Coping styles in patients with TMD

Aim: It was aim of the study to investigate whether coping styles were different between patients with temporomandibular disorders (TMD) and general population subjects without TMD.

Material and Methods: Consecutive adult TMD patients of the Department of Prosthodontics and Materials Science of the University of Leipzig (N=130) and adult subjects of a regional general population sample of Leipzig, Germany and the surrounding areas (N=728) were examined according to the German version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Inclusion criterion for TMD patients was that they received at least one diagnosis according to RDC/TMD, while general population subjects were excluded in case of any TMD diagnosis. Differences in coping styles between TMD patients and general population subjects, assessed using a common and well accepted German stress coping questionnaire (“Stressverarbeitungsformen”, SVF), were tested for (i) the summary scores and subscales using t-tests and (ii) the instrument subscale profiles using multivariate regression analysis adjusted for age and gender. Effect sizes expressing the score differences between patients and population subjects in terms of the measure's standard deviation were calculated using COHEN'S d. Effect sizes are defined as "small, d = .2", "medium, d = .5", and "large, d = .8".

Results: Although no significant differences in SVF sum scores were observed (p = .36), TMD patients differed statistically significantly in their profiles of coping styles compared with general population subjects without TMD (p = .03). TMD patients presented lower levels in adaptive coping styles (e.g., self-revalidation) and at the same time higher levels of maladaptive coping styles (e.g., resignation). Five “small” effect sizes were found among 19 investigated subscales.

Conclusion: TMD patients apply less adaptive and more maladaptive coping styles compared to general population subjects without TMD. This may have implications for clinical decision making and choosing among treatment alternatives.