Stress, coping, and personality hardiness in patients with temporomandibular disorders.

Abstract

To investigate the role of personality factors and stress coping in temporomandibular disorder (TMD), a chronic facial pain-dysfunction syndrome. Design/Participants: Descriptive cross-sectional study of 84 TMD and 79 orthodontic-periodontic contrast patients recruited from a 3-state region. Measures: Questionnaire consisting of validated measures of personality hardiness, microstressors ("hassles"), coping responses, neuroticism, dispositional optimism, depression, and pain perception. Results: Principal-components factor analysis (orthogonal and oblique rotations) suggested 4 conceptual factors: Escape-Neuroticism, Pain, Hardiness, and Problem Solving-Optimism. Linear discriminant analysis showed that these factors significantly distinguished TMD from non-TMD participants at a classification accuracy rate of 85%; this model was replicated in a cross-validation sample. Relative to contrast participants, TMD patients interpreted similar daily life events as more stressful and endorsed more use of nonadaptive coping responses. Conclusions: These findings support the assertion that psychological factors are important in the presentations of patients with TMD. Furthermore, TMD patients may present with a "negative stress coping" constellation distinguishing them from other chronic dental patients, suggesting a role for cognitivebehavioral interventions as part of the comprehensive rehabilitation plan. Despite 60 years of research, the role of psychological factors in the etiology of temporomandibular disorder (TMD) remains controversial. A chronic facial pain and dysfunction syndrome frequently treated within multidisciplinary pain rehabilitation programs, TMD consists of generalized pain of the head and neck, limited mandibular range of motion, clinically significant joint sounds on functional movement of the mandible, and radiographic evidence of change within the temporomandibular joints. Females are significantly more often diagnosed with

Self-regulatory fatigue in chronic multisymptom illnesses: scale development, fatigue, and self-control

“…For example, actively trying to cope with stress has been linked with relapses for people dieting, or trying to quit smoking or drinking 29–33. Patients with chronic multisymptom illness often engage in passive coping strategies focused on avoiding or disengaging from unpleasant activities,34–36 which may be an indication of SRF, and again could explain why treatments and interventions for chronic multisymptom illnesses at times are associated with high degrees of attrition, ranging from 38% to 87% 37–41. If patients with chronic multisymptom illness are experiencing SRF due to overwhelming illness-related demands, they may not have the strength to invoke active coping strategies, or if they do, they may not have the energy to persist with such.…”

Executive Functions, Self-Regulation, and Chronic Pain: A Review

“…Despite this, chronic pain patients are more likely to attempt to manage pain through passive coping strategies compared with controls and exhibit less involvement or commitment to activities [68,69]. Passive coping may not only impede rehabilitation, but it may also worsen the symptoms of the disease.…”

“…Passive coping, on the other hand, has been linked to diminished psychological adjustment and increased disability and pain [65,[68][69][70][71]. Despite this, chronic pain patients are more likely to attempt to manage pain through passive coping strategies compared with controls and exhibit less involvement or commitment to activities [68,69].…”

Psychological factors and responses to artificial interferences in subjects with and without a history of temporomandibular disorders

“…Severe TMD disturbances also associate with perception of pain outside one's control [30,33], while beliefs about personal control, e.g. personality hardiness [35] and selfefficacy, may facilitate adjustment to stress and pain, and may also result in better treatment outcome [11,18,20,30,32,36]. To conclude, biopsychosocial factors probably act in a complex interaction, and rather than a specific personality profile, a range of profiles [1,13,15,29] is likely to be found in TMD.…”