Matter?

This study examined whether differences exist in the emotional state of students whose approach to undergraduate courses is either preferentially learning-oriented or grade-oriented. It focused on an understudied population of female college students of Saudi Arabian descent who were enrolled in a challenging writing course. Their emotional state was assessed both globally, through the appraisal of their degree of happiness, and locally, through the appraisal of their writing anxiety (a task-specific emotional state). The study contributed to the extant literature by examining whether the association between goal orientation and emotional state, which is predicted by goal orientation theory, could be found in the selected understudied student population. Results illustrate differences between STEM and non-STEM learners. For STEM students, a grade orientation was associated with declining self-reported happiness and increasing writing anxiety. In contrast, for both STEM and non-STEM students, a learning orientation was associated with increasing happiness and declining writing anxiety. Differences existed in the particular type of writing anxiety that was experienced by STEM and non-STEM students. These findings suggest that interventions for students who are struggling academically may need to address personal dispositions if such interventions are to foster subjective well-being (including positive emotions).

Evaluation of a new intrinsic and extrinsic motivation scale in youth with psychosis spectrum symptoms

BACKGROUND

Impairment in intrinsic motivation (IM), the drive to satisfy internal desires like mastery, may play a key role in disability in psychosis. However, we have limited knowledge regarding relative impairments in IM compared to extrinsic motivation (EM) or general motivation (GM), in part due to limitations in existing measures.

METHODS

Here we address this gap using a novel Trait Intrinsic and Extrinsic Motivation self-report scale in a sample of n = 243 participants including those with schizophrenia, psychosis-risk, and healthy controls. Each of the 7 IM and 6 EM items used a 7-point Likert scale assessing endorsement of dispositional statements. Bifactor analyses of these items yielded distinct IM, EM, and GM factor scores. Convergent and discriminant validity were examined in relation to General Causality Orientation Scale (GCOS-CP) and Quality of Life 3-item IM measure (QLS-IM). Utility was assessed in relation to psychosis-spectrum (PS) status and CAINS clinical amotivation.

RESULTS

IM and EM showed acceptable inter-item consistency (IM: α = 0.88; EM: α = 0.66); the bifactor model exhibited fit that varied from good to borderline to inadequate depending on the specific fit metric (SRMR = 0.038, CFI = 0.94, RMSEA = 0.106 ± 0.014). IM scores correlated with established IM measures: GCOS-CP Autonomy (rho = 0.38, p < 0.01) and QLS-IM (rho = 0.29, p < 0.01). Supporting discriminant validity, IM did not correlate with GCOS-CP Control (rho = -0.14, p > 0.05). Two-year stability in an available longitudinal subset (n = 35) was strong (IM: rho = 0.64, p < 0.01; EM: rho = 0.55, p < 0.01). Trait IM was lower in PS youth (t = 4.24, p < 0.01), and correlated with clinical amotivation (rho = -0.36, p < 0.01); EM did not show significant clinical associations.

CONCLUSIONS

These results demonstrate the clinical relevance of IM in psychosis risk. They also provide preliminary support for the reliability, validity and utility of this new Trait IM-EM scale, which addresses a measurement gap and can facilitate identification of neurobehavioral and clinical correlates of IM deficits.

Intrinsic drive of medical staff: a survey of employee representatives from 22 hospitals in China

Objective

While several initiatives, including monetary rewards and performance system reform, are used to inspire medical staff, none are fully effective. We sought to describe the intrinsic drive of medical staff and identify elements that improve work enthusiasm by increasing internal motivation.

Methods

A cross-sectional study was conducted in which 2,975 employee representatives from 22 municipal hospitals in Beijing, China were interviewed using a self-made intrinsic motivation scale for medical staff which includes the achievement motivation, self-efficacy, conscientiousness, gratitude level and perceived organizational support. The Kruskal-Wallis analysis of variance and multiple linear regression methods were used to investigate the level of intrinsic motivation and identify any influencing factors. The correlation between employee drive and turnover intention was determined using Spearman rank correlation analysis and Kendall's tau b rank correlation coefficient.

Results

A total of 2,293 valid answers were obtained, with a valid recovery rate of 77.1%. There were statistically significant differences in intrinsic motivation and its five dimensions by marital status, political status, profession, service year, monthly income, number of working hours per week, and turnover intention (p < 0.05). Being divorced, a CPC member, in the nursing profession, and having a higher monthly income had a positive impact on intrinsic motivation while working a high hours per week had a negative effect. Higher work drive was associated with lower turnover intention. The correlation coefficients of intrinsic drive and its five dimensions with turnover intention ranged from 0.265 to 0.522 (p < 0.001).

Conclusion

Sociodemographic factors and work environment influenced the intrinsic motivation of medical staff. There was a correlation between work drive and turnover intention which indicated that stimulating the intrinsic drive of employees may help to increase staff retention.

Current study on the influence of psychological factors on returning to sports after ACLR

It is considered that psychological factors are important in determining exercise regression outcomes of patients with anterior cruciate ligament reconstruction (ACLR). This review summarizes the definition and research progress of current undefined psychological factors related to returning to sports (RTS) after ACLR, as well as the application of corresponding measuring scales, and common psychological interventions in the field. The aim is to understand and clarify the impact of psychological factors in the ACL injury and rehabilitation, and to provide a theoretical basis for the application of psychological evaluation and intervention in the later stage. It is believed that there are still many prospects for the research in this field.