Strategies for coping with pain and psychological distress associated with temporomandibular joint osteoarthrosis and internal derangement.

OBJECTIVE

To analyse the relationship among a variety of emotional, cognitive, and behavioral coping strategies and pain/suffering and psychological distress in patients with temporomandibular joint (TMJ) pain.

DESIGN

Cross-sectional, correlational study.

SETTING

Department of Oral and Maxillofacial Surgery, University Hospital Groningen.

SUBJECTS

A consecutive sample of 53 patients with a mean age of 25 with TMJ osteoarthrosis and internal derangement or synovitis without internal derangement. There were seven men and 46 women. No patient was excluded.

MAIN OUTCOME MEASURES

Pain/suffering was assessed using the West Haven-Yale Multidimensional Pain Inventory and visual analogue scales. Psychological distress was assessed by the General Health Questionnaire and the Symptom Checklist. Coping with pain was assessed by the Coping with Specific Symptoms Questionnaire.

RESULTS

Psychological distress and pain severity were low, and there was little interference by pain with daily life. While none of the coping strategies were frequently used, these strategies did explain a significant proportion of the variance in pain and psychological distress measures (27-58% of the variance). Stepwise regression analysis showed that patients scoring high on expression of emotions and wishful thinking had significantly higher levels of pain/suffering and psychological distress.

CONCLUSIONS

Previous studies of other subgroups of patients with temporomandibular disorders (TMDs) report higher degrees of psychological distress. The need to distinguish between specific subgroups of patients with TMD is emphasized by the results of this study. Cognitive-behaviorial interventions to improve ways of coping is not very useful for the subgroup in this study.