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自我转诊人群中牙科恐惧的表现、成因及诊断类别

Manifestations, acquisition and diagnostic categories of dental fear in a self-referred population.

作者信息

Moore R, Brødsgaard I, Birn H

机构信息

Royal Dental College, Department of Child Dental Health and Community Dentistry, Dental Phobia Research and Treatment Center, Aarhus, Denmark.

出版信息

Behav Res Ther. 1991;29(1):51-60. doi: 10.1016/s0005-7967(09)80007-7.

DOI:10.1016/s0005-7967(09)80007-7
PMID:2012589
Abstract

This study aimed to clarify how manifestations and acquisition relate to diagnostic categories of dental fear in a population of self-referred dental fear patients, since diagnostic criteria specifically related to dental fear have not been validated. DSM III-R diagnostic criteria for phobias were used to compare with four existing dental fear diagnostic categories, referred to as the Seattle system. Subjects were 208 persons with dental fear who were telephone interviewed, of whom a subsample of 155 responded to a mailed Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory and a modified FSS-II Geer Fear Scale (GFS). Personal interviews and a Dental Beliefs Scale of perceived trust and social interaction with dentists were also used to evaluate a subsample of 80 patients selected by sex and high dental fear. Results showed that the majority of the 80 patients (66%), suffered from social embarrassment about their dental fear problem and their inability to do something about it. The largest cause of their fear (84%) was reported to be traumatic dental experiences, especially in childhood (70%). A minority of patients (16%) could not isolate traumatic experiences and had a history of general fearfulness or anxiety. Analysis of GFS data for the 155 subjects showed that fear of snakes and injuries were highest among women; heights and injections among men. Fear of blood was rarely reported. Spearman correlations between GFS individual items and DAS scores indicated functional independence between dental fear and common fears such as blood, injections and enclosures in most cases. Only in specific types of dental fear did these results support Rachman and Lopatka's contention that fears are thought to summate.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究旨在阐明在自我转诊的牙科恐惧患者群体中,症状表现和成因与牙科恐惧诊断类别的关系,因为与牙科恐惧相关的诊断标准尚未得到验证。采用《精神疾病诊断与统计手册》第三版修订本(DSM III-R)中恐惧症的诊断标准,与四种现有的牙科恐惧诊断类别(即西雅图系统)进行比较。研究对象为208名有牙科恐惧的人,通过电话访谈,其中155人回复了邮寄的牙科焦虑量表(DAS)、状态-特质焦虑量表以及修订后的FSS-II吉尔恐惧量表(GFS)。还通过个人访谈以及一份关于对牙医的信任和社交互动的牙科信念量表,对按性别和高度牙科恐惧挑选出的80名患者的子样本进行评估。结果显示,80名患者中的大多数(66%)因牙科恐惧问题及其无力解决而感到社交尴尬。据报告,他们恐惧的最大原因(84%)是牙科创伤经历,尤其是在童年时期(70%)。少数患者(16%)无法找出创伤经历,且有一般恐惧或焦虑史。对155名受试者的GFS数据进行分析表明,女性中对蛇和受伤的恐惧最高;男性中对高度和注射的恐惧最高。很少有人报告对血液的恐惧。GFS各单项与DAS分数之间的斯皮尔曼相关性表明,在大多数情况下,牙科恐惧与对血液、注射和封闭空间等常见恐惧之间存在功能独立性。只有在特定类型的牙科恐惧中,这些结果才支持拉赫曼和洛帕特卡的观点,即恐惧被认为会累加。(摘要截选至250字)

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