Berggren U, Hakeberg M, Carlsson S G
Department of Oral Diagnosis, Institute of Odontology, Göteborg University, Sweden.
J Dent Res. 2000 Sep;79(9):1645-51. doi: 10.1177/00220345000790090201.
Cognitive therapy has been reported for the treatment of dental phobia, but comparisons with other behavioral treatments are scarce. This study investigated the outcome of two modes of treatment for phobic dental fear. Relaxation and cognitively oriented therapy were compared in a sample of 112 adult fearful dental patients. The patient made questionnaire assessments of background and outcome variables, and the specialist dentist rated successful/non-successful outcome. It was shown that a higher number of patients who received cognitively oriented therapy completed the treatment program, while anxiety was more reduced among patients who received relaxation-oriented therapy. Dropout during the initial phobia therapy with a psychologist was related to lower motivation (willingness to engage in treatment), while failures during dental treatment after the completion of therapy were related to higher levels of general fear and anxiety. A multiple logistic regression model explaining 67% of the variance revealed that the risk of failure was only slightly increased by general fears, while patients with low (below median) motivation ran a 3.6-times-higher risk of dropping out. In conclusion, it was shown that the two treatment methods were both effective in reducing dental phobic reactions. However, while cognitively oriented therapy resulted in a higher number of patients completing therapy, relaxation-oriented treatment generally resulted in a more significant reduction in dental fear as well as in general anxiety and fear. Motivation was found to be a significant predictor of successful treatment outcome.
已有报道称认知疗法可用于治疗牙科恐惧症，但与其他行为疗法的比较却很少。本研究调查了两种治疗牙科恐惧的方法的效果。在112名成年牙科恐惧症患者样本中，对放松疗法和认知导向疗法进行了比较。患者对背景和结果变量进行问卷评估，专科牙医对治疗结果成功与否进行评分。结果显示，接受认知导向疗法的患者中完成治疗计划的人数更多，而接受放松导向疗法的患者焦虑程度降低得更多。在最初接受心理学家的恐惧症治疗期间退出与较低的动机（参与治疗的意愿）有关，而治疗完成后牙科治疗期间的失败与更高水平的总体恐惧和焦虑有关。一个解释了67%方差的多元逻辑回归模型显示，总体恐惧只会使失败风险略有增加，而动机低（低于中位数）的患者退出风险高出3.6倍。总之，结果表明这两种治疗方法在减少牙科恐惧反应方面均有效。然而，虽然认知导向疗法使更多患者完成治疗，但放松导向治疗通常能更显著地减轻牙科恐惧以及总体焦虑和恐惧。研究发现动机是治疗成功结果的一个重要预测因素。
