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Brief cognitive-behavioral treatment for TMD pain: Long-term outcomes and moderators of treatment
Open accessAbstract
The purpose of this study was to determine whether a brief (6-8 sessions) cognitive-behavioral treatment for temporomandibular dysfunction-related pain could be efficacious in reducing pain, pain-related interference with lifestyle and depressive symptoms. The patients were 101 men and women with pain in the area of the temporomandibular joint of at least 3 months duration, randomly assigned to either standard treatment (STD; n=49) or standard treatment+cognitive-behavioral skills training (STD+CBT; n=52). Patients were assessed at posttreatment (6 weeks), 12 weeks, 24 weeks, 36 weeks, and 52 weeks. Linear mixed model analyses of reported pain indicated that both treatments yielded significant decreases in pain, with the STD+CBT condition resulting in steeper decreases in pain over time compared to the STD condition. Somatization, self-efficacy and readiness for treatment emerged as significant moderators of outcome, such that those low in somatization, or higher in self-efficacy or readiness, and treated with STD+CBT reported of lower pain over time. Somatization was also a significant moderator of treatment effects on pain-related interference with functioning, with those low on somatization reporting of less pain interference over time when treated in the STD+CBT condition. It was concluded that brief treatments can yield significant reductions in pain, life interference and depressive symptoms in TMD sufferers, and that the addition of cognitive-behavioral coping skills will add to efficacy, especially for those low in somatization, or high in readiness or self-efficacy.
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“Although the group-level treatment effects may be similar, there is substantial individual variability in treatment response to CBT and MBSR.19,51”
From Moderators and Nonspecific Predictors of Treatment Benefits in a Randomized Trial of Mindfulness-Based Stress Reduction vs Cognitive-Behavioral Therapy vs Usual Care for Chronic Low Back Pain (2023) · cites this paper as [51]
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“Previous studies provide conflicting evidence for pain self-efficacy, pain catastrophizing, depressive symptoms, and treatment expectations as moderators and predictors in behavioral trials for pain.5,19,51,56,81,86”
From Moderators and Nonspecific Predictors of Treatment Benefits in a Randomized Trial of Mindfulness-Based Stress Reduction vs Cognitive-Behavioral Therapy vs Usual Care for Chronic Low Back Pain (2023) · cites this paper as [51]
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“A study of CBT for temporomandibular disorder pain also found greater benefits for those with higher pain self-efficacy.51”
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“113,114 The expansion of Axis II instruments for the new DC/TMD allows for identification of patients’ psychosocial and behavioral status in order to identify factors that, if present, must be addressed from the beginning of any treatment in an attempt to decrease suffering and increase functioning.”
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Metadata
- Authors
- Litt, M. D., Shafer, D. M., & Kreutzer, D. L.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Litt, Mark D.
- Venue
- Pain
- Published
- 2010-10
- Volume
- 151
- Issue
- 1
- Pages
- 110-116
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC2939176
- OpenAlex
- W2097647917
- Cited by
- 118
- References
- 33
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 9 · 2023: 6 · 2022: 9 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 8 · 2017: 11 · 2016: 5 · 2015: 12 · 2014: 6 · 2013: 11 · 2012: 7
- FWCI
- 11.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- 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 › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- temporomandibular disorders, TMD pain, cognitive behavioral therapy, short-term treatment, pain interference, depressive symptoms, somatization, self-efficacy, moderators of treatment outcome, coping skills training
- MeSH terms
- Depression, Female, Humans, Longitudinal Studies, Male, Pain Measurement, Patient Compliance, Psychiatric Status Rating Scales, Temporomandibular Joint Disorders, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome
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