Development and initial validation of the medical fear survey-short version.

The present investigation employs item response theory (IRT) to develop an abbreviated medical fear survey (MFS). Application of IRT analyses in study 1 (n = 931) to the original 50-item MFS resulted in a 25-item shortened version. Examination of the location parameters also resulted in a reduction of the Likert-type scaling of the MFS by removing the last response category ("terror"). The five subscales of the original MFS were highly correlated with those of the MFS-short version. The short version also displayed comparable convergent and discriminant validity with the original MFS in relation to measures of fear, disgust, and anxiety. Confirmatory factor analysis in Study 2 revealed that the five-factor structure of the MFS-short form fit the data well in U.S. (n = 283) and Dutch (n = 258) samples. The short form also had comparable convergent and discriminant validity with the original MFS in relation to domains of disgust in both samples. Receiver operating characteristic (ROC) analysis in Study 3 demonstrated that the subscales of the short version were comparable with the original MFS in classifying participants high (n = 40) and low (n = 40) in blood/injection phobia. Last, structural equation modeling in Study 4 (n = 113) revealed that the MFS-short form demonstrated excellent convergent/discriminant validity with strong associations with injection fear and no association with spider fear. These findings suggest that the MFS-short form has considerable strengths, including decreased assessment time, while retaining sound psychometric properties.

Cross validation of a brazilian version of the dental fear survey / Avaliação cruzada de uma versão brasileira do exame do medo dentário

The Dental Fear Survey (DFS), a paper and pencil instrument for assessing dental fear and avoidance, has been widely used and validated in fear studies in the US. However, before such instruments are used in countries and cultures dissimilar to the one in which it was developed, they should be cross-validated in that culture. The present study is an examination of the DFS response characteristics in a group of 374 Brazilian University students. Factor analysis of the DFS revealed three factors essentially identical to those found among university students in the US and in Singapore, as well as among US adult dental patients. Higher DFS scores were significantly associated longer intervals since last dental visit. These results are taken as evidence that the DFS performs in this Brazilian sample very much as it does in other samples; and is thus, a valid indicator of dental fear at least among Brazilian University students

Psychosocial and demographic correlates of temporomandibular disorders and related symptoms: an assessment of community and clinical findings.

This study investigated the factor structure and relative prevalence of temporomandibular disorder (TMD) symptoms, in relation to demographic and psychosocial variables in a community sample. Two empirically distinct clusters of TMD symptoms were identified. Similar to reports of TMD clinic patients, more symptoms were reported by females than males and the greatest symptom prevalence was found in subjects between the ages of 30 and 49 years. Further, the number of symptoms reported was significantly and linearly related to scores on depression and repression-sensitization scales. These relationships, however, were similar for both sets of symptom composites even though one composite is clearly identifiable as the core TMD symptoms and the second composite consists of peripheral symptoms. Since the two symptom composites share some common variance, the relationship between demographic and psychosocial characteristics and the number of composite I and composite II symptoms was examined while controlling for the presence of symptoms from the other composite. When controlling for the presence of composite II symptoms, the correlations between psychosocial and demographic characteristics and composite I symptoms are small. When the presence of composite I symptoms is controlled there is little change in the magnitude of the correlations between psychosocial and demographic characteristics and composite II symptoms. It is concluded that the psychosocial profile described in clinical research is actually more characteristic of individuals with pain/dysfunction symptoms other than the classic TMD symptoms and that the relationship between core TMD symptoms (composite I) is largely spurious. It is suggested that this psychosocial profile of TMD patients may have developed through associating certain psychosocial characteristics with TMD while such characteristics are actually present in TMD clinic patients because of the covariation of the two symptom composites in individuals seeking treatment in TMD clinics.

An evaluation of the McGill pain questionnaire for use in dental pain assessment.

Pain following tooth extraction was assessed in 60 patients using the McGill Pain Questionnaire and the Anxiety Differential, along with other measures of patient expectations and behavior. The McGill Pain Questionnaire demonstrated efficacy in assessing postextraction pain with subscale measures relating to situational anxiety, recovery time and use of analgesics. Significant overlap among the subscales (7--58% common variance) was found suggesting further scale refinement is indicated. Pain descriptive words used and mean subscale scores were similar to those previously reported for toothache pain.