Prevalence of traumatic stressors in patients with temporomandibular disorders

The aim of the present study was to identify the prevalence of significant traumatic stressor(s) reported by chronic temporomandibular disorder patients, and to describe the nature of these stressors. A second aim of this study was to evaluate and compare the behavioral and psychological domains of patients who reported 1 or more significant traumatic stressors to those who did not. Twelve hundred twenty-one patients with chronic temporomandibular disorder pain completed a battery of psychometric measures including the Symptom Check List-90-Revised, Multidimensional Pain Inventory, Pittsburgh Sleep Quality Index, and a check list of major traumatic stressors. The prevalence of major traumatic stressors among our chronic pain patients was high (49.8%). Traumatic stressors were related to increased pain severity, affective distress, and disability among patients with chronic pain. Patients admitting to major traumatic stressors also scored higher on most psychometric measures and more often had pain from myogenous origin. It is argued that possible significant contributors to chronic orofacial pain may be anxiety, depression, and dysregulation of the hypothalamic-pituitary-adrenal axis. Prevalence of major traumatic stressors in chronic temporomandibular disorder patients is high. The greater distress on all psychological domains in patients endorsing major traumatic events may be a reflection of inadequate coping skills in these individuals. Therapy should be oriented toward the resolution of accompanying stressors such as depression, anxiety, and dysregulation of the hypothalamic-pituitary-adrenal axis.