| 其他摘要 | Temporomandibular disorder (TMD) is a group of chronic syndromes with high morbidity commonly seen in young adults. The disease is often associated with depression, anxiety, stress, and other harmful effects. However, the pathogenesis is not clear. The condition is often associated with negative emotions such as depression, anxiety, and stress.
This study investigates the characteristics and effects of negative emotions and situational memory under the self-referential impact on the course of chronic-phase pain-oriented TMD in adult female patients. Based on the patient characteristics revealed in Study 1，we used Cognitive Behavioral Therapy (CBT) and supportive therapy in combination with physiological treatment to intervene in the negative emotions of adult female patients with chronic pain dominated TMD with depression and anxiety, and longitudinally compare the effects of the two psychological interventions on improving pain from both physical and psychological dimensions. The impact of the two psychological interventions on improving pain was compared longitudinally in both physical and psychological dimensions.
In Study 1，23 female patients with TMD whom, doctors in 2019-2021 firstly diagnosed with a duration of more than three months and pain as the primary symptom. Aged 19 to 60 years, were randomly selected to be included in the CBT group; picked another 24 female patients with the same symptoms to be included in the supportive group一asked the 23 patients in the CBT group to record their emotional memories for three weeks using a thought recorder. Then, the descriptive words of the emotional memories were analyzed in-depth using qualitative analysis to investigate the characteristics of the emotional memories under the self-referential effect. The study results showed that the primary negative emotion of adult female TMD patients with chronic pain under the self-reference effect is mainly depression. The negative emotion is high arousal and instability. The connection of episodic memory and organizational source memory under the negative emotion is overgeneralized, and the effect of self-reference degree is weakened.
In Study 2, Given 23 patients in the CBT group and 24 patients in the supportive therapy group 8 sessions of 50 minutes/week of psychological intervention. According to physiological symptoms, patients received physiotherapy about analgesics, anti- inflammatory medication, joint cavity sodium hyaluronate injection, and occlusal plate treatment. Before the intervention, measured patients' data using the Chinese version of DC/TMD, DASS-21，a Chinese version of PCL-5, and the Mindfulness Checklist. Moreover, recorded negative deviant beliefs using the Thought Record Form, supplemented by a Cortisol index test and a self-reported semi-structured interview at the third-month follow-up. The study results showed that CBT patients had a high level of pain. In addition, the study results showed that CBT patients have "biased" and "the world is dangerous" bias beliefs that influence depression. Compared with supportive therapy, CBT can significantly improve the pain symptoms of adult female TMD patients with chronic pain from the physiological psychological level, enhance their psychological resilience and achieve post-traumatic psychological growth.
Aadult female patients with chronic pain based TMD had high arousal levels of negative emotions during the disease, with depressive feelings consisting of self-blame, self-guilt, guilt, powerlessness, and mainly anger and rage; the effect of self-referential degree of connectedness and diminished organizational sources of memory and observed negative bias of overgeneralized cognition; patients had "generalization," "the world is dangerous," and "the world is dangerous" bias beliefs. "Compared to supportive therapies, positive thinking regurgitation using CBT "looking for logical evidence" can significantly improve pain relief at the physiological-psychological level. Depression and post-traumatic growth of patients' psychological resilience were enhanced. |
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