The aims of this project are: 1) to get a better understanding of the mechanisms maintaining fear behaviors, specifically those related to dental fear, 2) to evaluate and compare those components of the therapeutic process which will optimize the ability of therapists to select the most appropriate therapeutic modality for various types of fearful patients, and 3) to attempt to relate the etiological factors associated with the development and maintenance to more successful therapeutic outcome. The project comprises two studies. In study 1, 120 severely fearful dental patients will be subjected to an experimental investigation of their physiological reactions to dental stimuli. Patients with a history including traumatic experiences (A) will be compared to patients where the fear is related to social learning (B), to test the hypothesis that dental fear is maintained by two different mechanisms, which are classically conditioned emotional responses and unfavorable cognitions of dentistry, respectively. The 120 patients will then be allotted to one of three different therapies (Study 2), 20 patients of type A and 20 of type B to each therapy. The first therapy is aimed at the elimination of conditioned physiological activation in dental situations, the second therapy variant actualizes and changes the patient's faulty cognitions, and the third one is a combination of the two others. After therapy changes in physiological activation upon dental stimulation will be assessed by repeating the experiment in Study 1; these changes will be related to therapeutic outcome. In addition to physiological registrations (vasodilation/vasoconstriction, heart rate, surface EMG and skin conductance activity) the patients will be followed by psychometric questionnaires as well as overt behavioral measurements. The psychometric instruments investigate areas of dental and general anxiety and fear reactions, emotional factors like depression, mood and tension before and during treatment, and attitudes towards general health, dentistry and treatments. The behavioral measurements include an approach test and dentist ratings of patients' treatment ability. Emotional facial expressivity will also be assessed during therapy. The project will promote a finer understanding of fear reactions in individual cases. It will also increase our ability to help individuals get rid of handicapping fear responses, specifically in relation to dentistry.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE008296-02
Application #
3222092
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1990-09-30
Project End
1993-09-29
Budget Start
1991-09-30
Budget End
1992-09-29
Support Year
2
Fiscal Year
1991
Total Cost
Indirect Cost
Name
Goteborg University
Department
Type
DUNS #
City
Gothenburg
State
Country
Sweden
Zip Code
SE-40-530
Lundgren, Jesper; Carlsson, Sven G; Berggren, Ulf (2006) Relaxation versus cognitive therapies for dental fear--a psychophysiological approach. Health Psychol 25:267-73
Lundgren, Jesper; Berggren, Ulf; Carlsson, Sven G (2004) Psychophysiological reactions in dental phobic patients with direct vs. indirect fear acquisition. J Behav Ther Exp Psychiatry 35:3-12
Abrahamsson, Kajsa Henning; Berggren, Ulf; Hakeberg, Magnus et al. (2003) The importance of dental beliefs for the outcome of dental-fear treatment. Eur J Oral Sci 111:99-105
Hakeberg, M; Hagglin, C; Berggren, U et al. (2001) Structural relationships of dental anxiety, mood, and general anxiety. Acta Odontol Scand 59:99-103
Abrahamsson, K H; Berggren, U; Hakeberg, M et al. (2001) Phobic avoidance and regular dental care in fearful dental patients: a comparative study. Acta Odontol Scand 59:273-9
Lundgren, J; Berggren, U; Carlsson, S G (2001) Psychophysiological reactions in dental phobic patients during video stimulation. Eur J Oral Sci 109:172-7
Berggren, U; Hakeberg, M; Carlsson, S G (2000) Relaxation vs. cognitively oriented therapies for dental fear. J Dent Res 79:1645-51
Abrahamsson, K H; Berggren, U; Carlsson, S G (2000) Psychosocial aspects of dental and general fears in dental phobic patients. Acta Odontol Scand 58:37-43
Berggren, U; Carlsson, S G; Hagglin, C et al. (1997) Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear. Eur J Oral Sci 105:213-20
Berggren, U; Carlsson, S G; Hakeberg, M et al. (1997) Assessment of patients with phobic dental anxiety. Acta Odontol Scand 55:217-22

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