Psychological well-being and distress: Their associations with temporomandibular disorder symptoms and interrelationships

Abstract

This cross-sectional study established the relationships between temporomandibular disorder (TMD) symptoms, psychological well-being (PWB), and psychological distress (PD). Additionally, the psychological predictors for various TMD features were determined. TMD symptoms were ascertained with the Diagnostic Criteria for TMDs Symptom Questionnaire in young adults and PWB and PD were assessed with Ryff's Scales of Psychological Well-Being-18 (SPWB-18) and Depression, Anxiety, and Stress Scales-21, respectively. Statistical analyses were conducted using Kruskal Wallis/Mann-Whitney U tests, Spearman's correlation, and multivariate logistic regression (α=.05). Of the 734 participants (mean age=19.35 ± 1.24 years) appraised, 40.7% had no TMD manifestations and 59.3% reported various TMD symptoms (25.2% pain-related, 14.6% intra-articular, and 19.5% combined). Among the 4 symptom groups, significant differences in PWB were perceived for total SPWB and the Environmental Mastery/Self-Acceptance subscales. Significant differences in total Depression, Anxiety, and Stress Scales-21, depression, anxiety, and stress were also noted between the pain-related TMD symptoms/combined TMD symptoms and no TMD symptoms groups. For all groups, the strongest correlation was observed between total SPWB and depression (rs=-0.52 to 0.65). Environmental mastery decreased the likelihood of pain-related and intra-articular TMD symptoms. Conversely, overall PD and anxiety predicted the presence of pain-related and intra-articular/combined TMD symptoms correspondingly.