title: Psychological traits regarding competitiveness are related to the incidence of anterior cruciate ligament injury in high school female athletes.
abstract: BACKGROUND
  The purpose of this study was to investigate the relationship between psychological competitive ability and the incidence of noncontact ACL injuries among high school female athletes.
  
  
  METHODS
  A three-year prospective cohort study was conducted using 300 15-year-old high school female athletes with no previous injuries or symptoms in their lower limbs (106 handball players and 194 basketball players). At baseline, their psychological competitive abilities were assessed using a self-administered questionnaire-the Diagnostic Inventory of Psychological Competitive Ability (DIPCA.3). After the baseline examination was performed at high school entry, all players were prospectively followed for 36months to document any subsequent incidence of ACL injury, according to their coaches. An unpaired t-test with Welch's correction was performed to compare the differences in the psychological competitive abilities between the injured and uninjured players.
  
  
  RESULTS
  Of the 300 players, 25 (8.3%) experienced a noncontact ACL injury during the three-year observation period. The injured players had significantly higher total DIPCA.3 scores for psychological competitive ability than the uninjured players (169.9±18.8 vs. 159.2±21.6, P=.036). Additionally, the injured players had significantly higher scores than the uninjured players in the following categories: aggressiveness, volition for self-realization, volition for winning, judgment, and cooperation. However, no significant differences were observed in patience, self-control, ability to relax, concentration, confidence, decision, and predictive ability.
  
  
  CONCLUSIONS
  High psychological competitive ability was associated with the incidence of noncontact ACL injuries in high school female athletes.
  
  
  METHODS
  Level II (prospective cohort study).
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kosaka
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan. Electronic address: nakase1007@yahoo.co.jp.
authors.forename: Junsuke
authors.initials: J
authors.lastname: Nakase
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Hitoaki
authors.initials: H
authors.lastname: Numata
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takata
authors.affiliation: Division of Rehabilitation, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Moriyama
authors.affiliation: Division of Rehabilitation, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Oda
authors.affiliation: Department of Orthopaedic Surgery, KKR Hokuriku Hospital, Kanazawa, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Shima
authors.affiliation: Department of Orthopaedic Surgery, Kijima Hospital, Kanazawa, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kitaoka
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000070598:Anterior Cruciate Ligament Injuries / Q000453:epidemiology* / Q000523:psychology*; D001265:Athletic Injuries / Q000453:epidemiology* / Q000523:psychology*; D003163:Competitive Behavior; D005260:Female; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D012574:Schools / Q000706:statistics & numerical data
keywords: Anterior cruciate ligament; Female athletes; Injury; Psychological competitive ability; Risk factor