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- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Ambivalence in Coping with Dental Fear and Avoidance: A Qualitative Study
- 2002
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Ingår i: Journal of Health Psychology. - : SAGE Publications. - 1359-1053 .- 1461-7277. ; 7:6, s. 653-664
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Tidskriftsartikel (refereegranskat)abstract
- Dental phobia is a widespread problem, which can have significant impact on the individual's health and daily life. This grounded theory study aims to explore the situation of dental phobic patients: how dental phobia interferes with their normal routines and functioning, social activities and relationships, what factors contribute to the maintenance of dental fear and how they cope with their fear. In the qualitative analysis of thematized in-depth interviews four main categories were developed: threat to self-respect and well-being, avoidance, readiness to act and ambivalence in coping. The results show that several psychological and social factors interact in determining how dental phobic individuals cope with their fear, and demonstrate in what way dental fear affects their daily lives.
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| 2. |
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| 3. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Dental phobic patients' view of dental anxiety and experiences in dental care: a qualitative study.
- 2002
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Ingår i: Scandinavian journal of caring sciences. - 0283-9318. ; 16:2, s. 188-96
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Tidskriftsartikel (refereegranskat)abstract
- Dental phobic patients' view of dental anxiety and experiences in dental care: a qualitative study The aim of this study was to explore and describe dental phobic patients' perceptions of their dental fear and experiences in dental care. The study sample consisted of 18 participants (12 women), with a mean age of 39.4 years, selected consecutively from patients applying for treatment at a specialized dental fear clinic in G?teborg, Sweden. Dental fear, assessed by the Dental Anxiety Scale, showed score levels well over established levels for severe dental fear. The method for sampling and analysis was inspired by the constant comparative method for Grounded Theory (GT). The thematized in-depth interviews took place outside the clinic and lasted for 1-1.5 h. All the interviews were conducted by the first author (KHA), audiotaped and transcribed verbatim. Three higher-order categories were developed and labelled existential threat, vulnerability and unsupportive dentist. Existential threat was identified as the core category, describing the central meaning of the subjects' experiences in dental care. The core category included two dimensions, labelled threat of violation and threat of loss of autonomy and independence. The core category and the descriptive categories are integrated in a model framing the process of dental fear, as described by the informants. In conclusion, the onset of dental fear was commonly related to individual vulnerability and to traumatic dental care experiences, where perceived negative dentist behaviour played a significant role. The patient was caught in a 'vicious circle' that was difficult to break, and where fear and anxiety were maintained by negative expectations about treatment and about patient's own ability to cope in dental care situations.
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| 4. |
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| 5. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Phobic avoidance and regular dental care in fearful dental patients: a comparative study.
- 2001
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 16, s. 188-196
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Tidskriftsartikel (refereegranskat)abstract
- The present investigation was a comparative study of 169 highly fearful dental patients, some of whom received regular dental care (n = 28) and some who never, or only when absolutely necessary, utilized dental care (n = 141). It was hypothesized that phobic avoidance is related to anticipatory stress and anxiety reactions, negative oral health effects, psychological distress, and negative social consequences. Background factors (sex, age, education, and dental attendance pattern), dental anxiety, general fears, general state and trait anxiety, mood states, depression, and quality of life effects were studied. Data were analyzed with descriptive statistics and with exploratory factor and multiple logistic regression analysis. It was shown that dental anxiety is significantly higher among the avoiders and this is in particular evident for anticipatory dental anxiety. Oral health differed between the groups, and it was shown that avoiders had significantly more missing teeth, whereas regular attenders had significantly more filled teeth. The avoiders reported a stronger negative impact on their daily life, whereas there were no significant differences between the groups with regard to general emotions. The logistic regression analysis showed that phobic avoidance was predicted only by anticipated dental anxiety and missing teeth. It was concluded that differences between high dental fear patients with regular dental care and phobic avoidance were mainly related to anticipated fear and anxiety, oral health effects, and concomitant negative life consequences. These results are discussed in terms of subjective stress, negative cognitions, social support, and coping-strategies.
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| 6. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Psychosocial aspects of dental and general fears in dental phobic patients.
- 2000
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 58:1, s. 37-43
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Tidskriftsartikel (refereegranskat)abstract
- Phobic reactions can often be a significant health problem for fearful dental patients. This is true in particular for individuals with long-time avoidance and elevated general psychological distress. The aim of this study was to investigate the expression of dental fear among 67 dental phobic individuals with a low versus high degree of general fear. Reported etiologic background factors, avoidance time, general psychological distress and psychosocial manifestations and consequences of dental phobia were studied. No significant difference in dental anxiety level between individuals with low versus high general fear was found, and both groups reported high frequencies of negative dental experiences. The low-fear group reported a longer (though not statistically significant) average avoidance time than the high-fear group. However, patients with a high level of general fear showed a significantly higher degree of psychological distress, and also reported stronger negative social consequences from their dental anxiety. These results indicate that the character of dental fear might be different between different groups of fearful patients, which makes the condition psychologically handicapping. Such aspects should be assessed in the diagnostic analysis of patients with severe dental anxiety. In particular, assessments of signs of general psychological distress are warranted.
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| 7. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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The importance of dental beliefs for the outcome of dental-fear treatment.
- 2003
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 111:2, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the importance of dental beliefs and the predictive value of the Dental Belief Survey (DBS) in dental-fear treatment. The sample comprised 117 adult patients seeking treatment at a dental-fear clinic. Pretreatment data were collected during a screening procedure, including two visits to the dentist. Outcome measurements were completed after treatment. The dentist rated successful/unsuccessful treatment outcome. Patients unsuccessful in treatment (n = 48) reported more initial negative dental beliefs, while patients successful in treatment (n = 69) showed a larger decrease in negative beliefs between the first and second visit to the dentist. However, these differences were small. There was a significant difference between the groups at visit two. Thus, patients unsuccessful in treatment reported more negative beliefs about how dentists communicate. Regression analyses showed that improved dental beliefs during the first two visits to the dentist predicted dental-fear reduction, while longer avoidance time, female gender, low engagement in treatment, and depressed mood increased the risk of unsuccessful treatment outcome. Our results suggest that the DBS provides valuable information, and that patients' subjective perceptions about how dentists communicate are important for treatment outcome. However, initial dental beliefs were not found to predict clinical treatment outcome.
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| 8. |
- Berggren, Ulf, 1948, et al.
(författare)
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Relaxation vs. cognitively oriented therapies for dental fear.
- 2000
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Ingår i: Journal of dental research. - 0022-0345 .- 1544-0591. ; 79:9, s. 1645-51
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive therapy has been reported for the treatment of dental phobia, but comparisons with other behavioral treatments are scarce. This study investigated the outcome of two modes of treatment for phobic dental fear. Relaxation and cognitively oriented therapy were compared in a sample of 112 adult fearful dental patients. The patient made questionnaire assessments of background and outcome variables, and the specialist dentist rated successful/non-successful outcome. It was shown that a higher number of patients who received cognitively oriented therapy completed the treatment program, while anxiety was more reduced among patients who received relaxation-oriented therapy. Dropout during the initial phobia therapy with a psychologist was related to lower motivation (willingness to engage in treatment), while failures during dental treatment after the completion of therapy were related to higher levels of general fear and anxiety. A multiple logistic regression model explaining 67% of the variance revealed that the risk of failure was only slightly increased by general fears, while patients with low (below median) motivation ran a 3.6-times-higher risk of dropping out. In conclusion, it was shown that the two treatment methods were both effective in reducing dental phobic reactions. However, while cognitively oriented therapy resulted in a higher number of patients completing therapy, relaxation-oriented treatment generally resulted in a more significant reduction in dental fear as well as in general anxiety and fear. Motivation was found to be a significant predictor of successful treatment outcome.
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| 9. |
- Dahlström, Lars, et al.
(författare)
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Changes in function and in pain-related and cognitive-behavioral variables after arthroscopy of temporomandibular joints.
- 2000
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Ingår i: European journal of oral sciences. - 0909-8836. ; 108:1, s. 14-21
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to prospectively evaluate changes in clinical, pain, and cognitive-behavioral variables in a structurally homogenous group of patients with painful temporomandibular joints (TMJ), who had undergone an identical intervention, arthroscopy. Twenty-six consecutive patients who had previously undergone unsuccessful conservative treatment participated. They were evaluated with the Craniomandibular Index (CMI), pain-related measures on visual analogue scales (VASs) for 1 wk, questionnaires, and the Multidimensional Pain Inventory (MPI). The mean CMI decreased significantly, from 0.28 to 0.18, 3 months after surgery. Pain measures also decreased significantly as rated on questionnaires, and "at worst" and "most of the time" on VASs. Intrapsychic variables related to pain also decreased significantly, while interpersonal and activity measures remained unchanged. An overall MPI dysfunctional variable correlated significantly with pain. Few further changes were observed at 12 months. Lysis and lavage of the upper TMJ compartment appears to effectively alleviate persisting functional and pain-related symptoms with low morbidity, in line with previous findings. Recoveries seem to be accompanied by changes in certain pain-related cognitive-behavioral variables within a limited sphere. Biological and intrapsychic features may interact with interpersonal factors in a complicated way in patients with orofacial pain.
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| 10. |
- Hakeberg, Magnus, 1954, et al.
(författare)
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Structural relationships of dental anxiety, mood, and general anxiety.
- 2001
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 59:2, s. 99-103
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the structural relationships between dental anxiety, mood, and general anxiety among 220 dentally anxious patients who participated in a clinical study. A structural equation modeling analysis (SEM) was applied by using the LISREL program on the hypothesized latent variables dental anxiety, mood, and general anxiety, which were measured by means of several psychometric tests. The final model showed that mood and general anxiety had positive factor loadings on dental anxiety. However, the impact of the general anxiety latent variable was not significant as compared with the mood factor. Another finding was that the residual variance for the latent variable dental anxiety was 0.68, indicating that a major portion of the variance is still unexplained by the tested variables. In conclusion, this study showed a relationship between dental anxiety, general anxiety, and mood among dentally anxious patients.
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