Thomson W M, Broadbent J M, Locker D, Poulton R
Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
Community Dent Oral Epidemiol. 2009 Jun;37(3):209-19. doi: 10.1111/j.1600-0528.2009.00473.x.
To examine predictors of dental anxiety trajectories in a longitudinal study of New Zealanders.
Prospective study of a complete birth cohort born in 1972/73 in Dunedin, New Zealand, with dental anxiety scale (DAS) scores and dental utilization determined at ages 15, 18, 26 and 32 years. Personality traits were assessed at a superfactor and (more fine-grained) subscale level via the Multidimensional Personality Questionnaire at age 18 years. Group-based trajectory analysis was used to identify dental anxiety trajectories.
DAS scores from at least three assessments were available for 828 participants. Six dental anxiety trajectories were observed: stable nonanxious low (39.6%); stable nonanxious medium (37.9%); recovery (1.6%); adult-onset anxious (7.7%); stable anxious (7.2%) and adolescent-onset anxious (5.9%). Multivariate analysis showed that males and those with higher DMFS at age 15 years were more likely to be in the stable nonanxious low trajectory group. Membership of the stable nonanxious medium group was predicted by the dental caries experience at age 15 years. Participants who had lost one or more teeth between ages 26 and 32 years had almost twice the relative risk for membership of the adult-onset anxious group. Personality traits predicted group membership. Specifically, high scorers (via median split) on the 'stress reaction' subscale had over twice the risk of being in the stable anxious group; low scorers on the traditionalism subscale were more likely to be members of the recovery trajectory group; and high scorers on the 'social closeness' subscale had half the risk of being in the stable anxious group. Dental caries experience at age 5 years was also a predictor for the stable anxious group. Membership of the late-adolescent-onset anxious group was predicted by higher dental caries experience by age 15 years, but none of the other predictors was significant.
Six discrete trajectories of dental anxiety have been observed. Some trajectories (totalling more than 90% of the cohort) had clear associations with external influences, but others were more strongly associated with characteristics such as personality traits. A mix of both influences was observed with only the stable anxious dental anxiety trajectory.
在一项针对新西兰人的纵向研究中，探究牙科焦虑轨迹的预测因素。
对1972/73年出生于新西兰达尼丁的一个完整出生队列进行前瞻性研究，在15、18、26和32岁时测定牙科焦虑量表（DAS）得分和牙科就诊情况。18岁时通过多维人格问卷在超因素和（更细化的）子量表水平评估人格特质。采用基于组的轨迹分析来识别牙科焦虑轨迹。
828名参与者至少有三次评估的DAS得分。观察到六种牙科焦虑轨迹：稳定非焦虑低水平（39.6%）；稳定非焦虑中等水平（37.9%）；恢复型（1.6%）；成年期起病焦虑型（7.7%）；稳定焦虑型（7.2%）和青少年期起病焦虑型（5.9%）。多变量分析表明，男性和15岁时DMFS较高者更有可能处于稳定非焦虑低水平轨迹组。15岁时的龋齿经历可预测稳定非焦虑中等水平组的成员情况。在26至32岁之间掉了一颗或多颗牙的参与者进入成年期起病焦虑组的相对风险几乎高出一倍。人格特质可预测组内成员情况。具体而言，“应激反应”子量表得分高（通过中位数分割）的参与者处于稳定焦虑组的风险高出两倍多；传统主义子量表得分低的参与者更有可能是恢复型轨迹组的成员；“社交亲密性”子量表得分高的参与者处于稳定焦虑组的风险减半。5岁时的龋齿经历也是稳定焦虑组的一个预测因素。15岁时较高的龋齿经历可预测青少年晚期起病焦虑组的成员情况，但其他预测因素均无显著意义。
观察到六种不同的牙科焦虑轨迹。一些轨迹（占队列总数的90%以上）与外部影响有明显关联，但其他轨迹与人格特质等特征的关联更强。仅在稳定焦虑型牙科焦虑轨迹中观察到两种影响的混合。
