Reissmann Daniel R, John Mike T, Schierz Oliver, Seedorf Hartwig, Doering Stephan
Department of Prosthetic Dentistry, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
J Orofac Pain. 2012 Summer;26(3):181-90.
To test whether patients with temporomandibular disorder (TMD) pain differ from subjects from the general population with regard to their stress-related coping styles.
Consecutive adult TMD patients (n = 70) and adult subjects of a regional general population sample (n = 868), examined according to the German version of the Research Diagnostic Criteria for TMD (RDC/TMD), were included in this study. The inclusion criterion for TMD patients was at least one pain-related diagnosis according to the RDC/ TMD, while general-population subjects were excluded if they had any pain-related TMD diagnosis. Coping styles were assessed using a common and well-accepted German 114-item stress-coping questionnaire ("Stressverarbeitungsfragebogen" SVF 114). The coping style-TMD pain relationship was investigated using logistic regression analyses adjusted for possible confounders (age, sex, level of education), as well as the influence of psychosocial measures (RDC/TMD Axis II). Odds ratios (OR) with 95% confidence intervals (CI) were calculated.
Study participants who used fewer adaptive coping styles (OR = 0.47, CI: 0.26-0.83) and more maladaptive coping styles (OR = 1.55, CI: 1.05-2.29) were at greater risk for TMD pain. After adjustment for sociodemographic confounders, the coping style-TMD pain relationship changed only slightly in magnitude. In an analysis adjusted for sociodemographic confounders and psychosocial RDC/TMD Axis II measures, adaptive coping styles were even more profoundly related to TMD pain (OR: 0.27, 95 CI: 0.09-0.83), but maladaptive coping styles were less related to TMD pain (OR: 1.17, 95% CI: 0.51-2.72).
Differences in the applied stress-related coping styles of TMD patients and subjects without TMD may have implications for clinical decision making and choosing among treatment alternatives.
测试颞下颌关节紊乱病（TMD）疼痛患者与普通人群在压力相关应对方式上是否存在差异。
本研究纳入了连续的成年TMD患者（n = 70）和区域普通人群样本中的成年受试者（n = 868），这些受试者均按照德国版颞下颌关节紊乱病研究诊断标准（RDC/TMD）进行了检查。TMD患者的纳入标准是根据RDC/TMD至少有一项与疼痛相关的诊断，而普通人群受试者若有任何与疼痛相关的TMD诊断则被排除。使用一份常见且被广泛接受的包含114个条目的德国压力应对问卷（“Stressverarbeitungsfragebogen”SVF 114）来评估应对方式。采用逻辑回归分析，对可能的混杂因素（年龄、性别、教育水平）以及社会心理测量指标（RDC/TMD轴II）进行调整，研究应对方式与TMD疼痛之间的关系。计算了比值比（OR）及其95%置信区间（CI）。
采用较少适应性应对方式（OR = 0.47，CI：0.26 - 0.83）和较多适应不良应对方式（OR = 1.55，CI：1.05 - 2.29）的研究参与者患TMD疼痛的风险更高。在对社会人口学混杂因素进行调整后，应对方式与TMD疼痛之间的关系在程度上仅略有变化。在对社会人口学混杂因素和社会心理RDC/TMD轴II测量指标进行调整的分析中，适应性应对方式与TMD疼痛的关联更为显著（OR：0.27，95% CI：0.09 - 0.83），但适应不良应对方式与TMD疼痛的关联则较弱（OR：1.17，95% CI：0.51 - 2.72）。
TMD患者与无TMD受试者在应用的压力相关应对方式上的差异可能对临床决策和治疗方案的选择具有启示意义。
