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Cited by 92Temporomandibular Joint DisordersMusculoskeletal pain and rehabilitationPediatric Pain Management Techniques

Momentary pain and coping in temporomandibular disorder pain: exploring mechanisms of cognitive behavioral treatment for chronic pain

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Litt, Mark D., Shafer, David M., Ibanez, Carlos R., Kreutzer, Donald L., Tawfik-Yonkers, Zeena·2009·Pain
DOI 10.1016/j.pain.2009.06.003PMC PMC2735598
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Abstract

The purpose of this study was to determine whether cognitive-behavioral treatment (CBT) operates by effecting changes in cognitions, affects, and coping behaviors in the context of painful episodes. Patients were 54 men and women with temporomandibular dysfunction-related orofacial pain (TMD) enrolled in a study of brief (6 weeks) standard conservative treatment (STD) or standard treatment plus CBT (STD+CBT). Momentary affects, pain, and coping processes were recorded on a cell phone keypad four times per day for 7 days prior to treatment, and for 14 days after treatment had finished, in an experience sampling paradigm. Analyses indicated no treatment effects on general retrospective measures of pain, depression, or pain-related interference with lifestyle at post-treatment. However, mixed model analyses on momentary pain and coping recorded pre- and post-treatment indicated that STD+CBT patients reported greater decreases in pain than did STD patients, significantly greater increases in the use of active cognitive and behavioral coping, and significantly decreased catastrophization. Analyses of experience sampling data indicated that post-treatment momentary pain was negatively predicted by concurrent active coping, self-efficacy, perceived control over pain, and positive-high arousal affect. Concurrent catastrophization was strongly predictive of pain. Active behavioral coping and self-efficacy reported at the prior time point (about 3h previously) were also protective, while prior catastrophization and negative-high arousal mood were predictive of momentary pain. The results suggest that CB treatment for TMD pain can help patients alter their coping behaviors, and that these changes translate into improved outcomes.

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Crossref · 10.1016/j.pain.2009.06.003

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  • For Litt 2009, incomplete outcome data was judged high risk because the study did not report flow of participants or attrition throughout the study, and it appears they conducted completer analyses.

    “High risk Did not report flow of participants in the study or attrition throughout the study. Appears they have conducted completer analyses”

    From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Litt 2009

    The Method > Participants section (page unavailable) says the analysis included 54 people who completed both assessments out of 101 in the larger study, supporting the concern about completer analyses. It also reports how many did not provide complete data, so the claim that attrition was not reported at all is too broad; the passage does not give a detailed account of participant flow throughout the study. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • For Litt 2009, allocation concealment was judged unclear risk because the Project Coordinator entered the urn data during the intake session and informed participants of their treatment assignments, and it was unclear if allocation was concealed from participants.

    “Unclear risk”

    From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Litt 2009

    Split into 2 atoms — 1 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • For Litt 2009, random sequence generation was judged low risk because computerised urn randomisation was used.

    “Low risk”

    From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Litt 2009

  • For Litt 2009, blinding of outcome assessment was judged unclear risk because it was not reported.

    “Unclear risk Not reported”

    From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Litt 2009

  • For Litt 2009, treatment expectations was judged unclear risk because it was not assessed.

    “Unclear risk Not assessed”

    From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Litt 2009

    The Method sections on Measures and Instruments and Procedure describe pain, coping, affect, and related assessments, but do not address whether treatment expectations were assessed. Searches for treatment expectations and expectancy also found no passage establishing the citing document’s ‘unclear risk’ judgment. (LLM, conf=0.70)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 17

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Authors
Litt, M. D., Shafer, D. M., Ibanez, C. R., Kreutzer, D. L., & Tawfik-Yonkers, Z.
Affiliations
UConn Health (US)
Corresponding author
Litt, Mark D.
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-09
Volume
145
Issue
1
Pages
160-168
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/j.pain.2009.06.003
PMC
PMC2735598
OpenAlex
W2102823216
Cited by
92
References
5
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 3 · 2016: 7 · 2015: 8 · 2014: 6 · 2013: 10 · 2012: 11
FWCI
12.03
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • 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 › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
temporomandibular disorders, orofacial pain, cognitive behavioral therapy, chronic pain, pain catastrophizing, coping styles, self-efficacy, affective states, therapeutic mechanisms, pain interference
MeSH terms
Adaptation, Psychological, Analysis of Variance, Anti-Inflammatory Agents, Chronic Disease, Female, Humans, Male, Pain, Pain Measurement, Predictive Value of Tests, Severity of Illness Index, Temporomandibular Joint Disorders, Cognitive Behavioral Therapy, Treatment Outcome, Patient Satisfaction, Pain Management

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