Document Type : Original Article
Authors
1 Dept. of Oral and Maxillofacial Medicine, School of Dentistry, Qom University of Medical Sciences, Qom, Iran.
2 Student, School of Dentistry, Qom University of Medical Sciences, Qom, Iran.
3 Dept. of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran.
Abstract
Background: Temporomandibular disorders (TMD) are a group of clinical issues affecting the masticatory system. While psychological factors like anxiety are recognized contributors, the role of deeper cognitive patterns, specifically early maladaptive schemas (EMS), is less understood.
Purpose: This study aimed to compare the levels of anxiety and the prevalence of EMS in patients with TMD against a healthy control group, and to investigate the associations between these variables in an Iranian population.
Materials and Method: We conducted a case-control study at the Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran, during 2024. The sample consisted of 67 patients diagnosed with TMD and 67 healthy controls. Participants completed the Beck Anxiety Inventory (BAI) and the Young Schema Questionnaire-Short Form (YSQ-SF), which assesses 15 schemas: Emotional Deprivation, Abandonment/Instability, Mistrust/ Abuse, Social Isolation/Alienation, Defectiveness/Shame, Failure, Dependence/ Incompetence, Vulnerability to Harm, Enmeshment/Undeveloped Self, Subjugation, Self-Sacrifice, Emotional Inhibition, Unrelenting Standards, Entitlement/Grandiosity, and Insufficient Self-Control. Data were analyzed using descriptive statistics, independent t-tests, chi-square tests, and Fisher's exact tests. A p Value of less than 0.05 was considered statistically significant for all tests.
Results: Anxiety levels were significantly higher in the TMD group (p Value< 0.001), where 62.7% of patients reported anxiety compared to 26.9% of controls. The "Mistrust/ Abuse" (p= 0.036) and "Enmeshment/Undeveloped Self" (p= 0.009) schemas were also significantly more common in the patient group. Furthermore, within the TMD patient group, eight specific schemas were significantly linked to moderate and severe anxiety levels (p< 0.05).
Conclusion: Unadjusted analyses suggested a preliminary association between the "Mistrust/Abuse" and "Enmeshment/Undeveloped Self" schemas and the presence of TMD. However, the findings must be interpreted with significant caution because the study did not employ multivariate logistic regression to control for potential confounding variables, such as the observed significant difference in educational attainment between the two groups. Therefore, no firm conclusions regarding an independent or causal association can be drawn. These preliminary data suggest a need for rigorous future investigation using multivariate models.
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