Cited by 528Temporomandibular Joint DisordersPsychosomatic Disorders and Their TreatmentsMusculoskeletal pain and rehabilitation

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Psychological Factors Associated With Development of TMD: The OPPERA Prospective Cohort Study

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Fillingim, Roger B., Ohrbach, Richard, Greenspan, Joel D., Knott, Charles, Diatchenko, Luda, Dubner, Ronald, Bair, Eric, Baraian, Cristina, Mack, Nicole, Slade, Gary D., Maixner, William·2013·The Journal of Pain

DOI 10.1016/j.jpain.2013.06.009PMC PMC3855656

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Abstract

Unlabelled 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.

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Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J.-P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., et al. (2014) · Journal of Oral & Facial Pain and Headache · doi:10.11607/jop.1151 · Cited by 4,567
“64,118 Widespread pain suggests potential systemic disorders, including rheumatic diseases and/or central sensitization (eg, fibromyalgia), suggesting the need for further medical assessment.”
BackgroundSelf-citation
The role of psychosocial processes in the development and maintenance of chronic pain
Edwards, R. R., Dworkin, R. H., Sullivan, M. D., Turk, D. C., & Wasan, A. D. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2016.01.001 · Cited by 954
Evaluating psychosocial contributions to chronic pain outcomes
Meints, S. M., & Edwards, R. R. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.01.017 · Cited by 719
Painful Temporomandibular Disorder
Slade, G. D., Ohrbach, R. K., Greenspan, J. D., Fillingim, R. B., Bair, E., Sanders, A. E., Dubner, R. A., Diatchenko, L. B., Meloto, C. B., Smith, S. B., et al. (2016) · Journal of Dental Research · doi:10.1177/0022034516653743 · Cited by 678
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Individual differences in pain: understanding the mosaic that makes pain personal
Fillingim, R. B. (2016) · Pain · doi:10.1097/j.pain.0000000000000775 · Cited by 758
Self-citation

See all 528

Authors: Fillingim, R. B., Ohrbach, R., Greenspan, J. D., Knott, C., Diatchenko, L., Dubner, R., Bair, E., Baraian, C., Mack, N., Slade, G. D., & Maixner, W.
Affiliations: University of Florida Health (US)
University at Buffalo, State University of New York (US)
University of Maryland, Baltimore (US)
Battelle (US)
University of North Carolina at Chapel Hill (US)
Corresponding author: Fillingim, Roger B.
ORCID: Fillingim, Roger B.
Ohrbach, Richard
Greenspan, Joel D.
Knott, Charles
Diatchenko, Luda
Bair, Eric
Mack, Nicole
Slade, Gary D.
Venue: The Journal of Pain
Publisher: Elsevier BV
Published: 2013-12
Volume: 14
Issue: 12
Pages: T75-T90
ISSN: 1526-5900 (ISSN-L)
DOI: 10.1016/j.jpain.2013.06.009
PMC: PMC3855656
OpenAlex: W2001391699
Cited by: 528
References: 93
Citations by year: 2026: 45 · 2025: 62 · 2024: 65 · 2023: 52 · 2022: 69 · 2021: 48 · 2020: 42 · 2019: 30 · 2018: 41 · 2017: 21 · 2016: 22 · 2015: 14 · 2014: 7 · 2013: 5
FWCI: 26.10
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 3571 d)
Locations: Journal of Pain (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
UNC Libraries
Funders: National Institutes of Health
University at Buffalo
National Institute of Dental and Craniofacial Research (U01DE017018)
Topics: Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Keywords: temporomandibular disorders, psychological risk factors, somatic symptoms, psychosocial stress, emotional distress, negative affectivity, pain coping, pain catastrophizing, psychological adjustment, personality, orofacial pain
MeSH terms: Adolescent, Adult, Facial Pain, Female, Humans, Male, Prospective Studies, Surveys and Questionnaires, Risk Factors, Temporomandibular Joint Disorders

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Psychological Factors Associated With Development of TMD: The OPPERA Prospective Cohort Study

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