PubMed Health⌕ Search

Biomedical subjects

J J Marbach

Publications and source records attributed to J J Marbach.

At least 19 recordsLinked to original sources
PubMed1992

The control group conundrum in chronic pain case/control studies.

The choice of an appropriate control group has been recognized as one of the most difficult problems in the methodology of case/control studies, both in theory and in practice. In the study of chronic pain, a "well control group" has frequently been employed. Although this design has intuitive appeal, it contains the potential for bias and error. In order to obtain the proper control group, the same exclusion criteria should be applied to cases and controls. Second, controls should be selected independently of exposure to the putative risk factors under investigation. To illustrate the nature of this problem we present two numerical examples, using a chronic pain disorder.

Case-Control Studies↗
PubMed1992

The 'temporomandibular pain dysfunction syndrome' personality: fact or fiction?

It is widely accepted that abnormal personality traits are important factors in the aetiology and maintenance of the temporomandibular pain and dysfunction syndrome (TMPDS). However, the foundation upon which this paradigm rests is largely based on clinical lore rather than evidence. The continued belief in the stress theory has onerous implications. First of all, clinicians could be lulled into a false sense of security about the efficacy of traditionally sanctioned treatments. Second, and potentially more important is the chilling effect on research that results from the premature and unsupported conclusions voiced by many, that certain issues regarding the diagnosis and treatment of TMPDS are solved. Such conclusions will lead not only to problems of patient care but may forge an unstable foundation for future research. Three theories are examined for convergent evidence in support of the putative relationship between personality and TMPDS. They are the 1) psychosomatic 2) coping and 3) psychophysiological theories. Currently evidence lacks for all three theories although there is partial support for the latter. It has not been demonstrated that TMPDS cases are characterized by a specific premorbid personality.

Adaptation, Psychological↗
PubMed1992

TM.

Explore the source record for details and available documents.

Bias↗
PubMed1992

The TMPDS personality: fact or fiction? An overview.

It is widely accepted that abnormal personality traits and psychological stress are important factors in the etiology and maintenance of the temporomandibular pain and dysfunction syndrome (TMPDS). However, this assumption is based largely on clinical lore rather than research evidence. Continued belief in the stress theory has onerous implications. Such conclusions will lead not only to problems of patient care, but may also forge an unstable foundation for future research. Three theories have been advanced that support a relationship between personality and TMPDS. They are the psychosomatic, coping and psychophysiological theories. But evidence in support of all three theories is currently lacking. It has not been shown that TMPDS cases are characterized by a specific premorbid personality or an exaggerated vulnerability to psychological stress.

Adaptation, Psychological↗
PubMed1991

Is major depression comorbid with temporomandibular pain and dysfunction syndrome? A pilot study.

There is a lack of information about the precise strength of the relationship between chronic pain and depression. In a prior study, women with temporomandibular pain and dysfunction syndrome (TMPDS) had much higher scores than did controls on a measure of nonspecific psychological distress. The question arose as to whether rates of clinical depression are also unusually high in TMPDS patients. Their former treating clinician rates cases for likely lifetime presence or absence of depression. A subset of those rated as likely depressed then had their diagnoses verified independently through a structured clinical interview by a psychiatrist and clinical psychologist. Results revealed a minimum lifetime prevalence rate for major depression of 41%. A rate of this magnitude in TMPDS cases is clearly much higher than would be found for women of similar background in the general population.

Adult↗
PubMed1990

Losing face: sources of stigma as perceived by chronic facial pain patients.

The purpose of this paper is to identify potential sources of estrangement and feeling psychologically flawed as perceived by temporomandibular pain and dysfunction syndrome (TMPDS) patients. It is our hypothesis that a primary source of patients' perceived stigma results from pejorative labeling by clinicians. The data come from a study of 151 women TMPDS patients. The results show that the lack of a known etiology or pathogenesis for the condition allows the possibility of pejorative labeling by influential others such as physicians and dentists that in turn causes TMPDS sufferers to feel stigmatized. Stigmatization is not the result of clinical factors per se or personality problems. Perceived stigma associated with TMPDS leads to the same sorts of strained interactions and feeling estranged that have been shown to be typical of people with other stigmatized conditions. These strains and feelings in turn may contribute to ill health.

Adaptation, Psychological↗
PubMed1990

Facial pain, distress, and immune function.

Chronic facial pain syndromes are associated with high levels of distress and depression. Immune system measures were investigated in otherwise healthy patients suffering from chronic temporomandibular pain and dysfunction syndrome (TMPDS) and in matched controls. No mean differences were found between TMPDS patients and the controls on any of the immune measures; however, both ConA and PWM responses in TMPDS patients were decreased in relation to the level of demoralization (P less than 0.05). Cognitive symptoms such as low self-esteem and perceptions of helplessness/hopelessness were implicated in these effects. In addition, among patients pain severity was independently associated with decreased ConA response (P less than 0.05). The data suggest possible correlates of stress-induced changes in the immune system.

Adult↗
PubMed1990

Coping and adaptation to facial pain in contrast to other stressful life events.

This article investigates whether coping with chronic pain influences adaptation to other negative life events using data on Temporomandibular Pain and Dysfunction Syndrome (TMPDS) patients (N = 99) and nonpatient controls (N = 98). It is found that cases cope very differently with pain than with other stressful events and that cases and controls do not differ on coping with nonpain events, with 2 exceptions. Cases view nonfateful events as more outside their control and they have more negative changes in usual activities following negative events. This excess of negative change is associated with greater demoralization and physical exhaustion. It is concluded that coping with repeated pain episodes leaves cases vulnerable to stressful events. Alternative interpretations, especially those involving the role of preexisting personality differences, are discussed.

Adaptation, Psychological↗
PubMed1990

The validity of tooth grinding measures: etiology of pain dysfunction syndrome revisited.

The current study explores the proposition that a treating clinician's etiologic model influences patients' reports of tooth grinding, the validity of, and subsequent research findings relying on these measures. The investigation compares self-reports of tooth grinding and related clinical variables for 151 cases of temporomandibular pain and dysfunction syndrome (TMPDS) treated by a clinician who does not explicitly support the grinding theory of the etiology of TMPDS, and 139 healthy controls. Cases were no more likely than well controls to report ever-grinding, but were actually significantly less likely than well controls to report current grinding. They were also significantly more likely to report that a dentist had told them they ground. Findings suggest that studies using self-report, clinician-report of tooth grinding (or both) are methodologically inadequate for addressing the relationship between tooth grinding and TMPDS.

Adult↗
PubMed1990

Current concepts in the management of pain in the head and neck cancer patient.

The question arises as to the role of the dentist in the management of patients whose pain is of malignant disease origin. Dentists called on to provide treatment to these patients will often be asked their opinions on pain management. The purpose of this article is to familiarize the dentist with current trends in the treatment of pain of malignant origins.

Acute Disease↗
PubMed1979

Arthritis of the temporomandibular joints.

The most common disease of the temporomandibular joint (TMJ) is osteoarthritis. Rheumatoid arthritis and psoriatic arthritis may also involve this joint. Other diseases that may occasionally affect the TMJ include familial Mediterranean fever, systemic lupus erythematosus, gout, Sjögren's syndrome and infectious arthritis. Many cases of TMJ syndrome are labeled as idiopathic facial pain syndrome, a category that probably represents a number of different entities. The role of dental malocclusion has been greatly overemphasized in the past.

Arthritis↗
PubMed1978

Facial pains and anxiety levels: considerations for treatment.

The data presented in this article question the traditional beliefs in the dental literature about the relationship between facial pain and anxiety. The findings have important implications for treating individuals with any of the IFP syndromes.

Adolescent↗
PubMed1978

Phantom bite syndrome.

Despite repeated treatment failures, some individuals seek bite correction from a succession of dentists. Their pathological narcissism focuses on their bite, in a manner reminiscent of phantom limb phenomena. The dentist's diagnosis and treatment are manipulated until the patient claims them a failure and consults another dentist. The author suggests that this behavior represents a defense against paranoia and severe personality disorders.

Adolescent↗