Addicks S H, McNeil D W, Randall C L, Goddard A, Romito L M, Sirbu C, Kaushal G, Metzger A, Weaver B D
Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, USA.
School of Dentistry, West Virginia University, Morgantown, WV, USA.
JDR Clin Trans Res. 2017 Jul;2(3):304-311. doi: 10.1177/2380084417691962. Epub 2017 Feb 9.
Distress tolerance, the degree to which one is able to cope with and endure negative emotional states, has been broadly applied to understand and treat a variety of health (including behavioral) problems, but little is known about its role in oral health care and specifically dental care-related fear and anxiety, making it a novel construct in the oral health care literature. This cross-sectional study examined distress tolerance as a possible predictor of dental fear and anxiety among a sample of adults with and without diagnoses of dental phobia, investigated possible differences in levels of distress tolerance between adults with and without dental phobia, and determined possible associations between distress tolerance and fear of pain, anxiety sensitivity, and depression. Using 52 volunteers ( = 31, dental phobia group; = 21, healthy comparison group), this investigation used self-report measures of distress tolerance, fear of pain, anxiety sensitivity, dental fear, and depression. The Anxiety Disorders Interview Schedule, a semi-structured interview, was used to assess for dental phobia and other psychological disorders. Distress tolerance significantly predicted dental fear and anxiety, even after controlling for age, sex, fear of pain, anxiety sensitivity, and depression. In addition, the dental phobia group had lower distress tolerance than the healthy comparison group. Distress tolerance was significantly associated with fear of pain, anxiety sensitivity, and depression. Findings indicate that low distress tolerance plays a unique and distinct role as a possible mechanism in the genesis of dental care-related fear and anxiety and phobia and may exacerbate the experience of other states, including fear of pain and anxiety sensitivity. : Results indicate that patients who have a lower ability to tolerate emotional and physical distress may have higher levels of dental care-related fear and anxiety and even dental phobia, as well as associated sequelae (e.g., avoidance of dental care). Treatment of highly fearful dental patients may helpfully include a focus on increasing distress tolerance.
痛苦耐受力是指一个人应对和忍受负面情绪状态的程度，已被广泛应用于理解和治疗各种健康（包括行为）问题，但对于其在口腔保健中的作用，尤其是与牙科护理相关的恐惧和焦虑，人们知之甚少，这使其成为口腔保健文献中的一个新结构。这项横断面研究将痛苦耐受力作为有无牙科恐惧症诊断的成年样本中牙科恐惧和焦虑的一个可能预测指标进行了检验，调查了有无牙科恐惧症的成年人在痛苦耐受力水平上的可能差异，并确定了痛苦耐受力与疼痛恐惧、焦虑敏感性和抑郁之间的可能关联。该研究使用了52名志愿者（ = 31，牙科恐惧症组； = 21，健康对照组），采用了痛苦耐受力、疼痛恐惧、焦虑敏感性、牙科恐惧和抑郁的自我报告测量方法。使用半结构化访谈《焦虑症访谈量表》来评估牙科恐惧症和其他心理障碍。即使在控制了年龄、性别、疼痛恐惧、焦虑敏感性和抑郁之后，痛苦耐受力仍能显著预测牙科恐惧和焦虑。此外，牙科恐惧症组比健康对照组的痛苦耐受力更低。痛苦耐受力与疼痛恐惧、焦虑敏感性和抑郁显著相关。研究结果表明，低痛苦耐受力作为与牙科护理相关的恐惧、焦虑和恐惧症发生的一种可能机制，发挥着独特而显著的作用，并且可能会加剧其他状态的体验，包括疼痛恐惧和焦虑敏感性。 ：结果表明，那些在情感和身体痛苦耐受力方面能力较低的患者，可能有更高水平的与牙科护理相关的恐惧和焦虑，甚至牙科恐惧症，以及相关的后遗症（例如，回避牙科护理）。对高度恐惧牙科的患者进行治疗时，可能有益地包括关注提高痛苦耐受力。
