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Cited by 107Temporomandibular Joint DisordersStudent Stress and CopingPsychosomatic Disorders and Their Treatments

Is there a relationship between psychological factors and TMD?

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Sójka, Anna, Stelcer, Bogusław, Roy, Marco, Mojs, Ewa, Pryliński, Mariusz·2019·Brain and Behavior
DOI 10.1002/brb3.1360PMC PMC7649956
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Abstract

Introduction: Medical students are in a very demanding environment and are affected by high degree of stress. High levels of anxiety can affect a student's academic performance and also increase the risk of other health‐related problems. This study aims to evaluate, thanks to the intensity of stress manifestations (4DSQ) together with the sense of coherence (SOC), the prevalence of TMD and oral parafunctions in students enrolled in the University of Medical Sciences. Moreover, it aims to evaluate the relationship between the psychosocial manifestations of stress and sense of coherence in relation to gender. Materials and Methods: A total of 324 students of Poznań University of Medical Sciences participated in this study. Students were assessed using a three‐part questionnaire: one was to assess symptoms of TMD, the second part was 4DSQ, and the third was a SOC Questionnaire. Results: About one‐third of the students in this study presented symptoms of TMD and perceived more intensively symptoms of distress, anxiety, somatization, and depression. They presented a higher level of somatic symptoms and a lower level of Sense of Coherence than students without TMD symptoms. Conclusion: There is a strong negative relationship between the sense of coherence and the level of perceived distress, anxiety, somatization, and depression. Female students attending Medical School showed a higher level of somatization of stress but with a higher capacity to overcome challenges as compared to men.

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  • Several studies find high levels of anxiety and depression in TMD patients.

    “Several studies find high levels of anxiety and depression in TMD patients (Simoen et al., Citation2020; Sójka et al., Citation2019).”

    From The association between pain-related factors and psychological distress in patients with temporomandibular disorder. (2023) · cites this paper as Sójka et al., 2019

    The Abstract’s Results report that students with TMD symptoms experienced more intense anxiety and depression than students without those symptoms. The Discussion says several studies found high depression in TMD patients with high pain-related disability, but it does not establish high levels of both anxiety and depression across TMD patients generally. Page numbers are unavailable in our copy. (LLM, conf=0.82)

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Research works printed but not linked: 51

  1. Antonovsky, A. (1998). The sense of coherence: A historical and future perspective In McCubbin H. I., Thompson E. A., Thompson A. I., & Fromer J. E. (Eds.), Stress, coping, and health in families: Sense of coherence and resiliency (pp. 3– 20). Thousand Oaks, CA: Sage Publications.
  2. Barbosa, T. D. S., Miyakoda, L. S., Pocztaruk, R. D. L., Rocha, C. P., & Gavião, M. B. D. (2008). Temporomandibular disorders and bruxism in childhood and adolescence: Review of the literature. International Journal of Pediatric Otorhinolaryngology, 73(3), 299– 314. 10.1016/j.ijporl.2007.11.006 18180045 · DOI
  3. Bodyk‐Cupak, I., Majda, A., Zalewska‐Puchała, J., & Kamińska, A. (2016). The impact of a sense of self‐efficacy on the level of stress and the ways of coping with difficult situations in Polish nursing students. Nurse Education Today, 45, 102– 107. 10.1016/j.nedt.2016.07.004 27429414 · DOI
  4. Bortsov, A., Bair, E., Dubner, E., Fillingim, R., Greenspan, J., Ohrbach, R., … Maixner, W. (2017). Autonomic correlates of pain intensity, somatic symptoms and sleep quality in TMD: The OPPERA study. Journal of Pain, 18(4), S73.
  5. Czachowski, S., Izdebski, A., Terluin, B., & Izdebski, P. (2013). Validation study of the Dutch Four‐Dimensional Symptom Questionnaire in Poland. (Walidacja kwestionariusza 4DSQ mierzącego dystres, depresję, lęk i somatyzację w Polsce). Problemy Medycyny Rodzzinnej, 4(40), 14– 20.
  6. De Leeuw, J. R. J., Steenks, M. H., Ros, W. J., Lobbezoo‐Scholte, A. M., Bosman, F., & Winnubst, J. A. (1994). Multidimensional evaluation of craniomandibular dysfunction. I: Symptoms and correlates. Journal of Oral Rehabilitation, 21, 501– 514. 7996335
  7. de Ridder, D., Geenen, R., Kuijer, R., & van Middendorp, H. (2008). Psychological adjustment to chronic disease. Lancet, 372(9634), 246– 255. 10.1016/S0140-6736(08)61078-8 18640461 · DOI · Paper page
  8. Dworkin, S. F. (2010). Research diagnostic criteria for temporomandibular disorders: Current status and future relevance. Journal of Oral Rehabilitation, 37, 734– 743. 20529171
  9. Dyrbye, L. N., Thomas, M. R., Huntington, J. L., Lawson, K. L., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2006). Personal life events and medical student burnout: A multicenter study. Academy Medicine, 81, 374– 384. 10.1097/00001888-200604000-00010 16565189 · DOI
  10. Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine, 81(4), 354– 373. 10.1097/00001888-200604000-00009 16565188 · DOI · Paper page
  11. Giannakopoulos, N. N., Keller, L., Rammelsberg, P., Kronmüller, K.‐T., & Schmitter, M. (2010). Anxiety and depression in patients with chronic temporomandibular pain and in controls. Journal of Dentistry, 38, 369– 376. 10.1016/j.jdent.2010.01.003 20079799 · DOI
  12. Gil‐Martínez, A., Grande‐Alonso, M., López‐de‐Uralde‐Villanueva, I., López‐López, A., Fernández‐Carnero, J., & La Touche, R. (2016). Chronic temporomandibular disorders: Disability, pain intensity and fear of movement. Journal of Headache and Pain, 17, 103 10.1186/s10194-016-0690-1 27812883 PMC5095086 · DOI
  13. Graue, A. M., Jokstad, A., Assmus, J., & Skeie, M. S. (2016). Prevalence among adolescents in Bergen, Western Norway, of temporomandibular disorders according to the DC/TMD criteria and examination protocol. Acta Odontologica Scandinavica, 74, 449– 455. 10.1080/00016357.2016.1191086 27251463 · DOI
  14. Hasenbring, M., Hallner, D., & Klasen, B. (2001). Psychological mechanisms in the transition from acute to chronic pain: Overview underrated? Schmerz, 15, 442– 447. 11793149
  15. Heinen, I., Bullinger, M., & Kocalevent, R. D. (2017). Perceived stress in first year medical students – associations with personal resources and emotional distress. Medical Education, 17(4), 1– 14. 10.1186/s12909-016-0841-8 28056972 PMC5216588 · DOI
  16. Huang, G. J., LeResche, L., Critchlow, C. W., Martin, M. D., & Drangsholt, M. T. (2002). Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD). Journal of Dental Research, 81(4), 284– 288. 12097315
  17. Humphris, G., Blinkhorn, A., Freeman, R., Gorter, R., Hoad‐Reddick, G., Murtomaa, H., … Splieth, C. H. (2002). Psychological stress in undergraduate dental students: Baseline results from seven European dental schools. European Journal of Dental Education, 6, 22– 29. 10.1034/j.1600-0579.2002.060105.x 11872070 · DOI
  18. Hurst, C. S., Baranik, L. E., & Daniel, F. (2013). College student stressors: A review of the qualitative research. Stress and Health, 29, 275– 285. 10.1002/smi.2465 23023893 · DOI · Paper page
  19. Ivkovic, N., Mladenovic, I., Petkovic, S., & Stojic, D. (2008). TMD chronic pain and masseter silent period in psychiatric patients on antidepressive therapy. Journal of Oral Rehabilitation, 35, 424– 432. 10.1111/j.1365-2842.2007.01819.x 18284562 · DOI
  20. Kafas, P., Kafas, G., Christofides, A., Chiotaki, N., & Theodoridis, M. (2008). Chewing ability, mood and sleep are negatively influenced by chronic TMJ pain: Preliminary results. Research Journal of Medical Science, 2, 5– 6.
  21. Kindler, S., Samietz, S., Houshmand, M., Grabe, H. J., Bernhardt, O., Biffar, R., … Schwahn, C. (2012). Depressive and anxiety symptoms as risk factors for temporomandibular joint pain: A prospective cohort study in the general population. Journal of Pain, 13, 1188. 23141187
  22. Kotiranta, U., Suvinen, T., Kauko, T., Le Bell, Y., Kemppainen, P., Suni, J., & Forssell, H. (2015). Subtyping patients with temporomandibular disorders in a primary health care setting on the basis of the research diagnostic criteria for temporomandibular disorders axis II pain‐related disability: A step toward tailored treatment planning? Journal of Oral & Facial Pain and Headache, 29, 126– 134. 10.11607/ofph.1319 25905530 · DOI
  23. LeResche, L. (1997). Epidemiology of temporomandibular disorders: Implications for the investigation of etiologic factors. Critical Reviews in Oral Biology and Medicine, 8, 291– 305. 9260045
  24. List, T., Wahlund, K., & Larsson, B. (2001). Psychosocial functioning and dental factors in adolescents with temporomandibular disorders: A case‐control study. Journal of Orofacial Pain, 15, 218– 227. 11575192
  25. Lobbezoo, F., Ahlberg, J., Glaros, A. G., Kato, T., Koyano, K., Lavigne, G. J., … Winocur, E. (2013). Bruxism defined and graded: An international consensus. Journal of Oral Rehabilitation, 40, 2– 4. 23121262
  26. Magnusson, T., Egermark, I., & Carlsson, G. E. (2000). A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. Journal of Orofacial Pain, 14, 310– 319. 11203765
  27. Manfredini, D., Borella, L., Favero, L., Ferronato, G., & Guarda‐Nar‐dini, L. (2010). Chronic pain severity and depression/somatization levels in TMD patients. International Journal of Prosthodontics, 23, 529– 534. 21209988
  28. Manfredini, D., Cantini, E., Romagnoli, M., & Bosco, M. (2003). Prevalence of bruxism in patients with different research diagnostic criteria for temporomandibular disorders (RDC/TMD) diagnoses. Cranio: the Journal of Craniomandibular Practice, 21, 279– 285. 14620701
  29. Manfredini, D., & Lobbezoo, F. (2009). Role of psychosocial factors in the etiology of bruxism. Journal of Orofacial Pain, 23, 153– 166. 19492540
  30. Manfredini, D., Winocur, E., Ahlberg, J., Guarda‐Nardini, L., & Lobbezoo, F. (2010). Psychosocial impairment in temporomandibular disorders patients. RDC/TMD axis II findings from a multi‐ center study. Journal of Dentistry, 38, 765– 772. 20600559
  31. Manfredino, D., Bandethini, A. B., & Cantini, E. (2009). Mood and anxiety Psychopathology and temporomandibular disorder. Journal of Oral Rehabilitation, 41, 933– 937. 15387831
  32. Marbach, J. J., Raphael, K. G., Janal, M. N., & Hirschkorn‐Roth, R. (2003). Reliability of clinician judgements of bruxism. Journal of Oral Rehabilitation, 30, 113– 118. 10.1046/j.1365-2842.2003.01146.x 12535135 · DOI
  33. Marcinkowska, U., Lau, K., & Jośko‐Ochojska, J. (2013). O potrzebie kształcenia studentów medycyny w aspekcie wiedzy o stresie – w ramach zajęć fakultatywnych. Hygeia Public Health, 48(2), 152– 155.
  34. Michie, S. (2002). Causes and management of stress at work. Occupational and Environmental Medicine, 59, 67– 72. 10.1136/oem.59.1.67 11836475 PMC1740194 · DOI
  35. Miller, C., Newton, S. E. (2006). Pain perception and expression: The influence of gender, personal self‐efficacy, and lifespan socialization. Pain Management Nursing, 7, 148– 152. 17145488
  36. Motta, L. J., Guedes, C. C., DeSantis, T. O., Fernandes, K. P. S., Mesquita‐Ferrari, R. A., & Bussadori, S. K. (2013). Association between parafunctional habits and signs and symptoms of temporomandibular dysfunction among adolescents. Oral Health & Preventive Dentistry, 11, 3– 7. 23507675
  37. Myers, C. D., Riley, J. L. III, & Robinson, M. E. (2003). Psychosocial contributions to sex‐correlated differences in pain. Clinical Journal of Pain, 19, 225– 232. 10.1097/00002508-200307000-00005 12840616 · DOI · Paper page
  38. Nash, J. M., & Thebarge, R. W. (2006). Understanding psychological stress, its biological processes, and impact on primary headache. Headache, 46(9), 1377– 1386. 10.1111/j.1526-4610.2006.00580.x 17040334 · DOI
  39. Nilsson, I. M., Drangsholt, M., & List, T. (2009). Impact of temporomandibular disorder pain in adolescents: Differences by age and gender. Journal of Orofacial Pain, 23(2), 115– 122. 19492536
  40. Ofili, A. N., Oriaifo, I., Okungbowa, E., & Eze, E. U. (2009). Stress and psychological health of medical students in a Nigerian University. Nigerian Journal of Clinical Practice, 12(2), 128– 133. 19764658
  41. Pedroni, C. R., De Oliveira, A. S., & Guaratini, M. I. (2003). Prevalence study of signs and symptoms of temporomandibular disorders in university students. Journal of Oral Rehabilitation, 30, 283– 289. 10.1046/j.1365-2842.2003.01010.x 12588501 · DOI
  42. Rollman, G. B., & Gillespie, J. M. (2000). The role of psychosocial factors in temporomandibular disorders. Current Review of Pain, 4, 71– 81. 10.1007/s11916-000-0012-8 10998718 · DOI
  43. Sanders, A. E., & Slade, G. D. (2011). Gender modifies effect of perceived stress on orofacial pain symptoms: National Survey of Adult Oral Health. Journal of Orofacial Pain, 25(4), 317– 326. 22247927
  44. Sherina, M. S., Rampa, L. L., & Kaneson, N. (2004). Psychological stress among undergraduate medical students. Medical Journal of Malaysia, 59(2), 207– 211. 15559171
  45. Su, N., Lobbezoo, F., Vanwijk, A., Vanderheide, G., & Visscher, C. M. (2017). Associations of pain intensity and pain‐related disability with psychological and socio‐demographic factors in patients with temporomandibular disorders: A cross‐sectional study at a specialised dental clinic. Journal of Oral Rehabilitation., 44, 187– 196. 10.1111/joor.12479 28036120 · DOI
  46. Suvinen, T., Reade, P. C., Sunden, B., Gerschman, J. A., & Koukounas, E. (1997a). Temporomandibular disorders: Part I. A comparison of symptom profiles in Australian and Finnish patients. Journal of Orofacial Pain, 11, 58– 66. 10332311
  47. Suvinen, T., Reade, P. C., Sunden, B., Gerschman, J. A., & Koukounas, E. (1997b). Temporomandibular disorders: Part II. A comparison of psychologic profiles in Australian and Finnish patients. Journal of Orofacial Pain, 11, 147– 157. 10332321
  48. Terluin, B. (1994). Overspanning onderbouwd. Een onderzoek naar de diagnose surmenage in de huisartspraktijk [Nervous breakdown substantiated. A study of the general practitioner's diagnosis of surmenage]. Ph.D. thesis. Utrecht, the Netherlands: DETAM.
  49. Terluin, B., Brouwers, E. P., van Marwijk, H. W., Verhaak, P., & van der Horst, H. E. (2009). Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four‐Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS). BMC Family Practice, 23(10), 58 10.1186/1471-2296-10-58 PMC2753335 19698153 · DOI
  50. White, K. S., & Farrell, A. D. (2006). Anxiety and psychosocial stress as predictors of headache and abdominal pain in urban early adolescents. Journal of Pediatric Psychology, 31(6), 582– 596. 10.1093/jpepsy/jsj050 16049263 · DOI
  51. Zakrzewska, J. M. (2002). Trigeminal neuralgia In: Zakrzewska J. M., & Harrison S. D. (Eds.), Assessment and management of orofacial pain, (1st ed., pp. 267– 370). Amsterdam, the Netherlands: Elsevier Sciences.

Cited by

Sorted by citations

Authors
Sójka, A., Stelcer, B., Roy, M., Mojs, E., & Pryliński, M.
Affiliations
Poznan University of Medical Sciences (PL)
Corresponding author
Roy, Marco
ORCID
Venue
Brain and Behavior
Publisher
Wiley
Published
2019-07-24
Volume
9
Issue
9
Pages
e01360-e01360
ISSN
  • 2157-9032 (ISSN-L)
  • 2162-3279
DOI
10.1002/brb3.1360
PMC
PMC7649956
OpenAlex
W2963052422
Cited by
107
References
7
Citations by year
2026: 4 · 2025: 15 · 2024: 25 · 2023: 22 · 2022: 20 · 2021: 15 · 2020: 3 · 2019: 3
FWCI
14.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Brain and Behavior (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
temporomandibular disorders, medical students, psychological stress, sense of coherence, anxiety, depression, somatization, parafunctional habits, gender differences, psychosocial stress
MeSH terms
Psychological Distress, Adolescent, Adult, Anxiety, Depression, Female, Humans, Male, Poland, Surveys and Questionnaires, Somatoform Disorders, Stress, Psychological, Students, Medical, Temporomandibular Joint Disorders, Prevalence, Young Adult, Sense of Coherence

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