STRATEGIES FOR COPING WITH PAIN AND PSYCHOLOGICAL DISTRESS ASSOCIATEDWITH TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT

Objective: To analyse the relationship among a variety of emotional, c ognitive, and behavioral coping strategies and pain/suffering and psyc hological distress in patients with temporomandibular joint (TMJ) pain . Design: Cross-sectional, correlational study. Setting: Department of Oral and Maxillofacial Surgery, University Hospital Groningen. Subjec ts: A consecutive sample of 53 patients with a mean age of 25 with TMJ osteoarthrosis and internal derangement or synovitis without internal derangement. There were seven men and 46 women. No patient was exclud ed. Main outcome measures: Pain/suffering was assessed using the West Haven-Yale Multidimensional Pain Inventory and visual analogue scales. Psychological distress was assessed by the General Health Questionnai re and the Symptom Checklist. Coping with pain was assessed by the Cop ing with Specific Symptoms Questionnaire. Results: Psychological distr ess and pain severity were low, and there was little interference by p ain with daily life. While none of the coping strategies were frequent ly used, these strategies did explain a significant proportion of the variance in pain and psychological distress measures (27-58% of the va riance). Stepwise regression analysis showed that patients scoring hig h on expression of emotions and wishful thinking had significantly hig her levels of pain/suffering and psychological distress. Conclusions: Previous studies of other subgroups of patients with temporomandibular disorders (TMDs) report higher degrees of psychological distress. The need to distinguish between specific subgroups of patients with TMD i s emphasized by the results of this study. Cognitive-behaviorial inter ventions to improve ways of coping is not very useful for the subgroup in this study.