Psychosocial aspects of craniomandibular dysfunction. An assessment of clinical and community findings

Abstract

This study was performed to assess whether subgroups of patients with signs and symptoms of craniomandibular dysfunction (CMD) and a control group of dental patients with and without signs of CMD can be characterized by psychosocial variables, and whether there is evidence of stress-induced muscle hyperactivity as a contributing factor in the development of signs and symptoms of CMD. A group of 127 care-seeking patients and a control group of 158 dental patients completed a Questionnaire Battery (QB) designed to measure external stressors, stress-related emotional reactions (anxiety and depression) and personal factors such as coping styles, health locus of control and personality. Patients with CMD with both a myogenous and an arthrogenous component reported more stress and stronger stress-related emotional reactions than patients with either an arthrogenous or a myogenous CMD. However, patients with arthrogenous CMD did not differ on psychosocial variables from patients with myogenous CMD. In contrast to expectations, controls with signs of CMD reported more stress than patients with CMD. Compared with controls, CMD-patients experienced less personal control over their health and they considered health to be determined by chance or fate. CMD-patients also reported to cope differently with stress than controls. Analyses of covariance showed that the results were not influenced by differences in age, sex or pain reported in the head, neck and/or shoulders. Results were interpreted with regard to the psychophysiological theory of the development of signs and symptoms of CMD as a consequence of the progression of stress-induced muscle hyperactivity. Differences between patients and controls in personal factors were interpreted with regard to treatment need for CMD.