Cognitive-behavioral-based physical therapy to enhance return to sport after anterior cruciate ligament reconstruction: An open pilot study.

OBJECTIVES: To describe feasibility, adherence, acceptability, and outcomes of a cognitive-behavioral-based physical therapy (CBPT-ACLR) intervention for improving postoperative recovery after anterior cruciate ligament reconstruction (ACLR). DESIGN: Pilot study. SETTING: Academic medical center. PARTICIPANTS: Eight patients (mean age [SD] = 20.1 [2.6] years, 6 females) participated in a 7-session telephone-based CBPT-ACLR intervention beginning preoperatively and lasting 8 weeks after surgery. MAIN OUTCOME MEASURES: At 6 months, patients completed Knee Injury and Osteoarthritis Outcome Score (KOOS) sports/recreation and quality of life (QOL) subscales, International Knee Documentation Committee (IKDC), Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS), and Knee Self-Efficacy Scale (K-SES), return to sport (Subjective Patient Outcome for Return to Sports), and satisfaction. Minimal clinically important difference (MCID) was used for meaningful change. RESULTS: Seven (88%) patients completed all sessions. Seven (88%) patients exceeded MCID on the TSK, 6 (75%) on the PCS, 5 (63%) on the KOOS sports/recreation subscale, 4 (50%) on the IKDC, and 3 (38%) on the KOOS QOL subscale. Three (38%) patients returned to their same sport at the same level of effort and performance. All patients were satisfied with their recovery. CONCLUSIONS: A CBPT-ACLR program is feasible and acceptable for addressing psychological risk factors after ACLR.

Personality correlates of individual differences in the recruitment of cognitive mechanisms when rewards are at stake.

Individuals differ greatly in their sensitivity to rewards and punishments. In the extreme, these differences are implicated in a range of psychiatric disorders from addiction to depression. However, it is unclear how these differences influence the recruitment of attention, working memory, and long-term memory when responding to potential rewards. Here, we used a rewarded memory-guided visual search task and ERPs to examine the influence of individual differences in self-reported reward/punishment sensitivity, as measured by the Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales, on the recruitment of cognitive mechanisms in conditions of potential reward. Select subscales of the BAS, including the fun seeking and reward responsiveness scales, showed unique relationships with context updating to reward cues and working memory maintenance of potentially rewarded stimuli. In contrast, BIS scores showed unique relationships with deployment of attention at different points in the task. These results suggest that sensitivity to rewards (i.e., BAS) and to punishment (i.e., BIS) may play an important role in the recruitment of specific and distinct cognitive mechanisms in conditions of potential rewards.

Impulsivity and response modulation deficits in psychopathy: evidence from the ERN and N1.

The response modulation hypothesis of psychopathy states that psychopaths' inability to adapt their behavior to changing circumstances results from an inability to process peripheral cues in the midst of a dominant response. The current study examined this relationship between psychopathic traits and response modulation using a lexical decision stop signal task and event-related potentials to assess deficits in stimulus and error processing. Overall, the impulsive antisocial (IA) factor of psychopathy was related to poor behavioral performance, particularly in relation to response inhibition. Additionally, IA was related to reduced processing of the stop signal itself as well as subsequent inhibition errors. This deficient processing of the stop signal was found to significantly mediate the relationship among IA, behavioral performance, and the processing of inhibition errors, indicating that a deficit in processing peripheral cues may be responsible for subsequent behavioral and error processing deficits in IA.