Date of Award
Doctor of Philosophy
This study examines the relationship between psychological factors and the development, maintenance, and treatment outcome of temporomandibular joint pain and dysfunction (TMJPD). Two hundred and two facial pain patients were classified, according to the diagnostic criteria of Eversole and Machado, as either myogenic facial pain (n = 42), internal derangement Type I (n = 69), internal derangement Type II n = 85), or internal derangement Type III (n = 6). During assessment, patients were administered a pressure pain threshold and tolerance task and completed the Basic Personality Inventory, the Illness Behavior Questionnaire, the Multidimensional Health Locus of Control, the Perceived Stress Scale, the McGill Pain Questionnaire, and the Ways of Coping Checklist. Subjects also answered questions pertaining to TMJPD symptomatology, including chronicity and severity. Patients were treated with simple jaw exercises and ultrasound and contacted again at 5 months to complete a follow-up questionnaire packet similar to the initial questionnaire battery. Comparison groups were comprised of 79 non-TMJ patients attending outpatient physiotherapy clinics for pain related injuries and 71 pain-free, healthy students. Data were analyzed using multivariate statistics. The results indicate a significant relationship between pain intensity, and to some extent chronicity, and diverse measures of personality among the pain controls but not among the TMJPD patients. This calls into question the validity of assuming individual pain disorders are subsets of a larger, homogeneous pain disorder population. TMJPD patients and pain controls score higher on hypochondriasis, depression, and anxiety than the pain-free controls but these elevations are not clinically significant. The elevations decrease to normal levels in response to a positive treatment outcome. There were no differences between the TMJPD patients and the pain controls on any of the measures. These results suggest that TMJPD patients do not appear to be significantly different from other pain patients or healthy controls in personality type, response to illness, attitudes towards health care, or ways of coping with stress. Lastly, at least with respect to TMJPD, it is difficult to identify factors that are important in predicting treatment outcome. This may be a function of how readily the disorder responds to treatment.
Schnurr, Robert Francis, "Psychological Factors In The Development, Maintenance, And Treatment Outcome Of Temporomandibular Joint Pain And Dysfunction" (1988). Digitized Theses. 1751.