This program of research seeks to increase scientific understanding of the role that beliefs and coping strategies play in temporomandibular disorder (TMD) patient adjustment, and to evaluate {{ the efficacy and underlying mechanisms of action of}} a brief {{cognitive-behavioral}} intervention designed to increase adaptive beliefs and coping strategy use, and decrease maladaptive beliefs. {{ Both observational and experimental methods will be used to test hypotheses derived from cognitive- behavioral theory concerning the relationships of beliefs and coping with pain intensity, activity interference, and mood. Electronic daily diary methodology will be used in a longitudinal study to assess temporal sequencing of relationships among patient beliefs, coping strategies, pain intensity, activity interference, and mood, within and across individuals before and during participation in a randomized clinical trial. Patients {{N=176}} who are seeking treatment for TMD at a specialty clinic {{and who have high levels of pain and activity interference}} will be assigned randomly to usual treatment plus a brief cognitive-behavioral intervention (UT + CBT) or to usual treatment {{plus an education and attention control (UT + Education).}} The effects of the cognitive- behavioral intervention on patient outcomes (pain intensity, activity interference, and mood) {{and on process variables (beliefs and coping) hypothesized to mediate outcomes}} will be assessed by questionnaire and daily diary measures from baseline to post-intervention, and by questionnaire measures at six and twelve month follow-ups. Data analyses will test the hypotheses that {{usual care plus the cognitive- behavioral intervention will result in greater short- and long-term improvement in TMD patient outcomes, as compared with usual care plus education and attention,}} and that improved outcomes in the UT + CBT group will be mediated by changes in patient beliefs and coping strategies. {{Additional analyses will test hypotheses concerning the temporal relationships among beliefs, coping, and patient outcomes.}} Thus, the proposed study will provide important information about (1) the temporal relationships among TMD patient beliefs, coping strategies, pain, and activity interference; (2) the efficacy of a brief cognitive- behavioral intervention integrated with usual treatment in a TMD clinic; and (3) specific beliefs and coping strategies that mediate improvement in patient pain and functioning and that therefore are important to target in treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Program Projects (P01)
Project #
2P01DE008773-11A1
Application #
6216904
Study Section
Special Emphasis Panel (ZDE1-GH (58))
Project Start
1989-01-01
Project End
2004-08-31
Budget Start
1998-10-01
Budget End
1999-09-30
Support Year
11
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Washington
Department
Type
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
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