Psychological variables and temporomandibular disorders: Distress, coping, and personality

https://doi.org/10.1016/j.tripleo.2003.12.030Get rights and content

Abstract

Objective

This study analyzes the psychological variables of distress, personality, and coping that are related to the diagnosis based on the Research Diagnostic Criteria for temporomandibular disorder.

Study design

An age and sex-matched controlled study conducted with a convenience sample (n = 89) in a tertiary care facility.

Results

The MANCOVA between the muscular (n = 47), articular (n = 42), and control groups (n = 100) showed that the muscular group differed from the control group, obtaining higher levels of distress, anxiety, and depression, and minor use of positive reinterpretation and humor as coping strategies; the articular group also showed higher distress, less positive reinterpretation, and a lower interest in the search of instrumental social support than the control group. The coping predictor of distress in both temporomandibular groups was behavioral disengagement; however, the personality predictors differed. Neuroticism and depression were present in the muscular group, whereas conscientiousness and self-discipline were in the articular group.

Conclusion

Temporomandibular disorder patients have different psychological features than control subjects. There are also some differences between the diagnostic groups that should be considered to address the treatment of these patients.

Section snippets

Sample and procedure

The design of this research is an age- and sex-matched controlled study conducted in a tertiary care facility hospital in the Valencian Community (Spain). All the patients residing in the area of reference of the University of Valencia General Hospital who show temporomandibular symptoms and wish to be treated by the public health services are sent to the Stomatology Service of this hospital. In this service, the data were collected for a period of 6 months. Approximately 425 patients were

Statistical analysis

A multiple analysis of variance (MANCOVA) was carried out to determine the existence of differences between the muscular, articular and the control groups, introducing age as a covariable. Previously, it was necessary to check the hypothesis of homoscedasticity through the Box test (M = 246.94; P > .05), given the absence of uniformity in the size of the groups.16 The MANCOVA is more robust than the simple variance analysis (ANOVA); therefore, the differences are not increased because of the number

Differences between the muscular, articular, and control groups

The analysis reflects the total score of the BSI, the coping strategies measured by COPE, and the personality factors evaluated through NEO-PI-R. The MANCOVA results showed that, overall, the differences found were significant, with 22% of the variance of the combination of variables included explaining the inclusion in the group. The differences between the groups showed the presence of greater distress and lesser use of the positive reinterpretation strategy in the TMD patients comparing to

Discussion

In this paper we are searching for specific characteristics in personality, coping strategies, and levels of distress in patients with TMD, attempting to allay diverse limitations present in the investigations reviewed. Selection of the sample was performed according to RDC/TMD.4 The clinical group was divided into muscular and articular groups since they seem to exhibit different characteristics both in the clinical presentation of the disorders,17 as well as in the aspect regarding the

References (29)

  • T.I. Suvinen et al.

    Temporomandibular disorders: a critical review of the nature of pain and its assessment

    J Orofac Pain

    (1995)
  • C.D. Callahan

    Stress, coping and personality hardiness in patients with temporomandibular disorders

    Rehabil Psychol

    (2000)
  • M. Kight et al.

    Temporomandibular disorders: evidence for significant overlap with psychopathology

    Health Psychol

    (1999)
  • A. Michelotti et al.

    Personality characteristics of temporomandibular disorder patients using MMPI

    Cranio

    (1998)
  • Cited by (85)

    View all citing articles on Scopus
    View full text