Psychological factors and adaptation to artificial interferences in healthy subjects with and without TMD history

Abstract

It has often been suggested that psychological factors play a role in temporomandibular disorders (TMD). However, reports on psychopathology and personality characteristics in TMD patients and controls have been equivocal. We have reported in a double‐blind RCT (LeBell et al., 2000) that subjects with a previous TMD history react differently in terms of TMD signs and symptoms to artificial interferences than subjects with no earlier TMD history. In the present study, we compared the psychological characteristics of these subjects and analysed the role of psychological factors in the adaptation process.The study sample of 47 women consisted of two groups: 26 women (mean age 24) without and 21 women (mean age 31) with TMD history. The subjects with TMD history had been treated earlier and they felt healthy when the intervention started. The groups were divided into true interference and placebo interference subgroups. Before the intervention, the subjects were interviewed. They also filled in questionnaires dealing with psychological and somatic symptoms, daily stress, coping strategies, personality characteristics, health hardiness and illness beliefs. During the 2‐week follow‐up period, the subjects rated the intensity of 10 symptoms on the visual analogue scale (VAS) scale and their impact on vocational and leisure time functioning. In addition, daily stress, life changes, somatic and psychological symptoms and coping with pain were explored. In general, the groups were similar in their psychological characteristics. There were, however, some differences in coping strategies. At the end of the intervention, the subjects with TMD history and exposed to true interferences reported more frequently than the other subjects muscle tension and neurological symptoms, thus indicating greater sensitivity to artificial interferences. This difference cannot be attributed to the observed base‐line personality characteristics as the groups did not differ in them. However, differences in coping strategies may play a role in the impaired adaptation.The financial support of Finska Läkaresäliskapet is gratefully acknowledged.