Cited by 86Temporomandibular Joint DisordersMusculoskeletal pain and rehabilitationFibromyalgia and Chronic Fatigue Syndrome Research

Determinants of pain treatment response and nonresponse: identification of TMD patient subgroups

Open access
Litt, Mark D., Porto, Felipe B.·2013·The Journal of Pain

Abstract

Unlabelled The purpose of the present study was to determine if we could identify a specific subtype of temporomandibular disorder (TMD) pain patients that does not respond to treatment. Patients were 101 men and women with chronic TMD pain recruited from the community and randomly assigned to 1 of 2 treatment conditions: a standard conservative care (STD) condition or a standard care plus cognitive-behavioral therapy condition (STD + CBT) in which patients received all elements of STD but also received cognitive-behavioral coping skills training. Growth mixture modeling, incorporating a series of treatment-related predictors, was used to distinguish several distinct classes of responders or nonresponders to treatment based on reported pain over a 1-year follow-up period. Results indicated that treatment nonresponders accounted for 16% of the sample and did not differ from treatment responders on demographics or temporomandibular joint pathology, but that they reported more psychiatric symptoms, poorer coping, and higher levels of catastrophizing. Treatment-related predictors of membership in treatment responder groups versus the nonresponder group included the addition of CBT to STD, treatment attendance, and decreasing catastrophization. It was concluded that CBT may be made more efficacious for TMD patients by placing further emphasis on decreasing catastrophization and on individualizing care.Perspective This article provides evidence that the TMD chronic pain population is heterogeneous and that a subsample of patients will be unresponsive to standard or psychosocial approaches. The addition of CBT to treatment may be helpful for this group, but new individualized approaches will be needed to treat all patients effectively.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jpain.2013.07.017

Cites

79 of 79 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • About 20% of people with chronic pain have depression, compared with less than 7% of the general population, and this pattern is found worldwide.

    “Approximately 20% of individuals with chronic pain also have depression, while less than 7% of the general population experiences this disorder, and these findings hold not just for the U.S. but around the world 231–235.”
  • Non-responders to pain treatment exhibit poorer coping and higher level of pessimism.

    “it has been shown that non-responders to pain treatment exhibit poorer coping and higher level of pessimism (Litt and Porto 2013).”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

2 retracted

Flagged first, then by citations

Research works printed but not linked: 3

  1. [25]Litt MD Shafer DM Ibanez CR Kreutzer DL Tawfik-Yonkers Z Momentary pain and coping in temporomandibular disorder pain: exploring mechanisms of cognitive behavioral treatment for chronic pain. Pain 2009 145 160 168 19553018 PMC2735598
  2. [35]Muthen LK Muthen BO Mplus User's Guide: Statistical Analysis with Latent Variables 1998-2007 Muthen & Muthen Los Angeles, CA Fourth edition
  3. [36]Nagin DS Group-based modelling of development 2005 Harvard University Press Cambridge, MA

Cited by

Sorted by citations

Authors
Litt, M. D., & Porto, F. B.
Affiliations
UConn Health (US)
Corresponding author
Litt, Mark D.
Venue
The Journal of Pain
Publisher
Elsevier BV
Published
2013-11
Volume
14
Issue
11
Pages
1502-1513
ISSN
1526-5900 (ISSN-L)
OpenAlex
W2002521930
Cited by
86
References
79
Citations by year
2026: 2 · 2025: 3 · 2024: 6 · 2023: 8 · 2022: 12 · 2021: 9 · 2020: 4 · 2019: 9 · 2018: 10 · 2017: 8 · 2016: 8 · 2015: 4 · 2014: 2 · 2012: 1
FWCI
7.51
Type
journal article
Language
en
Open access
Locations
  • Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Dental and Craniofacial Research (R01-DE14607, R01DE014607)
  • National Center for Research Resources (M01RR006192, M01 RR 06192)
Topics
  • Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords
temporomandibular disorders, chronic pain, treatment response, treatment non-responders, cognitive behavioral therapy, pain catastrophizing, coping, psychiatric symptoms, patient subgroups, growth mixture modeling, individualized care
MeSH terms
Adaptation, Psychological, Adult, Anti-Inflammatory Agents, Non-Steroidal, Female, Humans, Male, Middle Aged, Pain, Patient Compliance, Temporomandibular Joint Disorders, Cognitive Behavioral Therapy, Treatment Outcome, Treatment Failure, Catastrophization, Pain Management

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review