Background
Gagging is a behavioral response that interferes with oral health care and has been suggested to relate to dental care-related fear. Little is known, however, about the epidemiology of gagging during dental treatment.
Methods
To explore this phenomenon, 478 participants were recruited from the waiting area of an oral diagnosis clinic. Participants completed the Dental Fear Survey, the Short Form-Fear of Pain Questionnaire, Dental Beliefs Scale, and a demographics questionnaire that included items about problems with gagging.
Results
Over half of the participants reported gagging on at least one occasion during dental visits, with 7.5% almost always, or always gagging. With higher frequency of problems with gagging, patients were more likely to have greater levels of dental care-related fear, fear of pain, and more negative beliefs of dental professionals and dental treatment. Further, participants who gagged more readily had greater dental care-related fear than other gaggers.
Conclusion
Gagging in the dental clinic is a prevalent problem, and dental care-related fear and fear of pain are associated with more frequent gagging.
Clinical Implications
Given the prevalence of patients reporting problem gagging, it may be helpful for providers to assess for this barrier to treatment. By targeting dental care-related fear, fear of pain, and negative beliefs about dental care in patients who often gag in the clinic, gagging may be reduced in frequency or intensity, potentially making treatment more comfortable for patients and easier for dental care providers.
There is increasing recognition of the need for culturally sensitive services for individuals who identify as transgender or gender non-conforming (TGNC), and only recently have empirical studies appeared in the literature that inform best practices for TGNC people. Competent, culturally appropriate clinical services and research depend upon methodologically sound assessment of key constructs, but it is unclear whether appropriate self-report or clinician-rated assessment tools for adults exist. This paper reviewed existing published measures to identify areas of strength as well as existing gaps in the available research. The search strategy for this systematic review identified any published paper describing a self-report or clinician-rated scale for assessing transgender-related concerns. Each measure was reviewed for information on its scope, reliability, validity, strengths, limitations, and source. The majority of these questionnaires were developed with the TGNC communities and targeted important factors that affect quality of life for TGNC people. Limitations included limited evidence for validity, reliability, and sensitivity to change. Overall, the field is moving in the direction of TGNC-affirming assessment, and promising measures have been created to monitor important aspects of quality of life for TGNC people. Future research should continue to validate these measures for use in assessing clinical outcomes and the monitoring of treatment progress.
Because judges experience a myriad of occupational stressors, they are at risk of experiencing secondary trauma, burnout, negative mental/physical health, poor job performance and low job satisfaction. These experiences might not be uniform, however, as gender and social support might mitigate such stress-related outcomes. Judges from two states in the United States completed a variety of stress and subjective performance measures. Social support was related to less perceived stress, less burnout, and more job satisfaction, but only for males. This suggests that males and females might receive qualitatively different types of social support. Different types of social support could differ in their ability to buffer judges from these stress-related outcomes. Further, among judges with high social support, females scored higher than males on subjective job performance; the opposite pattern occurred for judges with low social support. Thus, a lack of social support appears to have a negative effect on performance self-appraisals but only for females. Results have implications for the psychological study of stress and for programs designed to reduce judges' stress.
Active duty military service members have high dropout rates for trauma-focused treatment in both clinical practice and research settings. Measuring patients' intent to complete (ITC) and intent to attend (ITA) treatment have been suggested as methods to reduce dropout, but no studies have examined the effectiveness of such measures. In an attempt to reduce high dropout rates, measures of ITC and ITA were included in a randomized controlled trial evaluating prolonged exposure (PE) and virtual reality exposure (VRE) in active duty soldiers with posttraumatic stress disorder (PTSD). Participants (N = 108) were randomized to either PE or VRE, and the last 49 to enroll were administered a measure of ITC at enrollment and a measure of ITA at the end of every session. A score of 7 or below triggered a problem-solving discussion with the individual's therapist. The results revealed that the ITA assessment predicted treatment dropout after controlling for mental health stigma, PTSD symptoms, and age, odds ratio (OR) = 0.24, p = .023. Additionally, participants who completed the ITA assessment were less likely to drop out than those who were not administered the ITA, OR = 0.29 p = .002. The ITC did not predict treatment dropout OR = 0.98, p = .402. These findings suggest that assessing ITA throughout trauma-focused therapy may reduce treatment dropout rather than solely measuring ITC prior to starting psychotherapy. Based on these preliminary findings, future research should randomize the measurement of ITA in clinical trials to evaluate its impact on treatment dropout.
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