Psychological Readiness for Anterior Cruciate Ligament Surgery: Describing and Comparing the Adolescent and Adult Experiences

J Athl Train. 2003 Jun;38(2):167-171.


OBJECTIVE: Our objectives were to describe the preoperative mood levels and psychological readiness levels of patients undergoing primary reconstruction of the anterior cruciate ligament (ACL) and to examine differences between adolescent and adult sports medicine patients relative to psychological readiness for ACL surgery. DESIGN AND SETTING: Subjects prospectively completed assessments of preoperative mood and psychological readiness for ACL surgery and rehabilitation. SUBJECTS: The sample consisted of subjects (N = 121) involved, on average, in sport or exercise participation 12.5 h/wk (SD = 7.5); subgroups included adolescents (15-19 years of age, n = 67) and adults (>/=30 years of age, n = 32). MEASUREMENTS: Subjects preoperatively provided self-reported assessments of demographics, mood disturbances, 10 psychological processes of change (consciousness raising, dramatic relief, environmental reevaluation, social liberation, self-reevaluation, counterconditioning, helping relationships, reinforcement management, stimulus control, and self-liberation), decisional balance (pros versus cons of surgery), and self-efficacy. RESULTS: Relative to the first objective, subjects reported more pros than cons associated with surgery and relatively high levels of self-efficacy. Relative to the second objective, a significant main effect was noted (Wilks lambda = 0.58, P <.01), with 42% of the variance in the dependent variables being attributed to differences among adolescents as compared with adults. Follow-up analyses indicated that, as compared with adults, adolescents reported higher mood disturbances, more pros associated with surgery, and greater use of dramatic relief, environmental reevaluation, social liberation, helping relationships, and self-liberation. CONCLUSIONS: It may be advantageous to screen patients preoperatively relative to their psychological readiness for surgery and rehabilitation. Also, adolescents reported higher preoperative mood-disturbance levels than adults but higher levels of what would be considered "psychological readiness" for surgery.