Psychological Factors Associated With Development of TMD: The OPPERA Prospective Cohort Study - 25/11/13
, Richard Ohrbach †, Joel D. Greenspan ‡, Charles Knott §, Luda Diatchenko ||, ¶, ∗∗, ††, Ronald Dubner ‡, Eric Bair ||, ¶, ‡‡, Cristina Baraian ‡‡, Nicole Mack ‡‡, Gary D. Slade ||, §§, ¶¶, William Maixner ||, ¶, †††Abstract |
Case-control studies have consistently associated psychological factors with chronic pain in general and with temporomandibular disorder (TMD) specifically. However, only a handful of prospective studies have explored whether preexisting psychological characteristics represent risk factors for first-onset TMD. The current findings derive from the prospective cohort study of the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 3,263 TMD-free participants completed a battery of psychological instruments assessing general psychological adjustment and personality, affective distress, psychosocial stress, somatic symptoms, and pain coping and catastrophizing. Study participants were then followed prospectively for an average of 2.8 years to ascertain cases of first-onset of TMD, and 2,737 provided follow-up data and were considered in the analyses of TMD onset. In bivariate and demographically adjusted analyses, several psychological variables predicted increased risk of first-onset TMD, including reported somatic symptoms, psychosocial stress, and affective distress. Principal component analysis of 26 psychological scores was used to identify latent constructs, revealing 4 components: stress and negative affectivity, global psychological and somatic symptoms, passive pain coping, and active pain coping. In multivariable analyses, global psychological and somatic symptoms emerged as the most robust risk factor for incident TMD. These findings provide evidence that measures of psychological functioning can predict first onset of TMD. Future analyses in the OPPERA cohort will determine whether these psychological factors interact with other variables to increase risk for TMD onset and persistence.
Perspective |
This article reports that several premorbid psychological variables predict first-onset TMD in the OPPERA study, a large prospective cohort study designed to discover causal determinants of TMD pain. Measures of somatic symptoms were most strongly associated with TMD onset, but perceived stress, previous life events, and negative affect also predicted TMD incidence.
Le texte complet de cet article est disponible en PDF.Key words : Temporomandibular disorder, psychological risk factors, chronic pain somatic symptoms, psychosocial stress
Plan
| Publication of this supplement was made possible with support of the National Institutes of Health grant U01DE017018. The OPPERA program also acknowledges resources specifically provided for this project by the participating institutions: Battelle Memorial Institute; University at Buffalo; University of Florida; University of Maryland; University of North Carolina at Chapel Hill. R.B.F. and G.D.S. are consultants and equity stock holders, and W.M. and L.D. are cofounders and equity stock holders in Algynomics, Inc, a company providing research services in personalized pain medication and diagnostics. Other authors declare no conflicts of interest. |
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| Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com. |
Vol 14 - N° 12S
P. T75-T90 - décembre 2013 Retour au numéro
Article précédent
- Pain Sensitivity and Autonomic Factors Associated With Development of TMD: The OPPERA Prospective Cohort Study
- Joel D. Greenspan, Gary D. Slade, Eric Bair, Ronald Dubner, Roger B. Fillingim, Richard Ohrbach, Charles Knott, Luda Diatchenko, Qian Liu, William Maixner
- Genetic Variants Associated With Development of TMD and Its Intermediate Phenotypes: The Genetic Architecture of TMD in the OPPERA Prospective Cohort Study
- Shad B. Smith, Ellen Mir, Eric Bair, Gary D. Slade, Ronald Dubner, Roger B. Fillingim, Joel D. Greenspan, Richard Ohrbach, Charles Knott, Bruce Weir, William Maixner, Luda Diatchenko
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