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Potential Psychosocial Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study - 08/11/11

Doi : 10.1016/j.jpain.2011.08.007 
Roger B. Fillingim , Richard Ohrbach , Joel D. Greenspan , Charles Knott §, Ronald Dubner , Eric Bair , #, ǂ, Cristina Baraian #, Gary D. Slade , , William Maixner , ǂ
 University of Florida, College of Dentistry, and North Florida/South Georgia Veterans Health System, Gainesville, Florida 
 Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York 
 Department of Neural and Pain Sciences, University of Maryland Dental School, Baltimore, Maryland 
§ Battelle Memorial Institute, Centers for Public Health Research and Evaluation, Columbus, Ohio 
 Center for Neurosensory Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 
# Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 
ǂ Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 
 Departments of Dental Ecology and Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 

Address reprint requests to Roger B. Fillingim, PhD, University of Florida College of Dentistry, 1329 SW 16th Street, Room 5180, PO Box 103628, Gainesville, FL 32610-3628.

Abstract

Case-control studies have consistently associated psychosocial factors with chronic pain in general, and with temporomandibular disorders (TMD) specifically. Moreover, a handful of prospective studies suggest that preexisting psychosocial characteristics represent risk factors for new onset TMD. The current study presents psychosocial findings from the baseline case-control study of the Orofacial Pain Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 1,633 TMD-free controls and 185 TMD cases completed a battery of psychosocial instruments assessing general psychosocial adjustment and personality, affective distress, psychosocial stress, somatic awareness, and pain coping and catastrophizing. In bivariate and demographically adjusted analyses, odds of TMD were associated with higher levels of psychosocial symptoms, affective distress, somatic awareness, and pain catastrophizing. Among controls, significant gender and ethnic group differences in psychosocial measures were observed, consistent with previous findings. Principal component analysis was undertaken to identify latent constructs revealing 4 components: stress and negative affectivity, global psychosocial symptoms, passive pain coping, and active pain coping. These findings provide further evidence of associations between psychosocial factors and TMD. Future prospective analyses in the OPPERA cohort will determine if the premorbid presence of these psychosocial factors predicts increased risk for developing new onset TMD.

Perspective

This article reports baseline psychosocial findings from the OPPERA Study, a large prospective cohort study designed to discover causal determinants of TMD pain. Findings indicate significant differences between TMD cases and TMD-free controls across multiple psychosocial constructs, and future analyses will determine whether these psychosocial factors increase risk for new onset TMD.

Le texte complet de cet article est disponible en PDF.

Key words : Temporomandibular disorders, psychosocial risk factors, chronic pain, somatic awareness, catastrophizing


Plan


 Supported by NIH grant U01DE017018. This material was also supported by the North Florida/South Georgia Veterans Health System, Gainesville, FL. The OPPERA program also acknowledges resources specifically provided for this project by the respective host universities: University at Buffalo, University of Florida, University of Maryland-Baltimore, and University of North Carolina-Chapel Hill.
 Roger Fillingim and Gary Slade are consultants and equity stock holders, and William Maixner is a cofounder and equity stock holder in Algynomics, Inc., a company providing research services in personalized pain medication and diagnostics. Richard Ohrbach, Joel Greenspan, Charles Knott, Ronald Dubner, Eric Bair, and Cristina Baraian declare that they have no conflicts of interest. Portions of these data were presented at the 2010 Annual Scientific Meeting of the American Pain Society in Baltimore, MD.
 Supplementary data accompanying this article are available online at jpain.org and sciencedirect.com.


© 2011  Publié par Elsevier Masson SAS.
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Vol 12 - N° 11S

P. T46-T60 - novembre 2011 Retour au numéro
Article précédent Article précédent
  • Clinical Findings and Pain Symptoms as Potential Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study
  • Richard Ohrbach, Roger B. Fillingim, Flora Mulkey, Yoly Gonzalez, Sharon Gordon, Henry Gremillion, Pei-Feng Lim, Margarete Ribeiro-Dasilva, Joel D. Greenspan, Charles Knott, William Maixner, Gary Slade
| Article suivant Article suivant
  • Pain Sensitivity Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case Control Study
  • Joel D. Greenspan, Gary D. Slade, Eric Bair, Ronald Dubner, Roger B. Fillingim, Richard Ohrbach, Charlie Knott, Flora Mulkey, Rebecca Rothwell, William Maixner

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