A cognitive-behavioral group intervention for patients with chronic temporomandibular joint pain: an exploratory study
Amy Taylor Pfeil (1987)
Outpatients with chronic facial pain resulting from Temporomandibular Joint (TMJ) and Myofascial Pain Dysfunction (MPD) were treated in an eight-week cognitive-behavioral group based on the model devised by Turk, Meichenbaum, and Genest (1983). Ten patients (9 women and 1 man), ranging in age from 25 to 64 and reporting facial pain from 4 months to 22 years duration, were referred by local health caregivers from seven specialties. Participants were randomly assigned to either an Experimental Group which received 8 weeks of treatment and an 8-week follow-up, or a waiting list Control Group which received similar treatment during the final eight weeks of the study. To measure changes in patients' anxiety, depression, or sense of personal effectiveness, the Beck Depression Inventory, Spielberger State-Trait Anxiety Inventories, and Levenson's I, P, and C locus of control scales were administered at pre and posttest periods. To measure changes in mood and pain perception, the Profile of Mood States and a simple questionnaire were administered weekly throughout the 16 weeks of the study. Caregivers observed and participated in the Experimental Group. While there was a consistent trend in the expected direction among group means on variables following treatment, significant differences between the Experimental and Control Groups occurred only on the personal effectiveness variable in the area of locus of control. Experimental Group participants decreased in the degree to which they believed "powerful others" govern their lives whereas Control Group members increased in this belief during the eight-week treatment period. Implications for treatment were drawn from examination of individual cases.