Self-esteem and coping responses of athletes with acute versus chronic injuries

Reinjury Anxiety and Return to Sport After Anterior Cruciate Ligament Reconstruction: A Cluster Analysis and Prospective Study Among 162 Athletes

BACKGROUND

Recent studies have investigated the effect of psychological factors on return to sport (RTS), but none has tested the existence of psychological profiles linked to reinjury anxiety and its links with RTS and reinjury.

PURPOSE

To assess the effect of different psychological profiles on RTS and reinjury.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

The study screened patients who were involved in all types of sports for anterior cruciate ligament (ACL) reconstruction (hamstring and patellar tendon autografts). All participants were included during the RTS phase (90-180 days after ACL reconstruction). Reinjury anxiety, fear of reinjury, kinesiophobia, perceived stress, anxiety, depression, knee confidence, self-esteem, optimism, coping, and pain were measured. Hierarchical cluster analysis (Ward method) and analysis of variance were performed. In the second year after surgery, patients were recontacted by telephone to follow-up. RTS and reinjury were compared by profile type.

RESULTS

A total of 162 athletes were initially included, of whom 123 responded regarding RTS and reinjury. Cluster analysis showed a 4-cluster solution (χ2[21] = 428.59; λ = .064; P < .001). Profile 1 (27.8%) was characterized by moderate reinjury anxiety and no depression. Profile 2 (22.8%) was characterized by moderate reinjury anxiety and minor anxious-depressive reaction. Profile 3 (30.9%) was characterized by no reinjury anxiety, no depression, and high confidence. Profile 4 (18.5%) was characterized by high anxiety, high depression, and low confidence. Profile 4 had the lowest self-esteem and optimism scores compared with profile 3 (P < .001). In addition, a higher percentage of men was found in profile 3 as opposed to profile 4 (χ2[3] = 11.35; P < .01). Profile 4 had the highest rate of non-RTS with 54.2% (profile 1: 14.3%, P = .001; profile 2: 25.0%, P = .031; profile 3: 22.2%, P = .011). Finally, patients with profile 3 had a higher risk of reinjury (13.9%) than those with profile 4 (0%) (P = .047), who had an extremely conservative RTS.

CONCLUSION

The different profiles will affect RTS, but also the risk of reinjury exclusively for profiles 3 and 4. Rehabilitation management will probably require all stakeholders to understand psychological profiles of athletes to develop an on-demand rehabilitation plan.

An Examination of the Relationship between Early Maladaptive Schemas, Coping, and Emotional Response to Athletic Injury

The present study examined the relationship between cognitive vulnerabilities, coping strategy, and emotional response to athletic injury among 40 NCAA Division I injured athletes. It was hypothesized that the presence of early maladaptive schemas (EMS) and avoidant coping strategies would predict greater emotional distress among injured athletes. Early maladaptive schemas were assessed by the Young Schema Questionnaire-Short Form, which injured athletes completed upon injury. Coping strategies were measured by the Coping Response Inventory Adult Form, which was completed upon the completion of recovery. The Profile of Mood States was used to assess mood, and was completed during three phases of injury: upon injury, middle of rehabilitation, and upon recovery. As predicted, hierarchical multiple regression analysis demonstrate that EMSs and avoidance-focused coping were associated with higher levels of negative mood among injured athletes. The results also indicate that the relationship between EMS and mood vary based on the phase of injury, suggesting that different EMSs are differentially related to subtle differences in stressors encountered during each phase of the injury process.

Reconstructing self-narratives in coping with traumatic brain injury

This study examined qualitative data from ten individuals with traumatic brain injuries (TBI) who felt at ease with their current situations. An analysis based on the grounded theory method revealed that one's experience of coping or adjustment to the disability was represented as narratives about him or herself. Each one with TBI reconstructed certain self-narratives in coping with their changed self-images and daily lives. The common narratives were classified into five categories: "the self better than others," "the grown self," "the recovering self," "the self living here and now," and "the protesting self." These self-narratives reflected renewed ways to view the selves, which were conceptualized to be intact "in spite of TBI" or to be worthwhile "because of TBI." The informants achieved this conceptualization by managing their perspectives on time or on space. This classification will serve as a framework for rehabilitation practice and for future research.