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牙颌面畸形患者与应激相关的人格模式及其正颌外科手术后的演变

Stress-Related Personality Patterns in Patients With Dentofacial Deformities and Their Evolution After Orthognathic Surgery.

作者信息

Altıparmak Nur, Akdeniz Sıdıka Sinem, Ergezen Ezgi, Enez Alaz

机构信息

Associate Professor Doctor, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Baskent University, Ankara, Turkey.

Professor, Dental Professionals Clinics, Private Practice, Ankara, Turkey.

出版信息

J Oral Maxillofac Surg. 2025 May;83(5):558-564. doi: 10.1016/j.joms.2025.01.011. Epub 2025 Jan 28.

Abstract

BACKGROUND

Orthognathic surgery significantly influences psychosocial well-being. Individuals with dentofacial deformities may experience psychological distress, characterized by negative affectivity (NA) and social inhibition (SI). When these 2 traits coexist, they define Type D personality.

PURPOSE

The aim of this study was to estimate the prevalence of Type D personality traits in patients with Class III dentofacial deformities and assess changes in these traits, which inherently reflect variations in Type D personality, following orthognathic surgery.

STUDY DESIGN, SETTING, SAMPLE: This prospective cohort study was conducted at Başkent University Department of Oral and Maxillofacial Surgery between November 2022 and March 2024. Sociodemographic data and psychological assessments were collected using the Type D Scale-14 preoperatively and 3 months postoperatively.

PREDICTOR

The predictor variable was the preoperative personality trait, measured using the validated Type D Scale-14 questionnaire. This questionnaire comprises the following 2 subscales: NA and SI, each consisting of 7 items. Responses are scored from 0 to 4, resulting in scores ranging from 0 to 28. A score of ≥10 on both NA and SI subscales indicates a Type D personality.

OUTCOME VARIABLE

The primary outcome variable was the postoperative personality trait, specifically changes in NA and SI, measured using the Type D Scale-14. The secondary outcomes were the prevalence of Type D personality traits before and after surgery.

COVARIATES

The covariates were age, sex, marital status, and employment status.

ANALYSES

Descriptive statistics and paired t-tests were performed to assess the differences between preoperative and postoperative results. A P value of <.05 was considered statistically significant.

RESULTS

The study sample comprised 41 participants (mean age: 22.24 ± 4.72 years), 65.9% (n = 27) of whom were female. The prevalence of Type D personality traits significantly decreased from 42.9% (n = 18) preoperatively to 17.1% (n = 7) postoperatively (P < .05). When the subscales of NA and SI were examined, both scores showed statistically significant reductions (P < .05).

CONCLUSIONS

Significant differences were observed in NA and SI before and after orthognathic surgery. This study represents the first application of the Type D Scale-14 in the context of orthognathic surgery. Observed psychological improvement highlights the importance of preoperatively assessing patients' psychosocial conditions.

摘要

背景

正颌手术对心理社会幸福感有显著影响。牙颌面畸形患者可能会经历心理困扰,其特征为消极情感(NA)和社交抑制(SI)。当这两种特质共存时,就定义为D型人格。

目的

本研究的目的是评估III类牙颌面畸形患者中D型人格特质的患病率,并评估这些特质(本质上反映D型人格的变化)在正颌手术后的变化。

研究设计、地点、样本:这项前瞻性队列研究于2022年11月至2024年3月在巴斯肯特大学口腔颌面外科进行。术前和术后3个月使用D型量表-14收集社会人口统计学数据和心理评估。

预测因素

预测变量是术前人格特质,使用经过验证的D型量表-14问卷进行测量。该问卷包括以下两个子量表:NA和SI,每个子量表由7个项目组成。回答从0到4评分,得分范围为0到28。NA和SI子量表得分均≥10表明为D型人格。

结果变量

主要结果变量是术后人格特质,具体为使用D型量表-14测量的NA和SI的变化。次要结果是手术前后D型人格特质的患病率。

协变量

协变量为年龄、性别、婚姻状况和就业状况。

分析

进行描述性统计和配对t检验以评估术前和术后结果之间的差异。P值<.05被认为具有统计学意义。

结果

研究样本包括41名参与者(平均年龄:22.24±4.72岁),其中65.9%(n = 27)为女性。D型人格特质的患病率从术前的42.9%(n = 18)显著降至术后的17.1%(n = 7)(P <.05)。当检查NA和SI子量表时,两个得分均显示出统计学上的显著降低(P <.05)。

结论

正颌手术前后在NA和SI方面观察到显著差异。本研究是D型量表-14在正颌手术背景下的首次应用。观察到的心理改善突出了术前评估患者心理社会状况的重要性。

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