The psychosocial benefits of participating in sports have long been appreciated. However, athletes are often faced with circumstances that make them susceptible to psychological challenges unique to the athletic population. One such circumstance is injury in sport, which can be a source of notable distress and may precipitate the emergence of new or exacerbation of underlying psychological disorders. In athletes who are injured, particularly those undergoing surgical intervention, psychological factors play a substantial role in the recovery process. A more comprehensive understanding of the complex interplay between psychological and physical health in the setting of an injury is essential to optimize patient care. The aim of this review was to highlight the impact of psychological factors on measurable outcomes after orthopaedic surgical interventions and to explore interventions that can be implemented to improve surgical outcomes and the overall care of injured athletes.

Background Previous studies have demonstrated the prevalence of social media use and identified the presence of high-risk behaviors among adolescents, including self-harm and sharing of sexually explicit messages. Objective This study aimed to identify patterns in the amount of time spent on social media by adolescents who engage in high-risk behavior and the extent to which they use social media as a platform for sharing such behaviors. Methods This was a descriptive cross-sectional study of 179 adolescents seen in a pediatric clinic at an urban medical center. We used an anonymous self-report survey to obtain demographic characteristics, rates of self-harm thoughts and behaviors, sharing of sexually explicit messages, and social media use as determined by total hours spent on social media per day and the number of applications used. Results Most adolescents reported spending 3 to 5 hours on social media each day and using 3 or more social media applications. Almost 1 in 8 (22/179, 12.3%) adolescents self-reported having ever engaged in self-injury with a mean age of onset of 11.8 years. Over a quarter (49/179, 27.4%) of adolescents reported sharing sexually explicit messages. Relative risk of engaging in self-injury and or sharing sexually explicit messages increased with the use of 4 or more social media applications (1.66; CI 1.11-2.48). Conclusions Results show a relationship between the number of social media applications used and increased rates of high-risk behaviors. We identified relevant risk factors that clinicians can use to screen for high-risk behavior and parents can monitor to encourage education about healthy online practices.

Although physicians believe that PCM increases with decreasing GA, parental report suggests that PCM is not associated with GA. Parents of full-term infants in particular may experience more PCM and desire for discussion than is currently recognized.

Background: Child and adolescent sports participation continues to rise, often with specialization in a single sport at an early age. Psychological associations with sport specialization have been reported, although targeted research is lacking. Hypothesis/Purpose: The purpose of this study was to examine associations between sport specialization, levels of athletic identity, and coping skills among adolescent athletes. Methods: A cross-sectional survey study of sports medicine patients, 12-18 years, was performed. Athletes completed a one-time, voluntary, anonymous survey. Surveys included demographics, sport participation information, Athletic Identity Measurement Scale (AIMS,10-item, range 7-70), Jayanthi Sport Specialization Scale (range 0-6), and Athletic Coping Skills Inventory (ACSI, 7 subscales, range 0-84). Statistical analysis included Fisher’s exact tests, t-tests, Pearson correlations, and linear regression. Results: 334 out of 430 eligible patients completed surveys, with a response rate of 78%. Mean age was 15.0±1.8 years and participants were 64.6% female. 97.7% of participants designated participation in a primary sport, where they spent most of their time. Athletes reported starting this primary sport at a mean age of 7.2±3.7 years. Using the Jayanthi scale, 52.1% of respondents were classified as low specialization (score 0-3) and 47.9% as highly specialized (score 4-6). Sport specialization patterns did not significantly differ by age, sex, or sport. AIMS and Jayanthi scores positively correlated (r=0.39, p<0.0001), and athletes with the highest athletic identities (top 25%) were significantly more specialized than those with the weakest (bottom 25%) athletic identities (4.1 vs 2.5, p<0.001). Regression analysis demonstrated that every 1 point increase in the Jayanthi specialization scale was associated with an AIMS score increase of 2.7 points (p<0.001). The AIMS score also increased 0.83 points for every one month increase in playing their primary sport (p<0.001), and decreased 0.42 points with each year delay in starting their primary sport (p=0.02). Highly specialized athletes had significantly higher overall coping skills scores compared to low specialization athletes (51.6 vs 48.4, p<0.02), particularly on ACSI subscales of Coachability, Concentration, Confidence & Achievement Motivation, and Goal Setting & Mental Preparation (Table 1), however highly specialized athletes reported less Freedom From Worry compared to those with less specialization (5.8 vs 6.7, p=0.02). Conclusion: Athletic identity was higher in athletes who were more specialized and started their primary sport earlier in life. Greater sport specialization may confer some advantages in developing coping strategies in young athletes, however these athletes may be at risk for more worry compared to less specialized athletes. [Table: see text]