Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders

Abstract

Aims Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations. Methods A community‐based sample of 110 individuals (83 women; 20–69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age‐ and gender‐matched controls (119 women; 20–69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS‐20), pain site number (whole‐body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann‐Whitney U test) of these variables were also calculated. Results Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1–2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294–0.321, p≤0.002), but not to number of pain sites. Conclusion Compared to controls, community‐based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.

A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity

“…The first relationship between brooding thought and fear of major painful harm is a confirmation of one of the main convergence hypotheses posed by this study. There is both a strand of studies in the literature that predictively links remorseful amplification to more intense pain perception ( Burri et al, 2018 ; Priore et al, 2019 ; Diotaiuti et al, 2021 ; Häggman-Henrikson et al, 2021 ; Nunziato et al, 2021 ), and further empirical evidence reporting a direct effect of fear of pain on the level of actually perceived pain ( Markfelder and Pauli, 2020 ; Luo et al, 2022 ). According to some scholars, fear of pain constitutes a stronger predictor of actually perceived pain than depressive catastrophic amplification ( George et al, 2006 ; Hirsh et al, 2008 ).…”

Relationship between self-reported pain, pain threshold, pain catastrophization and quality of life in patients with TMD

“…[9] Presence of primary headaches. e25 [10] When the main complaint was pain due to TMD of joint origin. [11] Those who did not want to participate in this research.…”

“…Pain catastrophizing is a cognitive factor represented by an exaggeration of the perceived threat of pain sensation (9). It is described in terms of a multidimensional construct including rumination (not being able to direct attention away from pain), magnification (worry or exaggeration of the seriousness of something"), and helplessness ("feeling nothing can be done to reduce the pain) (1,10). Pain catastrophizing clearly plays a role in the suffering of patients with orofacial pain, causing these patients to use health services more frequently (11).…”

“…Pain catastrophizing clearly plays a role in the suffering of patients with orofacial pain, causing these patients to use health services more frequently (11). In addition, pain catastrophizing is related to fear of pain due to movement (kinesiophobia), affecting the ability to perform tasks such as eating, chewing, and communicating (10). People with TMD often experience tension or pain in the neck (12).…”

“…attention away from pain), magnification (worry or exaggeration of the seriousness of something”), and helplessness (“feeling nothing can be done to reduce the pain) ( 1 , 10 ). Pain catastrophizing clearly plays a role in the suffering of patients with orofacial pain, causing these patients to use health services more frequently ( 11 ).…”