Fear Survey Schedule Research Articles

Joint hypermobility is also associated with anxiety disorders in the elderly population.

Anxiety disorders (AD) are very prevalent in the elderly, tend to compromise quality of life, and generate substantial costs. Considering that the prevention and early detection of anxiety may be relevant to increase health gains in older adults, it would be of great interest to identify whether the joint hypermobility syndrome (JHS) is also related to anxiety disorders in this age range. Cross-sectional data was collected in a sample of 108 subjects in a rural town in Spain. Instruments included Spielberger STAI, a modified Wolpe Fear Survey Schedule, General health Questionnaire (GHQ)-28, and the anxiety and mood disorders section of the SCID, to assess past year prevalence of anxiety disorders. JHS was evaluated by trained examiners using the "Hospital del Mar criteria". Among the 108 subjects (55% women, 45% men) over 60years old, 21.3% meet criteria for JHS. These subjects scored significantly higher in both State (F=5.53; p=0.02) and Trait (F=4.68; p=0.03) anxiety and the GHQ 28 (F=6.29; p=0.01). Compared with non JHS subjects, they had more AD (34.8% vs. 11.8%; x2 =6.90; p=0.02) and mood disorders (30.4% vs. 10.6%; x2 =5.65; p=0.041) in the past year prevalence. A multiple logistic regression analysis showed that both JHS (β=0.196; p=0.04) and fears (β=0.34; p=0.001) are predictors of AD (r2 =188; p=0.001) in this population. Joint hypermobility syndrome is associated with anxiety in the elderly population, and it may be used as a physical marker for AD among subjects within this age range. Copyright © 2017 John Wiley & Sons, Ltd.

Validación del Inventario de Miedo para Niños II en estudiantes de primaria y secundaria

In the current educational system, an enormous preoccupation by the low yield in the different academic areas exists, which promotes the search of new formulas of educational performance. This search cause that the pupils must learn new abilities and capacities with the purpose of conforming itself to this process in continuous evolution. From this perspective, with preoccupation by the little academic profits, the enormous importance is put of relief that can get to have the emotions and their suitable control for the improvement of himself. Socio-emotional states are starting to become more relevant and are now part of a reality in the field of Education. In this field there is high interest in emotional education programs, especially in earlier stages. These programs must be evaluated to check this efficiently. The objective of this paper is to validate a questionnaire to assess Fear, using as reference the Fear Survey Schedule for Children II (FSSC-II) (Ascensio et al., 2012) aimed at a sample of students from Primary to the end of Secondary Education. We focused on 961 participants from 8 different centers (4 schools and 4 high schools) that clearly reflect the city's pluricultural features. Considering age we focused on children from 6 to 18 years old. Considering gender, the 46.6% of them are boys and the 53.4% are girls. If we consider culture and custom religion, 66.3% are Muslims and 33.7% Christians. The technique used in this survey is a test developed to assess Fear (FSSC-II) adapted for its use in the Spanish language by Ascensio et al. (2012). The results show high levels of reliability. Our expectations about dimensions (5) were confirmed for the questionnaire. There are positive correlations between totals and the dimensions of the questionnaire. Therefore this questionnaire is an appropriate tool to evaluate the Fear in a teenager sample in our context.

Dental fear and caries in 6-12 year old children in Greece. Determination of dental fear cut-off points.

To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children&#x2041;s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of <0.05. First sample: The mean CFSS-DS score was 27.1&#177;10.8. Age was significantly (p<0.05) related to dental fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DS< 33 was defined as 'no dental fear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DS<33). Dental fear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).

Can we really use available scales for child and adolescent psychopathology across cultures? A systematic review of cross-cultural measurement invariance data.

In this systematic review, we assessed available evidence for cross-cultural measurement invariance of assessment scales for child and adolescent psychopathology as an indicator of cross-cultural validity. A literature search was conducted using the Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases. Cross-cultural measurement invariance data was available for 26 scales. Based on the aggregation of the evidence from the studies under review, none of the evaluated scales have strong evidence for cross-cultural validity and suitability for cross-cultural comparison. A few of the studies showed a moderate level of measurement invariance for some scales (such as the Fear Survey Schedule for Children-Revised, Multidimensional Anxiety Scale for Children, Revised Child Anxiety and Depression Scale, Revised Children's Manifest Anxiety Scale, Mood and Feelings Questionnaire, and Disruptive Behavior Rating Scale), which may make them suitable in cross-cultural comparative studies. The remainder of the scales either showed weak or outright lack of measurement invariance. This review showed only limited testing for measurement invariance across cultural groups of scales for pediatric psychopathology, with evidence of cross-cultural validity for only a few scales. This study also revealed a need to improve practices of statistical analysis reporting in testing measurement invariance. Implications for future research are discussed.

The first year after diagnosis: psychological impact on people with multiple sclerosis

The impact of multiple sclerosis (MS) diagnosis on newly diagnosed individuals remains so far little explored. Our aim is to outline affective, personality and quality of life (QoL) correlates of MS patients shortly after MS diagnosis. Thirty-eight (22 F and 16 M) newly-diagnosed MS patients (mean interval from diagnosis communication 4.7 ± 3.8 months, range 1–12 months) underwent the Montgomery–Åsberg Depression Rating Scale and a comprehensive psychological evaluation: Beck Depression Inventory-II, State-Trait Anxiety Inventory, Psychophysiological Questionnaire-Revised, Fear Survey Schedule, Maudsley Obsessional-Compulsive Questionnaire, Impact of Event Scale-Revised, Personal Meaning Questionnaire, Problem Solving Inventory and Multiple Sclerosis Quality of Life-54. The Expanded Disability Status Scale was assessed during the neurological examination. Depressive symptomatology, only partially related to disability, was observed in approximately 40% of patients. The prevalent approach to MS diagnosis was one of avoidance in 65.8% of cases. QoL reductions in self-perception and psychological well-being emerged, together with a peculiar perception of change in health that was not related to neurological disability. With regard to personality assessment, depressive personal meaning organization correlates inversely with important QoL measures. Newly-diagnosed patients go through a complex network of psychological changes still in the initial phases immediately after diagnosis. A thorough understanding of these adjusting aspects by the neurologist could be crucial in improving patients’ QoL, participation in relevant disease decisions and adherence to pharmacological therapy.

Tratamiento cognitivo-conductual de fobia específica en la infancia: estudio de caso

This article presents the case of a 12-year old adolescent referred to a child and adolescent mental health centre. The patient presented with anxious traits, leading to a primary diagnosis of specific phobias, which impaired his daily living. ObjectivesTo achieve a reduction in the patient's number of concerns and psychophysiological arousal, to challenge unrealistic expectations and to eliminate avoidance and escape behaviours. AssessmentAmong others, the Spanish version of the Spence Children's Anxiety Scale (SCAS) and the Fear Survey Schedule for Children-Revised (FSSC-R), were used. InterventionGroup adaptation of the Brief Coping Cat (BCC) and individual in vivo exposure. ResultsOverall anxious symptoms were reduced and the patient successfully exposed himself to his fears until anxiety completely disappeared. We highlight the importance of expectancy violation and positive stimuli techniques as change factors associated with exposure. ConclusionsThis article underscores the effectiveness of adapting the BCC to a group treatment format and the importance of optimising exposure techniques that may work for children and adolescents.

Relationship between Early Childhood Oral Health Impact Scale and Preschools?Fear and Behavior during Dental Treatment

This study aimed to investigate the relationship between Early Childhood Oral Health Impact Scale (ECOHIS) and preschoolers’ fear and behavior during dental treatment. This cross-sectional study was conducted on 385 children aged 3 to 6 attending the pediatric dentistry department of Tabriz Faculty of Dentistry in their first dental appointment. Oral health related quality of life was measured with ECOHIS questionnaire and dental fear using Children’s Fear Survey Schedule (CFSS-DS) questionnaire. Frankle’s behavioral scale was also used for the evaluation of behavioral status. Data were analyzed by SPSS version13.0. ECOHIS score was correlated with CFSS-DS score (P<0.01) and Frakle’s behavioral scale. There was an association between ECOHIS and CFSS-DS score (B =0.198), and ECOHIS and behavioral status (B=-0.193). According to the results, the poorest oral health related quality of life was associated with high levels of dental anxiety and behavioral disorders. According to the results, there was an association between early childhood oral health related quality of life and the level of dental fear and behavioral status.

The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear.

No studies assessing the association between gagging and dental fear are available in pediatric samples. To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.

An exploratory study of fears among adolescent students from an urban cohort in India.

Normal fear is an adaptive response to a real or imagined threat. Fears occur in children and adolescents at varying levels while they negotiate different developmental phases. The present study aimed at assessing the types of fears in children and adolescents between the ages of 11 and 19 years. Age and gender based differences in these fears were also studied. The study sample consisted of 2010 adolescents from an urban setting between the ages of 11 and 19 who filled in a proforma questionnaire for socio-demographic details and also filled in the Fear Survey Schedule for Children-Revised (FSSC-R). Statistical analysis of the data was done along with the use of descriptive statistics. The prevalence of fears among adolescents was found to be 85.17% in the total sample. Girls reported a significantly greater number of fears (p<0.0001) and greater levels of fear (p<0.0001) than boys. Age however, did not affect the number of fears reported. Girls scored significantly higher on all the subscales of the FSSC-R. 'Failing a test' emerged as the most common fear expressed by the sample. Girls expressed a greater fear for snakes and earthquakes than boys. Girls expressed fears to a greater extent than boys and adolescents demonstrated a high level of fears in general. There is a need for further studies in this direction to elucidate the nature of fears in this population.

Sex differences are not attenuated by a sex-invariant measure of fear: The situated fear questionnaire

Widely-used fear questionnaires may exaggerate sex differences because they do not ensure sex invariance of items and conflate anxiety with fear. Beginning with 50 descriptions of fear-eliciting situations, we used Rasch analysis to identify sex-invariant items and Mokken analysis to establish unidimensional scalability. The resulting 27-item Situated Fear Questionnaire (SFQ) correlated highly with the widely-used Fear Survey Schedule, while demonstrating better discrimination between anxiety and fear. Sex differences in three samples were all in excess of d=1.00 and were not explained by gender role adherence or anxiety levels. The hedonic tone associated with fear situations (ranging from distressing/alarming to thrilling/exhilarating) was rated as more positive by men and this was only partially explained by their lower reported fear.

Fears in anxious children

IntroductionFear is a distressing emotion aroused by a risk or a damage, real or imaginary. Fears have a warning function against dangers. Nevertheless, fear can also become in one of the most limiting elements of a person's life.ObjectivesTo characterize the profile of fears presented in a sample of 19 children, aged between 8 and 13 years old, who had previously been diagnosed with one of the following: Generalized Anxiety Disorder, Separation Anxiety Disorder or Social Phobia.Material and methodsThe sample was taken from patients who participated in a cognitive-behavioral group therapy. The Spanish version of the Fear Survey Schedule for Children-Revised (FSSC-R) questionnaire was employed. The FSSC-R asks children to indicate on a 3-point scale (‘none’, ‘some’, ‘a lot’) how much they fear 80 specific stimuli or situations. Five basic categories of fears can be stablished: failure and criticism (17 items); the unknown (17 items); minor injury and small animals (13 items); danger and death (16 items); medical fears (5 items).ResultsThe sample includes 19 children: 12 boys (63.2%) and 7 girls (36.8%). The median age is 10.74 years. The sample shows 15 excessive fears on average (those scored as ‘a lot’). Girls show higher rates of excessive fears than boys: 19 versus 13. The most common fears were ‘being hit by a car or truck’, ‘bombing attacks. Being invaded’, ‘a burglar breaking into our house’ and ‘falling from high places’.ConclusionsMost common excessive fears belong to danger and death category. Females report more fears than males.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Dental Fear in Children with Repeated Tooth Injuries.

Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years. Subjects in both age groups were divided into subroups without dental trauma, with one dental trauma and with repeated dental trauma. The validated Children’s Fear Survey Schedule – Dental Subscale was used on fear assessment. Results showed that only 12.2% of children without trauma, 33.3% with one trauma and 51.7% with repeated trauma were not afraid of injection. Older children had a significantly lower fear of injections, touch of an unknown person, choking, going to the hospital and people in white uniforms. Dentist was not the cause of fear in 65.5% of patients with repeated trauma. With each repeated injury of teeth, the degree of their fear of dental treatment was lower.

Prevalence of dental anxiety in 10-14 years old children and its implications.

BackgroundThe aim of this study was to provide insight on dental fear amongst schoolchildren and evaluate the association between caries experience and fear of dental procedures.MethodsA sample size of 250 students (both sexes) of ages 10-14 years were enrolled in the study. Before dental examination, each participant was informed about the study and given the Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) questionnaire. Children who scored greater than 38 were included in the 'with dental fear' group and those who scored less than 38 were assigned to the 'without dental fear' group. All oral check-ups were carried out on the school premises according to WHO criteria.ResultsThere were 105 children (42%) who experienced dental fear. As CFSS-DS scores increased, scores on the Decayed, Missing and Filled Surfaces Index (DMFS) also increased. Scores were highest on "injections" followed by "dentist drill" and "feeling of choking". Children were significantly less anxious about items of dental treatment if they had experienced that particular form of treatment. Female participants were found to be more dentally anxious than the male participants.ConclusionsThe data revealed dental fear in 10-14 years old children and showed that dental fear scores decreased with increase in age and experience.

Pro-Activeness of Parents in Accepting Behavior Management Techniques: A Cross-Sectional Evaluative Study.

The contemporary parents are more active and participate in the decision making during dental treatment. To assess the parents' acceptance towards behavior management techniques commonly used in the pediatric dentistry in different dental situation. Fifty-one parents participated in the study. Children's dental fear was assessed by the parents before attending power point presentation using Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents viewed power point presentation of eight behavior management techniques being used during pediatric dental treatment. The techniques were: 1) Voice control; 2) Tell-Show-Do; 3) Positive reinforcement; 4) Parental presence or absence; 5) HOME; 6) Physical restraint; 7) N2O-O2 sedation; 8) General anesthesia. Parents were asked to arrange various behavior management techniques from most accepted technique to least accepted technique in various dental situations according to their view. All the parents completed the questionnaire. Most children show increased anxiety related to dental component of CFSS-DS scale particularly during the administration of local anesthetic. In present study most preferred behavior management technique was Tell-Show-Do followed by positive reinforcement and least preferred behavior management technique was general anesthesia followed by physical restraint. Children's anxiety level increases during the condition related to dentistry which can be overcome by developing positive approach in children and parents towards dentistry and by utilizing various behaviour management strategies. A generalized low parental tolerance level for firm management techniques was seen in the present study population.

Relationship between Child and Parental Dental Anxiety with Child's Psychological Functioning and Behavior during the Administration of Local Anesthesia.

The aims of this study were to determine: 1) the relationship between children's psychological functioning, dental anxiety and cooperative behavior before and during local anesthesia, 2) the relationship of parental dental anxiety with all the above child characteristics. There was a convenient sample of 100 children (4-12 years). Child dental anxiety and psychological functioning were measured using the "Children's Fear Survey Schedule" (CFSS-DS) and the "Strengths and Difficulties Questionnaire" (SDQ) respectively. Parental dental anxiety was measured using the "Modified Dental Anxiety Scale" (MDAS). All questionnaires were completed by parents. Before and during local anesthesia, the child behavior was scored by one experienced examiner, using the Venham scale. Non-parametric tests and correlations (Mann-Whitney, Spearman's rho) were used for the analysis. The mean SDQ score was 10±5.6 for boys (n=60) and 8.3±4.8 for girls (n=40) (p=0.038), but there was no correlation with children's age. The mean CFSS-DS score was 33.1±11.86 and there was no correlation with age or gender. Children with higher levels in the pro-social subscale of the SDQ had significantly less anxiety and better behavior before local anesthesia. Higher mean CFSS-DS scores were significantly associated with uncooperative behavior during local anesthesia (p=0.04). There was no correlation between parents' and their children's dental anxiety, psychological functioning and behavior. 46% of the children had previous dental experience in the last 6 months. As time since the last dental treatment increased, an improvement was found in children's behavior during local anesthesia. Child psychological functioning was related to dental anxiety and behavior during dental appointment involving local anesthesia.

The Hierarchic Structure of Fears: A Cross-Cultural Replication with the Fear Survey Schedule in a Portuguese Sample

A confirmatory attempt is made to assess the validity of a hierarchic structural model of fears. Using a sample comprising 1,980 adult volunteers in Portugal, the present study set out to delineate the multidimensional structure and hierarchic organization of a large set of feared stimuli by contrasting a higher-order model comprising general fear at the highest level against a first-order model and a unitary fear model. Following a refinement of the original model, support was found for a five-factor model on a first-order level, namely (1) Social fears, (2) Agoraphobic fears, (3) Fears of bodily injury, death and illness, (4) Fears of display to aggressive scenes, and (5) Harmless animals fears. These factors in turn loaded on a General fear factor at the second-order level. However, the firstorder model was as parsimonious as a hierarchic higher-order model. The hierarchic model supports a quantitative hierarchic approach which decomposes fear disorders into agoraphobic, social, and specific (animal and bloodinjury) fears.

Psychometric Properties of Farsi Version of the Revised Fear Survey Schedule for Children.

This study examined the psychometric properties of the Farsi version of the Revised Fear Survey Schedule for Children (Ollendick, 1983), namely the FSSC-FA, in a sample of Iranian children and adolescents (N = 394, 206 girls) aged 9-11:11 years. The internal consistency coefficient was found to range from .79 to .96 for total and subscale scores. The authors used exploratory and confirmatory factor analyses to determine the factor structure of the FSSC-FA. The results showed that a 71-item, six-factor model provided a satisfactory fit for the structure of the FSSC-FA (RMSEA = .07, 90% CIs [.068, .072], CFI = .94, NNFI = .94, χ2/df = 2.94). With regard to gender and age differences in fears of the present sample, girls typically reported more fears than boys (Cohen's d = .28, 95% CIs [.08, .48], p < .001), but differences between older and younger participants were modest. The study also reported most common fears in the sample which were very similar to those reported by other studies except one item being specific to the Iranian population. Bearing in mind the limitations discussed, the results generally show that the FSSC-FA scores are valid and reliable to assess fears in Iranian youth.

Predicting children's behaviour during dental treatment under oral sedation.

The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. Cross-sectional prospective study. The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. In total 404 children (215 girls, 53%) were included, with the mean age of 4.57years, SD=1.9. Behaviour was scored as acceptable in 336 (83%) and unacceptable in 68 (17%) children. The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p=0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95% CI 1.33-3.88, p=0.003). CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.

Oral health-related quality-of-life among children in Swedish dental care: The impact from malocclusions or orthodontic treatment need

Objectives. To describe oral health-related quality-of-life (OHRQoL) and the impact of malocclusions or orthodontic treatment need in a cohort of children in Swedish dental care, using the Swedish version of the Child Perceptions Questionnaire–Impact Short Form (CPQ11–14–ISF:16). Subjects and methods. Two hundred and fifty-seven children (mean age = 11.5 years, SD = 0.8, range = 9.8–13.5 years) completed the CPQ11–14–ISF:16 in conjunction with a clinical examination. In addition to malocclusions and orthodontic treatment need (based on the Index of Orthodontic Treatment Need–Dental Health Component), possible confounders (caries, enamel defects, dental trauma, headache and socio-economic markers) were recorded. Children also rated their own dental fear on the Children’s Fear Survey Schedule–Dental Sub-scale (CFSS-DS). Results. The mean total CPQ11–14–ISF:16 score was 9.31. The logistic regression analyses revealed an impact of orthodontic treatment need on OHRQoL (CPQ), but no clear association between higher severity and higher impact on OHRQoL was seen. Dental fear and headache appeared to discriminate for poorer OHRQoL. No impact from caries, enamel defects, dental trauma, or socio-economic markers was revealed. Conclusions. This cohort of children reported good self-perceived OHRQoL. Effects on OHRQoL from malocclusions or orthodontic treatment need were limited and inconsistent. Dental fear and headache were found to be more distinct impact factors on OHRQoL than were malocclusions or orthodontic treatment need.

Longitudinal Changes in Dental Fear and Coping Behavior in Children, Adolescents, and Young Adults With Cleft Lip and/or Cleft Palate.

To determine changes in dental anxiety levels of cleft lip and/or palate (CL/P) children and to explore the role of coping strategies in the development of their dental anxiety. Prospective study. Free University Medical Center Amsterdam. A sample of CL/P children (at T1: n = 153, 4 to 18 years, 67 girls; at T2: n = 113, 7 to 21 years, 51 girls). Data were available at both time points for 102 children. Dental anxiety and coping strategies were assessed at the start of the study (T1; mean age: 9.8 years, standard deviation 4.1) and 3 years later (T2; mean age: 13.4 years, standard deviation 3.8). These scores were compared to a normative group of Dutch children. The severity of dental anxiety was indexed using the Parental Version of the Dental Subscale of the Children's Fear Survey Schedule. Dental coping strategies were assessed with the Dental Cope Questionnaire. Overall, dental anxiety decreased to a level equal to normative scores of Dutch children. However, 5% of the children became more anxious. At T2, children used significantly fewer coping strategies. Children whose level of dental anxiety increased significantly used more destructive coping strategies than children whose level of dental anxiety decreased significantly or remained stable. Results suggest that dental anxiety levels of most CL/P children gradually decline over time. Whereas some coping strategies have the potential to be protective, more destructive coping strategies may put children at greater risk for developing and maintaining their dental anxiety.